Related Experiment Video
Updated: Sep 16, 2025
Direct Intrabronchial Administration to Improve the Selective Agent Deposition Within the Mouse Lung
Published on: May 20, 2019
Optimal intrapleural therapy with alpha-hemolytic streptococci bio-product (Mannatide) in controlling malignant
Yan Zhang1,2,3, Xiao-Tian Zheng1,2,4, Jiao Xu1,2,4
1Evidence-Based Medicine Center, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563003, China.
Background:
Mannatide is an alpha-hemolytic streptococci bio-product. We conducted a comprehensive clustered systematic review and meta-analysis to reveal the clinical values of Mannatide for controlling malignant pleural effusion (MPE), identify the optimal therapeutic regimens, indications and usage, and assess their clinical effectiveness and safety.
Methods:
We collected all eligible studies from both Chinese and English databases and clustered them into homogeneous comparisons or therapeutic regimens. We evaluated the risk of bias in eligible studies using RoB 2, pooled the data from each regimen using Review Manager 5.4, and summarized the quality of evidence.
Results:
Seventy-eight studies met the eligibility criteria. Among six comparisons of perfusion with sclerosant alone, Mannatide showed only better complete response of MPE and lower pleurodesis failure and disease progression than interleukin-2. Among twelve combination therapeutic regimens, Mannatide and cisplatin might significantly improve the complete response (2.46, 2.07 to 2.91) and result in a low pleurodesis failure (0.28, 0.23 to 0.33) and disease progression (0.32, 0.21 to 0.48). For MPE with primary treatment, moderate to massive effusion, Karnofsky Performance Status ≥ 40 to 60 or anticipated survival time ≥ two to three months, perfusion with Mannatide at 20 to 50 mg/time, once per week and two to four times and cisplatin at 30 to 60 mg/time might achieve ideal clinical response. Most outcomes were moderate to low quality.
Conclusion:
Mannatide may be a potential pleural sclerosant, which combination with cisplatin may represent a preferred therapeutic approach with a good clinical response and safety in controlling MPE.
Trial Registration:
PROSPERO CRD42022338798.
Related Concept Videos
01:28Pleural Effusion II: Symptoms and Management
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
01:27Pneumothorax-II
Clinical Manifestations:
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...