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      Efficacy of terpenoids in attenuating pulmonary edema in acute lung injury: A meta-analysis of animal studies

      systematic-review

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          Abstract

          Background: The clinical efficiency of terpenoids in treating human acute lung injury (ALI) is yet to be determined. The lipopolysaccharide-induced rat model of ALI is a well-established and widely used experimental model for studying terpenoids’ effects on ALI. Using a systematic review and meta-analysis, the therapeutic efficiency of terpenoid administration on the lung wet-to-dry weight ratio in rats was investigated.

          Methods: Using the Cochrane Library, Embase, and PubMed databases, a comprehensive literature search for studies evaluating the therapeutic efficacy of terpenoids on ALI in rats was conducted. The lung wet-to-dry weight ratio was extracted as the main outcome. The quality of the included studies was assessed using the Systematic Review Center for Laboratory Animal Experimentation’s risk of bias tool.

          Results: In total, 16 studies were included in this meta-analysis. In general, terpenoids significantly lowered the lung wet-to-dry weight ratio when compared with the control vehicle ( p = 0.0002; standardized mean difference (SMD): −0.16; 95% confidence interval (CI): −0.24, −0.08). Subgroup analysis revealed that low dose (≤10 μmol/kg) ( p < 0.0001; SMD: −0.68; 95% CI: −1.02, −0.34), intraperitoneal injection ( p = 0.0002; SMD: −0.43; 95% CI: −0.66, −0.20), diterpenoid ( p = 0.004; SMD: −0.13; 95% CI: −0.23, −0.04), and triterpenoid ( p = 0.04; SMD: −0.28; 95% CI: −0.54, −0.01) significantly lowered the lung wet-to-dry weight ratio when compared with the control vehicle.

          Conclusion: A low dose of diterpenoid and triterpenoid administered intraperitoneally is effective in alleviating ALI. This systematic review and meta-analysis provides a valuable mirror for clinical research aiming at the advancement of terpenoids for preventive and therapeutic use.

          Systematic Review Registration: CRD42022326779

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          SYRCLE’s risk of bias tool for animal studies

          Carlijn Hooijmans, Maroeska Rovers, Rob de Vries … (2014)
          Background Systematic Reviews (SRs) of experimental animal studies are not yet common practice, but awareness of the merits of conducting such SRs is steadily increasing. As animal intervention studies differ from randomized clinical trials (RCT) in many aspects, the methodology for SRs of clinical trials needs to be adapted and optimized for animal intervention studies. The Cochrane Collaboration developed a Risk of Bias (RoB) tool to establish consistency and avoid discrepancies in assessing the methodological quality of RCTs. A similar initiative is warranted in the field of animal experimentation. Methods We provide an RoB tool for animal intervention studies (SYRCLE’s RoB tool). This tool is based on the Cochrane RoB tool and has been adjusted for aspects of bias that play a specific role in animal intervention studies. To enhance transparency and applicability, we formulated signalling questions to facilitate judgment. Results The resulting RoB tool for animal studies contains 10 entries. These entries are related to selection bias, performance bias, detection bias, attrition bias, reporting bias and other biases. Half these items are in agreement with the items in the Cochrane RoB tool. Most of the variations between the two tools are due to differences in design between RCTs and animal studies. Shortcomings in, or unfamiliarity with, specific aspects of experimental design of animal studies compared to clinical studies also play a role. Conclusions SYRCLE’s RoB tool is an adapted version of the Cochrane RoB tool. Widespread adoption and implementation of this tool will facilitate and improve critical appraisal of evidence from animal studies. This may subsequently enhance the efficiency of translating animal research into clinical practice and increase awareness of the necessity of improving the methodological quality of animal studies.
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            Animal models of acute lung injury

            Gustavo Matute-Bello, Charles W Frevert, Thomas R Martin (2008)
            Acute lung injury in humans is characterized histopathologically by neutrophilic alveolitis, injury of the alveolar epithelium and endothelium, hyaline membrane formation, and microvascular thrombi. Different animal models of experimental lung injury have been used to investigate mechanisms of lung injury. Most are based on reproducing in animals known risk factors for ARDS, such as sepsis, lipid embolism secondary to bone fracture, acid aspiration, ischemia-reperfusion of pulmonary or distal vascular beds, and other clinical risks. However, none of these models fully reproduces the features of human lung injury. The goal of this review is to summarize the strengths and weaknesses of existing models of lung injury. We review the specific features of human ARDS that should be modeled in experimental lung injury and then discuss specific characteristics of animal species that may affect the pulmonary host response to noxious stimuli. We emphasize those models of lung injury that are based on reproducing risk factors for human ARDS in animals and discuss the advantages and disadvantages of each model and the extent to which each model reproduces human ARDS. The present review will help guide investigators in the design and interpretation of animal studies of acute lung injury.
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              Acute Lung Injury: A Clinical and Molecular Review.

              Yasmeen Butt, Anna Kurdowska, Timothy Allen (2016)
              Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are a continuum of lung changes arising from a wide variety of lung injuries, frequently resulting in significant morbidity and frequently in death. Research regarding the molecular pathophysiology of ALI/ARDS is ongoing, with the aim toward developing prognostic molecular biomarkers and molecular-based therapy.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Pharmacol
                Journal ID (iso-abbrev): Front Pharmacol
                Journal ID (publisher-id): Front. Pharmacol.
                Title: Frontiers in Pharmacology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1663-9812
                Publication date (Electronic): 10 August 2022
                Publication date Collection: 2022
                Volume: 13
                Electronic Location Identifier: 946554
                Affiliations
                [1] 1 Department of Vascular Surgery, General Surgery Center, The First Hospital of Jilin University , Chasngchun, JL, China
                [2] 2 Center for Pathogen Biology and Infectious Diseases , Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education , Department of Respiratory Medicine , State Key Laboratory for Zoonotic Diseases , The First Hospital of Jilin University , Changchun, China
                Author notes

                Edited by: Bing Chun Yan, Yangzhou University, China

                Reviewed by: Nasra Ayuob, Damietta University, Egypt

                Renping Liu, Nanchang University, China

                Di Qi, Chongqing Medical University, China

                *Correspondence: Han Liu, liuhan@ 123456jlu.edu.cn ; Lei Song, lsong@ 123456jlu.edu.cn

                This article was submitted to Experimental Pharmacology and Drug Discovery, a section of the journal Frontiers in Pharmacology

                Article
                Publisher ID: 946554
                DOI: 10.3389/fphar.2022.946554
                PMC ID: 9401633
                PubMed ID: 36034851
                SO-VID: 30d91bc7-d4b3-49ec-bce6-ca2667d8b6b7
                Copyright © Copyright © 2022 Wang, Luo, Jie, Li, Liu and Song.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 17 May 2022
                Date accepted : 27 June 2022
                Categories
                Subject: Pharmacology
                Subject: Systematic Review

                ScienceOpen disciplines: Pharmacology & Pharmaceutical medicine
                Keywords: acute lung injury,terpenoids,lipopolysaccharide,lung wet-to-dry weight ratio,animal model
                Data availability:
                ScienceOpen disciplines: Pharmacology & Pharmaceutical medicine
                Keywords: acute lung injury, terpenoids, lipopolysaccharide, lung wet-to-dry weight ratio, animal model

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