Evaluating the efficacy of nano-cyclosporine A in mice model of ulcerative colitis: a meta-analysis.

Cyclosporine A is an immunosuppressive drug used in clinics to treat steroid-refractory ulcerative colitis (UC). However, due to its side effects, researchers are evaluating novel drug delivery-based treatment options. Nanoparticles-based cyclosporine (Nano-CSA) offers a promising option for the treatment of UC, and various in vivo studies on animals have been conducted. This meta-analysis was performed to clarify the effects of using Nano-CSA based formulations in the mouse UC model. A systemic literature search was conducted on five different electronic databases (ScienceDirect, PubMed, Embase, PMC, and Cochrane) to search studies conducted between the timeline of 2016 and 2024. The search terms include "nanoparticles," "ulcerative colitis," and "cyclosporine A." The primary outcomes include histological scores and colon length. The Nano-CSA effects on UC were assessed by analyzing the difference between the treatment and untreated control groups, through the use of standardized mean difference (SMD). A fixed effect model was used where heterogeneity was less than 50%, for higher heterogeneity random effect model was used. The total number of included studies for this systematic review was six, from which meta-analysis was performed on four studies. In all the studies, dextran sulfate sodium (DSS) was used to induce UC, except for one study that used TNBS (2,4,6-trinitrobenzene sulfonic acid) for UC induction. Four studies measured histological score and colon length, and two studies measured other secondary outcomes (IL-6, TNF-α, and MPO (myeloperoxidase activity)). Meta-analysis results have demonstrated that there is an increase in colon length with SMD of 6.879 and a decrease in histological score with SMD of 10.956 in the Nano-CSA treated group. There was also a decrease in the levels of pro-inflammatory cytokines including TNF-α and IL-6 in the Nano-CSA treated group and no significant difference in MPO activity of the two groups. Colon length, MPO activity, and TNF-α expression demonstrated heterogeneity values of 84.638, 86.113, and 51.567 respectively. The results of this meta-analysis have demonstrated the potential therapeutic efficiency of Nano-CSA for the treatment of UC in mice models. Further research is required in order to explore nano-based novel therapeutics options for UC treatment in other models as well as with human applications.