IMR Press / JIN / Volume 21 / Issue 1 / DOI: 10.31083/j.jin2101011
Open Access Original Research
Dichotomous effects of autophagy on infarct volume in experimental permanent/transient ischemic stroke model: a systematic review and meta-analysis
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1 Cardiovascular Research Center, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
2 Emergency Medicine Research Team, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
3 Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
4 Stem Cell Research Center, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
5 Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
6 Research Development & Coordination Center, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
7 Neurosciences Research Center, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
*Correspondence: aysapharma.rezabakhsh@gmail.com; rezabakhsha@tbzmed.ac.ir (Aysa Rezabakhsh); sarvin_so2000@yahoo.com (Sarvin Sanaie)
These authors contributed equally.
J. Integr. Neurosci. 2022, 21(1), 11; https://doi.org/10.31083/j.jin2101011
Submitted: 7 April 2021 | Revised: 17 May 2021 | Accepted: 18 August 2021 | Published: 28 January 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

According to the recent findings, autophagy modulation is being a potential therapeutic target in the management of ischemic stroke in a pre-clinical setting. However, the pros and cons of autophagic response strongly depend on the activation time of autophagy after injury. In this systematic review, we aimed to explore the impacts of pharmacological modulation of autophagy on infarct size in experimental ischemic stroke models. Based on our preliminary search, 3551 publications were identified. Of twenty-nine publications that met the inclusion criteria, twenty studies reported infarct volume reduction by percentage (%) with no evidence of any publication bias while nine studies reported by mm3, which had publication bias (39.25 units, standardized mean differences (SMD) = 41.92, 95% confidence interval (CI): 30.33 to 53.51). Based on a meta-analysis, the point estimate (pooled mean difference) for improvement of infarct volume during autophagy modulation according to the mm3 and percentage were 35.64 (mean differences (MD) = 35.64, 95% CI: 26.43 to 44.85, z-value = 7.58, p-value < 0.001) and 14.38 (MD = 14.38, 95% CI = 10.50 to 18.26, z-value = 7.26, p < 0.001) units, respectively. Despite the undeniable role of autophagy in ischemic stroke, the dichotomous effects of autophagy regarding infarct volume reduction should be taken into account. Based on our findings, the studies included in this meta-analysis mostly reported a negative relation between autophagy induction and stroke volume development due to over-activity of autophagy upon the severe ischemic stroke; therefore, further pre-clinical studies are also recommended to establish adjusted autophagy with considering a time-dependent effect as a promising therapeutic target.

Keywords
Autophagy
Dual effects
Ischemic stroke
Pre-clinical setting
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