Evaluation of Nile Tilapia ( <i>Oreochromis niloticus</i> ) Skin Peptides for Wound Healing: A Systematic and Meta-Analysis Review

Management of chronic wounds poses a significant challenge for medical teams worldwide, as it often requires prolonged hospitalization periods and frequently leaves sequelae, thereby becoming a public health problem. Furthermore, available medical treatments are usually ineffective for treating this type of injury; therefore, a survey for new treatments to achieve favorable outcomes is frequently sought. Among new treatment options for wound healing, the use of peptides extracted from the skin of Nile tilapia (<i>Oreochromis niloticus</i>) has shown favorable results. The objective of this work was to evaluate the evidence demonstrating the effectiveness of Nile tilapia skin peptides (NTSP) in modulating cellular and molecular mechanisms involved in the wound healing process in animal models. A systematic review and meta-analysis were performed using the PubMed, SciELO, Web of Science, and EMBASE databases. Articles from 2014 to 2024 were selected using a combination of keywords (tilapia skin) AND (wound healing) AND (peptides), along with synonyms, according to the MeSH criteria. A total of 378 studies were identified, of which 16 were deemed relevant based on the inclusion and exclusion criteria. According to the studies analyzed, NTSP delivery systems led to a decrease in the wound healing period, stimulated blood vessel formation, regulated and mediated anti- and pro-inflammatory cytokines, and controlled infection. Syrcle's scale was used to assess the risk of bias, which was determined to be low. Additionally, the results from the meta-analysis demonstrate statistical significance in the findings from experiments utilizing NTSP. It is particularly evident in relation to wound retraction, wound closure, inflammatory score, and angiogenesis, indicating that the use of NTSP affects cellular and molecular mechanisms that stimulate the wound-healing process. However, significant heterogeneity was observed among the studies, which is a limitation of the analysis. Therefore, further clinical trials and standardized protocols are necessary to better elucidate the effects of NTSP.