Protective effects and possible mechanisms of matrine-type alkaloids (matrine and oxymatrine) in animal models of ulcerative colitis: a preclinical systematic review and meta-analysis.

BACKGROUND: Matrine and oxymatrine are bioactive alkaloids from Sophora species with reported anti-inflammatory and antioxidant effects in ulcerative colitis (UC). However, their overall efficacy has not been systematically evaluated. METHODS: Databases including PubMed, EMBASE, Web of Science, Scopus, CNKI, Wanfang, VIP, and SinoMed were searched to January 2026. Animal studies using matrine or oxymatrine monotherapy in UC models were included. Effect sizes were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs). RESULTS: Thirteen studies were included. Compared with controls, matrine-type alkaloids significantly reduced histopathological scores (SMD = -3.47, 95% CI: -4.83 to -2.11) and decreased Disease Activity Index (DAI) at 3 days (SMD = -2.92, 95% CI: -4.27 to -1.57) and 7 days (SMD = -4.76, 95% CI: -6.30 to -3.23), but not at 14 days (SMD = -1.01, 95% CI: -2.22 to 0.20). Body weight increased at 7 days (SMD = 2.76, 95% CI: 1.95-3.57) and 14 days (SMD = 2.41, 95% CI: 0.12-4.69), and colon length was also increased (SMD = 2.09, 95% CI: 1.55-2.64). Matrine-type alkaloids reduced TNF-α (SMD = -2.88, 95% CI: -3.50 to -2.26), IL-6 (SMD = -2.91, 95% CI: -4.64 to -1.17), IL-1β (SMD = -2.73, 95% CI: -4.27 to -1.19), and MDA levels (SMD = -3.06, 95% CI: -4.47 to -1.65), while increasing SOD activity (SMD = 2.63, 95% CI: 1.37-3.89). Subgroup analyses suggested generally similar directions of effect across species and model types. The pooled effect estimate appeared larger in the oxymatrine subgroup than in the matrine subgroup, but this indirect comparison should be interpreted cautiously. CONCLUSION: Matrine-type alkaloids may exert protective effects in UC animal models by improving histological damage, reducing disease activity, and modulating inflammatory and oxidative stress pathways. These findings suggest their potential as multi-target therapeutic agents, although further high-quality studies are required for clinical translation. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261376235, identifier CRD420261376235.