五种植物多糖调节环磷酰胺诱导免疫抑制小鼠免疫功能的网状Meta分析

Regulation of Immune Function of Cyclophosphamide-induced Immunosuppressed Mice by Five Plant Polysaccharides:A Network Meta-analysis

目的:采用网状Meta分析比较5种植物多糖对环磷酰胺(CTX)诱导免疫抑制小鼠免疫功能的影响,为多糖临床应用提供循证医学的证据支持,同时为更优效的多糖、寡糖新药开发提供参考。方法:计算机检索PubMed、Embase、Web of Science等7个数据库,并选择符合纳入标准的研究,使用动物实验系统评价中心(SYRCLE)的偏倚评估工具对纳入研究的方法学质量进行评价,采用RStudio、StataSE 17软件进行数据分析。结果:共纳入62项随机对照试验(RCTs),包含了1512只小鼠,涉及黄芪多糖(APS)、香菇多糖(LNT)、灵芝多糖(GLP)、茯苓多糖(PCC)、党参多糖(CPP)5种植物多糖。网状Meta分析结果显示,(1)在升高脾指数方面,概率排序第1为APS(均数差(MD)=3.54,95%置信区间(CI)[2.10,5.96]);(2)在升高胸腺指数方面,概率排序第1为APS(MD=1.98,95%CI[1.55,2.54]);(3)在升高外周血白细胞数量方面,概率排序第1为CPP(MD=24.16,95%CI[8.21,71.12]);(4)在升高T辅助细胞(CD4+)/T抑制细胞(CD8+)方面,概率排序第1为APS(MD=1.63,95%CI[1.13,2.37]);(5)在升高巨噬细胞吞噬指数方面,概率排序第1为CPP(MD=2.52,95%CI[1.32,4.82]);(6)在升高免疫球蛋白M(IgM)含量方面,概率排序第1为CPP(MD=1.79,95%CI[1.12,2.85])。结论:5种植物多糖均能调节免疫抑制小鼠的免疫功能,其中,APS在升高脾指数、胸腺指数和CD4+/CD8+方面具有一定优势,而CPP侧重于升高外周血白细胞数量、巨噬细胞吞噬指数及IgM含量。由于纳入研究数量及质量存在差异,结论的可靠性仍需开展大样本、高质量的研究进行验证。

Objective:To compare the regulatory effects of five plant polysaccharides on immune function of cyclophosphamide(CTX)-induced immunosuppressed mice by network Meta-analysis,to provide evidence for the clinical application of polysaccharides and the development of effective polysaccharides and oligosaccharides.Method:Seven databases including PubMed,Embase and Web of Science were searched,and studies that met the inclusion criteria were selected.The methodological quality of the included studies was evaluated using the risk of bias tool of Systematic Review Centre for Laboratory Animal Experimentation(SYRCLE),and the data were analyzed using RStudio and StataSE 17.Result:A total of 62 randomized controlled trials(RCTs)were included,involving 1512 mice and five plant polysaccharides:Astragalus polysaccharide(APS),lentinan(LNT),Ganoderma lucidum polysaccharide(GLP),Poria cocos polysaccharide(PCC),and Codonopsis pilosula polysaccharide(CPP).The network Meta-analysis showed that APS ranked first in increasing spleen index(mean deviation(MD)=3.54,95%confidence interval(CI)[2.10,5.96]),thymus index(MD=1.98,95%CI[1.55,2.54])and T helper cells(CD4+)/T suppressor cells(CD8+)(MD=1.63,95%CI[1.13,2.37]),while CPP ranked first in up-regulating the number of peripheral blood leukocytes(MD=24.16,95%CI[8.21,71.12]),macrophage phagocytosis index(MD=2.52,95%CI[1.32,4.82])and immunoglobulin M(IgM)content(MD=1.79,95%CI[1.12,2.85]).Conclusion:All the five plant polysaccharides can regulate the immune function of immunosuppressed mice.Among them,APS has advantages in elevating spleen index,thymus index and CD4+/CD8+,while CPP focuses on increasing the number of peripheral blood leukocytes,macrophage phagocytosis index and IgM content.Due to limited number and quality of included studies,the conclusions needs to be further verified with large samples and high-quality studies.