Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studies

ObjectivesThe aim of this systematic review and meta-analysis is to synthesize the effects and mechanisms of Tetramethylpyrazine (TMP) on renal outcomes in animal models of renal I/R injury.MethodsAnimal studies from seven electronic databases were searched up to October 2024. The risk of bias of th...

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Main Authors: Zhongmei Fu, Lianyan Jiang, Xiaojuan Su, Hua Wang, Mingquan Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1559314/full
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author Zhongmei Fu
Lianyan Jiang
Xiaojuan Su
Hua Wang
Mingquan Li
author_facet Zhongmei Fu
Lianyan Jiang
Xiaojuan Su
Hua Wang
Mingquan Li
author_sort Zhongmei Fu
collection DOAJ
description ObjectivesThe aim of this systematic review and meta-analysis is to synthesize the effects and mechanisms of Tetramethylpyrazine (TMP) on renal outcomes in animal models of renal I/R injury.MethodsAnimal studies from seven electronic databases were searched up to October 2024. The risk of bias of the selected studies was assessed using the SYRCLE risk of bias tool. Standardized mean difference (SMD) or mean difference (MD) were estimated for the effects of TMP on serum creatinine (Scr), blood urea nitrogen (BUN), oxidative stress, inflammation and apoptotic. Random-effects models were used to summarize results. Heterogeneity was expressed as I2. Subgroup analyses were used to clarify the sources of heterogeneity. Egger’s test was used to assess publication bias. Sensitivity analyses were used to assess the robustness of the results. Statistical analysis was performed using RevMan 5.3 software.ResultsThirty studies involving 559 animals were identified for analysis. TMP treatment significantly decreased Scr (SMD = 2.35, 95% CI: −2.97 to −1.72, P < 0.05), BUN (SMD = −2.4, 95% CI: −3.01 to −1.79, P < 0.05). TMP treatment significantly improved oxidative stress expression (i.e., SOD, MDA, GSHPX, CAT, TAC) and alleviated inflammation levels (i.e., TNF-α, ICAM-1, IL-6, IL-10, NLRP3). TMP treatment also regulate the expression of apoptosis-related proteins (i.e., bcl-2, Bax, caspase 3, Caspase-12 and GRP78).ConclusionTMP could improve renal outcomes and alleviate injury through multiple signaling pathways. However, positive results should be treated with caution due to the significant heterogeneity and poor quality of the included studies.Systematic Review RegistrationCRD420251017081.
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spelling doaj-art-8d82a2371d1240df8a1267457134e4672025-08-20T03:18:44ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-06-011610.3389/fphar.2025.15593141559314Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studiesZhongmei Fu0Lianyan Jiang1Xiaojuan Su2Hua Wang3Mingquan Li4Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaClinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaOphthalmology, Hubei provincial hospital of Traditional Chinese Medicine, Wuhan, ChinaDepartment of pharmacy, Kunming Maternal and Child Health Care Hospital, Kunming, ChinaHospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaObjectivesThe aim of this systematic review and meta-analysis is to synthesize the effects and mechanisms of Tetramethylpyrazine (TMP) on renal outcomes in animal models of renal I/R injury.MethodsAnimal studies from seven electronic databases were searched up to October 2024. The risk of bias of the selected studies was assessed using the SYRCLE risk of bias tool. Standardized mean difference (SMD) or mean difference (MD) were estimated for the effects of TMP on serum creatinine (Scr), blood urea nitrogen (BUN), oxidative stress, inflammation and apoptotic. Random-effects models were used to summarize results. Heterogeneity was expressed as I2. Subgroup analyses were used to clarify the sources of heterogeneity. Egger’s test was used to assess publication bias. Sensitivity analyses were used to assess the robustness of the results. Statistical analysis was performed using RevMan 5.3 software.ResultsThirty studies involving 559 animals were identified for analysis. TMP treatment significantly decreased Scr (SMD = 2.35, 95% CI: −2.97 to −1.72, P < 0.05), BUN (SMD = −2.4, 95% CI: −3.01 to −1.79, P < 0.05). TMP treatment significantly improved oxidative stress expression (i.e., SOD, MDA, GSHPX, CAT, TAC) and alleviated inflammation levels (i.e., TNF-α, ICAM-1, IL-6, IL-10, NLRP3). TMP treatment also regulate the expression of apoptosis-related proteins (i.e., bcl-2, Bax, caspase 3, Caspase-12 and GRP78).ConclusionTMP could improve renal outcomes and alleviate injury through multiple signaling pathways. However, positive results should be treated with caution due to the significant heterogeneity and poor quality of the included studies.Systematic Review RegistrationCRD420251017081.https://www.frontiersin.org/articles/10.3389/fphar.2025.1559314/fulltetramethylpyrazinerenal ischemia-reperfusion injurypreclinical studymeta-analysissystematic review
spellingShingle Zhongmei Fu
Lianyan Jiang
Xiaojuan Su
Hua Wang
Mingquan Li
Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studies
Frontiers in Pharmacology
tetramethylpyrazine
renal ischemia-reperfusion injury
preclinical study
meta-analysis
systematic review
title Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studies
title_full Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studies
title_fullStr Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studies
title_full_unstemmed Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studies
title_short Tetramethylpyrazine and renal ischemia-reperfusion injury: a systematic review and meta-analysis of preclinical studies
title_sort tetramethylpyrazine and renal ischemia reperfusion injury a systematic review and meta analysis of preclinical studies
topic tetramethylpyrazine
renal ischemia-reperfusion injury
preclinical study
meta-analysis
systematic review
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1559314/full
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