Akbarian Shadi, Chaibakhsh Samira, Kashkouli Mohsen Bahmani, Karimi Nasser, Abdolalizadeh Parya, Ghahvehchian Hossein
Eye Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
Skull Base Research Center, Eye Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
J Curr Ophthalmol. 2022 Apr 16;34(1):16-24. doi: 10.4103/joco.joco_266_21. eCollection 2022 Jan-Mar.
To systematically review the role of antioxidants in management of patients with thyroid eye disease (TED).
A literature search of the electronic databases was performed without restrictions on the date of publication till the end of March 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical trials, case-control studies, cohorts, case series, case reports, and experimental (including ) studies in the English language were included. The primary outcome in human studies was improvement in severity, activity scores, and/or quality of life scores. There was a decrease in the level of HO-dependent oxidative stress, Hyaluronic acid release, reactive oxygen species, cell proliferation, or antifibrotic/antiproliferative actions in the studies.
Out of 374 initially screened articles, 157 studies were selected, the full texts of 82 were reviewed, and 14 papers were finally included. There were 4 clinical and 10 studies from 1993 to 2018. While β-carotene, retinol, Vitamin E, Vitamin C, melatonin, resveratrol, N-acetyl-l-cysteine, and quercetin showed some efficacy in studies; allopurinol, nicotinamide, pentoxifylline, and selenium (Se) were effective in both clinical and experimental reports. Se was the only recommended antioxidant based on one high-level randomized controlled trial.
While different antioxidants could potentially be effective in the management of TED, no strong recommendation for any or combination of antioxidants could be made to be implemented in the daily practice.
系统评价抗氧化剂在甲状腺眼病（TED）患者管理中的作用。
按照系统评价和Meta分析的首选报告项目指南，对电子数据库进行文献检索，检索截止至2021年3月底，不受发表日期限制。纳入英文的临床试验、病例对照研究、队列研究、病例系列研究、病例报告及实验性（包括……）研究。人体研究的主要结局为严重程度、活动评分和/或生活质量评分的改善。在……研究中，HO依赖性氧化应激水平、透明质酸释放、活性氧、细胞增殖或抗纤维化/抗增殖作用降低。
在最初筛选的374篇文章中，选择了157项研究，对其中82篇的全文进行了综述，最终纳入14篇论文。有1993年至2018年的4项临床研究和10项……研究。虽然β-胡萝卜素、视黄醇、维生素E、维生素C、褪黑素、白藜芦醇、N-乙酰半胱氨酸和槲皮素在……研究中显示出一定疗效；别嘌醇、烟酰胺、己酮可可碱和硒（Se）在临床和实验报告中均有效。基于一项高水平随机对照试验，Se是唯一被推荐的抗氧化剂。
虽然不同的抗氧化剂可能对TED的管理有效，但在日常实践中，无法对任何一种或多种抗氧化剂组合给出强有力的推荐建议。
