Hou Jun-Jie, Li Wei-Wei, Wang Xiao-Li, Ma A-Huo, Qin Yue-Hua
Department of Gastroenterology, Shaoxing People's Hospital, Shaoxing, China.
Front Pharmacol. 2023 Oct 26;14:1260134. doi: 10.3389/fphar.2023.1260134. eCollection 2023.
Extracellular vesicles (EVs) mediate inflammation, immune responses, gut barrier integrity, and intestinal homeostasis. Recently, the application of EVs in the treatment of inflammatory bowel disease (IBD) has been under intensive focus. Some studies have been conducted in animal models of colitis, while systematic reviews and meta-analyses are lacking. The current study aimed to conduct a systematic review and meta-analysis of studies investigating the efficacy of EVs on IBD. A systematic retrieval of all studies in PubMed, EMBASE, MEDLINE, Web of Science, and Cochrane Library reported the effects of EVs in the colitis model up to 22 June 2023. The methodological quality was assessed based on SYRCLE's risk of bias (RoB) tool. Disease activity index (DAI), myeloperoxidase activity (MPO), histopathological score (HS), and inflammatory cytokines (TNF-α, NF-κB, IL-1β, IL-6, and IL-10) were extracted as analysis indicators by Web Plot Digitizer 4.5. A meta-analysis was performed to calculate the standardized mean difference and 95% confidence interval using random-effect models by Review Manager 5.3 and STATA 14.0 software. A total of 21 studies were included in this meta-analysis. Although the heterogeneity between studies and the potential publication bias limits confidence in the extent of the benefit, EV treatment was superior to the control in the colitis evaluation with reduced DAI, HS, MPO activity, and pro-inflammatory cytokines, including TNF-α, NF-κB, IL-1β, and IL-6, while increasing the content of anti-inflammatory cytokine IL-10 (all < 0.05). Our meta-analysis results supported the protective effect of EVs on colitis rodent models based on their potential role in IBD therapy and propelling the field toward clinical studies.
细胞外囊泡（EVs）介导炎症、免疫反应、肠道屏障完整性和肠道内稳态。最近，EVs在炎症性肠病（IBD）治疗中的应用受到了广泛关注。一些研究已在结肠炎动物模型中开展，但缺乏系统评价和荟萃分析。本研究旨在对调查EVs治疗IBD疗效的研究进行系统评价和荟萃分析。通过系统检索截至2023年6月22日在PubMed、EMBASE、MEDLINE、Web of Science和Cochrane图书馆中报道的关于EVs在结肠炎模型中作用的所有研究。采用SYRCLE的偏倚风险（RoB）工具评估方法学质量。通过Web Plot Digitizer 4.5提取疾病活动指数（DAI）、髓过氧化物酶活性（MPO）、组织病理学评分（HS）和炎性细胞因子（TNF-α、NF-κB、IL-1β、IL-6和IL-10）作为分析指标。使用Review Manager 5.3和STATA 14.0软件通过随机效应模型进行荟萃分析，计算标准化均数差和95%置信区间。本荟萃分析共纳入21项研究。尽管研究间的异质性和潜在的发表偏倚限制了对获益程度的信心，但在结肠炎评估中，EV治疗优于对照组，可降低DAI、HS、MPO活性以及包括TNF-α、NF-κB、IL-1β和IL-6在内的促炎细胞因子水平，同时增加抗炎细胞因子IL-10的含量（均P<0.05）。我们的荟萃分析结果支持了EVs对结肠炎啮齿动物模型的保护作用，基于其在IBD治疗中的潜在作用，并推动该领域向临床研究发展。
