The Efficacy and Immunomodulatory Effects of Ulinastatin and Thymosin<i>α</i>1 for Sepsis: A Systematic Review and Meta-Analysis

Wang, Shou Zhen; Fang, Bin; Qiang, Xin; Yu, Tie Ou; Zhong, Jia; Cao, Jun; Zhou, Li

doi:10.1155/2016/9508493

Cited by 12 publications

(12 citation statements)

References 30 publications

(25 reference 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%

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%

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

et al. 2019

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“…Cardiac microvascular dysfunction in sepsis has been demonstrated (5) and the protective role of ulinastatin against sepsis has also been reported (22). Nevertheless, the effects of ulinastatin on CMVEC dysfunction in sepsis are still unclear.…”

Section: Discussionmentioning

confidence: 99%

Ulinastatin protects against lipopolysaccharide-induced cardiac microvascular endothelial cell dysfunction via downregulation of lncRNA MALAT1 and EZH2 in sepsis

Rayile

Zhang

et al. 2017

International Journal of Molecular Medicine

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The present study aimed to evaluate the effects of ulinastatin on the permeability and apoptosis of lipopolysaccharide (LPS)-induced cardiac microvascular endothelial cells (CMVECs), and investigate its molecular mechanisms in sepsis. The sepsis rat model was induced by cecal ligation and puncture (CLP), and rat CMVECs were isolated and treated with LPS or/and ulinastatin. Then, cell permeability was evaluated by transendothelial electrical resistance, reactive oxygen species (ROS) levels were assessed by 2,7-dichlorofluorescein diacetate, cell apoptosis was detected using Annexin V-FITC apoptosis detection kit, and the expression levels of Bcl-2, Bax, caspase-3, metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and EZH2 were detected by RT-qPCR and/or western blotting. In addition, the relationship of MALAT1 and EZH2 was evaluated by RNA immunoprecipitation (RIP) assay and chromatin immunoprecipitation (ChIP) assay. Compared with LPS-induced CMVECs, treatment with ulinastatin significantly reduced CMVEC permeability and the percentage of apoptotic cells, as well as an increased level of Bcl-2 and inhibited the levels of ROS, caspase-3 and Bax (all p<0.05). In addition, long non-coding RNA (lncRNA) MALAT1 was confirmed to interact with EZH2 in CMVECs. Overexpression of lncRNA MALAT1 and EZH2 was found in the hearts of the sepsis rat and LPS-induced CMVECs, while ulinastatin inhibited the upregulation of lncRNA MALAT1 and EZH2 in the LPS-induced CMVECs (all p<0.05). Ulinastatin protected against LPS-induced CMVEC cell hyperpermeability and apoptosis via downregulation of lncRNA MALAT1 and EZH2 in sepsis.

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“…Notably, regarding the blood analysis, SARS-CoV-2 is mainly characterised by low numbers of both white blood cells and lymphocytes. Thymosin a1-a, as a widely used immunomodulatory agent, was given to the patient to enhance his immunity during the treatment [5]. After injection, the number of lymphocytes and the lymphocyte percentage of the patient returned to normal, and no drug-related fever or allergic reactions were detected.…”

Section: Sars-mentioning

confidence: 99%

SARS-CoV-2: minireview and review of first case in Foshan, China

et al. 2020

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The outbreak of the 2019 new coronavirus pneumonia has caught worldwide attention. Since December 2019, several pneumonia cases of unknown origin have been found in hospitals in Wuhan, Hubei Province, China. The Chinese epidemic prevention authorities have quickly organised laboratories to conduct pathogen tests on alveolar lavage fluid, throat swabs, blood and other samples by methods of virus isolation, nucleic acid testing and genome sequencing, among others. On 7 January 2020, a novel coronavirus, previously undetected in humans, was isolated and its full genome sequence was decoded [1]. On 12 January 2020, the World Health Organization (WHO) officially named this new coronavirus causing the outbreak of pneumonia in Wuhan the "2019 new coronavirus (SARS-CoV-2)." Since the end of December 2019, the number of cases with SARS-CoV-2 infection has increased rapidly. As of 24:00 h on 13 February, there were 63 946 confirmed cases of SARS-CoV-2 acute respiratory disease in China and 162 confirmed cases in 26 other countries. WHO has classified this outbreak as a public health emergency of international concern. The outbreak of SARS-CoV-2 seriously endangers human health and life, affects the social order, and causes substantial economic losses. Currently, there are no effective drugs for SARS-CoV-2, and its primary treatment is only symptomatic and supportive. Critically ill patients are in danger at any time. Timely measures to prevent the occurrence of severe pneumonia and the development of acute respiratory distress syndrome (ARDS) are the key to the treatment of SARS-CoV-2. Although the pathogenesis of SARS-CoV-2 is unclear, its molecular mechanism of infecting human respiratory epithelial cells through the Spike protein is the same as that of SARS-CoV-1 and the symptoms caused by its infection are similar to those of severe acute respiratory syndrome (SARS). At the end of 2002, our hospital had hospitalised and cured the world's first SARS patient, and the total number of these cases admitted and confirmed would surpass 110. No hospitalised patients died and all were eventually discharged. Our hospital has gained meaningful experience in the treatment of severe pneumonia caused by coronavirus infection. To provide a reference for the treatment of SARS-CoV-2, we report the detailed history, onset, disease evolution, diagnosis and treatment of the first case of SARS-CoV-2 in Foshan, China. This patient was a 40-year-old man with no underlying disease other than hypertension. The patient had no recent travel history to Hubei Province or Wuhan but his wife had recently travelled to Wuhan and returned to Foshan City (Guangdong Province) on 6 January 2020. During her trip, she had a low fever and cough but symptoms were relieved within 1 week without any treatments. The patient went to Guangzhou South railway station, a crowded high-speed rail hub, to pick up his wife. On 10 January 2020, the patient began to get sick, with fever as the initial symptom. There was no discernible pattern of fever, and the highest temp...

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The Efficacy and Immunomodulatory Effects of Ulinastatin and Thymosinα1 for Sepsis: A Systematic Review and Meta-Analysis

Cited by 12 publications

References 30 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

Ulinastatin protects against lipopolysaccharide-induced cardiac microvascular endothelial cell dysfunction via downregulation of lncRNA MALAT1 and EZH2 in sepsis

SARS-CoV-2: minireview and review of first case in Foshan, China

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