Abstract
With the increase of the aging population, the high mortality and disability rates caused by ischemic stroke are some of the major problems facing the world, and they dramatically burden the society. Panax notoginseng (Burk) F. H. Chen, a traditional Chinese medicine, is commonly used for promoting blood circulation and removing blood stasis, and its main bioactive components are Panax notoginseng saponins (PNS). Therefore, we performed a meta-analysis on focal cerebral ischemia-reperfusion animal models established with middle cerebral artery occlusion (MCAO) surgery to evaluate the therapeutic effect of PNS. We systematically searched the reports of PNS in MCAO animal experiments in seven databases. We assessed the study quality using two literature quality evaluation criteria; evaluated the efficacy of PNS treatment based on the outcomes of the neurological deficit score (NDS), cerebral infarct volume (CIV), and biochemical indicators via a random/fixed-effects model; and performed a subgroup analysis utilizing ischemia duration, drug dosage, intervention time, and administration duration. We also compared the efficacy of PNS with positive control drugs or combination treatment. As a result, we selected 14 eligible studies from the 3,581 searched publications based on the predefined exclusion-inclusion criteria. PNS were significantly associated with reduced NDS, reduced CIV, and inhibited release of the inflammatory factors IL-1β and TNF-α in the focal MCAO rat models. The PNS combination therapy outperformed the PNS alone. In addition, ischemia time, drug dosage, intervention time, and administration duration in the rat models all had significant effects on the efficacy of PNS. Although more high-quality studies are needed to further determine the clinical efficacy and guiding parameters of PNS, our results also confirmed that PNS significantly relieves the focal cerebral ischemia-reperfusion in rat models. In the animal trials, it was suggested that an early intervention had significant efficacy with PNS alone or PNS combination treatment at a dosage lower than 25 mg/kg or 100–150 mg/kg for 4 days or longer. These findings further guide the therapeutic strategy for clinical cerebral ischemic stroke.
Highlights
As the population ages, stroke, especially ischemic stroke, has become a serious disease that threatens human life (Benjamin et al, 2018)
Based on a large-scale trove of experimental animal data, this study systematically evaluated and meta-analyzed the efficacy of Panax notoginseng saponins (PNS) in middle cerebral artery occlusion (MCAO) animal models with focal cerebral ischemia-reperfusion (I/R)
After heterogeneity judgment and sensitivity analysis, 43 study groups with 749 participants were included in our study
Summary
Stroke, especially ischemic stroke, has become a serious disease that threatens human life (Benjamin et al, 2018). The global prevalence of cerebrovascular disease was 80.1 million people in 2016 Of these patients, 67.6 million were affected by ischemic stroke (Benjamin et al, 2018; Benjamin, 2020). Based on comparisons in the past few decades, the prevalence and mortality rates of stroke have generally declined in high-income countries, but no significant changes have been found in low- and middle-income countries (Nogles and Galuska, 2020). This situation is likely related to advancements in the awareness, treatment, and control rates of modifiable risk factors in higher-income countries. The incidence of hemorrhagic stroke has decreased by 1.7% annually, and the ischemic stroke has increased by 8.7% from 1984 to 2004 (Boehme et al, 2017)
Published Version (Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have