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Jia J, Gu SX, Mo X, Liu J, Chen D. An updated systematic review and meta-analysis of efficacy and safety of Chinese herbal medicine for treating atopic dermatitis. J DERMATOL TREAT 2023; 34:2268766. [PMID: 37955143 DOI: 10.1080/09546634.2023.2268766] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND This systematic review evaluated the Chinese herbal medicine (CHM) for treating atopic dermatitis (AD). METHODS PubMed, EMBASE, the Cochrane library, the Wanfang database, and China National Knowledge Infrastructure (CNKI) were searched for relevant randomized controlled trials (RCTs) from inception to December 2021. Overall recovery rate, disease/symptom severity scoring, quality of life (QoL), recurrence rate, and incidence of adverse events (AEs) were evaluated. STATA SE 14.0 software was used for statistical analysis. RESULTS 17 RCTs involving 1624 patients were eligible. CHM was associated with a higher overall recovery rate (risk ratio [RR] = 1.15, 95% confidence interval [CI]: 1.05, 1.26, p = .003) and decreased recurrence rate (odds ratio [OR] = 0.19, 95% CI: 0.07, 0.55, p = .002), both confirmed by sensitivity analyses. CHM could decrease scoring atopic dermatitis index (MD = -0.61, 95% CI: -1.12, -0.11, p = .017), however, sensitivity analysis revealed non-robustness. No significant differences were found between the CHM and the control group in Eczema Area and Severity Index, QoL, and the incidence of AEs. CONCLUSIONS CHM was effective for treating AD as it could improve the overall recovery rate and decrease the recurrence rate. More studies are required to validate the potential of CHM on disease/symptoms severity and QoL.
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Affiliation(s)
- Jinjing Jia
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Sherman X Gu
- School of Health and Biomedical Sciences, STEM College, RMIT University, Melbourne, Australia
| | - Xiumei Mo
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junfeng Liu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dacan Chen
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
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Lu R, Peng Z, Lian P, Wazir J, Gu C, Ma C, Wei L, Li L, Pu W, Liu J, Wang H, Su Z. Vitamin D attenuates DNCB-induced atopic dermatitis-like skin lesions by inhibiting immune response and restoring skin barrier function. Int Immunopharmacol 2023; 122:110558. [PMID: 37393836 DOI: 10.1016/j.intimp.2023.110558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
Atopic dermatitis (AD) is a common chronic inflammatory skin disease causing erythema and itching. The etiology of AD is complex and not yet clear. Vitamin D is a fat-soluble vitamin that promotes skin cell growth and differentiation and regulates immune function. This study aimed to explore the therapeutic effect of calcifediol, the active metabolite of vitamin D, on experimental AD and the possible mechanism of action. We found that the levels of vitamin D binding protein (VDBP) and vitamin D receptor (VDR) in biopsy skin samples from AD patients decreased compared with controls. We used 2,4-dinitrochlorobenzene (DNCB) to induce an AD mouse model on the ear and back of BALB/c mice. A total of five groups were used: the control group, the AD group, the AD + calcifediol group, the AD + dexamethasone group, and the calcifediol alone group. Under calcifediol treatment, mice exhibited reduced spinous layer thickening, reduced inflammatory cell infiltration, downregulated aquaporin 3 (AQP3) expression, and restored the barrier function of the skin. Simultaneous calcifediol treatment decreased STAT3 phosphorylation, inhibited inflammation and chemokine release, decreased AKT1 and mTOR phosphorylation, and suppressed epidermal cell proliferation and abnormal differentiation. In conclusion, our study demonstrated that calcifediol significantly protected mice against DNCB-induced AD. In a mouse model of AD, calcifediol may reduce inflammatory cell infiltration and chemokines by inhibiting the phosphorylation of STAT3 and may restore skin barrier function through the downregulation of AQP3 protein expression and inhibition of cell proliferation.
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Affiliation(s)
- Renwei Lu
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Ziqi Peng
- The First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China
| | - Panpan Lian
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Junaid Wazir
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Chaode Gu
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Chujun Ma
- Department of Dermatology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Lulu Wei
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Li Li
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Wenyuan Pu
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Jun Liu
- Department of Dermatology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Hongwei Wang
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China.
| | - Zhonglan Su
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
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Huang C, Li S, Guo W, Zhang Z, Meng X, Li X, Gao B, Wen R, Niu H, Zhang C, Li M. Cymbaria daurica L.: A Mongolian herbal medicine for treating eczema via natural killer cell-mediated cytotoxicity pathway. JOURNAL OF ETHNOPHARMACOLOGY 2023; 308:116246. [PMID: 36791926 DOI: 10.1016/j.jep.2023.116246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/28/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cymbaria daurica L. (C. daurica) is a perennial herb known commonly as "Xinba" (Chinese) and "Kanba-Arong" (Mongolian). In Mongolia, it is used as a traditional medicine to treat eczema and other skin diseases due to its anti-swelling, anti-inflammatory, anti-hemorrhagic, and anti-itching properties. However, the potential mechanism of action for eczema treatment has not been reported. AIM OF THE STUDY To investigate the effect of C. daurica on 1-chloro-2,4-dinitrobenzene (DNCB)-induced eczema in rats and the associated action mechanism. MATERIALS AND METHODS Qualitative analysis of C. daurica was performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Based on information obtained from compound identification and relevant literature, the possible targets of C. daurica against eczema were analyzed using network pharmacology and molecular docking methods. The DNCB-induced eczema rat models were treated with different dosages of C. daurica extract (10, 50, and 250 mg/mL per day), and the therapeutic effects subsequently evaluated based on the degree of skin inflammation, spleen index, and hematoxylin and eosin staining (H&E staining). Enzyme-linked immunosorbent assay (ELISA), reverse transcription quantitative polymerase chain reaction (RT-qPCR), and western blotting were used to analyze the relevant target effects. The C. daurica mechanism of action on eczema was verified by animal experiments. High-performance liquid chromatography (HPLC) was carried out to determine the content of active ingredients in C. daurica. In addition, the physicochemical properties of the extract were evaluated. RESULTS Our analysis of the 173 targets included in the protein-protein interaction (PPI) network identified tumor necrosis factor (TNF) and interleukin 2 (IL-2) as key targets involved in the treatment of eczema with C. daurica extract. Furthermore, the 173 targets were associated with the natural killer cell-mediated cytotoxicity pathway. Our results showed that C. daurica significantly reduced IL-2 and TNF-α serum levels in eczema rat models (P < 0.0001); thus, playing an important role in the anti-inflammatory response. Furthermore, according to the p-value, RT-qPCR and western blotting showed that the expression of Src homology 2 domain-containing protein tyrosine phosphatase 1 (SHP-1), Vav guanine nucleotide exchange factor (Vav), and growth factor receptor-bound protein 2 (Grb2) changed in the skin of the eczema model rats after treatment with the C. daurica extract. CONCLUSION Our study confirms that C. daurica can inhibit SHP-1, Vav, and Grb2 expression; thereby, inhibiting the natural killer cell-mediated cytotoxicity pathway. These results provide insight into the mechanism of C. daurica in treating eczema.
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Affiliation(s)
- Congying Huang
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Siqi Li
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Wenxin Guo
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Ziyan Zhang
- Department of Pharmacy, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Xiangxi Meng
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Xing Li
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Bing Gao
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Rong Wen
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Hui Niu
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Chunhong Zhang
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China.
| | - Minhui Li
- Department of Pharmacy, Baotou Medical College, Baotou, 014040, China; Department of Pharmacy, Inner Mongolia Medical University, Hohhot, 010110, China; Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, 010020, China.
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Enhanced Expression of IL-18 and IL-18BP in Plasma of Patients with Eczema: Altered Expression of IL-18BP and IL-18 Receptor on Mast Cells. Mediators Inflamm 2017; 2017:3090782. [PMID: 28839348 PMCID: PMC5559929 DOI: 10.1155/2017/3090782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 04/18/2017] [Accepted: 05/11/2017] [Indexed: 11/18/2022] Open
Abstract
IL-18 has been found to be associated with eczema. However, little is known of the role of IL-18 binding protein (BP) and IL-18 receptor (R) in eczema. We therefore investigated the expression of IL-18, IL-18BP, and IL-18R on mast cells by using flow cytometry analysis and mouse eczema model. The results showed that plasma free IL-18 and free IL-18BP levels in eczema patients were higher than those in healthy controls. IL-18 provoked up to 3.1-fold increase in skin mast cells. IL-18 induced also an increase in IL-18BP+ mast cells, but a reduction of IL-18R+ mast cells in mouse eczema skin. It was found that house dust mite allergen Der p1 and egg allergen OVA induced upregulation of the expression of IL-18, IL-18BP, and IL-18R mRNAs in HMC-1 cells following 2 and 16 h incubation. In conclusion, correlation of IL-18 and IL-18BP in eczema plasma suggests an important balance between IL-18 and IL-18BP in eczema. The decrease in molar concentration ratio of plasma IL-18BP/IL-18 and allergen-induced upregulated expression of IL-18 and IL-18R in skin mast cells of the patients with eczema suggests that anti-IL-18 including IL-18BP therapy may be useful for the treatment of eczema.
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Zhan M, Zheng W, Jiang Q, Zhao Z, Wang Z, Wang J, Zhang H, He S. Upregulated expression of substance P (SP) and NK1R in eczema and SP-induced mast cell accumulation. Cell Biol Toxicol 2017; 33:389-405. [DOI: 10.1007/s10565-016-9379-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 12/25/2016] [Indexed: 01/10/2023]
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Okhlopkov VA, Zubareva EYU, Novikov YUA, Sukach MS, Repina TV, Lekavitchus IYU, Grankina NV. Estimation of clinical efficiency of topical combination therapy patients with pyoderma complicated eczema. VESTNIK DERMATOLOGII I VENEROLOGII 2014. [DOI: 10.25208/0042-4609-2014-90-3-121-127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The results of direct open-label study of efficacy and portability of combination therapy with topical betamethasone dipropionate and mupirocin are presented. Material and methods. Twenty two patients with pyoderma complicated eczema were treated with ointment for external use (betamethasone dipropionate and mupirocin) 2 times a day for 14 days. Clinical efficacy was assessed by the reliability decrease of index EASI and dermatological symptoms scale index (DSSI). Results. Clinical convalescense was achieved in all patients by the 14th day of therapy. There was a statistically significant decrease in the indices EASI, DSSI. Portability were well. Conclusion. Our study results showed clinical efficacy and portability of topical combination therapy of betamethasone dipropionate and mupirocin in patients with pyoderma complicated eczema.
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Tan HY, Zhang AL, Chen D, Xue CC, Lenon GB. Chinese herbal medicine for atopic dermatitis: A systematic review. J Am Acad Dermatol 2013; 69:295-304. [DOI: 10.1016/j.jaad.2013.01.019] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 12/20/2012] [Accepted: 01/08/2013] [Indexed: 11/30/2022]
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Moed H, Yang Q, Oranje AP, Panda S, van der Wouden JC. Different strategies for using topical corticosteroids for established eczema. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd010080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Heleen Moed
- Erasmus MC; Department of General Practice; PO Box 2040 Room GK 1051 Rotterdam Netherlands 3000 CA
| | - Quan Yang
- University of Bath; Department of Pharmacy and Pharmacology; Bath UK BA2 7AY
| | - Arnold P Oranje
- Erasmus MC, University Medical Center, Havenziekenhuis; Pediatric Dermatology Division, Department of Pediatrics and KinderHaven; Dr. Molewaterplein 60 Rotterdam Netherlands 3015 GD
| | - Saumya Panda
- KPC Medical College and Hospital; Department of Dermatology; 18D/11, Anupama Housing Complex Phase I Kolkata India 700052
| | - Johannes C van der Wouden
- VU University Medical Center; Department of General Practice and EMGO Institute for Health and Care Research; PO Box 7057 Amsterdam Netherlands 1007 MB
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Bakulev AL, Kravchenya SS, Murashkin NN, Igonina IA, Epifanova AY, Slesarenko NA. Mikrobnaya ekzema: novye vozmozhnostikombinirovannoy topicheskoy terapii. VESTNIK DERMATOLOGII I VENEROLOGII 2011. [DOI: 10.25208/vdv1098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors assessed clinical efficacy and safety of Supirocin-B for patients suffering from microbial eczema.
The dynamic assessment of EASI, Dermatological Index of Symptom Scale, DLQI and results of bacterioscopic
examination showed that evident positive results of the use of Supirocin-B in patients suffering from microbial eczema are
related to the strong antibacterial action of such a topical antibiotic as Mupirocin as well as high topical anti-inflammatory
action of betamethasone dipropionate.
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Rawal RC, Shah BJ, Jayaraaman AM, Jaiswal V. Clinical Evaluation of an Indian Polyherbal Topical Formulation in the Management of Eczema. J Altern Complement Med 2009; 15:669-72. [DOI: 10.1089/acm.2008.0508] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Bela J. Shah
- B. J. Medical College & Civil Hospital, Ahmedabad, India
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