Efeito dos imunossupressores tacrolimus e ciclosporina na regeneração de nervos periféricos : revisão sistemática e metanálise

Abstract

The present study aimed to review the scientific evidence of the impact of immunosuppressants Tacrolimus and Ciclosporin (CsA) in the regeneration of Peripheral Nerve Injuries (LNPs). For the systematic review with meta-analysis, studies available in all languages were searched and analyzed without restriction on publication date. The search was made from the inception until February 2018 in the following databases: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science, Oxford Pain Relief Database, and LILACS. This study analyzed results from 56 articles, of which 22 studies with animal models were meta-analyzed. The inverted variance method with random effects was used to aggregate the results of the meta-analysis. Study durations ranged from 7 days to 12 months. Tacrolimus's use showed significant effects in the increase of myelinated axons (SMD=1.66, 95%CI=0.93; 2.39), in the thickness of the myelin sheath (SMD= 3.85, 95%CI=2.00; 5.71), in the increase of the muscular weight (SMD= 2.45, 95%CI=0.68; 4.22), and the improvement of the sciatic function (SMD= 3.34, 95%CI=1.44; 5.24). CsA had no significant effects on increasing the number of myelinated axons (SMD= 0.40, 95%CI= -0.38; 1.18). The use of immunosuppressants, more specifically, Tacrolimus, had a significant effect in improving aspects related to neural regeneration of animals submitted to LNP.