Transforming growth factor-ß and matrix metalloproteinases as potential biomarkers of fibrotic lesions induced by tuberculosis: a systematic review and meta-analysis.

OBJECTIVES: Very few studies and limited information are available regarding the mechanism of fibrosis in tuberculosis (TB). This study aimed to identify, describe and synthesise potential biomarkers of the development of tissue fibrosis induced by TB through a systematic method and meta-analysis. METHODS: A literature search was performed using keywords according to the topic from electronic databases (ScienceDirect and PubMed) and other methods (websites, organisations and citations). Studies that matched predetermined eligibility criteria were included. The quality assessment tool used was the Quality Assessment of Diagnostic Accuracy Score 2, and the data obtained were processed using Review Manager V.5.3. RESULTS: Of the 305 studies, 7 met the eligibility criteria with a total sample of 365. The results of the meta-analysis showed that the post-TB group of patients with pulmonary parenchymal fibrosis had a higher transforming growth factor (TGF)-ß level (6.09) than the control group (1.82), with a 4.27 (95% CI: 0.92 to 7.61) mean difference. Moreover, patients with residual pleural thickening post-TB had a higher mean of TGF-ß (0.61) than the control group (0.56), with a 0.05 (95% CI: 0.04 to 0.06) mean difference. Besides TGF-ß, our qualitative synthesis also found that matrix metalloproteinase-1 might have a role in forming and developing pulmonary tissue fibrosis, thus, could be used as a predictor marker in the formation of fibrotic lesions in patients with TB. In addition, several other biomarkers were assessed in the included studies, such as tumour necrosis factor-α, interleukin (IL)-4, IL-8, IL-10, plasminogen activator inhibitor-1 and platelet-derived growth factor. However, this study is not intended to examine these biomarkers. CONCLUSIONS: There were differences in the results of TGF-ß levels in patients with fibrotic lesions compared with controls. TGF-ß might be a biomarker of fibrotic tissue formation or increased pulmonary tissue fibrosis in post-TB patients. However, further studies are needed on a larger scale.

Efficacy of Prolotherapy for Osteoarthritis: A Systematic Review.

OBJECTIVE: Current treatments for osteoarthritis do not resolve the underlying cause. Dextrose prolotherapy is an alternative method that has been proposed for treatment of osteoarthritis, due to its ability to aid tissue regeneration, improve clinical manifestations, and repair damaged tissue structures, which are pathological conditions in osteoarthritis. The aim of this systematic review was to evaluate the efficacy of dextrose prolotherapy compared with other interventions in the management of osteoarthritis. METHODS: Electronic databases PubMed, Google Scholar, Cochrane, and BioMed Central were searched from inception to October 2021. Search terms included [(prolotherapy) OR (prolotherapies) OR (dextrose prolotherapy)] AND [(osteoarthritis) OR (osteoarthritides) OR (knee osteoarthritis) OR (hip osteoarthritis) OR (hand osteoarthritis) OR (shoulder osteoarthritis)]. Randomized controlled trials that compared the use of dextrose prolotherapy with other interventions (injection, placebo, therapy, or conservative treatment) in the treatment of osteoarthritis were included. Potential articles were screened for eligibility, and data were extracted by all authors. Risk of bias was assessed using the Cochrane Risk of Bias tool. Study population, methods, and results data were extracted and tabulated by 3 authors. RESULTS: 12 studies reported that DPT was as effective or even more effective in improving functional outcomes compared with other interventions whilst others found that HA, PRP, EP, and ACS were more effective. 14 studies assessed the effectiveness of DPT and ten of them reported that DPT was more effective in reducing pain compared with other interventions. CONCLUSION: Dextrose prolotherapy in osteoarthritis confers potential benefits for pain and functional outcomes, but this systematic review found that the studies to date are at high risk of bias.

Role of hypertension as a risk factor for open-angle glaucoma: a systematic review and meta-analysis.

Glaucoma is the leading cause of irreversible blindness. It is estimated that as many as 3.2 million people worldwide experience blindness due to glaucoma, including open-angle glaucoma (OAG). Until now, there is no definite mechanism related to the incidence of OAG. However, increased intraocular pressure (IOP) is considered to be the most important risk factor. Several current studies show that there is a significant relationship between hypertension (HTN) and IOP. In particular, several epidemiological studies have shown that an increase in systemic blood pressure (BP) is associated with an increase in IOP. However, several studies report that high BP provides a protective effect at a young age against the incidence of OAG. Therefore, this literature aims to explore the effect of HTN on the incidence of OAG. In this review, search for the literature using keywords that match the topic, then a gradual screening was carried out with the predetermined eligibility criteria. From 3711 studies, 16 studies matched the criteria having a total sample size of 72 212 and then a quantitative meta-analysis was conducted. The results showed a risk ratio of 1.69 (95% CI 1.50 to 1.90) in the HTN group. However, from our qualitative synthesis, we found that people who have an unstable diastolic blood pressure (DBP), either high or low, are both able to increase the risk of OAG events. In conclusion, we found that HTN was able to increase the risk of OAG and DBP instability, whether high or low, can also increase the risk of OAG incidence.