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Simard M, Morin S, Ridha Z, Pouliot R. Current knowledge of the implication of lipid mediators in psoriasis. Front Immunol 2022; 13:961107. [PMID: 36091036 PMCID: PMC9459139 DOI: 10.3389/fimmu.2022.961107] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
The skin is an organ involved in several biological processes essential to the proper functioning of the organism. One of these essential biological functions of the skin is its barrier function, mediated notably by the lipids of the stratum corneum, and which prevents both penetration from external aggression, and transepidermal water loss. Bioactive lipid mediators derived from polyunsaturated fatty acids (PUFAs) constitute a complex bioactive lipid network greatly involved in skin homeostasis. Bioactive lipid mediators derived from n-3 and n-6 PUFAs have well-documented anti- and pro-inflammatory properties and are recognized as playing numerous and complex roles in the behavior of diverse skin diseases, including psoriasis. Psoriasis is an inflammatory autoimmune disease with many comorbidities and is associated with enhanced levels of pro-inflammatory lipid mediators. Studies have shown that a high intake of n-3 PUFAs can influence the development and progression of psoriasis, mainly by reducing the severity and frequency of psoriatic plaques. Herein, we provide an overview of the differential effects of n-3 and n-6 PUFA lipid mediators, including prostanoids, hydroxy-fatty acids, leukotrienes, specialized pro-resolving mediators, N-acylethanolamines, monoacylglycerols and endocannabinoids. This review summarizes current findings on lipid mediators playing a role in the skin and their potential as therapeutic targets for psoriatic patients.
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Affiliation(s)
- Mélissa Simard
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval/Laboratoire d’Organogénèse EXpérimentale (LOEX), Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec, Québec, QC, Canada
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
| | - Sophie Morin
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval/Laboratoire d’Organogénèse EXpérimentale (LOEX), Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec, Québec, QC, Canada
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
| | - Zainab Ridha
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval/Laboratoire d’Organogénèse EXpérimentale (LOEX), Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec, Québec, QC, Canada
| | - Roxane Pouliot
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval/Laboratoire d’Organogénèse EXpérimentale (LOEX), Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec, Québec, QC, Canada
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- *Correspondence: Roxane Pouliot,
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Gao Y, Li X, Liu T, Liu Z. The Effect of Methotrexate on Serum Levels of Trace/Mineral Elements in Patients with Psoriatic Arthritis. Biol Trace Elem Res 2021; 199:4498-4503. [PMID: 33452668 DOI: 10.1007/s12011-021-02594-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
Psoriatic arthritis is a type of inflammatory arthritis that occurs in some patients with psoriasis. Clinically, low-dose methotrexate was used to treat psoriatic arthritis as a first-line agent. However, the pathogenesis of psoriatic arthritis and the mechanism of methotrexate treating psoriatic arthritis remained unclear. In recent years, a variety of side effects associated with methotrexate have been reported. In order to illuminate the role of trace/mineral elements in the pathogenesis of psoriatic arthritis and the side effect of low-dose methotrexate on blood cells and trace/mineral elements in patients with psoriatic arthritis, 37 psoriatic arthritis patients and healthy 50 people with similar age and gender were enrolled in this study. The blood cells, serum trace/mineral elements, liver function, and kidney function were determined. The results revealed that the level of serum zinc was significantly lower and copper was significantly higher in psoriatic arthritis patients in comparison with healthy control. After giving patients methotrexate intravenously (15 mg weekly), their serum zinc was significantly increased, and copper was significantly decreased with symptoms relieved. Our study provided the evidence that low zinc and high copper might be associated with the pathogenesis of psoriatic arthritis, and the possible mechanism of methotrexate treating psoriatic arthritis was through elevating zinc and reducing copper in serum. Moreover, we demonstrated that low-dose methotrexate could induce liver damage to psoriatic arthritis patients.
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Affiliation(s)
- Yue Gao
- College of Medical Laboratory Science, Guilin Medical University, No. 109, Huanchengbeier Road, Guilin, 541004, Guangxi, China
| | - Xia Li
- Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Tao Liu
- Department of Ophthalmology, 3201 hospital, Hanzhong, Shaanxi, China
| | - Zheng Liu
- College of Medical Laboratory Science, Guilin Medical University, No. 109, Huanchengbeier Road, Guilin, 541004, Guangxi, China.
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Wang Y, Wei L, Guan Y, Wang Q, Xie Q, Hao C. Diabetes is a risk factor for high-dose methotrexate-associated AKI in lymphoma patients. Ren Fail 2021; 42:1111-1117. [PMID: 33164656 PMCID: PMC7655081 DOI: 10.1080/0886022x.2020.1838926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose The aim of the study was to investigate the incidence of acute kidney injury (AKI) occurring after high-dose methotrexate (HDMTX) administration and the role of type 2 diabetes (T2D) playing in the occurrence of AKI. Methods We assessed associations between T2D along with other confounding factors mainly including baseline estimated glomerular filtration rate (eGFR), methotrexate (MTX) elimination and urine pH, and AKI occurrence. Patients who were diagnosed as primary central nervous system lymphoma with treatment of HDMTX and with eGFR ≥60 mL/min/1.73 m2 were enrolled in this study. Results Of the 507 courses enrolled in this study, 132 courses have T2D. Lower baseline eGFR, delayed MTX elimination, lower urine pH, and higher incidence of AKI were observed in T2D group. Using univariate logistic regression, several confounding factors including baseline eGFR, hypertension, MTX elimination, and urine alkalinization statistically and clinically important were screened out. After adjusting for these factors, T2D remained an independent association with AKI occurrence. AKI outcome had no significant relationship with severe hematological toxicity or hepatotoxicity. AKI was associated with faster eGFR decline after a series of HDMTX treatment courses. Conclusions Patients with T2D have a higher sensitivity to AKI when administrated with HDMTX. This conclusion addresses safety concerns for making chemotherapy regimen for this population.
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Affiliation(s)
- Yujia Wang
- Division of Nephrology, Huashan Hospital, and Nephrology Research Institute, Fudan University, Shanghai, China
| | - Li Wei
- Division of Hematology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi Guan
- Division of Nephrology, Huashan Hospital, and Nephrology Research Institute, Fudan University, Shanghai, China
| | - Qian Wang
- Division of Hematology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qionghong Xie
- Division of Nephrology, Huashan Hospital, and Nephrology Research Institute, Fudan University, Shanghai, China
| | - Chuanming Hao
- Division of Nephrology, Huashan Hospital, and Nephrology Research Institute, Fudan University, Shanghai, China
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Petit RG, Cano A, Ortiz A, Espina M, Prat J, Muñoz M, Severino P, Souto EB, García ML, Pujol M, Sánchez-López E. Psoriasis: From Pathogenesis to Pharmacological and Nano-Technological-Based Therapeutics. Int J Mol Sci 2021; 22:4983. [PMID: 34067151 PMCID: PMC8125586 DOI: 10.3390/ijms22094983] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 12/12/2022] Open
Abstract
Research in the pathogenesis of inflammatory skin diseases, such as skin dermatitis and psoriasis, has experienced some relevant breakthroughs in recent years. The understanding of age-related factors, gender, and genetic predisposition of these multifactorial diseases has been instrumental for the development of new pharmacological and technological treatment approaches. In this review, we discuss the molecular mechanisms behind the pathological features of psoriasis, also addressing the currently available treatments and novel therapies that are under clinical trials. Innovative therapies developed over the last 10 years have been researched. In this area, advantages of nanotechnological approaches to provide an effective drug concentration in the disease site are highlighted, together with microneedles as innovative candidates for drug delivery systems in psoriasis and other inflammatory chronic skin diseases.
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Affiliation(s)
- Robert Gironés Petit
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
| | - Amanda Cano
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
- Center for Biomedical Research in Neurodegenerative Diseases Network, Carlos III Health Institute, 28031 Madrid, Spain
| | - Alba Ortiz
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Marta Espina
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Josefina Prat
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Montserrat Muñoz
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Patrícia Severino
- University of Tiradentes (Unit) Av. Murilo Dantas, Aracaju 49010-390, Brazil;
- Institute of Technology and Research (ITP) Av. Murilo Dantas, Aracaju 49010-390, Brazil
| | - Eliana B. Souto
- CEB—Centre of Biological Engineering, Campus de Gualtar, University of Minho, 4710-057 Braga, Portugal
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Maria L. García
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
- Center for Biomedical Research in Neurodegenerative Diseases Network, Carlos III Health Institute, 28031 Madrid, Spain
| | - Montserrat Pujol
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain; (R.G.P.); (A.C.); (A.O.); (M.E.); (J.P.); (M.M.); (M.L.G.)
- Institute of Nanoscience and Nanotechnology, Universitat de Barcelona, 08028 Barcelona, Spain
- Center for Biomedical Research in Neurodegenerative Diseases Network, Carlos III Health Institute, 28031 Madrid, Spain
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Mahant S, Rao R, Souto EB, Nanda S. Analytical tools and evaluation strategies for nanostructured lipid carrier-based topical delivery systems. Expert Opin Drug Deliv 2021; 17:963-992. [PMID: 32441158 DOI: 10.1080/17425247.2020.1772750] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The inception of nanostructured lipid carriers (NLCs) proved to be a revolutionary step toward the treatment of dermatological disorders. To uncover its true potential, it is imperative that the system be characterized and evaluated comprehensively. AREAS COVERED The present review has been written to furnish an in-depth account of analytical tools and evaluation procedures under one roof. Besides discussing the challenges of topical delivery and benefits of NLCs, the paper elaborates on their physicochemical characterization. Further, in vitro evaluation of NLCs for dermatological benefits, followed by their evaluation in a hydrogel/cream base is covered. Lastly, disease-specific evaluation of NLC-based formulations is presented. EXPERT OPINION The research endeavors for NLCs have largely focused on the fabrication of NLCs for different bioactives. However, scientific efforts should be aimed toward the lesser explored realm of NLCs, i.e. exploitation of analytical techniques, such as Parelectric spectroscopy, Electron Spin Resonance, and Nuclear Magnetic Resonance spectroscopy. NLCs have been proven for their potential to foster the therapeutic modalities applicable to cutaneous disorders. More attention needs to be devoted to their evaluation for disease-specific parameters. The futuristic steps must involve clinical studies, to lay the path for their commercialization.
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Affiliation(s)
- Sheefali Mahant
- Department of Pharmaceutical Sciences, Maharshi Dayanand University , Rohtak, Haryana, India
| | - Rekha Rao
- Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science and Technology , Haryana, India
| | - Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal.,CEB-Centre of Biological Engineering, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Sanju Nanda
- Department of Pharmaceutical Sciences, Maharshi Dayanand University , Rohtak, Haryana, India
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Zong J, Cheng J, Fu Y, Song J, Pan W, Yang L, Zhang T, Zhou M. Serum Metabolomic Profiling Reveals the Amelioration Effect of Methotrexate on Imiquimod-Induced Psoriasis in Mouse. Front Pharmacol 2020; 11:558629. [PMID: 33364938 PMCID: PMC7751755 DOI: 10.3389/fphar.2020.558629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The imiquimod (IMQ)-induced psoriasis mouse model has been used as a model for pathogenic mechanism research, and methotrexate (MTX) is widely employed to treat various clinical manifestations of psoriasis. We explored the underlying pathogenesis of psoriasis and the treatment mechanism of the conventional drugs from the metabolic perspective of the psoriasis mouse model. METHODS Male BALB/c mice were smeared IMQ for 7 days to induce treatment-resistant psoriasis and intragastrically administered 1 mg/kg MTX. We evaluated inflammation of psoriasis-like lesions and therapeutic effects of MTX based on histological changes and immunohistochemistry. Based on gas chromatography-mass spectrometer detection of serum samples, a comprehensive metabolomics analysis was carried out to identify alterations of metabolites. RESULTS It was found that MTX ameliorated psoriatic lesions (representative erythema, scaling, and thickening) by inhibiting proliferation and differentiation of keratinocytes. Using multivariate statistical analysis to process metabolomics data, the results displayed alterations in serum metabolites among mice of the control group, IMQ group, and MTX group. Compared with group, psoriasis mice had the higher level of d-galactose and lower expression of myo-inositol, 9,12-octadecadienoic acid, and cholesterol. In contrast with the model set, serum levels of glycine, pyrrolidone carboxylic acid, d-galactose, and d-mannose were significantly decreased in the MTX group. CONCLUSION The differential metabolites, reflecting the perturbation in the pathways of inositol phosphate metabolism; galactose metabolism; glyoxylate and dicarboxylate metabolism; glycine, serine, and threonine metabolism; and glutathione metabolism, may lead to the pathogenesis of psoriasis, and they are also related to the pharmacological treatment effect of MTX on psoriasis. This study established the foundation for further research on the mechanism and therapeutic targets of psoriasis.
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Affiliation(s)
- Jiaxin Zong
- Murad Research Center for Modernized Chinese Medicine, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jieyi Cheng
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanfeng Fu
- Murad Research Center for Modernized Chinese Medicine, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Song
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Weisong Pan
- Guangzhou Institute for Drug Control, Guangzhou, China
| | - Li Yang
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ting Zhang
- Murad Research Center for Modernized Chinese Medicine, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mingmei Zhou
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Hoshyar R, Sebzari A, Balforoush M, Valavi M, Hosseini M. The impact of Crocus sativus stigma against methotrexate-induced liver toxicity in rats. ACTA ACUST UNITED AC 2019; 17:/j/jcim.ahead-of-print/jcim-2019-0201/jcim-2019-0201.xml. [DOI: 10.1515/jcim-2019-0201] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022]
Abstract
AbstractBackgroundThe adverse effects of methotrexate (MTX) mainly hepatotoxicity restrict its clinical use. This study was designed to investigate the protective effects of saffron (Crocus sativus) (CS) extract on MTX-induced hepatotoxicity.MethodsTwenty-eight male Wistar rats randomly divided into four equal groups. Except for control, all groups received a single intraperitoneal (i.p.) injection of MTX on the 3rd day of study. The CS extract was given (80 mg/kg i.p.) to rats 3 days before MTX and continued for the next 7 days (Pre&Post-CS group) or administrated after MTX injection and lasted for 7 days (Post-CS group). On the 11th day, all rats were sacrificed and their plasma levels of liver enzymes including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were determined. Also, liver histopathology and hepatic levels of malondialdehyde (MDA), nitric oxide (NO) and super oxidase dismutase (SOD) were evaluated.ResultsThe results showed that MTX significantly incremented plasma levels of AST, ALT, ALP and LDH (all p<0.001) and hepatic MDA and NO levels; whereas, decreased SOD activity. Histological alterations such as early fatty changes were evident in the MTX group. Administration of CS extract at both methods could ameliorate liver enzyme elevation, oxidative/nitrosative stresses and morphological alterations of the liver. Pre-and-post treatment with CS extract showed better protective effects than only post-treatment.ConclusionThe present findings provide showing CS could effectively alleviate MTX-induced hepatotoxicity in rats. Further investigations are recommended to determine the exact mechanisms underlying the hepatoprotective potential of saffron.
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Affiliation(s)
- Reyhane Hoshyar
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmadreza Sebzari
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohadeseh Balforoush
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoomeh Valavi
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mehran Hosseini
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Natarajan K, Abraham P, Kota R. Activation of the mitochondrial apoptotic pathway contributes to methotrexate-induced small intestinal injury in rats. Cell Biochem Funct 2017; 35:378-391. [DOI: 10.1002/cbf.3285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/12/2017] [Accepted: 07/07/2017] [Indexed: 01/05/2023]
Affiliation(s)
- Kasthuri Natarajan
- Department of Biochemistry; Christian Medical College Campus; Vellore Tamil Nadu India
| | - Premila Abraham
- Department of Biochemistry; Christian Medical College Campus; Vellore Tamil Nadu India
| | - Rekha Kota
- Department of Pathology; Madha Medical College Thandalam; Chennai Tamil Nadu India
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An J, Zhang D, Wu J, Li J, Teng X, Gao X, Li R, Wang X, Xia L, Xia Y. The acitretin and methotrexate combination therapy for psoriasis vulgaris achieves higher effectiveness and less liver fibrosis. Pharmacol Res 2017; 121:158-168. [PMID: 28414177 DOI: 10.1016/j.phrs.2017.04.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/30/2017] [Accepted: 04/11/2017] [Indexed: 02/05/2023]
Abstract
Both acitretin and methotrexate are effective in ameliorating psoriatic lesion. However, their combination has been seldom reported in the treatment of psoriasis because of the warning regarding the potential hepatotoxicity of the drug interactions. This study was designed to investigate the effectiveness of such combination therapy for psoriasis vulgaris, and the potential benefit as well as side effect during the treatment. Thirty-nine patients with psoriasis vulgaris were treated with acitretin, methotrexate or their combination or as control. Similarly, K14-VEGF transgenic psoriasis-like mice were treated with these drugs. Human primary keratinocytes and hepatic stellate cells were used for analyzing their effect in vitro. The results showed that the combination therapy exhibited higher effectiveness in remitting skin lesion, but did not significantly affect the liver function of both patients and mice. Moreover, the combination groups showed less elevation of profibrotic factors in sera when compared with methotrexate alone groups accordingly. Furthermore, primary keratinocytes expressed more involucrin as well as loricrin and proliferated more slowly on the combined stimulation. Interestingly, such combination treatment induced lower expression of profibrotic factors in hepatic stellate cells. In conclusion, the acitretin-methotrexate combination therapy for psoriasis vulgaris can achieve higher effectiveness and result in less liver fibrosis.
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Affiliation(s)
- Jingang An
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Dingwei Zhang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Jiawen Wu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Jiong Li
- State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, China
| | - Xiu Teng
- State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, China
| | - Xiaomin Gao
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Ruilian Li
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Xiuying Wang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Linlin Xia
- Core Research Laboratory, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Yumin Xia
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
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