Effect of pentoxifylline on serum levels and gene expression of inflammatory markers: a systematic review and meta-analysis of randomized controlled trials.

IF 5.3 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2025-09-10 DOI:10.1007/s10787-025-01936-2

Banafsheh Safizadeh, Sahar Yarahmadi, Farzad Sadri, Elham Bahreini, Yaser Mohammadi, Taraneh Rezaei

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引用次数: 0

Abstract

Background: Pentoxifylline (PTX), a methylxanthine derivative, has been recognized as a potential anti-inflammatory treatment across various conditions, yet its effects on inflammatory markers remain inconsistent. This systematic review/meta-analysis evaluated the impact of PTX on serum levels and gene expression of key inflammatory markers in randomized controlled trials (RCTs).

Methods: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, and ProQuest up to May 2025. Search results were screened in two stages by two independent reviewers. Data was extracted and the quality of the studies included was assessed using the Cochrane Risk of Bias (RoB) tool. Statistical analysis was performed using STATA -17. The present study was conducted in accordance with the PRISMA guidelines.

Results: This study included 81 RCTs involving 7,058 participants. PTX treatment significantly reduced serum levels of CRP (SMD = -0.30, 95% CI: -0.47 to -0.13), IL-6 (SMD = -0.51, 95% CI: -0.81 to -0.22), TNF-α (SMD = -0.72, 95% CI: -0.95 to -0.48), and IL-8 (SMD = -1.14, 95% CI: -1.94 to -0.33) compared to controls. No statistically significant effects were observed for IL-1β, ESR, IL-10, or TNFR. High heterogeneity was noted in most outcomes, partly attributed to variations in age, treatment duration, dosage, geographic region, and health conditions. Subgroup analyses revealed that younger patients, shorter interventions, and lower PTX doses were associated with stronger anti-inflammatory responses.

Conclusion: PTX reduces TNF-α, IL-6, IL-8, and CRP, supporting its role in chronic inflammatory diseases. Efficacy varies by age, dose, duration, geography, and disease, requiring personalized treatment. Contradictory biomarker effects and study limitations warrant high-quality trials with standardized protocols.

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己酮茶碱对血清水平和炎症标志物基因表达的影响：随机对照试验的系统回顾和荟萃分析。

背景：己酮茶碱（PTX）是一种甲基黄嘌呤衍生物，已被认为是一种潜在的抗炎治疗方法，但其对炎症标志物的影响仍不一致。本系统综述/荟萃分析在随机对照试验（rct）中评估了PTX对血清水平和关键炎症标志物基因表达的影响。方法：系统检索截至2025年5月的PubMed、Scopus、Embase、Web of Science、ProQuest等数据库。搜索结果由两名独立审查员分两个阶段进行筛选。提取资料，并使用Cochrane风险偏倚（RoB）工具评估纳入研究的质量。采用STATA -17进行统计分析。本研究是按照PRISMA指南进行的。结果：本研究纳入81项随机对照试验，涉及7058名受试者。与对照组相比，PTX治疗显著降低了血清CRP （SMD = -0.30, 95% CI: -0.47至-0.13）、IL-6 （SMD = -0.51, 95% CI: -0.81至-0.22）、TNF-α （SMD = -0.72, 95% CI: -0.95至-0.48）和IL-8 （SMD = -1.14, 95% CI: -1.94至-0.33）的水平。IL-1β、ESR、IL-10或TNFR未见统计学显著影响。大多数结果存在高度异质性，部分归因于年龄、治疗持续时间、剂量、地理区域和健康状况的差异。亚组分析显示，较年轻的患者、较短的干预和较低的PTX剂量与较强的抗炎反应相关。结论：PTX可降低TNF-α、IL-6、IL-8和CRP，支持其在慢性炎性疾病中的作用。疗效因年龄、剂量、持续时间、地理和疾病而异，需要个性化治疗。相互矛盾的生物标志物效应和研究局限性保证了采用标准化方案的高质量试验。

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]