Evidências científicas sobre a ação de plantas medicinais na inflamação e na dor em modelos animais de pancreatite

Abstract

Pancreatitis is an inflammation of the pancreas, often caused by factors such as alcoholism and gallstones, and it can lead to severe complications, including intense abdominal pain and organ dysfunction. Currently, there is no specific and effective treatment for the disease, making further research essential to identify new therapeutic approaches. Studies involving medicinal plants have been conducted to explore alternative treatments for pancreatitis. This systematic review aimed to assess the efficacy of medicinal plants in treating inflammation and controlling pain in animal models of pancreatitis.Following the PRISMA guidelines, the article selection process resulted in 39 studies, chosen from 1,894 articles (1,081 from PUBMED, 136 from Web of Science, 565 from EMBASE, 2 from LILACS, and 110 from SCOPUS). After analysis, 32 plant species were identified, with both prophylactic and therapeutic approaches. The most studied plants included Camellia sinensis (L.), Kuntze, Curcuma longa L., Emblica officinalis Gaertn., Nardostachys jatamansi (D.Don) DC., Rheum palmatum L., Salvia miltiorrhiza Bunge, and Trigonella foenum-graecum L.The studies involved eight distinct induction models, with cerulein used in 20 studies, followed by sodium taurocholate in six studies. Larginine was used in five studies, while a combination of cerulein or CCK with ethanol was used in three studies. The remaining studies employed CCK, sodium deoxycholate, a choline-deficient diet, dimethoate, and bile duct obstruction for induction. Among the 39 studies, 27 administered the inducer via intraperitoneal injection, seven via intraductal injection (six of which involved taurocholate), two via oral administration, and the remaining three via intravenous, subcutaneous, or mechanical induction.The primary focus of the studies was inflammation reduction and the control of biochemical markers, such as amylase, which was evaluated in all studies, and lipase, assessed in 29 studies. Cytokine analysis was conducted in 20 studies, with TNF-α (15), IL-1β (12), and IL-6 (15) being the most frequently analyzed. Myeloperoxidase activity was examined in 17 studies, and malondialdehyde concentrations in 12 studies. Only one study specifically addressed hyperalgesia.From the analysis of these studies, a lack of standardization in the induction methodologies and analytical procedures was observed, hindering the identification of the most effective approach. The risk of bias analysis, conducted using the SYRCLE tool, revealed that animal allocation, researcher blinding, and outcome reporting were poorly detailed, compromising the quality of the studies. Despite these limitations, all the studies included in the review presented promising results, demonstrating the potential of medicinal plants in treating pancreatitis. This review contributes to a broader understanding of the therapeutic potential of these plants and highlights the need for more studies focusing on the abdominal pain associated with the disease.