Terapia antioxidante na doença inflamatória intestinal: uma revisão sistemática com metanálise de ensaios clínicos randomizados

Abstract

The objective of this study was to evaluate the action of substances used in the treatment of inflammatory bowel diseases (IBD) on biomarkers of oxidative stress and cytokine levels . For this review, a search was carried out in the PubMed, Science Direct and Scopus databases published until July 2023. The keywords were used: “inflammatory bowel disease”, “ulcerative colitis”, “colitis”, “Crohn Disease”, “antioxidant”, “Antioxidant Effects”, “Anti Oxidants”, “Agents, Antiinflammatory”, “Anti Inflammatories ”, “therapy”, “treatment”, “oxidative stress,” and “redox imbalance”. Clinical trials in humans were eligible for the systematic review and randomized clinical trials (RCTs) for meta-analysis that evaluated markers of oxidative stress (inhibition of the generation of reactive oxygen and nitrogen species - ERONS; action on enzymatic or non-enzymatic antioxidant defense; inhibition oxidative damage andeffectsonpro/anti-inflammatorycytokines.106studieswerefoundand after excluding those that did not meet the inclusion criteria, 19 were included in the systematic review and 8 in the meta-analysis (6 for the outcome total antioxidant capacity AOC; 6 for superoxide dismutase - SOD and 5 for peroxidation lipid analyzed using malondialdehyde - MDA). SOD was significantly modulated (RR = 0.3764, 95% CI[0.0262 to 0.7267], p = 0.035), but notAOC(RR:0.3424,95%CI[0.0334to0.7183],p=0.0742)or MDA (RR = - 0.8534, 95% CI [-1.9333 to 0.2265], p = 0.1214) for the treatments tested. These results suggest that SOD may be an important marker in the treatment of IBD. Its elevation contributes to reducing the formation of peroxynitrite, an important reactive nitrogen species that causes damage to several macromolecules, including lipid membrane and DNA, which would reduce tissue damage and mutations, respectively, contributing to a better prognosis of patients with IBD. Therefore, it is necessary that potential therapies tested for individuals with IBD include markers of oxidative stress, especially SOD, so that therapeutic approaches for these patients are better recognized.