SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Inflammation Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1591470
Immunomodulatory Effects of Ulinastatin Combined with Continuous Blood Purification in Sepsis: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Hepatobiliary and Pancreatic Surgery Department, Ziyang Central Hospital, Ziyang, China
- 2Emergency Department, Ziyang Central Hospital, Ziyang, China
- 3Intensive Care and Emergency Medicine Department, Ziyang Central Hospital, Ziyang China, Ziyang, China
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Background: Sepsis involves a dysregulated immune response to infection, causing inflammation and organ dysfunction. This systematic review and meta-analysis evaluated the immunomodulatory effects of ulinastatin combined with continuous blood purification (CBP) in sepsis. Methods: This study involved a literature search, data extraction, quality assessment, and meta-analysis to evaluate the effects of ulinastatin combined with CBP. A total of 34 studies, including 28 randomized controlled trials (RCTs) and 6 retrospective studies involving patients with sepsis, were included. Results: The pooled results demonstrated significant reductions in inflammatory markers including CRP (SMD: -2.210, 95% CI: -2.760 to -1.661, P < 0.0001), IL-1β (SMD: -1.536, 95% CI: -1.773 to -1.299, P < 0.0001), IL-6 (SMD: -2.679, 95% CI: -3.271 to -2.086, P < 0.0001), IL-8 (SMD: -2.959, 95% CI: -4.582 to -1.337, P < 0.0001), IL-10 (SMD: -4.449, 95% CI: -7.216 to -1.682, P = 0.002), PCT (SMD: -3.787, 95% CI: -4.597 to -2.977, P < 0.0001), TNF-α (SMD: -2.734, 95% CI: -3.480 to -1.987, P < 0.0001), and mortality (OR: 0.30, 95% CI: 0.22 to 0.42, P < 0.0001) in ulinastatin group compared with control group. Egger’s test indicated significant publication bias (P = 0.002). Conclusion: Ulinastatin combined with CBP significantly reduces inflammatory markers and mortality in sepsis patients, suggesting its potential benefit in managing sepsis-related inflammation. Further studies are needed to confirm these findings.
Keywords: Ulinastatin, Continuous blood purification, Sepsis, Inflammatory markers, Meta-analysis
Received: 31 Mar 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Gao, Tang, Zhao and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuanjun Zhang, Intensive Care and Emergency Medicine Department, Ziyang Central Hospital, Ziyang China, Ziyang, China
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