Anti-inflammatory action of silver nanoparticles in vivo: systematic review and meta-analysis

The aim of this study was to systematically review the literature to investigate whether silver nanoparticles (AgNPs) have an anti-inflammatory effect in vivo. The guidelines of PRISMA were applied, and a registration was made in PROSPERO. A personalized search of the PubMed, Web of Science, Scopus, Embase, Lilacs, and Google Scholar databases was conducted in September 2023. For the data analysis, the inverse variance in the random effects model was used. The tools of SYRCLE and GRADE were used to assess the risk of bias and the certainty of evidence, respectively. From the 9185 identified studies, 5685 duplicate studies were excluded; 52 were read in full text, and 7 were included in this review. Six studies were evaluated by the meta-analysis, and an increase in anti-inflammatory molecules (SMD -5.22; PI [-6.50, -3.94]) and an increase in anti-inflammatory ones (SMD 5.75; PI [3.79, 7.72]) were observed. Qualitative analysis showed a reduction in pro-inflammatory proteins and in the COX-2 pathway. It was concluded that AgNPs present an anti-inflammatory action in vivo through mechanisms involving the reduction of pro-inflammatory molecules and proteins, the increase of anti-inflammatory molecules, and selective inhibition of the COX-2 pathway.