Effect of ulinastatin combined with thymosin alpha1 on sepsis: A systematic review and meta-analysis of Chinese and Indian patients

Liu, Dadong; Yu, Zongying; Yin, Jie; Chen, Yikun; Zhang, Hao; Fan, Xiaoxuan; Fu, Haiyan; Wan, Bing

doi:10.1016/j.jcrc.2017.02.005

Cited by 4 publications

(4 citation statements)

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“…Recently, clinical trials in sepsis patients treated with UTI or UTI combined with thymosin α1 showed a survival benefit trend (Wu et al, 2013a; Karnad et al, 2014). Meanwhile, five meta-analysis of studies in sepsis patients either UTI administration alone or a combination of UTI and thymosin α1 have been published (Han et al, 2015; Li et al, 2015; Feng et al, 2016; Wang et al, 2016; Liu et al, 2017). Among these five meta-analysis, two meta-analysis (Feng et al, 2016; Liu et al, 2017) analyzed the effect of using UTI alone and no significant difference between UTI group and control group in the 28-day mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Meanwhile, five meta-analysis of studies in sepsis patients either UTI administration alone or a combination of UTI and thymosin α1 have been published (Han et al, 2015; Li et al, 2015; Feng et al, 2016; Wang et al, 2016; Liu et al, 2017). Among these five meta-analysis, two meta-analysis (Feng et al, 2016; Liu et al, 2017) analyzed the effect of using UTI alone and no significant difference between UTI group and control group in the 28-day mortality. Given that the results of these two meta-analysis are based on subgroup analysis, which included the same two trials (Wu et al, 2013a; Karnad et al, 2014), it is difficult to prove the effect of UTI alone.…”

Section: Introductionmentioning

confidence: 99%

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Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2019

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Background: Ulinastatin has been prescribed to treat sepsis. However, there is doubt regarding the extent of any improvement in outcomes to guide future decision making.Objectives: To evaluate the effects of ulinastatin on mortality and related outcomes in sepsis patients.Methods: Thirteen randomized controlled trials and two prospective studies published before September 1, 2018, that included 1358 patients with sepsis, severe sepsis, or septic shock were evaluated. The electronic databases searched in this study were PubMed, Medline, Embase, and China National Knowledge Infrastructure (CNKI) for Chinese Technical Periodicals.Results: Ulinastatin significantly decreased the all-cause mortality {odds ratio (OR) = 0.48, 95% confidence interval (CI) [0.35–0.66], p < 0.00001, I2 = 13%}, Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score {mean difference (MD) = −2.40, 95% CI [−4.37, −0.44], p = 0.02, I2 = 66%}, and reduced the incidence of multiple organ dysfunction syndrome (MODS) (OR = 0.3, 95% CI [0.18, 0.49], p < 0.00001, I2 = 0%). Ulinastatin also decreased the serum levels of IL-6 (MD = −88.5, 95% CI [−123.97, −53.04], p < 0.00001), TNF-α (MD = −56.22, 95% CI [−72.11, −40.33], p < 0.00001), and increased the serum levels of IL-10 (MD = 37.73, 95% CI [16.92, 58.54], p = 0.0004). Ulinastatin administration did not lead to any difference in the occurrence of adverse events.Conclusions: Ulinastatin improved all-cause mortality and other related outcomes in patients with sepsis or septic shock. The results of this meta-analysis suggest that ulinastatin may be an effective treatment for sepsis and septic shock.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2019

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“…Animal studies suggest that high-dose ulinastatin achieves a comparable anti-inflammatory effect to glucocorticoids (Xu et al, 2018). In 2017, a meta-analysis of eight RCTs suggested that ulinastatin combined with thymosin α1 (Tα1) in sepsis patients suppressed pro-inflammatory factor production, reduced the Acute Physiology and Chronic Health Evaluation (APACHE) II score, shortened the durations of mechanical ventilation, and improved the 28-days survival rate (Liu et al, 2017). In addition, it does not induce immunosuppression and causes fewer side effects than glucocorticoids.…”

Section: Ulinastatinmentioning

confidence: 99%

Immune Intervention in Sepsis

Chen

Wei

2021

Front. Pharmacol.

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Sepsis is a host immune disorder induced by infection. It can lead to multiple organ dysfunction syndrome (MODS), which has high morbidity and mortality. There has been great progress in the clinical diagnosis and treatment of sepsis, such as improvements in pathogen detection technology, innovations regarding anti-infection drugs, and the development of organ function support. Abnormal immune responses triggered by pathogens, ranging from excessive inflammation to immunosuppression, are recognized to be an important cause of the high mortality rate. However, no drugs have been approved specifically for treating sepsis. Here, we review the recent research progress on immune responses in sepsis to provide a theoretical basis for the treatment of sepsis. Constructing and optimizing a dynamic immune system treatment regimen based on anti-infection treatment, fluid replacement, organ function support, and timely use of immunomodulatory interventions may improve the prognosis of sepsis patients.

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“…Thymalfasin, also known as thymosin alpha-1, is a polypeptide hormone generated by thymic epithelial cells which can effectively increase the number of T cells, support T cell differentiation and maturation, and reduce apoptosis. Pathological observation of previous clinical studies [3] have con rmed the therapeutic e cacy of Thymalfasin in patients infected by hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunode ciency virus (HIV). Some current studies have demonstrated that thymosin drugs can increase the number of lymphocytes of COVID-19 patients and even reduce the mortality rate of critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

Early use of Thymalfasin prevents progression of common COVID-19 infection to severe pneumonia

Wang¹,

Wang²,

Fei³

et al. 2023

Preprint

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Introduction Thymosin drugs are commonly used for the treatment of viral infections due to their immunomodulatory effects. Whether the use of thymosin drugs can reduce the rate of COVID-19 progression to severe pneumonia has not been well documented. The aim of the present study was to explore the clinical value of Thymalfasin in preventing COVID-19 progression to severe pneumonia by retrospective review of the clinical data of 338 inpatients with common COVID-19 infection who received treatment in our hospital. Methods The primary index of observation was whether progression to severe pneumonia occurred within a week after admission, and the secondary indexes were the length of hospital stay, time of negative conversion of COVID-19 antigen, the number of peripheral lymphocytes and white blood cells (WBC), and C-reactive protein (CRP) and procalcitonin (PCT) levels. Results The length of hospital stay of patients in Thymalfasin group was significantly shorter than that of patients in the control group (p < 0.01). Multivariate logistic regression analysis showed that the use of Thymalfasin was an independent protective factor affecting the progression to severe pneumonia. Multifactorial Cox model analysis indicated that negative conversion of COVID-19 antigen was significantly faster in patients using Thymalfasin and younger patients. Conclusion Thymalfasin can prevent progression of common COVID-19 infection to severe pneumonia via multiple immunity-enhancing and anti-inflammatory protective mechanisms. However, it is necessary to grasp the timing of treatment to achieve better therapeutic effects. The present study demonstrated that use of Thymalfasin within a week of confirmed diagnosis of COVID-19 infection could offer greater clinical efficacy.

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Effect of ulinastatin combined with thymosin alpha1 on sepsis: A systematic review and meta-analysis of Chinese and Indian patients

Abstract: Treatment of UTI+Tα1 can suppress the production of proinflammatory cytokines, decrease the APACHE II score, shorten the duration of mechanical ventilation and vasopressor use, and improve the 28-day survival rate.

Cited by 4 publications

References 5 publications

Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Immune Intervention in Sepsis

Early use of Thymalfasin prevents progression of common COVID-19 infection to severe pneumonia

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