ObjectiveRecent studies reported that SLE is characterised by altered interactions between the microbiome and immune system. We performed a meta-analysis of publications on this topic.MethodsCase–control studies that compared patients with SLE and healthy controls (HCs) and determined the diversity of the gut microbiota and the abundance of different microbes were examined. Stata/MP V.16 was used for the meta-analysis. A Bonferroni correction for multiple tests was used to reduce the likelihood of false-positive results.ResultsWe included 11 case–control studies that examined 373 patients with SLE and 1288 HCs. These studies were performed in five countries and nine cities. Compared with HCs, patients with SLE had gut microbiota with lower Shannon-Wiener diversity index (weighted mean difference=−0.22, 95% CI −0.32 to –0.13, p<0.001) and lower Chao1 richness (standardised mean difference (SMD)=−0.62, 95% CI −1.04 to –0.21, p=0.003). Patients with SLE had lower abundance of Ruminococcaceae (SMD = −0.49, 95% CI −0.84 to −0.15,p=0.005), but greater abundance of Enterobacteriaceae (SMD=0.45, 95% CI 0.01 to 0.89, p=0.045) and Enterococcaceae (SMD=0.53, 95% CI 0.05 to 1.01, p=0.03). However, only the results for Ruminococcaceae passed the Bonferroni correction (p=0.0071). The two groups had no significant differences in Lachnospiraceae and Bacteroides (both p>0.05). Patients with SLE who used high doses of glucocorticoids had altered gut microbiota based on the Chao1 species diversity estimator, and hydroxychloroquine use appeared to reduce the abundance of Enterobacteriaceae.ConclusionsPatients with SLE have imbalanced gut microbiota, with a decrease in beneficial bacteria and an increase in harmful bacteria. Drugs used to treat SLE may also alter the gut microbiota of these patients.
Objective This study aims to evaluate pharmacological and behavioral interventions for the treatment of fatigue in Parkinson's disease (PD) patients. Methods We systematically searched PubMed, PsycINFO, Web of Science, EMBASE, CNKI, Wan fang, and VIP up to July 31, 2022. We used Revman 5.3 software for the meta-analysis. The outcomes included Fatigue Severity Scale (FSS) and Parkinson's Fatigue Scale (PFS). The mean difference (MD) and 95% confidence intervals (CI) were collected or calculated. Results Thirteen randomized controlled trials (RCTs) with a total of 1758 patients were included. The meta-analysis showed that current clinical treatments reduced FSS (MD: −1.60, 95% CI: −3.14 to −0.05) and PFS (MD: −0.61, 95% CI: −1.17 to −0.05) in patients with PD. Subgroup meta-analysis showed that: (1) neither pharmacological interventions nor behavioral interventions reduced FSS in PD patients; (2) dopaminergic drugs dose-dependently significantly reduced the PFS in patients with PD; (3) behavioral interventions have an almost significant effect (MD: −6.69, 95% CI: −13.71 to 0.33, P = 0.06, I2 = 74%) on alleviating PFS in PD patients; (4) vestibular rehabilitation training significantly reduced the PFS in patients with PD. Conclusions Current clinical treatments alleviate fatigue in PD patients. Dopaminergic drugs may act a stronger effect than amphetamines. Behavioral interventions, especially vestibular rehabilitation training, may be a promising way for the treatment of fatigue in patients with PD though further evidence is still needed.
Objectives: To assess the efficacy and safety of oral glucokinase activator (GKA) in the treatment of type 2 diabetes mellitus(T2DM). Methods: We searched PubMed, ClinicalTrails, Cochrane Library, Web of Science, and CNKI and collected randomized controlled trials (RCTs) of glucokinase activator in the treatment of T2DM. Revman5.3 software was used to do the meta-analysis. And the risk of bias in the included RCTs was evaluated according to the Cochrane tool. Results: Seven double-blind RTCs were included in the final analysis, with a total of 762 patients. Regarding the efficacy, GKAs significantly reduced fasting blood glucose (mean difference-0.71, 95% CI:-1.11 to-0.31, based on 459 patients from 5 literatures), and glycated hemoglobin also significantly reduced (mean difference:-0.65%, 95% CI:-0.82 to-0.48, based on 570 patients from 4 literatures). Regarding safety, GKAs did not affect the total rate of adverse events(AEs) (relative risk(RR) 1.11, 95% CI:
Introduction: Evaluate the changes of gut Microbiota in patients with Systemic Lupus Erythematosus (SLE) and healthy people by meta-analysis. Methods We searched the case-control studies of SLE and healthy controls (HCs) for detecting the diversity of gut Microbiota and the abundance level of some microbiota in the two groups. StataMP16 software was applied for this meta-analysis. The Newcastle-Ottawa quality assessment scale (NOS) was used to assess the quality of the included studies. Results Eleven case-control studies were included. There were 373 SLE patients and 1288 healthy people, involving 5 countries and 9 different cities. Compared with the HCs, the Shannon-wiener diversity index (WMD=-0.22; 95% CI=-0.32 to -0.13; P = 0.000) and Chao1 richness estimator (SMD=-0.62; 95% CI=-1.04 to -0.21; P = 0.003) of gut Microbiota in SLE decreased, and the abundance level of Ruminococcaceae decreased (SMD=--0.48; 95% CI = 0.76 to-0.21; P = 0.001). Enterobacteriaceae (SMD = 0.39,95% CI = 0.11 to 0.66;P = 0.006) and Enterococcaceae (SMD = 0.55; 95% CI = 0.19 to 0.9; P = 0.03) showed higher abundance levels in comparison with HCs. The subgroup analysis showed the abundance level of Ruminococcaceae (SMD=-0.89; 95% CI =-1.34 to -0.45; P = 0.000) was lower and Enterococcaceae was higher (SMD = 0.77; 95% CI = 0.34 to 1.21༛P = 0.001) in Chinese with SLE compared with HCs. In non-Chinese patients with SLE, there were no significant difference between the abundance level of Ruminococcaceae (SMD=-0.22; 95% CI=--0.58 to 0.13; P = 0.216) and Enterococcaceae (SMD=-0.08; 95% CI=-0.49 to 0.32; P = 0.682 ) with HCs. The subgroup analysis also found the level of Enterobacteriaceae was affected by the sample size. Conclusion Compared with the diversity of healthy people, richness and evenness of gut microbiota in patients with SLE are impaired. There is a decrease in the abundance level of beneficial bacteria and an increase in the harmful bacteria. Thus, gut microbiota in patients with SLE appear disorder, which may lead to metabolic imbalance, destruction of the integrity of the small intestine, immune system disorders and pro-inflammatory. Regulating the abundance of gut microbiota can be used as one of the key strategies for treating SLE.
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