Perioperative taurine or taurolidine supplementation on clinical outcomes: A systematic review with meta-analysis

Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through its interactions with gut microbiome. Although taurine has been widely used as a health supplement and also for treatment of congestive heart failure i...

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Published inANESTHESIOLOGY AND PERIOPERATIVE SCIENCE Vol. 2; no. 2; pp. 1 - 7
Main Authors Ho, Kwok M., Harahsheh, Yusra
Format Journal Article
LanguageEnglish
Published Singapore Springer Nature Singapore 25.03.2024
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Abstract Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through its interactions with gut microbiome. Although taurine has been widely used as a health supplement and also for treatment of congestive heart failure in Japan, its roles in the perioperative setting have not been well characterized. The purpose of this systematic review and meta-analysis was to assess whether oral or intravenous taurine, or its derivatives such as taurolidine, can offer benefits compared to placebo in the perioperative setting. Non-randomized studies, trials assessed topical taurine or taurolidine, or trials did not report clinical outcomes were excluded. Six randomized-controlled-trials (RCTs) involving a total of 596 adult surgical patients, in PubMed, MEDLINE and EMBASE databases on September 14, 2023 were identified and meta-analyzed using a fixed-effect model. Biases were assessed by reporting individual trial elements. Taurine or taurolidine (which is readily metabolized by hydrolysis to taurine) supplementation was associated with a reduction in all-cause infection (5 trials: pooled odds ratio (OR) 0.59; 95% confidence interval (CI) 0.38–0.92; p  = 0.020) but not delirium (2 trials: OR 0.63, 95% CI 0.38–1.04; p  = 0.071) or mortality (4 trials: OR 0.82, 95% CI 0.43–1.58; p  = 0.557) compared to placebo. Using the ‘trim and fill’ technique to adjust for publication bias did not change the favorable effect of taurine on risk of infection (OR 0.61, 95% CI 0.40–0.95). Because the number of studies included was small, the promising benefits of taurine on risks of perioperative infection should be confirmed by adequately-powered RCTs.
AbstractList Abstract Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through its interactions with gut microbiome. Although taurine has been widely used as a health supplement and also for treatment of congestive heart failure in Japan, its roles in the perioperative setting have not been well characterized. The purpose of this systematic review and meta-analysis was to assess whether oral or intravenous taurine, or its derivatives such as taurolidine, can offer benefits compared to placebo in the perioperative setting. Non-randomized studies, trials assessed topical taurine or taurolidine, or trials did not report clinical outcomes were excluded. Six randomized-controlled-trials (RCTs) involving a total of 596 adult surgical patients, in PubMed, MEDLINE and EMBASE databases on September 14, 2023 were identified and meta-analyzed using a fixed-effect model. Biases were assessed by reporting individual trial elements. Taurine or taurolidine (which is readily metabolized by hydrolysis to taurine) supplementation was associated with a reduction in all-cause infection (5 trials: pooled odds ratio (OR) 0.59; 95% confidence interval (CI) 0.38–0.92; p = 0.020) but not delirium (2 trials: OR 0.63, 95% CI 0.38–1.04; p = 0.071) or mortality (4 trials: OR 0.82, 95% CI 0.43–1.58; p = 0.557) compared to placebo. Using the ‘trim and fill’ technique to adjust for publication bias did not change the favorable effect of taurine on risk of infection (OR 0.61, 95% CI 0.40–0.95). Because the number of studies included was small, the promising benefits of taurine on risks of perioperative infection should be confirmed by adequately-powered RCTs.
Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through its interactions with gut microbiome. Although taurine has been widely used as a health supplement and also for treatment of congestive heart failure in Japan, its roles in the perioperative setting have not been well characterized. The purpose of this systematic review and meta-analysis was to assess whether oral or intravenous taurine, or its derivatives such as taurolidine, can offer benefits compared to placebo in the perioperative setting. Non-randomized studies, trials assessed topical taurine or taurolidine, or trials did not report clinical outcomes were excluded. Six randomized-controlled-trials (RCTs) involving a total of 596 adult surgical patients, in PubMed, MEDLINE and EMBASE databases on September 14, 2023 were identified and meta-analyzed using a fixed-effect model. Biases were assessed by reporting individual trial elements. Taurine or taurolidine (which is readily metabolized by hydrolysis to taurine) supplementation was associated with a reduction in all-cause infection (5 trials: pooled odds ratio (OR) 0.59; 95% confidence interval (CI) 0.38–0.92; p  = 0.020) but not delirium (2 trials: OR 0.63, 95% CI 0.38–1.04; p  = 0.071) or mortality (4 trials: OR 0.82, 95% CI 0.43–1.58; p  = 0.557) compared to placebo. Using the ‘trim and fill’ technique to adjust for publication bias did not change the favorable effect of taurine on risk of infection (OR 0.61, 95% CI 0.40–0.95). Because the number of studies included was small, the promising benefits of taurine on risks of perioperative infection should be confirmed by adequately-powered RCTs.
ArticleNumber 12
Author Ho, Kwok M.
Harahsheh, Yusra
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Keywords Infection
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Taurine
Operation
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References_xml – reference: Sun Q, Wang B, Li Y, Sun F, Li P, Xia W, et al. Taurine supplementation lowers blood pressure and improves vascular function in prehypertension: randomized, double-blind placebo-controlled study. Hypertension. 2016;67(3):541–9. https://doi.org/10.1161/HYPERTENSIONAHA.115.06624.
– reference: Ho KM, Lee A, Wu W, Chan MTV, Ling L, Lipman J, et al. Flattening the biological age curve by improving metabolic health: to taurine or not to taurine, that’s the question. J Geriatr Cardiol. 2023;20(11):813–23. https://doi.org/10.26599/1671-5411.2023.11.004.
– reference: Nguyen KH, Murakami S, Schaffer SW, Ito T. Examination of taurine chloramine and taurine on LPS-induced acute pulmonary inflammatory in mice. Adv Exp Med Biol. 2022;1370:23–9. https://doi.org/10.1007/978-3-030-93337-1_2.
– reference: Stacy A, Andrade-Oliveira V, McCulloch JA, Hild B, Oh JH, Perez-Chaparro PJ, et al. Infection trains the host for microbiota-enhanced resistance to pathogens. Cell. 2021;184(3):615-27.e17. https://doi.org/10.1016/j.cell.2020.12.011.
– reference: Schaffer SW, Jong CJ, Ramila KC, Ito T, Kramer J. Differences between physiological and pharmacological actions of taurine. Adv Exp Med Biol. 2022;1370:311–21. https://doi.org/10.1007/978-3-030-93337-1_30.
– reference: Li C, Zhou Y, Niu Y, He W, Wang X, Zhang X, et al. Deficiency of Pdk1 drives heart failure by impairing taurine homeostasis through Slc6a6. FASEB J. 2023;37(9):e23134. https://doi.org/10.1096/fj.202300272R.
– reference: AnichCOrth-HöllerDLacknerMNaglMN-chlorotaurine, a potent weapon against multiresistant bacteriaJ Appl Microbiol20211314174217481:CAS:528:DC%2BB38XitlSntw%3D%3D10.1111/jam.15052336388978518795
– reference: Kolluru GK, Shackelford RE, Shen X, Dominic P, Kevil CG. Sulfide regulation of cardiovascular function in health and disease. Nat Rev Cardiol. 2023;20(2):109–25. https://doi.org/10.1038/s41569-022-00741-6.
– reference: Arrieta F, Balsa JA, de la Puerta C, Botella JI, Zamarrón I, Elías E, et al. Phase IV prospective clinical study to evaluate the effect of taurine on liver function in postsurgical adult patients requiring parenteral nutrition. Nutr Clin Pract. 2014;29(5):672–80. https://doi.org/10.1177/0884533614533610.
– reference: Huxtable RJ. Physiological actions of taurine. Physiol Rev. 1992;72(1):101–63. https://doi.org/10.1152/physrev.1992.72.1.101.
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Snippet Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through its...
Abstract Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through...
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SubjectTerms Anesthesiology
Critical Care Medicine
Infection
Intensive
Medicine
Medicine & Public Health
Neurosciences
Operation
Pharmacology/Toxicology
Prevention
Review Article
Surgery
Taurine
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Title Perioperative taurine or taurolidine supplementation on clinical outcomes: A systematic review with meta-analysis
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