背景和目的:多项研究表明内皮素-1(ET-1)水平与各种类型的青光眼之间存在复杂的关系。本系统评价和荟萃分析探讨了不同类型青光眼患者血浆和房水中ET-1的水平。材料与方法:文献检索(PubMed,ScienceDirect,Cochrane图书馆)制作至2024年4月(PROSPERO:CRD42023430471)。根据PRISMA指南合成结果。结果表示为具有95%置信区间(CI)的标准化平均差(SMD)。结果:共有2597名受试者(1513名青光眼患者与来自23项研究的1084名健康对照)被纳入荟萃分析。值得注意的是,青光眼患者的血浆ET-1水平明显高于对照组(SMD:1.21,95%CI:0.59-1.82,p<0.001).特别是,原发性开角型青光眼(POAG)血浆ET-1水平较高(SMD:0.87,95%CI:0.09-1.65,p<0.05),正常眼压性青光眼(SMD:0.86,95%CI:0.27-1.46,p=0.05),与健康对照组相比,闭角型青光眼患者(SMD:1.03,95%CI:0.43-1.63,p<0.001)。此外,与对照组相比,青光眼患者的ET-1房水水平显着升高(SMD:1.60,95%CI:1.04-2.15,p<0.001)。特别是,POAG患者的房水水平较高(SMD:2.0395%CI:1.00-3.14,p<0.001),与对照组相比,假性剥脱性青光眼患者(SMD:2.03,95%CI:1.00-3.07,p<0.001)。结论:这项荟萃分析表明,血浆ET-1和房水水平升高与不同类型的青光眼显着相关。ET-1相关机制的发病机制可能因不同类型的青光眼而异。这表明针对ET-1途径的可能治疗方法应针对每种特定类型的青光眼进行调整。
Background and Objectives: Several studies suggest the complex relationship between Endothelin-1 (ET-1) levels with various types of glaucoma. This systematic
review and meta-analysis explore ET-1 levels in plasma and aqueous humor among different types of glaucoma. Materials and Methods: A literature search (PubMed, ScienceDirect, Cochrane Library) was made up to April 2024 (PROSPERO: CRD42023430471). The results were synthesized according to PRISMA Guidelines. Results were presented as standardized mean differences (SMD) with 95% confidence intervals (CI). Results: A total of 2597 subjects (1513 patients with glaucoma vs. 1084 healthy controls) from 23 studies were included in a meta-analysis. Notably, patients with glaucoma reported significantly higher plasma levels of ET-1 compared to controls (SMD: 1.21, 95% CI: 0.59-1.82, p < 0.001). Particularly, plasma ET-1 levels were higher in primary open-angle glaucoma (POAG) (SMD: 0.87, 95% CI: 0.09-1.65, p < 0.05), normal-tension glaucoma (SMD: 0.86, 95% CI: 0.27-1.46, p = 0.05), and angle-closure glaucoma patients (SMD: 1.03, 95% CI: 0.43-1.63, p < 0.001) compared to healthy controls. Moreover, ET-1 aqueous humor levels were significantly higher in patients with glaucoma compared to controls (SMD: 1.60, 95% CI: 1.04-2.15, p < 0.001). In particular, aqueous humor levels were higher in POAG patients (SMD: 2.03 95% CI: 1.00-3.14, p < 0.001), and pseudoexfoliative glaucoma patients (SMD: 2.03, 95% CI: 1.00-3.07, p < 0.001) compared to controls. Conclusions: This meta-analysis indicates that elevated levels of ET-1 plasma and aqueous humor are significantly associated with different types of glaucoma. The pathogenesis of ET-1-related mechanisms may vary across different glaucoma types, indicating that possible therapeutic approaches targeting ET-1 pathways should be tailored to each specific glaucoma type.