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Chen G, Lv C, Nie Q, Li X, Lv Y, Liao G, Liu S, Ge W, Chen J, Du Y. Essential Oil of Matricaria chamomilla Alleviate Psoriatic-Like Skin Inflammation by Inhibiting PI3K/Akt/mTOR and p38MAPK Signaling Pathway. Clin Cosmet Investig Dermatol 2024; 17:59-77. [PMID: 38222858 PMCID: PMC10785696 DOI: 10.2147/ccid.s445008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/13/2023] [Indexed: 01/16/2024]
Abstract
Background The traditional Matricaria chamomilla L. has been used to treat dermatitis for thousands of years. Due to emerging trends in alternative medicine, patients prefer natural remedies to relieve their symptoms. Therefore, finding safe and effective plant medicines for topical applications on the skin is an important treatment strategy for dermatologists. German chamomile (Matricaria chamomilla L.) from the Compositae family is a famous medicinal plant, often known as the "star of medicinal species."However, the function of Matricaria chamomilla essential oil on skin inflammation has not been thoroughly examined in earlier research. Methods GC-MS analyzed the components of MCEO, and this study explored the anti-inflammation effects of MCEO on psoriasis with network pharmacological pathway prediction. Following this, we used clinical samples of psoriasis patients to confirm the secretory characteristic of relative inflammatory markers. The therapeutic effect of MCEO on skin inflammation was detected by examination of human keratinocytes HaCaT. At the same time, we prepared imiquimod-induced psoriatic-like skin inflammation in mice to investigate thoroughly the potential inhibition functions of MCEO on psoriatic skin injury and inflammation. Results MCEO significantly reduced interleukin-22/tumor necrosis factor α/lipopolysaccharide-stimulated elevation of HaCaT cell inflammation, which was correlated with downregulating PI3K/Akt/mTOR and p38MAPK pathways activation mediated by MCEO in HaCaT cells treated with IL-22/TNF-α/LPS. Skin inflammation was evaluated based on the PASI score, HE staining, and relative inflammatory cytokine levels. The results showed that MCEO could significantly contribute to inflammatory skin disease treatment. Conclusion MCEO inhibited inflammation in HaCaT keratinocytes induced by IL-22/TNF-α/LPS, the potential mechanisms associated with inhibiting excessive activation and crosstalk between PI3K/Akt/mTOR and p38MAPK pathways. MCEO ameliorated skin injury in IMQ-induced psoriatic-like skin inflammation of mice by downregulating the levels of inflammatory cytokines but not IL-17A. Thus, anti-inflammatory plant drugs with different targets with combined applications were a potential therapeutic strategy in psoriasis.
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Affiliation(s)
- Guang Chen
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, 318000, People’s Republic of China
| | - Caohua Lv
- Department of Dermatology, Taizhou Second People’s Hospital, Taizhou, 317200, People’s Republic of China
| | - Qing Nie
- Weifang Centers for Disease Control and Prevention, Weifang, 261061, People’s Republic of China
| | - Xin Li
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, 318000, People’s Republic of China
| | - Yinyi Lv
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, 318000, People’s Republic of China
| | - Guoyan Liao
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, 318000, People’s Republic of China
| | - Shuangchun Liu
- Municipal Hospital Affiliated to Medical School of Taizhou University, Taizhou, 318000, People’s Republic of China
| | - Weiwei Ge
- Department of Dermatology, Taizhou Second People’s Hospital, Taizhou, 317200, People’s Republic of China
| | - Jinguang Chen
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, 318000, People’s Republic of China
| | - Yunting Du
- Department of Laboratory Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, 110042, People’s Republic of China
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Zhou X, Lyu C, Chen X, Ye Y, Lei Y, Liu Y, Zhang T, Yang Y. Fufang Shengdi mixture alleviates psoriasis-like skin inflammation via promoting Annexin-A proteins expression. JOURNAL OF ETHNOPHARMACOLOGY 2023; 312:116329. [PMID: 36940737 DOI: 10.1016/j.jep.2023.116329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 05/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditional Chinese medicine believes that "blood fever" is an important cause of psoriasis. Fufang Shengdi mixture (FFSD), based on the Hongban Decoction, is composed of Rehmannia glutinosa (Gaertn.) DC., Raw gypsum (Chinese: Sheng Shi Gao), and Lonicera japonica Thunb (Caprifoliaceae). FFSD has effects on nourishing Yin, clearing heat, connecting collaterals, and cooling blood. In modern medical explanation, FFSD has the effects of anti-inflammatory and immunosuppression. Our study proved that FFSD can suppress immunity and ameliorate the symptoms of imiquimod-induced psoriasis in mice. AIM OF THE STUDY This study evaluated the efficacy and possible mechanism of FFSD in psoriasis mice. METHODS AND MATERIALS First, the main components of FFSD were analyzed using high-performance liquid chromatography-tandem high-resolution mass spectrometry (HPLC-HRMS). An imiquimod (IMQ)-induced psoriasis mouse model was used to evaluate the efficacy of FFSD orally. Psoriasis area and severity index (PASI) scores were recorded throughout the course of the mice to reflect the severity of psoriasis. Hematoxylin-eosin staining was used to observe the pathological changes in skin lesions. Enzyme-linked immunosorbent assay (ELISA) was performed to test the level of IFN-γ and TNF-α in plasma. To further investigate the immunopharmacological effect of FFSD, we used chicken ovalbumin (OVA) to induce immunoreaction in mice. ELISA was used to detect the levels of anti-OVA antibody, IFN-γ and TNF-α in mice. Flow cytometry was performed to quantify the ratio of cell types in peripheral blood mononuclear cells (PBMCs) to evaluate the effect of FFSD on immunosuppression. Proteomics and bioinformatics analyzes were performed to find the regulation pathway of the immunosuppressive effect of FFSD. Finally, quantitative PCR (qPCR) and immunohistochemistry were used to measure the upregulation of Annexin-A proteins (ANXAs) in the skin lesion tissue of IMQ-induced mouse. RESULTS On the basis of knowing the composition of FFSD, we first proved the efficacy of FFSD in alleviating IMQ-induced psoriasis in mice. Second, we further clarified the pharmacological effect of FFSD on immunosuppression via OVA-induced mice. Subsequently, it was found that the significant up-regulation of ANXAs was caused by FFSD through proteomics analysis, and the finding was proved in the IMQ-induced psoriasis mouse model. CONCLUSIONS This study elucidates the immunosuppressive pharmacological effect of FFSD on improving psoriasis through up-regulating ANXAs.
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Affiliation(s)
- Xiaoying Zhou
- Shanghai University of Traditional Chinese Medicine Science and Technology Experiment Center, Shanghai, 201203, China.
| | - Chunming Lyu
- Shanghai University of Traditional Chinese Medicine Science and Technology Experiment Center, Shanghai, 201203, China.
| | - Xingmi Chen
- Shanghai University of Traditional Chinese Medicine Science and Technology Experiment Center, Shanghai, 201203, China.
| | - Yuhan Ye
- Shanghai University of Traditional Chinese Medicine Science and Technology Experiment Center, Shanghai, 201203, China.
| | - Yuanyuan Lei
- Shanghai University of Traditional Chinese Medicine Science and Technology Experiment Center, Shanghai, 201203, China.
| | - Ying Liu
- Shanghai University of Traditional Chinese Medicine Science and Technology Experiment Center, Shanghai, 201203, China.
| | - Tong Zhang
- Shanghai University of Traditional Chinese Medicine School of Pharmacy, Shanghai, 201203, China.
| | - Yang Yang
- Shanghai University of Traditional Chinese Medicine Science and Technology Experiment Center, Shanghai, 201203, China.
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Wang G, Bai F, Tian Z, Fan L, Lei M. Balneotherapy with Chinese herbal medicine prolongs the remission period in patients with psoriasis vulgaris. Dermatol Ther 2020; 33:e13351. [PMID: 32232885 DOI: 10.1111/dth.13351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/22/2020] [Accepted: 03/25/2020] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate whether the supplementary balneotherapy with Chinese herbal medicine (CHM) could facilitate the treatment of psoriasis vulgaris and thus be beneficial for long-term remission from the symptoms. Two hundred psoriasis vulgaris patients with moderate-to-severe plaque psoriasis from January 2013 to June 2014 were evenly divided into two groups: the consolidated therapy group (CTG) and unconsolidated therapy group (UTG); the remission period of the two groups was compared. There was no significant difference in Psoriasis Area Severity Index (PASI) score between the two groups at the beginning and the end of the treatment. However, the average remission time in CTG was 10.99 months, which was significantly longer than that of 7.94 months in UTG (P = .001). After a correction of age, course of disease, skin type as well as PASI baseline value using a COX model, we found that the risk of recurrence of psoriasis vulgaris in UTG was higher than that in the CTG (P < .001). No adverse reactions were discovered when combing the two treatments together. The combined treatment of CHM balneotherapy and narrowband ultraviolet B could significantly prolong the remission time in patients with psoriasis vulgaris.
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Affiliation(s)
- Genhui Wang
- Department of Dermatology, Hebei Traditional Chinese Medical Hospital, Shijiazhuang City, Hebei, China
| | - Fan Bai
- Department of Dermatology, Hebei Traditional Chinese Medical Hospital, Shijiazhuang City, Hebei, China
| | - Zan Tian
- Department of Dermatology, Hebei Traditional Chinese Medical Hospital, Shijiazhuang City, Hebei, China
| | - Lifang Fan
- Department of Dermatology, Hebei Traditional Chinese Medical Hospital, Shijiazhuang City, Hebei, China
| | - Mingjun Lei
- Department of Dermatology, Hebei Traditional Chinese Medical Hospital, Shijiazhuang City, Hebei, China
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Dos Santos DS, Barreto RDSS, Serafini MR, Gouveia DN, Marques RS, Nascimento LDC, Nascimento JDC, Guimarães AG. Phytomedicines containing Matricaria species for the treatment of skin diseases: A biotechnological approach. Fitoterapia 2019; 138:104267. [PMID: 31319107 DOI: 10.1016/j.fitote.2019.104267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 01/09/2023]
Abstract
Skin diseases have a notable impact on the life of the affected and in their health conditions. In order to allow a more effective and economical treatment for such disorders, new therapeutic approaches have been continuously investigated. Due to its high therapeutic and phytochemical potential, Matricaria species emerges as a pleasant alternative, since it is an important source of bioactive secondary metabolites suitable for the treatment of varied skin diseases. Therefore, this review aimed to catalog inventions that have used Matricaria species as the active component for skin disease treatment in order to assess the status of the technological development of the fitomedicines. For this, a search of patents was performed in four specialized patent database, which have reported the discovery of pharmaceutical bioproducts that used Matricaria species in its composition for skin treatment. Therefore, it is possible to notice that the pharmaceutical industry has driven efforts and investment to produce medicines for the dermatopathies, using species of this genus as an active principle. Besides, a trend of growth has been identified for the last years, which is accompanied by the continuous publication of scientific articles on the subject. It is known that a long journey is traversed between the scientific findings and their applications in the pharmaceutical market, creating the perspective that new Matricaria-based medicines may reach the pharmaceutical market in the coming years.
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Affiliation(s)
- Damaris Silva Dos Santos
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
| | - Rosana de Souza Siqueira Barreto
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil; Departmento de Educação em Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
| | - Mairim Russo Serafini
- Departmento de Farmácia, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Daniele Nascimento Gouveia
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
| | - Raquel Souza Marques
- Programa de Pós-graduação em Ciências Odontológicas, Universidade do Estado de São Paulo, Araraquara, São Paulo, Brazil
| | | | | | - Adriana Gibara Guimarães
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil; Departmento de Educação em Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil.
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Deng J, Lu C, Xiang Y, Deng H, Wen Z, Yao D, Xuan M, Yan Y. Auricular acupressure as a complementary therapy for psoriasis vulgaris: study protocol for a multicenter randomized controlled trial. Trials 2019; 20:358. [PMID: 31208470 PMCID: PMC6580514 DOI: 10.1186/s13063-019-3475-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/27/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Psoriasis vulgaris is a common skin disease characterized by persistent localized erythematous scaly plaques, typically on the elbows, knees, and scalp. It is an immune-abnormal disease that progresses slowly over a long period with frequent symptom recurrence. Current studies have shown that acupuncture is an effective therapy for psoriasis. However, the scientific evidence of the efficacy of auricular acupressure treatment for patients with psoriasis is still insufficient. Therefore, we designed a randomized controlled clinical trial to investigate the effect, safety, and cost-effectiveness of auricular acupressure in addition to medication in patients with psoriasis. METHODS AND ANALYSIS This on-going study is a two-arm parallel, assessor-blinded, randomized controlled trial in which 180 participants with psoriasis will be recruited and then randomly allocated into two groups in a 1:1 ratio. Equal randomization will be conducted using a computer-generated random allocation sequence. Participants in the intervention group will receive auricular acupressure treatment once per week for 4 weeks, and calcipotriol betamethasone ointment for topical use once daily for 4 weeks. Participants in the control group will receive only calcipotriol betamethasone ointment treatment once daily for 4 weeks. All patients will be followed up for 12 weeks. The primary outcome is relapse rate. The secondary outcomes include time to relapse, rebound rate, time to new onset, Psoriasis Area and Severity Index score improvement rate, body surface area affected, a visual analogue scale, and Dermatology Life Quality Index. Cost-effectiveness analysis will be carried out from a health and community care provider perspective. DISCUSSION This multicenter randomized controlled trial will provide important clinical evidence for the effect and safety of auricular acupressure as a complementary therapy in patients with psoriasis. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR-TRC-14004916 . Registered on 20 May 2014. This protocol is version 3.0 which was updated on 24 September 2016.
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Affiliation(s)
- Jingwen Deng
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Chuanjian Lu
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Yu Xiang
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, 510120 China
- School of Medical Information Engineering, Guangdong Pharmaceutical University, Guangzhou, 510006 China
| | - Hao Deng
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Zehuai Wen
- Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
| | - Danni Yao
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Meiling Xuan
- Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
| | - Yuhong Yan
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
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A Novel Integrative Processing Technology for the Preparation of Rehmanniae Radix Slices. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2018:4524797. [PMID: 30671128 PMCID: PMC6317129 DOI: 10.1155/2018/4524797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/19/2018] [Accepted: 12/10/2018] [Indexed: 11/17/2022]
Abstract
The traditional processing method for the slices preparation of Rehmanniae roots is time- and energy-consuming and is prone to result in loss of active components during twice water-treatment (once for wash and the other for softening) and drying steps. In this study, we firstly explored an integrative processing technique for Rehmanniae Radix by 2x3 factorial experiment based on the contents of catalpol and verbascoside as measured by HPLC. The potential differences between the traditional stepwise processing technique and the integrative processing technique for catalpol and verbascoside in the prepared slices were investigated. To further confirm the effectiveness of drugs using the integrative processing technique, some pharmacological variables, such as rectal temperature, hematologic parameters (RBC, HGB, HCT, and blood viscosity), and coagulation parameters (TT, APTT, PT and FIB), were detected in a blood-heat and hemorrhage syndrome rat model. Two-way ANOVA analysis showed that drying for 18 h at 50°C was considered as the best combination of process conditions. The mean catalpol and verbascoside contents in the integrative method-processed samples (4.30% and 0.33%, respectively) were higher than those in the traditional method-processed samples (2.61% and 0.21%, respectively). Significant increases in rectal temperature, and hematologic parameters, TT, APTT, and FIB, were observed in the model group rats, compared to the blank group animals (P<0.01). Both in the integrative groups and traditional groups, the extracts caused significant decreases in rectal temperature, RBC, HGB, and HCT with increased concentration compared to the model group animals. All coagulation parameters tested were shortened in model rats received two kind prepared slices. There were no significant therapeutic differences between the integrative and the traditional method-processed slices on the hemostasis and hemorheological parameters in this blood-heat and hemorrhage syndrome rat model, indicating that our integrative method may be a feasible technique for processing Rehmanniae Radix slices.
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Deng J, Yao D, Lu C, Wen Z, Yan Y, He Z, Wu H, Deng H. Oral Chinese herbal medicine for psoriasis vulgaris: protocol for a randomised, double-blind, double-dummy, multicentre clinical trial. BMJ Open 2017; 7:e014475. [PMID: 29101128 PMCID: PMC5695474 DOI: 10.1136/bmjopen-2016-014475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Psoriasis vulgaris is a common skin disease that is characterised by persistent localised erythematous scaly plaques. Yinxieling is a Chinese herbal formula for psoriasis that has been used for more than 20 years in China. To facilitate application, PSORI-CM01 was developed based on the optimisation and simplification of Yinxieling tablets performed in a previous study and in clinical practice. However, the scientific evidence regarding whether PSORI-CM01 is more effective for psoriasis than the original Yinxieling remains insufficient. Therefore, we designed a randomised clinical trial to investigate the effect, safety and cost-effectiveness of PSORI-CM01 granules compared with those of Yinxieling tablets for the treatment of patients with psoriasis. METHODS AND ANALYSIS This ongoing study is a two-arm parallel, randomised, double-blind, double-dummy clinical trial. Five hundred and fifty-six participants with psoriasis will be recruited and then randomly allocated into two groups in a 1:1 ratio. Participants in PSORI-CM01 group will receive a 5.5 g granule of PSORI-CM01 two times daily and five placebo tablets three times daily for 12 weeks. The participants in the Yinxieling group will receive five Yinxieling tablets three times daily and a placebo granule two times daily for 12 weeks. The primary outcome is the reduction of the Psoriasis Area and Severity Index. The secondary outcomes include relapse rate, Visual Analogue Scale scores, body surface area and the Dermatology Life Quality Index. Cost-effectiveness analysis will be performed from a health and community care provider perspective. ETHICS AND DISSEMINATION This research protocol had been reviewed and approved by the institutional review boards of three trial centres (Guangdong Provincial Hospital of Chinese Medicine (B2014-026-01), Affiliated Hospital of Tianjin Chinese Medicine Academy (2014-KY-001) and Third Hospital of Hangzhou (B2014-026-01)). The findings will be disseminated to the public through conference presentations and open-access journals. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR-TRC-14005185); Pre-results.
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Affiliation(s)
- Jingwen Deng
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Danni Yao
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Chuanjian Lu
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Zehuai Wen
- Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yuhong Yan
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Ziyang He
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Huimei Wu
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Hao Deng
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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Deng S, Cheng J, Zhao J, Yao F, Xu J. Natural Compounds for the Treatment of Psoriatic Arthritis: A Proposal Based on Multi-Targeted Osteoclastic Regulation and on a Preclinical Study. JMIR Res Protoc 2017; 6:e132. [PMID: 28698171 PMCID: PMC5527251 DOI: 10.2196/resprot.7636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/30/2017] [Accepted: 04/30/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic inflammatory arthritis affecting approximately 2% to 3% of the population globally, and is characterized by both peripheral articular manifestations and axial skeletal involvement. Conventional therapies for PsA have not been fully satisfactory, though natural products (NPs) have been shown to be highly effective and represent important treatment options for psoriasis. PsA is a multigenic autoimmune disease with both environmental and genetic factors contributing to its pathogenesis. Accordingly, it is likely that the use of natural compounds with a multi-targeted approach will enable us to develop better therapies for PsA and related disorders. OBJECTIVE PsA, either on joint damage or on bone erosion, has been shown to respond to anti-psoriatic pharmacotherapy (APP), APP-like NPs, and their natural compounds. This study aims to uncover specific natural compounds for improved PsA remedies. Specifically, by targeting bone erosion caused by increased osteoclastic bone resorption, we aim to predict the key signaling pathways affected by natural compounds. Further, the study will explore their anti-arthritis effects using an in silico, in vitro, and in vivo approach. Following the signaling pathway prediction, a preclinical efficacy study on animal models will be undertaken. Collectively, this work will discover lead compounds with improved therapeutic effects on PsA. METHODS We hypothesize that 9 potential APP-like NPs will have therapeutic effects on arthritis via the modulation of osteoclast bone resorption and signaling pathways. For in silico identification, the Latin name of each NP will be identified using the Encyclopedia of Traditional Chinese Medicine (Encyclopedia of TCM). The biological targets of NPs will be predicted or screened using the Herbal Ingredients' Targets (HIT) database. With the designed search terms, DrugBank will be used to further filter the above biological targets. Protein ANnotation THrough Evolutionary Relationship (PANTHER) will be used to predict the pathways of the natural compound sources. Subsequently, an in vitro sample preparation including extraction, fractionation, isolation, purification, and bioassays with high-speed counter-current chromatography-high-performance liquid chromatography-diode array detection (HSCCC-HPLC-DAD) will be carried out for each identified natural source. In vitro investigations into the effect of NPs on osteoclast signaling pathways will be performed. The experimental methods include cell viability assays, osteoclastogenesis and resorption pit assays, quantitative reverse transcription polymerase chain reaction (RT-PCR), western blot, and luciferase reporter gene assays. Finally, an in vivo preclinical efficacy on a collagen-induced arthritis rat model will be carried out using a treatment group (n=10), a control group (n=10), and a non-arthritis group (n=10). Main outcome measure assessments during intervention include daily macroscopic scores and a digital calipers measurement. Post-treatment tissue measurements will be analyzed by serological testing, radiographic imaging, and histopathological assessment. RESULTS Studies are currently underway to evaluate the in silico data and the in vitro effects of compounds on osteoclastogenesis and bone resorption. The preclinical study is expected to start a year following completion of the in silico analysis. CONCLUSIONS The in silico rapid approach is proposed as a more general method for adding value to the results of a systematic review of NPs. More importantly, the proposed study builds on a multi-targeted approach for the identification of natural compounds for future drug discovery. This innovative approach is likely to be more precise, efficient, and compatible to identify the novel natural compounds for effective treatment of PsA.
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Affiliation(s)
- Shiqiang Deng
- Molecular Laboratory, School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Jianwen Cheng
- Molecular Laboratory, School of Biomedical Sciences, The University of Western Australia, Perth, Australia.,Research Centre for Regenerative Medicine and Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Nanning, China.,Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinmin Zhao
- Molecular Laboratory, School of Biomedical Sciences, The University of Western Australia, Perth, Australia.,Research Centre for Regenerative Medicine and Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Nanning, China.,Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Felix Yao
- Molecular Laboratory, School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Jiake Xu
- Molecular Laboratory, School of Biomedical Sciences, The University of Western Australia, Perth, Australia.,Research Centre for Regenerative Medicine and Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Nanning, China.,Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Thomas J, Narkowicz CK, Jacobson GA, Peterson GM. Safety and efficacy of kunzea oil-containing formulations for the management of psoriasis: a randomized, controlled trial. J Clin Pharm Ther 2015; 40:566-572. [PMID: 30156327 DOI: 10.1111/jcpt.12311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 06/28/2015] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Anecdotally, topical kunzea oil has been used to treat various skin conditions, including psoriasis and eczema, with good results. This study compared the clinical efficacy of kunzea oil (20%)-containing formulations in mild to moderate psoriasis. METHODS A randomized, comparative, double-blind, 8-week study was undertaken. Thirty patients (age range: 25-74 years and mean ± SD: 52·8 ± 13·6 years) with mild to moderate psoriasis (affecting at least 10% of one or more body regions: arms, head, legs and trunk) randomly received ointment and/or scalp lotion containing 20% kunzea oil (test group) or control medications not containing kunzea oil (control group). Formulations in both treatment arms also contained 5% liquor carbonis detergens (LCD) and 3% salicylic acid. The clinical responses to the test and control formulations were evaluated using the Psoriasis Area and Severity Index (PASI). RESULTS AND DISCUSSION After 8 weeks of treatment, both test and control groups demonstrated a significant (P < 0·05) improvement in PASI scores. Subjects in the test group had a decrease in mean±SD PASI score from 12·7 ± 7·9 to 6·7 ± 7·2, whereas the control group showed a decrease in PASI score from 8·1 ± 4·6 to 3·5 ± 4·7. Comparative efficacy analysis between the test and control groups did not reveal any significant difference (P > 0·05). WHAT IS NEW AND CONCLUSIONS The inclusion of kunzea oil made no difference to the efficacy of topical formulations containing LCD and salicylic acid for the treatment of psoriasis.
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Affiliation(s)
- J Thomas
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
| | - C K Narkowicz
- Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - G A Jacobson
- Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - G M Peterson
- Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
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Yang L, Zhang CS, May B, Yu J, Guo X, Zhang AL, Xue CC, Lu C. Efficacy of combining oral Chinese herbal medicine and NB-UVB in treating psoriasis vulgaris: a systematic review and meta-analysis. Chin Med 2015; 10:27. [PMID: 26413149 PMCID: PMC4583725 DOI: 10.1186/s13020-015-0060-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/17/2015] [Indexed: 11/22/2022] Open
Abstract
Background The combination of a Chinese herbal medicine (CHM) bath and narrowband ultraviolet B (NB-UVB) improved the efficacy of NB-UVB treatment of psoriasis vulgaris, but bath therapy is inconvenient. Oral CHM plus NB-UVB has been tested in clinical practice. This study aims to evaluate whether adding oral CHM could be beneficial for NB-UVB therapy by a systematic review and meta-analysis. Methods Nine English and Chinese databases were searched from their inception to April 2014. Randomized controlled trials (RCTs) comparing the combination of orally administered CHM and NB-UVB with that of CHM placebo and NB-UVB or NB-UVB alone for treating psoriasis vulgaris and reporting Psoriasis Area Severity Index (PASI) outcomes were included. A systematic review, meta-analysis, risk of bias assessment and the GRADE assessment were conducted in accordance with Cochrane Collaboration methodology to assess the evidence for efficacy outcome. Data were analyzed in RevMan5.2. Results Eighteen eligible RCTs (n = 1416) were included for systematic review, and 17 (n = 1342) of them were included in meta-analysis. Risk of bias in terms of blinding was high and so was in publication bias. Quality of evidence was low according the GRADE assessment. PASI-60 or above [risk ratio (RR) = 1.35, 95 % confidence interval (CI) 1.26–1.45, I2 = 5 %, number needed to treat = 4.27] and PASI-90 or above (RR = 1.71, 95 % CI 1.45–2.01, I2 = 0 %, number needed to treat = 5.92) were higher in the intervention group. The combination treatment conferred a 24 % benefit of PASI-60 or above (83 vs 59 %, RR = 1.35, 95 % CI 1.26–1.45, P < 0.01). The incidence of NB-UVB-induced adverse events was lower in the intervention group (95/464 vs 123/428, RR = 0.66, 95 % CI 0.46–0.96, P < 0.01). Mild gastrointestinal reactions (2.87 %) and liver function impairments (0.68 %) were reported in the intervention group. No serious adverse events were reported. Conclusion The orally administrated CHM combined with NB-UVB in treating psoriasis vulgaris showed improved efficacy but quality of evidence was low. Electronic supplementary material The online version of this article (doi:10.1186/s13020-015-0060-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lihong Yang
- Evidence Based Medicine and Clinical Research Service Group, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China ; The 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China ; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Claire Shuiqing Zhang
- China-Australia International Research Centre for Chinese Medicine, School of Health Sciences, RMIT Health Innovations Research Institute, RMIT University, PO Box 71, Bundoora, Melbourne, VIC 3083 Australia
| | - Brian May
- China-Australia International Research Centre for Chinese Medicine, School of Health Sciences, RMIT Health Innovations Research Institute, RMIT University, PO Box 71, Bundoora, Melbourne, VIC 3083 Australia
| | - Jingjie Yu
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xinfeng Guo
- Evidence Based Medicine and Clinical Research Service Group, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China ; The 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China ; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Anthony Lin Zhang
- China-Australia International Research Centre for Chinese Medicine, School of Health Sciences, RMIT Health Innovations Research Institute, RMIT University, PO Box 71, Bundoora, Melbourne, VIC 3083 Australia
| | - Charlie Changli Xue
- The 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China ; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China ; China-Australia International Research Centre for Chinese Medicine, School of Health Sciences, RMIT Health Innovations Research Institute, RMIT University, PO Box 71, Bundoora, Melbourne, VIC 3083 Australia
| | - Chuanjian Lu
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China ; The 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China ; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China ; China-Australia International Research Centre for Chinese Medicine, School of Health Sciences, RMIT Health Innovations Research Institute, RMIT University, PO Box 71, Bundoora, Melbourne, VIC 3083 Australia
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May BH, Deng S, Zhang AL, Lu C, Xue CCL. In silico database screening of potential targets and pathways of compounds contained in plants used for psoriasis vulgaris. Arch Dermatol Res 2015; 307:645-57. [PMID: 26142738 DOI: 10.1007/s00403-015-1577-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 03/11/2015] [Accepted: 05/14/2015] [Indexed: 11/24/2022]
Abstract
Reviews and meta-analyses of clinical trials identified plants used as traditional medicines (TMs) that show promise for psoriasis. These include Rehmannia glutinosa, Camptotheca acuminata, Indigo naturalis and Salvia miltiorrhiza. Compounds contained in these TMs have shown activities of relevance to psoriasis in experimental models. To further investigate the likely mechanisms of action of the multiple compounds in these TMs, we undertook a computer-based in silico investigation of the proteins known to be regulated by these compounds and their associated biological pathways. The proteins reportedly regulated by compounds in these four TMs were identified using the HIT (Herbal Ingredients' Targets) database. The resultant data were entered into the PANTHER (Protein ANnotation THrough Evolutionary Relationship) database to identify the pathways in which the proteins could be involved. The study identified 237 compounds in the TMs and these retrieved 287 proteins from HIT. These proteins identified 59 pathways in PANTHER with most proteins being located in the Apoptosis, Angiogenesis, Inflammation mediated by chemokine and cytokine, Gonadotropin releasing hormone receptor, and/or Interleukin signaling pathways. All four TMs contained compounds that had regulating effects on Apoptosis regulator BAX, Apoptosis regulator Bcl-2, Caspase-3, Tumor necrosis factor (TNF) or Prostaglandin G/H synthase 2 (COX2). The main proteins and pathways are primarily related to inflammation, proliferation and angiogenesis which are all processes involved in psoriasis. Experimental studies have reported that certain compounds from these TMs can regulate the expression of proteins involved in each of these pathways.
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Affiliation(s)
- Brian H May
- School of Health Sciences, and Traditional and Complementary Medicine Research Program, Health Innovations Research Institute, RMIT University, Bundoora, VIC, 3083, Australia
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