Kuo Chien-Liang, Ting Berne, Tseng Ray Jui-Hung, Liu Shih-Ping, Liou Jun-Yang
Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 404328, Taiwan.
School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
Antioxidants (Basel). 2025 May 30;14(6):660. doi: 10.3390/antiox14060660.
This study systematically evaluates the hepatoprotective effects of different types and doses of extracts (triterpenoids, polysaccharides, and ubiquinone derivatives) on liver function biomarkers, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), malondialdehyde (MDA), and tumor necrosis factor-alpha (TNF-α), using a network meta-analysis (NMA) approach. Comprehensive literature searches were conducted in PubMed, Embase, Cochrane CENTRAL, and Web of Science databases to identify eligible animal studies involving standardized mouse and rat models. Interventions were categorized based on extract types and dosage levels (high, medium, low), with controls including negative groups (vehicle-treated) and positive groups (e.g., silymarin, N-acetylcysteine). A random-effects model estimated mean differences (MDs) with 95% confidence intervals (CIs), risk of bias was assessed with the SYRCLE tool, and sensitivity analyses verified robustness. The protocol has been registered in INPLASY (INPLASY202540040). The results indicated that triterpenoids, particularly at high and medium doses, were the most effective in reducing ALT (MD: -42.37, 95% CI: -54.19 to -30.54) and AST (MD: -50.18, 95% CI: -73.31 to -27.05). High-dose polysaccharides also showed notable effects, while other interventions demonstrated variable efficacy. For oxidative stress, high-dose triterpenoids showed the most pronounced reduction in MDA (MD: -19.05, 95% CI: -24.00 to -14.09), followed by medium-dose triterpenoids and all-dose polysaccharides. Regarding inflammation, high- and medium-dose triterpenoids significantly reduced TNF-α levels (high-dose MD: -88.75, 95% CI: -119.68 to -57.82; medium-dose MD: -89.27, 95% CI: -125.51 to -53.02), with overlapping confidence intervals indicating similar efficacy. High- and low-dose polysaccharides also demonstrated moderate anti-inflammatory effects. In conclusion, high-dose triterpenoids showed favorable and consistent effects across multiple biomarkers, which highlights their potential value for future liver-related therapeutic strategies.
本研究采用网络荟萃分析（NMA）方法，系统评估了不同类型和剂量的提取物（三萜类化合物、多糖和泛醌衍生物）对肝功能生物标志物的肝脏保护作用，这些生物标志物包括丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、丙二醛（MDA）和肿瘤坏死因子-α（TNF-α）。在PubMed、Embase、Cochrane CENTRAL和Web of Science数据库中进行了全面的文献检索，以确定涉及标准化小鼠和大鼠模型的合格动物研究。干预措施根据提取物类型和剂量水平（高、中、低）进行分类，对照组包括阴性组（赋形剂处理）和阳性组（如水飞蓟宾、N-乙酰半胱氨酸）。随机效应模型估计了平均差异（MDs）及其95%置信区间（CIs），使用SYRCLE工具评估偏倚风险，并通过敏感性分析验证稳健性。该方案已在INPLASY注册（INPLASY202540040）。结果表明，三萜类化合物，特别是高剂量和中剂量的三萜类化合物，在降低ALT（MD：-42.37，95%CI：-54.19至-30.54）和AST（MD：-50.18，95%CI：-73.31至-27.05）方面最有效。高剂量多糖也显示出显著效果，而其他干预措施的疗效各不相同。对于氧化应激，高剂量三萜类化合物使MDA降低最为显著（MD：-19.05，95%CI：-24.00至-14.09），其次是中剂量三萜类化合物和所有剂量的多糖。关于炎症，高剂量和中剂量三萜类化合物显著降低了TNF-α水平（高剂量MD：-88.75，95%CI：-119.68至-57.82；中剂量MD：-89.27，95%CI：-125.51至-53.02），置信区间重叠表明疗效相似。高剂量和低剂量多糖也表现出适度的抗炎作用。总之，高剂量三萜类化合物在多种生物标志物上显示出良好且一致的效果，这突出了它们在未来肝脏相关治疗策略中的潜在价值。
