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Current Pediatric Reviews Jan 2024The mechanism of occurrence and complications of asphyxia change in the treatment process and the future prognosis of newborns. One of the discussed mechanisms is the...
INTRODUCTION
The mechanism of occurrence and complications of asphyxia change in the treatment process and the future prognosis of newborns. One of the discussed mechanisms is the disruption of oxidants to anti-oxidants balance. Therefore, the current study was conducted aiming to systematically review and conduct a meta-analysis on the diagnosis and prognosis of prenatal asphyxia based on oxidant-antioxidant balance.
METHODS
A comprehensive electronic search was conducted using PubMed, Cochrane Library, Scopus, and Web of Science databases, up to February 2023 to identify relevant studies examining the association between Prooxidant anti-oxidant balance (PAB) and Malondialdehyde 1 levels with the risk of prenatal asphyxia. Only English studies were incorporated. The search terms used included Asphyxia, Diagnosis, Prognosis, Newborns, Prenatal, Oxidant antioxidant balance, and oxidative stress. A total of 13 studies were retrieved. Data regarding the standard mean difference (SMD) were collected, and a pooled SMD with 95%CI was calculated using a random-effect model to determine the strength of the relationship. Furthermore, the risk of publication bias was assessed through funnel plot and Egger's linear regression tests. Inclusion criteria was 1) The studies conducted on neonates, diagnosis and outcomes of prenatal asphyxia, oxidants and antioxidants were included. Research conducted on adults or on animals or review articles, and articles in which only their abstracts were available were excluded. The quality of the reported studies was also assessed.
RESULTS
Out of 980 searched articles, 13 articles (10 prospective articles and 3 cross-sectional articles) were studied. An increase in antioxidant enzymes (Glutathione peroxidase (GSH-Px), catalase (CAT) and Plasma superoxide dismutase (SOD)) cannot be dealt with excessive oxidants produced in the body (Plasma and cerebrospinal fluid levels of Malondialdehyde (MDA), free radical products (F8-isoprostane and MDA), saturated fatty acids and % CoQ-10). Prooxidant anti-oxidant balance (PAB) levels among neonates who had asphyxia were announced to be two times higher than normal newborns. PAB values in neonates with asphyxia, who had adverse prognosis, were about three times higher than those with favorable prognosis. The sensitivity of PAB in predicting the prognosis of neonates with asphyxia was reported 83- 89% and its specificity was 71- 92%. The pooled SMD analysis revealed a significant association between PAB and MDA levels with the risk of prenatal asphyxia both overall (SMD = 1.447, 95%CI: 0.961-1.934, P < 0.001), as well as separately in subgroups of PAB (SMD = 1.134, 95%CI: 0.623-1.644, P < 0.001) and MDA (SMD = 1.910, 95%CI: 0.916-2.903, P < 0.001).
CONCLUSION
Our meta-analysis findings revealed the potential of evaluating antioxidant enzymes and oxidant agents, as well as assessing the balance between them (PAB), in diagnosing and predicting the prognosis of neonatal asphyxia. The limitations of the present study included not having access to all related complete articles, lack of quality and usability in reports of some articles, and the different diagnostic methods of prenatal asphyxia in different studies.
PubMed: 38279715
DOI: 10.2174/0115733963264881231227112345 -
Journal of Traditional Chinese Medicine... Feb 2024To evaluate the efficacy of electroacupuncture (EA) intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with... (Meta-Analysis)
Meta-Analysis
Efficacy of electroacupuncture on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and Meta-analysis.
OBJECTIVE
To evaluate the efficacy of electroacupuncture (EA) intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
METHODS
Eight databases, including PubMed, Embase, the Cochrane Library, Web of Science, Chinese BioMedical Literature Database, China National Knowledge Infrastructure Database, Wanfang Data, China Science and Technology Journal Database, and two clinical trial registries, were searched. All randomized controlled trials (RCTs) related to EA intervention in cardiac surgery with CPB were collected. Based on the inclusion and exclusion criteria, two researchers independently screened articles and extracted data. After the quality evaluation, RevMan 5.3 software was used for analysis.
RESULTS
Fourteen RCTs involving 836 patients were included. Compared with the control treatment, EA significantly increased the incidence of cardiac automatic rebeat after aortic unclamping [relative risk () = 1.15, 95% confidence interval () (1.01, 1.31), 0.05; moderate]. Twenty-four hours after aortic unclamping, EA significantly increased the superoxide dismutase [standardized mean difference () = 0.96, 95% (0.32, 1.61), 0.05; low], and interleukin (IL)-2 [ = 1.33, 95% (0.19, 2.47), 0.05; very low] expression levels and decreased the malondialdehyde [ =-1.62, 95% (-2.15, -1.09), 0.05; moderate], tumour necrosis factor-α [ = -1.28, 95% (-2.37, -0.19), 0.05; moderate], and cardiac troponin I [SMD = -1.09, 95% (-1.85, -0.32), 0.05; low] expression levels as well as the inotrope scores [ = -0.77, 95% (-1.22, -0.31), 0.05; high]. There was no difference in IL-6 and IL-10 expression levels. The amount of intraoperative sedative [ = -0.31, 95% (-0.54, -0.09), 0.05; moderate] and opioid analgesic [ = -0.96, 95% (-1.53, -0.38), 0.05; low] medication was significantly lower in the EA group than in the control group. Moreover, the postoperative tracheal intubation time [ = -0.92, 95% (-1.40, -0.45), 0.05; low] and intensive care unit stay [ = -1.71, 95% (-3.06, -0.36), 0.05; low] were significantly shorter in the EA group than in the control group. There were no differences in the time to get out of bed for the first time, total days of antibiotic use after surgery, or postoperative hospital stay. No adverse reactions related to EA were reported in any of the included studies.
CONCLUSIONS
In cardiac surgery with CPB, EA may be a safe and effective strategy to reduce myocardial ischaemia-reperfusion injury and speed up the recovery of patients after surgery. These findings must be interpreted with caution, as most of the evidence was of low or moderate quality. More RCTs with larger sample sizes and higher quality are needed to provide more convincing evidence.
Topics: Humans; Cardiac Surgical Procedures; Cardiopulmonary Bypass; China; Electroacupuncture
PubMed: 38213234
DOI: 10.19852/j.cnki.jtcm.20230904.003 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Jan 2023To evaluate the clinical value and safety of combined anesthesia of acupuncture-pharmacotherapy in pulmonary resection surgery. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the clinical value and safety of combined anesthesia of acupuncture-pharmacotherapy in pulmonary resection surgery.
METHODS
The randomized controlled trials (RCTs) related to combined anesthesia of acupuncture-pharmacotherapy in pulmonary resection surgery were searched in PubMed, EMbase, Cochrane Library, Web of Science, SinoMed, CNKI, VIP database, Wanfang database, ClinicalTrials.gov, and the Chinese Clinical Trial Registry (http://www.chictr.org.cn/) from the inception of each database up to July 12, 2022. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool, and Meta-analysis was conducted using RevMan5.4.
RESULTS
A total of 33 RCTs were included, involving 2 526 participants. The Meta-analysis results showed that compared to conventional anesthesia, the patients receiving combined anesthesia of acupuncture-pharmacotherapy had more stable vital signs during surgery, reduced intraoperative fentanyl usage [=-3.73, 95%(-5.28, -2.18), =4.72, <0.000 01], decreased postoperative sufentanil consumption [=-20.85, 95%(-24.84, -16.86), =10.24, <0.000 01], reduced total/effective presses of the postoperative patient-controlled analgesia pump [=-5.70, 95% (-9.04, -2.36), =3.35, =0.000 8], lowered postoperative pain visual analogue scale (VAS) [=-1.63, 95%(-2.02, -1.23), =7.97, <0.000 01], shorter length of postoperative hospital stay [=-1.14, 95%(-1.85, -0.43), =3.15, =0.002], and higher levels of CD 4+ T lymphocytes, CD 8+ T lymphocytes, natural killer (NK) cell activity, and superoxide dismutase (SOD). Additionally, tumor necrosis factor-alpha (TNF-α), adrenaline and cortisol levels were decreased (<0.05). No adverse events related to acupuncture or electrical stimulation were reported, and the incidence of postoperative complications was lower than that of conventional anesthesia [=0.47, 95%(0.36, 0.62), =5.36, <0.000 01].
CONCLUSIONS
The combined anesthesia of acupuncture-pharmacotherapy in pulmonary resection surgery could improve anesthesia and analgesia effectiveness, reduce anesthesia drug usage, regulate immune responses, suppress stress reactions, and the safety is satisfactory. However, there is substantial heterogeneity among the included studies, and outcome measures vary widely. Further large-sample, high-quality, internationally standardized clinical trials are needed to clarify its clinical value and safety, providing reliable evidence for clinical practice.
Topics: Humans; Anesthesia; Acupuncture Therapy; Postoperative Complications; Pain Management; Analgesia, Patient-Controlled
PubMed: 38191169
DOI: 10.13703/j.0255-2930.20221008-0005 -
Biologia Futura Jun 2024Heavy metals (HMs) toxicity has become one of the major global issues and poses a serious threat to the environment in recent years. HM pollution in agricultural soil is... (Review)
Review
Heavy metals (HMs) toxicity has become one of the major global issues and poses a serious threat to the environment in recent years. HM pollution in agricultural soil is caused by metal mining, smelting, volcanic activity, industrial discharges, and excessive use of phosphate fertilizers. HMs above a threshold level adversely affect the cellular metabolism of plants by producing reactive oxygen species (ROS), which attack cellular proteins. There are different mechanisms (physiological and morphological) adopted by plants to survive in the era of abiotic stress. Various osmoprotectants or compatible solutes, including amino acids, sugar, and betaines, enable the plants to counteract the HM stress. Glycine betaine (GB) is an effective osmolyte against HM stress among compatible solutes. GB has been shown to improve plant growth, photosynthesis, uptake of nutrients, and minimize oxidative stress in plants under HM stress. Additionally, GB increases the activity of antioxidant enzymes such as CAT (catalase), SOD (superoxide dismutase), and POD (peroxidase), which are effective in scavenging unwarranted ROS. Since not all species of plants can naturally produce or accumulate GB in response to stress, various approaches have been explored for introducing them. Plant hormones like salicylic acid, ABA (abscisic acid), and JA (jasmonic acid) co-ordinately stimulate the accumulation of GB inside the cell under HM stress. Apart from the exogenous application, the introduction of GB pathway genes in GB deficient species via genetic engineering also seems to be efficient in mediating HM stress. This review complied the beneficial effects of GB in mitigating HM stress and its role as a plant growth regulator. Additionally, the review explores the potential for engineering GB biosynthesis in plants as a strategy to bolster their resilience to HMs.
Topics: Betaine; Metals, Heavy; Plants
PubMed: 38183566
DOI: 10.1007/s42977-023-00198-9 -
Nutrition Reviews Dec 2023Carnosine and histidine-containing dipeptides (HCDs) are suggested to have anti-inflammatory and antioxidative benefits, but their effects on circulating adipokines and...
CONTEXT
Carnosine and histidine-containing dipeptides (HCDs) are suggested to have anti-inflammatory and antioxidative benefits, but their effects on circulating adipokines and inflammatory and oxidative stress biomarkers remain unclear.
OBJECTIVES
The aim of the present systematic review and meta-analysis was to determine the impact of HCD supplementation on inflammatory and oxidative stress biomarkers.
DATA SOURCES
A systematic search was performed on Medline via Ovid, Scopus, Embase, ISI Web of Science, and the Cochrane Library databases from inception to 25 January 2023.
DATA EXTRACTION
Using relevant key words, trials investigating the effects of carnosine/HCD supplementation on markers of inflammation and oxidative stress, including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), adiponectin, malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), total antioxidant capacity (TAC), and catalase (CAT) were identified. Meta-analyses were conducted using random-effects models to calculate the weighted mean differences (WMDs) and 95% confidence intervals (CIs).
DATA ANALYSIS
A total of 9 trials comprising 350 participants were included in the present meta-analysis. Carnosine/HCD supplementation led to a significant reduction in CRP (WMD: -0.97 mg/L; 95% CI: -1.59, -0.36), TNF-α (WMD: -3.60 pg/mL; 95% CI: -7.03, -0.18), and MDA (WMD: -0.34 μmol/L; 95% CI: -0.56, -0.12) and an elevation in CAT (WMD: 4.48 U/mL; 95% CI: 2.43, 6.53) compared with placebo. In contrast, carnosine/HCD supplementation had no effect on IL-6, adiponectin, GSH, SOD, and TAC levels.
CONCLUSION
Carnosine/HCD supplementation may reduce inflammatory and oxidative stress biomarkers, and potentially modulate the cardiometabolic risks associated with chronic low-grade inflammation and lipid peroxidation.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42017075354.
PubMed: 38086332
DOI: 10.1093/nutrit/nuad150 -
Frontiers in Cardiovascular Medicine 2023Oxidative stress induced by the excessive production of reactive oxygen species is one of the primary mechanisms implicated in anthracycline (ANT)-induced... (Review)
Review
BACKGROUND
Oxidative stress induced by the excessive production of reactive oxygen species is one of the primary mechanisms implicated in anthracycline (ANT)-induced cardiotoxicity. There is a strong clinical need for a molecule capable of effectively preventing and reducing the oxidative damage caused by ANT. In vitro and studies conducted in mice have shown that melatonin stimulates the expression of antioxidative agents and reduces lipid peroxidation induced by ANT.
METHODS
We investigated this issue through a meta-analysis of murine model studies. The outcome of the meta-analysis was to compare oxidative damage, estimated by products of lipid peroxidation (MDA = Malondialdehyde) and markers of oxidative stress (SOD = Superoxide Dismutase, GSH = Glutathione), along with a marker of cardiac damage (CK-MB = creatine kinase-myocardial band), assessed by measurements in heart and/or blood samples in mice undergoing ANT chemotherapy and assuming melatonin vs. controls. The PubMed, OVID-MEDLINE and Cochrane library databases were analysed to search English-language review papers published from the inception up to August 1st, 2023. Studies were identified by using Me-SH terms and crossing the following terms: "melatonin", "oxidative stress", "lipid peroxidation", "anthracycline", "cardiotoxicity".
RESULTS
The metanalysis included 153 mice administered melatonin before, during or immediately after ANT and 153 controls from 13 studies. Compared with controls, the levels of all oxidative stress markers were significantly better in the pooled melatonin group, with standardized mean differences (SMD) for MDA, GSH and SOD being -8.03 ± 1.2 (CI: -10.43/-5.64, < 0.001), 7.95 ± 1.8 (CI: 4.41/11.5, < 0.001) and 3.94 ± 1.6 (CI: 0.77/7.12, = 0.015) respectively. Similarly, compared with controls, CK-MB levels reflecting myocardial damage were significantly lower in the pooled melatonin group, with an SMD of -4.90 ± 0.5 (CI: -5.82/-3.98, < 0.001).
CONCLUSION
Melatonin mitigates the oxidative damage induced by ANT in mouse model. High-quality human clinical studies are needed to further evaluate the use of melatonin as a preventative/treatment strategy for ANT-induced cardiotoxicity.
PubMed: 38075951
DOI: 10.3389/fcvm.2023.1289384 -
BMC Oral Health Dec 2023We performed this systematic review and meta-analysis to synthesize all studies that reported the level of oxidative and antioxidative markers in recurrent aphthous... (Meta-Analysis)
Meta-Analysis
BACKGROUND
We performed this systematic review and meta-analysis to synthesize all studies that reported the level of oxidative and antioxidative markers in recurrent aphthous stomatitis (RAS) patients compared to controls.
METHODS
We registered our study in PROSPERO (CRD42023431310). PubMed, ProQuest, Scopus, EMBASE, Google Scholar, and Web of Science were searched to find relevant publications up to June 5, 2023. The standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. We included 30 articles after multiple stags of screening.
RESULTS
We found that erythrocyte superoxide dismutase and Glutathione peroxidase activity were significantly lower in patients with RAS compared to healthy controls (SMD = - 1.00, 95%CI = -1.79 to -0.21, p = 0.013, and SMD = - 1.90, 95%CI = -3.43 to -0.38, p = 0.01, Respectively). However, there was not any difference between patients with RAS and healthy controls in erythrocyte Catalase (SMD = - 0.71, 95%CI = -1.56-0.14, p = 0.10). The total antioxidant status (TAS) level, in serum was significantly lower in patients than healthy controls (SMD = - 0.98, 95%CI = -1.57 to -0.39, p = 0.001). In addition, RAS patients had higher levels of serum Malondialdehyde (MDA), Serum total oxidant status, and serum oxidative stress index than healthy controls (SMD = 2.11, 95%CI = 1.43-2.79, p < 0.001, SMD = 1.53, 95%CI = 0.34-2.72, p = 0.01, and SMD = 1.25, 95%CI = 0.25-2.25, p = 0.014, Respectively); However, salivary MDA and TAS, and serum uric acid, vitamin E and C, and reduced glutathione levels of patients with RAS were not different from that of healthy controls.
CONCLUSIONS
The relationship between oxidative stress and RAS is well established in this meta-analysis. Although the molecular processes underlying the etiology of this pathology remain unknown, evidence indicating oxidative stress has a significant role in the pathogenesis of RAS has been revealed.
Topics: Humans; Antioxidants; Uric Acid; Stomatitis, Aphthous; Oxidative Stress
PubMed: 38042793
DOI: 10.1186/s12903-023-03636-1 -
Antioxidants (Basel, Switzerland) Oct 2023The aim of this meta-analysis is to explore all the available literature to obtain updated data about the potential use of antioxidants in the treatment of rheumatoid... (Review)
Review
OBJECTIVE
The aim of this meta-analysis is to explore all the available literature to obtain updated data about the potential use of antioxidants in the treatment of rheumatoid arthritis (RA) and its ability to reduce disease progression and cardiovascular risk.
METHODS
This systematic review and meta-analysis was performed strictly in accordance with the PRISMA guidelines. English and Chinese databases were searched with a retrieval time up to March 2023. These databases included the PubMed, Embase, Medline Complete, Web of Sciences and Cochrane Collaboration, Wanfang, China National Knowledge Infrastructure, and VIP databases. This literature search was formulated by the two researchers independently. The search strategy consists of reading, collecting the literature, and conducting the preliminary screening. After that, they provide the final selection of the literature according to the inclusion criteria and data extraction. Also, for all studies, the risk bias was assessed to evaluate the quality of the included references. The content of the risk assessment of bias included the following criteria: random allocation method, allocation plan hiding, blind method, completeness of result data, and selectivity of reporting of results, as well as other biases. The main outcomes were clinical efficiency of antioxidant therapy (C-reactive protein, DAS28 score, HAQ, Number of tender joints, etc.) and oxidative stress indicators (catalase, superoxide dismutase, or total antioxidant capacity).
RESULTS
We observed, in most of the studies, the small or moderate effects of antioxidant treatment. The mean effect size is 0.525, and that means that moderate effects were observed in 30 selected RCTs. Also, this effect is confirmed in the 1652 patients with RA with the mean confidence interval of 0.276 (lower limit) and 0.983 (upper limit). Cohen coefficient was calculated at 0.05.
CONCLUSION
The existing evidence is that antioxidants can reduce systemic and local oxidative stress and can reduce damage as the main agent involved in autoimmune diseases such as rheumatoid arthritis.
PubMed: 38001790
DOI: 10.3390/antiox12111938 -
Journal of Agricultural and Food... Nov 2023Alzheimer's disease (AD) is a neurodegenerative disease of the central nervous system that occurs in old age and pre-aging, characterized by progressive cognitive... (Meta-Analysis)
Meta-Analysis Review
Alzheimer's disease (AD) is a neurodegenerative disease of the central nervous system that occurs in old age and pre-aging, characterized by progressive cognitive dysfunction and behavioral impairment. Salidroside (Sal) is a phenylpropanoid mainly isolated from species with various pharmacological effects. However, the exact anti-AD mechanism of Sal has not been clearly elucidated. This meta-analysis aims to investigate the possible mechanisms by which Sal exerts its anti-AD effects by evaluating behavioral indicators and biochemical characteristics. A total of 20 studies were included, and the results showed that the Sal treatment significantly improved behavior abnormalities in AD animal models. With regard to neurobiochemical indicators, Sal treatment could effectively increase the antioxidant enzyme superoxide dismutase, decrease the oxidative stress indicator malondialdehyde, and decrease the inflammatory indicators interleukin 1β, interleukin 6, and tumor necrosis factor α. Sal treatment was effective in reducing neuropathological indicators, such as amyloid-β levels and the number of apoptotic cells. When the relevant literature on the treatment of rodent AD models is combined with Sal, the therapeutic potential of Sal through multiple mechanisms was confirmed. However, further confirmation by higher quality studies, larger sample sizes, and more comprehensive outcome evaluations in clinical trials is needed in the future.
Topics: Animals; Alzheimer Disease; Neurodegenerative Diseases; Oxidative Stress; Amyloid beta-Peptides; Neuroprotective Agents
PubMed: 37934032
DOI: 10.1021/acs.jafc.3c06672 -
Pharmaceuticals (Basel, Switzerland) Sep 2023The objective of this study is to assess the effectiveness of treatment for inflammatory bowel diseases in modulating oxidative stress biomarkers and cytokine levels. A... (Review)
Review
The objective of this study is to assess the effectiveness of treatment for inflammatory bowel diseases in modulating oxidative stress biomarkers and cytokine levels. A systematic review of clinical trials was conducted, searching electronic databases including PubMed, Science Direct, and Scopus. After excluding articles that did not meet the inclusion criteria, 19 studies were included in the systematic review and 8 in the meta-analysis (6 for antioxidant capacity, 6 for superoxide dismutase (SOD), and 5 for lipid peroxidation analyzed through malondialdehyde (MDA) levels). SOD was significantly modulated (RR = 0.3764, 95% CI [0.0262 to 0.7267], = 0.035) but not antioxidant capacity (RR = 0.3424, 95% CI [0.0334 to 0.7183], = 0.0742) or MDA (RR = -0.8534, 95% CI [-1.9333 to 0.2265], = 0.1214). Nonetheless, studies investigating oxidative stress biomarkers and cytokines in the context of alternative therapies for IBD treatment are still scarce. This review highlights the potential of antioxidant supplementation in IBD management and underscores the need for further investigations into its effects on oxidative stress biomarkers and cytokines to improve therapeutic approaches for IBD patients.
PubMed: 37895845
DOI: 10.3390/ph16101374