PDF(Pubmed)
Abstract：
Inflammation, oxidative injury, and gut dysbiosis play an important role in the pathogenesis of necrotising enterocolitis (NEC). Plant-derived substances have historically been used as therapeutic agents due to their anti-inflammatory, antioxidant, and antimicrobial properties. We aimed to review pre-clinical evidence for plant-derived substances in the prevention and treatment of NEC. A systematic review was conducted using the following databases: PubMed, EMBASE, EMCARE, MEDLINE and Cochrane Library (PROSPERO CRD42022365477). Randomized controlled trials (RCTs) and quasi-RCTs that evaluated a plant-derived substance as an intervention for NEC in an animal model of the illness and compared pre-stated outcomes (e.g., clinical severity, severity of intestinal injury, mortality, laboratory markers of inflammation and oxidative injury) were included. Sixteen studies (n = 610) were included in the systematic review. Ten of the sixteen included RCTs (Preterm rat pups: 15, Mice: 1) reported mortality and all reported NEC-related histology. Meta-analysis showed decreased mortality [12/134 vs. 27/135; RR: 0.48 (95% CI: 0.26 to 0.87); p = 0.02, 10 RCTs] and decreased NEC in the experimental group [24/126 vs. 55/79; RR: 0.34 (95% CI: 0.22 to 0.52); p < 0.001, 6 RCTs]. Markers of inflammation (n = 11) and oxidative stress (n = 13) improved in all the studies that have reported this outcome. There was no significant publication bias for the outcome of mortality. Plant-derived substances have the potential to reduce the incidence and severity of histologically diagnosed NEC and mortality in rodent models. These findings are helpful in guiding further pre-clinical studies towards developing a food supplement for the prevention of NEC in preterm infants.
摘要：
炎症，氧化损伤，肠道菌群失调在坏死性小肠结肠炎（NEC）的发病机制中起重要作用。由于植物来源的物质具有抗炎作用，因此历来被用作治疗剂。抗氧化剂，和抗菌性能。我们旨在回顾植物衍生物质在NEC预防和治疗中的临床前证据。使用以下数据库进行了系统评价：PubMed，EMBASE,EMCARE,MEDLINE和Cochrane图书馆（PROSPEROCRD42022365477）。随机对照试验（RCTs）和准RCTs，评估了植物衍生物质作为疾病动物模型中NEC的干预措施，并比较了预先设定的结果（例如，临床严重程度，肠损伤的严重程度，死亡率,包括炎症和氧化损伤的实验室标志物）。16项研究（n=610）纳入系统评价。16个中的10个包括RCT(早产大鼠幼崽:15,小鼠:1)报告死亡率和所有报告的NEC相关组织学。Meta分析显示死亡率降低[12/134vs.27/135；RR：0.48（95％CI：0.26至0.87）；p=0.02，10个RCT]，实验组NEC降低[24/126vs.55/79；RR：0.34（95%CI：0.22至0.52）；p<0.001，6个RCTs]。炎症标志物（n=11）和氧化应激（n=13）在所有报道这一结果的研究中都得到了改善。死亡率结局没有显著的发表偏倚。植物来源的物质具有降低啮齿动物模型中组织学诊断的NEC和死亡率的发生率和严重程度的潜力。这些发现有助于指导进一步的临床前研究，以开发用于预防早产儿NEC的食品补充剂。
