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干扰素-γ 水平升高与重症疟疾风险增加的关系:一项荟萃分析。

Increased interferon-γ levels and risk of severe malaria: a meta-analysis.

机构信息

Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.

出版信息

Sci Rep. 2022 Nov 7;12(1):18917. doi: 10.1038/s41598-022-21965-z.

Abstract

Interferon (IFN)-γ contributes to the pathogenesis of severe malaria; however, its mechanism remains unclear. Herein, differences in IFN-γ levels between patients with severe and uncomplicated malaria were evaluated using qualitative and quantitative (meta-analysis) approaches. The systematic review protocol was registered at PROSPERO (ID: CRD42022315213). The searches for relevant studies were performed in five databases, including PubMed, Scopus, Embase, MEDLINE and Web of Science, between 1 January and 10 July 2022. A meta-analysis was conducted to pool the mean difference (MD) of IFN-γ levels between patients with severe malaria and those with uncomplicated malaria using a random-effects model (DerSimonian and Laird method). Overall, qualitative synthesis indicated that most studies (14, 58.3%) reported no statistically significant difference in IFN-γ levels between patients with severe malaria and those with uncomplicated malaria. Meanwhile, remaining studies (9, 37.5%) reported that IFN-γ levels were significantly higher in patients with severe malaria than those in patients with uncomplicated malaria. Only one study (4.17%) reported that IFN-γ levels were significantly lower in patients with severe malaria than those in patients with uncomplicated malaria. The meta-analysis results indicated that patients with severe malaria had higher mean IFN-γ levels than those with uncomplicated malaria (p < 0.001, MD: 13.63 pg/mL, 95% confidence interval: 6.98-20.29 pg/mL, I: 99.02%, 14 studies/15 study sites, 652 severe cases/1096 uncomplicated cases). In summary, patients with severe malaria exhibited higher IFN-γ levels than those with uncomplicated malaria, although the heterogeneity of the outcomes is yet to be elucidated. To confirm whether alteration in IFN-γ levels of patients with malaria may indicate disease severity and/or poor prognosis, further studies are warranted.

摘要

干扰素 (IFN)-γ 参与严重疟疾的发病机制;然而,其机制尚不清楚。本研究采用定性和定量(荟萃分析)方法评估严重和无并发症疟疾患者之间 IFN-γ 水平的差异。系统评价方案在 PROSPERO(ID:CRD42022315213)中注册。在 2022 年 1 月 1 日至 7 月 10 日期间,在五个数据库(PubMed、Scopus、Embase、MEDLINE 和 Web of Science)中进行了相关研究的检索。采用随机效应模型(DerSimonian 和 Laird 方法)对 IFN-γ 水平在严重疟疾患者和无并发症疟疾患者之间的均数差值(MD)进行荟萃分析。总体而言,定性综合分析表明,大多数研究(14 项,58.3%)报告严重疟疾患者和无并发症疟疾患者之间 IFN-γ 水平无统计学显著差异。同时,其余研究(9 项,37.5%)报告严重疟疾患者的 IFN-γ 水平明显高于无并发症疟疾患者。只有一项研究(4.17%)报告严重疟疾患者的 IFN-γ 水平明显低于无并发症疟疾患者。荟萃分析结果表明,严重疟疾患者的 IFN-γ 水平高于无并发症疟疾患者(p<0.001,MD:13.63 pg/mL,95%置信区间:6.98-20.29 pg/mL,I:99.02%,14 项研究/15 个研究地点,652 例严重病例/1096 例无并发症病例)。总之,与无并发症疟疾患者相比,严重疟疾患者的 IFN-γ 水平更高,尽管其结果的异质性尚待阐明。为了确认疟疾患者 IFN-γ 水平的改变是否表明疾病严重程度和/或预后不良,需要进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed79/9640646/521da5c27b58/41598_2022_21965_Fig1_HTML.jpg

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