背景:多发性硬化症(MS)是一种病因不明的慢性免疫介导疾病,可导致身体和认知障碍。不同的研究表明,亚硝基应激可能在MS的发病机制和残疾中起关键作用。此外,报告评估了NO及其代谢物,与其他病理相比,MS患者的亚硝酸盐和硝酸盐(NOx)水平表示,但未评估残疾和复发/缓解期.
目标:因此,这项研究的目的是对复发/缓解期MS患者的NOx水平进行系统评价和荟萃分析,以及它与病人残疾的关系。
方法:该方案已在PROSPERO(CRD42022327161)中注册。我们使用GRADE评估文章的质量,并使用Egger和Begg检验评估发表偏倚。
结果:这里,通过Pubmed中的搜索,Scopus和EMBASE数据库,发现了5.276项研究,在选择过程之后,本系统综述和荟萃分析包括20项研究。这些研究包括1474名MS患者和1717名健康对照的数据,1010RRMS和221原发性进行性MS(PPMS)。
结论:复发缓解型MS(RRMS)患者在复发阶段NOx水平升高。此外,残疾程度较高的MS患者的NOx水平升高。然而,仍然需要进一步的研究来控制生活习惯,疼痛,和MS处理效果在有偏差的NOx水平。
BACKGROUND: Multiple sclerosis (MS) is a chronic and immune-mediated disease of unknown etiology and leading to a physical and cognitive disability. Different studies suggest that nitrosative stress may play a pivotal role in the pathogenesis and disability in MS. Besides, reports evaluated NO and their metabolites, expressed by nitrite and nitrate (
NOx) levels of MS patients compared with other pathologies, but did not evaluate disability and relapse/remission phases.
OBJECTIVE: Thus, this study aimed to conduct a systematic
review and meta-analysis of
NOx levels in MS patients in relapse/remission phases and its involvement in patient disability.
METHODS: The protocol was registered in PROSPERO (CRD42022327161). We used GRADE to estimate the articles\' quality and evaluated the publication bias using Egger\'s and Begg\'s tests.
RESULTS: Here, through a search in the Pubmed, Scopus, and EMBASE databases, 5.276 studies were found, and after the selection process, 20 studies were included in this systematic
review and meta-analysis. The studies included data from 1.474 MS patients and 1.717 healthy controls, 1.010 RRMS and 221 primary progressive MS (PPMS).
CONCLUSIONS: NOx levels are increased in relapsing-remitting MS (RRMS) patients in the relapse phase. Also,
NOx levels were increased in MS patients with higher disability. However, further studies are still needed to control lifestyle habits, pain, and MS treatment effects in biased NOx levels.