title: The Efficacy and Immunomodulatory Effects of Ulinastatin and Thymosin α1 for Sepsis: A Systematic Review and Meta-Analysis.
abstract: Objective. To systematically review the efficacy and potential immunomodulatory effect of ulinastatin combined with thymosin α1 (UTI) for sepsis. Design. A systematic review and meta-analysis of randomized controlled trials (RCTs). Data Sources. The following databases: PubMed, Embase, and Cochrane Central were searched to identify related clinical trials. The search terms were "ulinastatin", "thymosin", and "sepsis". Results. Six RCTs, 944 septic patients in total, were included in this meta-analysis. The result shows UTI increased the 28-day survival rate of septic patients, odds ratio (OR) = 2.01, 95% CI [1.53, 2.64]. After the treatment with UTI, the APACHE II score (four studies) dropped 4.72 further, mean = -4.72, 95% CI [-6.54, -2.91] (p < 0.00001). The mean time of ICU stay (four studies) in UTI group decreased 3.03 days further, mean = -3.03 [-6.99, 0.95] (p = 0.14), and mechanical ventilation time (four studies) decreased 2.05 days, mean = -1.81 [-2.96, -0.66] (p = 0.002). With the treatment of UTI, CD4+T cells raised 5.13%, mean = 5.13, 95% CI [2.75, 7.50] (p < 0.0001); there was no significant change in CD8+T cells, mean = -0.74 [-2.93, 1.45] (p = 0.51). Conclusion. According to this meta-analysis, with the treatment of UTI, the short-term survival rate of septic patients was increased and the illness severity was alleviated. ICU stay and mechanical ventilation time were effectively shortened. The beneficial effect of UTI might be due to the potential immunomodulatory effects of these two drugs.
authors.affiliation: First People's Hospital of Foshan, Critical Care Department, Foshan 528000, China.
authors.forename: Feng Yun
authors.initials: FY
authors.lastname: Wang
authors.affiliation: First People's Hospital of Foshan, Critical Care Department, Foshan 528000, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Fang
authors.affiliation: First People's Hospital of Foshan, Critical Care Department, Foshan 528000, China.
authors.forename: Xin Hua
authors.initials: XH
authors.lastname: Qiang
authors.affiliation: First People's Hospital of Foshan, Critical Care Department, Foshan 528000, China.
authors.forename: Tie Ou
authors.initials: TO
authors.lastname: Yu
authors.affiliation: First People's Hospital of Foshan, Critical Care Department, Foshan 528000, China.
authors.forename: Jia Rong
authors.initials: JR
authors.lastname: Zhong
authors.affiliation: First People's Hospital of Foshan, Critical Care Department, Foshan 528000, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: First People's Hospital of Foshan, Critical Care Department, Foshan 528000, China.
authors.forename: Li Xin
authors.identifier: 0000-0003-3385-4881
authors.initials: LX
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D005260:Female; D006023:Glycoproteins / Q000008:administration & dosage*; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000401:mortality; D012131:Respiratory Insufficiency / Q000401:mortality* / Q000517:prevention & control; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D015996:Survival Rate; D000077596:Thymalfasin; D013947:Thymosin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D006023:Glycoproteins; D007155:Immunologic Factors; D013947:Thymosin; C028665:urinastatin; D000077596:Thymalfasin