The First Clinical Medical College of Lanzhou University, Lanzhou, China.
The First Clinical Medical College of Lanzhou University, Lanzhou, China; Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, China.
World Neurosurg. 2024 Feb;182:12-28. doi: 10.1016/j.wneu.2023.10.135. Epub 2023 Nov 3.
To systematically evaluate the efficacy of valproic acid (VPA) in rats with spinal cord injury (SCI) to reduce the risk of clinical conversion and provide a valuable reference for future animal and clinical studies.
We searched scientific databases, including PubMed, Ovid-Embase, Web of Science, and Scopus databases. The relevant literature was searched from the establishment date of the database to June 28, 2023. The search results were screened, data were extracted, and the quality of the literature was evaluated independently by 2 reviewers.
Among 656 nonduplicated references, 14 articles were included for meta-analysis. The summary results showed that the overall Basso, Beattie and Bresnahan scores of the VPA intervention group were significantly higher than those in the control group at 1-6 weeks after VPA intervention. Subgroup analysis showed that the injury model, administration dose, rat strain, country of study, or follow-up duration had no significant effect on the efficacy of VPA on rats with SCI. In addition, mesh analysis showed that high doses of the VPA group had a better effect on SCI rats, compared with the low dose group and the medium dose group.
To date, this is the first systematic evaluation of the potential effects of VPA on motor recovery in rats with SCI. We concluded that VPA can promote motor recovery in rats with SCI, and higher doses of VPA seem to be more effective in rats with SCI. However, the limited quality and sample of included studies reduced the application of this meta-analysis. In the future, more high-quality, direct comparative studies are needed to explore this issue in depth.
系统评价丙戊酸(VPA)治疗脊髓损伤(SCI)大鼠的疗效,降低临床转化风险,为今后的动物和临床研究提供有价值的参考。
我们检索了科学数据库,包括 PubMed、Ovid-Embase、Web of Science 和 Scopus 数据库。从数据库建立日期到 2023 年 6 月 28 日检索相关文献。由 2 位评审员独立筛选检索结果、提取数据并评估文献质量。
在 656 篇非重复参考文献中,有 14 篇文章进行了荟萃分析。汇总结果显示,VPA 干预组大鼠在 VPA 干预后 1-6 周的总体 Basso、Beattie 和 Bresnahan 评分明显高于对照组。亚组分析显示,损伤模型、给药剂量、大鼠品系、研究国家或随访时间对 VPA 治疗 SCI 大鼠的疗效无显著影响。此外,网状分析显示,高剂量 VPA 组对 SCI 大鼠的疗效优于低剂量组和中剂量组。
到目前为止,这是首次系统评价 VPA 对 SCI 大鼠运动功能恢复的潜在作用。我们得出结论,VPA 可促进 SCI 大鼠的运动功能恢复,高剂量 VPA 似乎对 SCI 大鼠更有效。但是,纳入研究的质量和样本有限,降低了本荟萃分析的应用价值。未来需要更多高质量的直接比较研究来深入探讨这一问题。