Anti-inflammatory effects of coumarins on a murine model of acute lung injury (ALI): a brief systematic review

Acute lung injury (ALI) is one of most critical inflammatory conditions. It is produced by different scenarios, which poses a challenge for its clinical management and treatment. Coumarins, a class of natural and synthetic compounds, identified as important candidates for new drugs due to their anti-inflammatory action, could be an alternative for the development of new medicines to manage ALI. In this article, we compile the results of a literature review to conclude whether coumarins are as effective as anti-inflammatory compounds when used in LPS-induced ALI in mice. The outcomes used as parameters to answer this question were: the ability to reduce the influx of inflammatory cells, and edema in inflamed lungs. A total of eight manuscripts were reviewed that unanimously addressed the anti-inflammatory efficacy of coumarin compounds in inhibiting the formation of edema and the influx of leukocytes into the lungs in LPS-induced ALI in mice. Most of the studies also highlighted the role of compounds in decreasing the production of pro-inflammatory cytokines, and these effects were associated with interference in the cell signaling pathways, which were investigated by some of the studies included in this review. The assessment of methodological quality showed that the studies evaluated in this review had moderate to high risk of bias, related to the lack of data on randomization of the animals, and the blinding of the investigators, compromising the reliability of the experimental results of the published works. Leading the results of the manuscripts is possible affirm that coumarins have important anti-inflammatory effects in LPS-induced ALI in mice, and the effect is comparable to the reference anti-inflammatory drug dexamethasone.

Graphical abstract