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Sahu N, Madan S, Walia R, Tyagi R, Fantoukh OI, Hawwal MF, Akhtar A, Almarabi I, Alam P, Saxena S. Multi-target mechanism of Solanum xanthocarpum for treatment of psoriasis based on network pharmacology and molecular docking. Saudi Pharm J 2023; 31:101788. [PMID: 37811124 PMCID: PMC10551897 DOI: 10.1016/j.jsps.2023.101788] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/10/2023] [Indexed: 10/10/2023] Open
Abstract
Solanum xanthocarpum (SX) has been used to treat a variety of diseases, including skin disorders like psoriasis (PSO). SX possesses many pharmacological activities of anti-inflammatory, anti-cancer, immunosuppressive, and healing qualities. However, the multi-target mechanism of SX on PSO still needs clarity. Materials and methods: The Indian Medicinal Plants, Phytochemicals and Therapeutics (IMPPAT) database and the Swiss Target Prediction online tool were used to find the active phytochemical components and their associated target proteins. OMIM and GeneCards databases were used to extract PSO-related targets. A Venn diagram analysis determined the common targets of SX against PSO. Subsequently, the protein-protein interaction (PPI) network and core PPI target analysis were carried out using the STRING network and Cytoscape software. Also, utilising the online Metascape and bioinformatics platform tool, a pathway enrichment analysis of common targets using the Kyoto Encyclopaedia of Genes and Genome (KEGG) and Gene Ontology (GO) databases was conducted to verify the role of targets in biological processes, cellular components and molecular functions with respect to KEGG pathways. Lastly, molecular docking simulations were performed to validate the strong affinity between components of SX and key target receptors. Results: According to the IMPPAT Database information, 8 active SX against PSO components were active. According to the PPI network and core targets study, the main targets against PSO were EGFR, SRC, STAT3, ERBB2, PTK2, SYK, EP300, CBL, TP53, and AR. Moreover, molecular docking simulations verified the binding interaction of phytochemical SX components with their PSO targets. Last but not least, enrichment analysis showed that SX is involved in several biological processes, including peptidyl-tyrosine phosphorylation, peptidyl-tyrosine modification, and peptidyl-serine modification. The relevant KEGG signalling pathways are the PI3K-AKT signalling pathway, the EGFR tyrosine kinase inhibitor resistance pathway, and the MAPK signalling pathway. Conclusion: The network pharmacology technique, which is based on data interpretation and molecular docking simulation techniques, has proven the multi-target function of SX phytoconstituents.
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Affiliation(s)
- Nilanchala Sahu
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh 201303, India
| | - Swati Madan
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh 201303, India
| | - Ramanpreet Walia
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh 201303, India
| | - Rama Tyagi
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh 201303, India
| | - Omer I. Fantoukh
- Department of Pharmacognosy, College of Pharmacy, P.O. Box 2457, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed F. Hawwal
- Department of Pharmacognosy, College of Pharmacy, P.O. Box 2457, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ali Akhtar
- Department of Pharmacognosy, College of Pharmacy, P.O. Box 2457, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ibrahim Almarabi
- Division of Pharmacognosy, Department of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, Oxford, MS 38677, USA
| | - Perwez Alam
- Department of Pharmacognosy, College of Pharmacy, P.O. Box 2457, King Saud University, Riyadh 11451, Saudi Arabia
| | - Shikha Saxena
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh 201303, India
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Guo JW, Cheng YP, Lim CJ, Liu CY, Jee SH. A Promising Approach to Treat Psoriasis: Inhibiting Cytochrome P450 3A4 Metabolism to Enhance Desoximetasone Therapy. Pharmaceutics 2023; 15:2016. [PMID: 37631230 PMCID: PMC10458942 DOI: 10.3390/pharmaceutics15082016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 07/22/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: Human keratinocytes and murine skin express various cytochrome P450 enzymes. These include cytochrome P450 3A4, which may participate in the metabolism of cytochrome P450 3A4 substrate drugs. Desoximetasone, a topical corticosteroid and cytochrome P450 3A4 substrate, is used to treat skin conditions such as skin allergies, atopic dermatitis, and psoriasis. In this study, we aimed to investigate the anti-psoriatic effect of a low dose of desoximetasone by inhibiting cytochrome P450 3A4 metabolism in the epidermis. (2) Methods: Psoriasis-like skin was induced in BALB/c mice via the topical administration of imiquimod. The mice were then topically treated with 0.01-0.05% desoximetasone loaded into a cytochrome P450 3A4 enzyme inhibitor excipient base emollient microemulsion, 0.25% commercial desoximetasone ointment, or 0.5 mg/gm clobetasol ointment. (3) Results: The topical application of 0.05% desoximetasone loaded into a cytochrome P450 3A4 enzyme inhibitor excipient base emollient formulation restored the imiquimod-induced skin barrier disruption and resulted in fewer severe clinical and pathological features compared with the treatments with 0.25% commercial desoximetasone ointment and 0.5 mg/gm clobetasol ointment. (4) Conclusions: The cytochrome P450 3A4 enzyme inhibitor excipient base emollient formulation improved and prolonged the therapeutic effect of cytochrome P450 3A4 substrate drugs and may be a promising approach for psoriasis treatment.
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Affiliation(s)
- Jiun-Wen Guo
- Department of Medical Research, Cathay General Hospital, Taipei 10630, Taiwan
| | - Yu-Pin Cheng
- Department of Dermatology, Cathay General Hospital, Taipei 10630, Taiwan;
| | - Cherng-Jyr Lim
- Department of Emergency Medicine, Cathay General Hospital, Taipei 10630, Taiwan;
| | - Chih-Yi Liu
- Division of Pathology, Sijhih Cathay General Hospital, New Taipei City 22174, Taiwan;
| | - Shiou-Hwa Jee
- Department of Dermatology, College of Medicine, National Taiwan University, Taipei 10617, Taiwan;
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Heim M, Irondelle M, Duteil L, Cardot-Leccia N, Rocchi S, Passeron T, Tulic MK. Impact of topical emollient, steroids alone or combined with calcipotriol, on the immune infiltrate and clinical outcome in psoriasis. Exp Dermatol 2022; 31:1764-1778. [PMID: 36054319 DOI: 10.1111/exd.14657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/25/2022] [Accepted: 08/07/2022] [Indexed: 01/07/2023]
Abstract
Psoriasis is a chronic inflammatory disease whereby long-term disease control remains a challenge for the patients. Latest evidence suggests that combined topical treatment with steroids and vitamin D analogue foam (Calcipotriol/Betamethasone) is efficient in long-term management of the disease and reducing the number of relapses. Its effects on cellular inflammation and cytokine production remain to be explored. We set out to examine the effect of topical therapies on cellular infiltrate and cytokine profile in the lesional skin of psoriasis patients. This was a monocentric, double-blind, randomized trial with 30 patients. Patients were treated with the combined Calcipotriol/Betamethasone foam, Betamethasone foam alone, Clobetasol Propionate ointment or placebo. 4 mm skin biopsies from lesional and non-lesional sites were taken before and 4 weeks after treatment. Cellular infiltrate, IFNγ and IL-17 were studied by immunofluorescence. Each patient was their own control. Evolution in skin inflammation was studied in parallel with changes in patient's epidermal thickness and their tPASI clinical score. Lesional skin was characterized by increased epidermal thickness, increased number of IL-17 and IFNγ producing CD8+ T cells, NK cells and neutrophils. All treatment reduced epidermal thickness and improved patients tPASI scores. Only the combined Calcipotriol/Betamethasone foam completely abolished epidermal and dermal influx of CD8+ T cells, reduced number of CD8 + IFNγ+ cells (but not CD8 + IL-17+ cells) and significantly reduced the number of MPO+ neutrophils which were predominantly IL-17+. None of the treatments had effect on NK cells. We have shown the combined topical treatment with Calcipotriol/Betamethasone foam to be effective in reducing cellular influx into lesional skin of psoriasis patients and this effect to be superior to emollient or Betamethasone alone. Its previously described efficacy in the clinic may be attributed to its unique and rapid ability to inhibit both adaptive CD8+ T cell and innate immune neutrophilia influx into the skin, which was not observed for the other treatments.
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Affiliation(s)
- Marjorie Heim
- Centre Méditerranéen de Médecine Moléculaire (C3M), Université Côte d'Azur, Nice, France.,Department of Dermatology, CHU Nice, Université Côte d'Azur, Nice, France
| | - Marie Irondelle
- Centre Méditerranéen de Médecine Moléculaire (C3M), Université Côte d'Azur, Nice, France
| | - Luc Duteil
- CHU Nice, Centre de Pharmacologie Clinique Appliquée à la Dermatologie (CPCAD), Université Côte d'Azur, Nice, France
| | | | - Stéphane Rocchi
- Centre Méditerranéen de Médecine Moléculaire (C3M), Université Côte d'Azur, Nice, France
| | - Thierry Passeron
- Centre Méditerranéen de Médecine Moléculaire (C3M), Université Côte d'Azur, Nice, France.,Department of Dermatology, CHU Nice, Université Côte d'Azur, Nice, France
| | - Meri K Tulic
- Centre Méditerranéen de Médecine Moléculaire (C3M), Université Côte d'Azur, Nice, France
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Licata G, Arisi M, Venturini M, Rossi M, Tomasi C, Calzavara-Pinton I, Calzavara-Pinton P. Pretreatment with an Aerosol Foam Containing Calcipotriene and Betamethasone Strongly Improves the Efficacy of Narrow-Band UVB Phototherapy. Dermatol Ther (Heidelb) 2022; 12:2161-2171. [PMID: 36018478 PMCID: PMC9464281 DOI: 10.1007/s13555-022-00792-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Narrow-band (NB) UVB has been combined with a number of topical treatments. However, there have been no specific data regarding treatment results of a fixed combination of calcipotriene 50 μg/g plus betamethasone 0.5 mg/g aerosol foam (Cal/BD) combined with NB-UVB phototherapy so far. OBJECTIVES To assess the efficacy of Cal/BD foam coupled to twice-weekly NB-UVB and whether this combined regimen requires fewer UVB treatments and a lower cumulative UVB dose compared to phototherapy alone. METHODS This cross-sectional, prospective, parallel-group study enrolled 187 consecutive moderate-to-severe psoriatic patients who were allocated to two groups in a 1:2 ratio. The overall duration of the treatment cycle was 12 weeks. At baseline and after 2, 4, 8 and 12 weeks, we registered the modified (not considering head lesions) PASI, the number of Cal/BD applications, the NRS score for itching and the adverse effects. RESULTS The combined regimen was more effective in clearing psoriasis [final mPASI: 2.1 (0; 8.2) versus 4.4 (0; 19.6); p < 0.01] and reducing itching [(final NRS score for itching: 0 (0; 3) versus 1 (0; 4); p < 0.01]. Fewer exposures [12 (4; 20) versus 24 (8; 24); p < 0.01] and a lower cumulative UVB dose [6.1 (5.4; 9.3) J cm-2 versus 13.1 (9.8; 19.7) J cm-2; p < 0.01] were required. A higher number of patients achieved complete clearance [47 (74.6%) versus 58 (46.8%) patients (p < 0.001)]. Both treatments were well tolerated without acute adverse effects. CONCLUSION Cal/BD + NB-UVB is a very effective treatment that produces a rapid improvement in clinical lesions and itching and can be considered a valuable alternative to systemic treatments for psoriasis.
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Affiliation(s)
- Gaetano Licata
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy.
| | - Mariachiara Arisi
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
| | - Marina Venturini
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
| | - Mariateresa Rossi
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
| | - Cesare Tomasi
- Department of Experimental and Applied Medicine, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Irene Calzavara-Pinton
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
| | - Piergiacomo Calzavara-Pinton
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
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Rudnicka L, Olszewska M, Goldust M, Waśkiel-Burnat A, Warszawik-Hendzel O, Dorożyński P, Turło J, Rakowska A. Efficacy and Safety of Different Formulations of Calcipotriol/Betamethasone Dipropionate in Psoriasis: Gel, Foam, and Ointment. J Clin Med 2021; 10:jcm10235589. [PMID: 34884291 PMCID: PMC8658256 DOI: 10.3390/jcm10235589] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/11/2022] Open
Abstract
Preparations containing calcipotriol combined with betamethasone dipropionate (in the forms of ointment, gel, and foam) are available for the topical treatment of psoriasis. This review summarizes the differences in the efficacy and safety of these formulations, as well as the preferences of patients with various forms of psoriasis (plaque, scalp, and nail psoriasis). It has been documented that foams provide higher bioavailability, resulting in increased efficacy in plaque psoriasis compared to ointments and gels. Gels or foams are preferred by patients for their different practical qualities (e.g., gels for “easy application”, and foams for “immediate relief”). The available data indicate that ointments may be the most effective formulation in nail psoriasis, and gels are preferred by patients with scalp psoriasis because of their cosmetic features. Treatment with a foam formulation is associated with a lower number of medical appointments compared to treatment with an ointment and with a lower probability of developing indications for systemic treatment. The safety profiles of foams, ointments, and gels are comparable, with the most common adverse effect being pruritus at the application site (in 5.8% of the patients). A long-term proactive maintenance therapy markedly reduces the number of relapses and is likely to close the gap between topical and systemic treatment in psoriasis.
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Affiliation(s)
- Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
- Correspondence: ; Tel.: +48-225021324; Fax: +48-228242200
| | - Małgorzata Olszewska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Anna Waśkiel-Burnat
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
| | - Olga Warszawik-Hendzel
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
| | - Przemysław Dorożyński
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, 02-097 Warsaw, Poland; (P.D.); (J.T.)
| | - Jadwiga Turło
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, 02-097 Warsaw, Poland; (P.D.); (J.T.)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
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6
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Fabbrocini G, De Simone C, Dapavo P, Malagoli P, Martella A, Calzavara Pinton P. Long-term maintenance treatment of psoriasis: the role of calcipotriol/betamethasone dipropionate aerosol foam in clinical practice. J DERMATOL TREAT 2021; 33:2425-2432. [PMID: 34694953 DOI: 10.1080/09546634.2021.1998310] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Most patients with psoriasis present with localized mild-to-moderate disease. In this case, the application of topical treatments in the first-line setting is recommended in most cases.Among different topical options, the fixed-dose combination of betamethasone dipropionate (BD) and vitamin D analogue (Cal) aerosol foam (Enstilar®, Leo Pharma) is approved as first-line topical therapy for the treatment of psoriasis in USA and the EU, due to its high efficacy and its favorable administration scheme.The PSO-LONG was the first trial to report on the long-term efficacy and safety of the Cal/DB foam treatment for the proactive management of psoriasis and now, the indications of Cal/BD foam included its use in the psoriasis maintenance treatment. However, the precise role of this treatment and the potential therapeutic schemes in the long-term management of psoriasis need further clarification.This Position Paper, authored by a group of Italian Expert Dermatologists, critically discusses the long-term management of psoriasis with Cal/BD foam in clinical practice. In particular, the biological rationale in the proactive treatment with Cal/BD foam and current evidence regarding this therapeutic approach are presented, along with its application also in patients with moderate-to-severe disease, difficult-to-treat lesions, or within combination regimens. In addition, strategies to improve adherence to long-term treatment of psoriasis are discussed.
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Affiliation(s)
- G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Policlinico "A. Gemelli", IRCCS, Rome, Italy
| | - P Dapavo
- ASO City of Health and Science, University Dermatological Clinic, Corso Vittorio Emanuele II, 62, Torino, Italy
| | - P Malagoli
- Head Psocare Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato, Milano, Italy
| | - A Martella
- Myskin Dermatology Practice, Tiggiano, Lecce, Italy
| | - P Calzavara Pinton
- Dermatology Department, University of Brescia, ASST Spedali Civili, P.le Spedali Civili, 1, Brescia, Italy
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7
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Navarro-Triviño FJ, Lozano-Lozano M, Ruiz-Villaverde R. Calcipotriol/Betamethasone Dipropionate Aerosol Foam for Plaque Psoriasis: A Prospective, Observational, Non-Interventional, Single-Center Study of Patient Adherence and Satisfaction in Daily Use. Dermatol Pract Concept 2021; 11:e2021056. [PMID: 34123560 DOI: 10.5826/dpc.1103a56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 10/31/2022] Open
Abstract
Background Psoriasis is a chronic inflammatory disease that has a negative impact on patients' quality of life. Patients with mild-moderate psoriasis can be treated with topical medications, such as the combination drug calcipotriol/betamethasone dipropionate (Cal/BD). Objectives This study investigated the adherence of psoriasis patients to therapy with Cal/BD aerosol foam, as well as their satisfaction with the treatment's efficacy, safety, and effect on their quality of life. Methods Patients with mild-moderate plaque psoriasis were eligible to participate in this open-label, non-placebo controlled, prospective single-center study. Adherence to treatment was assessed using the Morisky-Green scale 4 and 12 weeks after the start of treatment. Satisfaction with the treatment was assessed using the abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9). The severity of psoriasis was assessed on the mIGA and PGA scales, and the impact on quality of life was assessed using the PDI and DLQI scales. Results A total of 65 patients entered the study. Adherence to treatment was good, with 73.8% of patients showing high adherence at 12 weeks. Satisfaction was also good, with 46 patients (70.8%) being completely satisfied. Conclusions Over a 4-week period, patients treated with Cal/BD aerosol foam had significant improvement in disease severity that was directly related to treatment adherence.
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Affiliation(s)
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, and University of Granada & Sport and Health Joint University Institute (iMUDS), Granada, Spain
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