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. 2022 Aug 10:13:946554.
doi: 10.3389/fphar.2022.946554. eCollection 2022.

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

Shuai Wang  1 , Sean X Luo  1 , Jing Jie  2 , Dan Li  2 , Han Liu  2 , Lei Song  2
Affiliations

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

Shuai Wang et al. Front Pharmacol. .

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.

Keywords: acute lung injury; animal model; lipopolysaccharide; lung wet-to-dry weight ratio; terpenoids.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

Figures

FIGURE 1
FIGURE 1
The flow diagram of the study identification and selection process.
FIGURE 2
FIGURE 2
The risk of bias and quality evaluation score (%) per risk of bias item.
FIGURE 3
FIGURE 3
The funnel plot for accessing publication bias.
FIGURE 4
FIGURE 4
The forest plot of therapeutic efficiency of terpenoids on lung wet-to-dry weight ratio. Subgroup analyses investigated the therapeutic efficiency of monoterpenoid, sesquiterpene, diterpenoid, and triterpenoid. CI, confidence interval; IV, inverse variance; Std, standard; SD, standard deviation.
FIGURE 5
FIGURE 5
The forest plot of therapeutic efficiency of the route of terpenoid administration on lung wet-to-dry weight ratio. Subgroup analyses evaluated the therapeutic efficiency of intraperitoneal injection, intravenous injection, and intragastric administration. CI, confidence interval; IV, inverse variance; Std, standard; SD, standard deviation.
FIGURE 6
FIGURE 6
The forest plot of therapeutic efficiency of terpenoid dose on lung wet-to-dry weight ratio. Subgroup analyses investigated therapeutic efficiency of high dose (>10 µmol/kg) and low dose (≤10 µmol/kg). CI, confidence interval; IV, inverse variance; Std, standard; SD, standard deviation.
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