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The effect of metformin on ameliorating neurological function deficits and tissue damage in rats following spinal cord injury: A systematic review and network meta-analysis.

作者信息

Zhou Long-Yun, Chen Xu-Qing, Yu Bin-Bin, Pan Meng-Xiao, Fang Lu, Li Jian, Cui Xue-Jun, Yao Min, Lu Xiao

机构信息

Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Department of Otolaryngology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Front Neurosci. 2022 Aug 11;16:946879. doi: 10.3389/fnins.2022.946879. eCollection 2022.


DOI:10.3389/fnins.2022.946879
PMID:36117612
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9479497/
Abstract

Spinal cord injury (SCI) is a devastating condition with few treatment options. Metformin, a classical antidiabetic and antioxidant, has extended its application to experimental SCI treatment. Here, we performed a systematic review to evaluate the neurobiological roles of metformin for treating SCI in rats, and to assess the potential for clinical translation. PubMed, Embase, China National Knowledge Infrastructure, WanFang data, SinoMed, and Vip Journal Integration Platform databases were searched from their inception dates to October 2021. Two reviewers independently selected controlled studies evaluating the neurobiological roles of metformin in rats following SCI, extracted data, and assessed the quality of methodology and evidence. Pairwise meta-analyses, subgroup analyses and network analysis were performed to assess the roles of metformin in neurological function and tissue damage in SCI rats. Twelve articles were included in this systematic review. Most of them were of moderate-to-high methodological quality, while the quality of evidence from those studies was not high. Generally, Basso, Beattie, and Bresnahan scores were increased in rats treated with metformin compared with controls, and the weighted mean differences (WMDs) between metformin and control groups exhibited a gradual upward trend from the 3rd (nine studies, = 164, WMD = 0.42, 95% CI = -0.01 to 0.85, = 0.06) to the 28th day after treatment (nine studies, = 136, WMD = 3.48, 95% CI = 2.04 to 4.92, < 0.00001). Metformin intervention was associated with improved inclined plane scores, tissue preservation ratio and number of anterior horn motor neurons. Subgroup analyses indicated an association between neuroprotection and metformin dose. Network meta-analysis showed that 50 mg/kg metformin exhibited greater protection than 10 and 100 mg/kg metformin. The action mechanisms behind metformin were associated with activating adenosine monophosphate-activated protein kinase signaling, regulating mitochondrial function and relieving endoplasmic reticulum stress. Collectively, this review indicates that metformin has a protective effect on SCI with satisfactory safety and we demonstrate a rational mechanism of action; therefore, metformin is a promising candidate for future clinical trials. However, given the limitations of animal experimental methodological and evidence quality, the findings of this pre-clinical review should be interpreted with caution.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/6b471799fdbf/fnins-16-946879-g0008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/7725bf12e615/fnins-16-946879-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/ba3737512bc4/fnins-16-946879-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/61f2d26c721d/fnins-16-946879-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/2c298cb49daf/fnins-16-946879-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/52f0810ae3b2/fnins-16-946879-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/8e237f7ec645/fnins-16-946879-g0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/4f6300d57b2b/fnins-16-946879-g0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/6b471799fdbf/fnins-16-946879-g0008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/7725bf12e615/fnins-16-946879-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/ba3737512bc4/fnins-16-946879-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/61f2d26c721d/fnins-16-946879-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/2c298cb49daf/fnins-16-946879-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/52f0810ae3b2/fnins-16-946879-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/8e237f7ec645/fnins-16-946879-g0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/4f6300d57b2b/fnins-16-946879-g0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b968/9479497/6b471799fdbf/fnins-16-946879-g0008.jpg

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引用本文的文献

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Front Pharmacol. 2025-4-7

[2]
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[3]
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[4]
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[6]
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Front Neurosci. 2023-10-10

[7]
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[8]
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[10]
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本文引用的文献

[1]
Mitochondrial Transplantation Attenuates Neural Damage and Improves Locomotor Function After Traumatic Spinal Cord Injury in Rats.

Front Neurosci. 2022-4-12

[2]
Metformin attenuates early brain injury after subarachnoid hemorrhage in rats via AMPK-dependent mitophagy.

Exp Neurol. 2022-7

[3]
Ginseng extract and ginsenosides improve neurological function and promote antioxidant effects in rats with spinal cord injury: A meta-analysis and systematic review.

J Ginseng Res. 2022-1

[4]
Spinal cord injury chronically depresses glucose uptake in the rodent model.

Neurosci Lett. 2022-2-6

[5]
Effect of Metformin on Locomotor Function Recovery in Rat Spinal Cord Injury Model: A Meta-analysis.

Oxid Med Cell Longev. 2021

[6]
Metformin promotes microglial cells to facilitate myelin debris clearance and accelerate nerve repairment after spinal cord injury.

Acta Pharmacol Sin. 2022-6

[7]
Zinc Regulates Glucose Metabolism of the Spinal Cord and Neurons and Promotes Functional Recovery after Spinal Cord Injury through the AMPK Signaling Pathway.

Oxid Med Cell Longev. 2021

[8]
Rostro-caudal different energy metabolism leading to differences in degeneration in spinal cord injury.

Brain Commun. 2021-3-28

[9]
Efficacy and Safety of Metformin for Obesity: A Systematic Review.

Pediatrics. 2021-3

[10]
Irisin Protects Against Motor Dysfunction of Rats with Spinal Cord Injury via Adenosine 5'-Monophosphate (AMP)-Activated Protein Kinase-Nuclear Factor Kappa-B Pathway.

Front Pharmacol. 2020-11-16

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