Fu Zhongmei, Jiang Lianyan, Su Xiaojuan, Wang Hua, Li Mingquan
Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ophthalmology, Hubei provincial hospital of Traditional Chinese Medicine, Wuhan, China.
Front Pharmacol. 2025 Jun 2;16:1559314. doi: 10.3389/fphar.2025.1559314. eCollection 2025.
The aim of this systematic review and meta-analysis is to synthesize the effects and mechanisms of Tetramethylpyrazine (TMP) on renal outcomes in animal models of renal I/R injury.
Animal studies from seven electronic databases were searched up to October 2024. The risk of bias of the selected studies was assessed using the SYRCLE risk of bias tool. Standardized mean difference (SMD) or mean difference (MD) were estimated for the effects of TMP on serum creatinine (Scr), blood urea nitrogen (BUN), oxidative stress, inflammation and apoptotic. Random-effects models were used to summarize results. Heterogeneity was expressed as I. Subgroup analyses were used to clarify the sources of heterogeneity. Egger's test was used to assess publication bias. Sensitivity analyses were used to assess the robustness of the results. Statistical analysis was performed using RevMan 5.3 software.
Thirty studies involving 559 animals were identified for analysis. TMP treatment significantly decreased Scr (SMD = 2.35, 95% CI: -2.97 to -1.72, P < 0.05), BUN (SMD = -2.4, 95% CI: -3.01 to -1.79, P < 0.05). TMP treatment significantly improved oxidative stress expression (i.e., SOD, MDA, GSHPX, CAT, TAC) and alleviated inflammation levels (i.e., TNF-α, ICAM-1, IL-6, IL-10, NLRP3). TMP treatment also regulate the expression of apoptosis-related proteins (i.e., bcl-2, Bax, caspase 3, Caspase-12 and GRP78).
TMP could improve renal outcomes and alleviate injury through multiple signaling pathways. However, positive results should be treated with caution due to the significant heterogeneity and poor quality of the included studies.
CRD420251017081.
本系统评价和荟萃分析旨在综合川芎嗪（TMP）对肾缺血/再灌注损伤动物模型肾脏结局的影响及机制。
检索截至2024年10月七个电子数据库中的动物研究。使用SYRCLE偏倚风险工具评估所选研究的偏倚风险。估计TMP对血清肌酐（Scr）、血尿素氮（BUN）、氧化应激、炎症和凋亡影响的标准化均数差（SMD）或均数差（MD）。采用随机效应模型汇总结果。异质性用I²表示。进行亚组分析以阐明异质性来源。用Egger检验评估发表偏倚。进行敏感性分析以评估结果的稳健性。使用RevMan 5.3软件进行统计分析。
确定30项涉及559只动物的研究进行分析。TMP治疗显著降低Scr（SMD = 2.35，95%CI：-2.97至-1.72，P < 0.05）、BUN（SMD = -2.4，95%CI：-3.01至-1.79，P < 0.05）。TMP治疗显著改善氧化应激表达（即超氧化物歧化酶、丙二醛、谷胱甘肽过氧化物酶、过氧化氢酶、总抗氧化能力）并减轻炎症水平（即肿瘤坏死因子-α、细胞间黏附分子-1、白细胞介素-6、白细胞介素-10、NOD样受体蛋白3）。TMP治疗还调节凋亡相关蛋白（即bcl-2、Bax、半胱天冬酶3、半胱天冬酶-12和葡萄糖调节蛋白78）的表达。
TMP可通过多种信号通路改善肾脏结局并减轻损伤。然而，由于纳入研究存在显著异质性和质量较差，阳性结果应谨慎对待。
CRD420251017081。
