脊髓损伤(SCI)是一种灾难性的疾病,几乎没有治疗选择。虾青素(AST),一种具有强大抗氧化活性的天然营养补充剂,正在SCI领域寻找新的应用。这里,我们进行了系统评价,以评估AST在SCI后大鼠中的神经学作用,并评估其临床转化的潜力.搜索是在PubMed上进行的,Embase,科克伦图书馆,WebofScience,中国国家知识基础设施,万方数据,Vip期刊集成平台,和SinoMed数据库。包括评估AST在SCI大鼠模型中的神经生物学作用的动物研究。共收录10篇,大多具有中等到较高的方法学质量,而总体证据质量不高。一般来说,荟萃分析显示,用AST治疗的大鼠表现出增加的巴索,Beattie,和Bresnahan(BBB)得分与对照组相比,两组之间的加权平均差异(WMD)从第7天开始逐渐上升(六项研究,n=88,WMD=2.85,95%CI=1.83至3.87,p<0.00001)至第28天(五项研究,治疗后n=76,WMD=6.42,95%CI=4.29~8.55,p<0.00001)。AST治疗与保留白质区域改善预后相关,运动神经元存活,SOD和MDA水平。亚组分析表明,不同损伤类型之间的BBB评分改善存在差异。然后,试验顺序分析坚定地证明了AST可以促进SCI后大鼠的运动恢复。此外,这篇综述表明AST可以调节氧化应激,神经炎症,神经元丢失,和自噬通过多个信号通路治疗SCI。总的来说,具有保护作用,安全性好,和系统的行动机制,AST是未来SCI临床试验的有希望的候选者。尽管如此,鉴于纳入研究的局限性,需要更大规模和高质量的研究来验证。
Spinal cord injury (SCI) is a catastrophic condition with few therapeutic options.
Astaxanthin (AST), a natural nutritional supplement with powerful antioxidant activities, is finding its new application in the field of SCI. Here, we performed a systematic review to assess the neurological roles of AST in rats following SCI, and assessed the potential for clinical translation. Searches were conducted on PubMed, Embase, Cochrane Library, the Web of Science, China National Knowledge Infrastructure, WanFang data, Vip Journal Integration Platform, and SinoMed databases. Animal studies that evaluated the neurobiological roles of AST in a rat model of SCI were included. A total of 10 articles were included; most of them had moderate-to-high methodological quality, while the overall quality of evidence was not high. Generally, the meta-analyses revealed that rats treated with AST exhibited an increased Basso, Beattie, and Bresnahan (BBB) score compared with the controls, and the weighted mean differences (WMDs) between those two groups showed a gradual upward trend from days 7 (six studies, n = 88, WMD = 2.85, 95% CI = 1.83 to 3.87, p < 0.00001) to days 28 (five studies, n = 76, WMD = 6.42, 95% CI = 4.29 to 8.55, p < 0.00001) after treatment. AST treatment was associated with improved outcomes in spared white matter area, motor neuron survival, and SOD and MDA levels. Subgroup analyses indicated there were differences in the improvement of BBB scores between distinct injury types. The
trial sequential analysis then firmly proved that AST could facilitate the locomotor recovery of rats following SCI. In addition, this review suggested that AST could modulate oxidative stress, neuroinflammation, neuron loss, and autophagy via multiple signaling pathways for treating SCI. Collectively, with a protective effect, good safety, and a systematic action mechanism, AST is a promising candidate for future clinical trials of SCI. Nonetheless, in light of the limitations of the included studies, larger and high-quality studies are needed for verification.