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Huang S, Duan XW, Zhang HC, Dai BW, Bai YP. Adjunctive Chinese medicine therapy reduces relapse of psoriasis vulgaris after discontinuation of biologics: a prospective registry-based cohort study. J DERMATOL TREAT 2024; 35:2355261. [PMID: 38767401 DOI: 10.1080/09546634.2024.2355261] [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: 01/08/2024] [Accepted: 03/31/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Biologics have revolutionized psoriasis treatment; however, relapse of psoriasis after discontinuation of biologics remains unresolved. OBJECTIVE To assess the impact of adjunctive Chinese medicine (CM) therapy on relapse of psoriasis vulgaris (PV) after discontinuation of biologics. METHODS We constructed a prospective cohort study through a psoriasis case registry platform that enrolled patients treated with biologics (in combination with or without CM). The endpoint event was relapse, defined as loss of psoriasis area and severity index (PASI) 75. RESULTS A total of 391 patients completed the study and were included in the analysis, of whom 169 (43.2%) experienced relapse during follow-up. To minimize the bias, a 1:1 propensity score matching (PSM) was performed, generating matched cohorts of 156 individuals per group. Adjuvant CM therapy significantly associated with reduced incidence of relapse (HR =0.418, 95% CI = 0.289 ∼ 0.604, p < 0.001), and the protective effect of CM in the subgroup analysis was significant. In addition, PASI 90 response and disease duration were associated with relapse (p < 0.05). CONCLUSION Adjunctive CM therapy is associated with reduced relapse incidence in PV after discontinuation of biologics.
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Affiliation(s)
- Shan Huang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xing-Wu Duan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hua-Chao Zhang
- Department of Dermatology and Venereal Disease, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo-Wen Dai
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yan-Ping Bai
- Department of Dermatology and Venereal Disease, China-Japan Friendship Hospital, Beijing, China
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Zhu X, Xu Q, Liu Z, Cao Z, Li M, Wei J, Du L, Han C, Zhang C. Qingre Lishi Decoction ameliorates imiquimod-induced psoriasis-like skin lesions in SKH-1 mice by regulating the Treg-DC-Th17 axis and inhibiting MAPK-mediated DC maturation. JOURNAL OF ETHNOPHARMACOLOGY 2024; 318:116931. [PMID: 37473822 DOI: 10.1016/j.jep.2023.116931] [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: 05/19/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Psoriasis, an immune system disorder, is a chronic relapsing disease that cannot be cured. Chinese herbal medicine is gradually considered a promising alternative treatment for psoriasis due to its multiple effects, ability to target multiple pathways and lower toxicity. Qingre Lishi Decoction (QRLSD) is effective in clinical treatment. However, its related molecular mechanism remains to be elucidated. AIM OF THE STUDY The purpose of this research was to investigate the therapeutic impacts of Qingre Lishi Decoction on the murine model of psoriasis-like skin lesions induced by imiquimod and to reveal the underlying mechanisms. MATERIALS AND METHODS First, QRLSD was orally administered to evaluate its efficacy in an imiquimod (IMQ)-induced psoriasis mouse model. Further, UPLC-Q-TOF/MS was used to analyze the compounds of QRLSD. To investigate the mechanism and main targets of QRLSD for treating psoriasis, network pharmacology and molecular docking methods were utilized. Finally, To further confirm the anti-psoriasis target, dendritic cells derived from bone marrow (BMDCs) were cultured in vitro. RESULTS In vivo experiments found that QRLSD could regulate the ratio of dendritic cells, Treg cells, and Th17 cells in the body and inhibit inflammation and keratinocyte proliferation in psoriasis-like skin lesions. Further analysis showed that the p38-MAPK pathway is one of its main signaling pathways. In vitro experiments confirmed that QRLSD suppressed the maturation and activation of BMDCs via the p38-MAPK signaling pathway. CONCLUSIONS This study suggests that Qingre Lishi Decoction has the promise to be an effective formula for treating psoriasis through the p38-MAPK pathway, which can help break through the current limitations of psoriasis in clinical treatment.
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Affiliation(s)
- Xia Zhu
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Qingqing Xu
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Zhaoyang Liu
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Zhiqiang Cao
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Mingming Li
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Jingjing Wei
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Lingyun Du
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Changyu Han
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Chunhong Zhang
- Department of Dermato-Venereology, The Second Hospital of Shandong University, Jinan, 250033, China.
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Moini Jazani A, Nasimi Doost Azgomi H, Nasimi Doost Azgomi A, Hossein Ayati M, Nasimi Doost Azgomi R. Efficacy of hydrotherapy, spa therapy, and balneotherapy on sleep quality: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:975-991. [PMID: 37145200 DOI: 10.1007/s00484-023-02471-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023]
Abstract
The purpose of this article was to review and assess the results obtained from human studies on the effects of hydrotherapy, balneotherapy, and spa therapy on sleep disorders. In this study, databases such as Pubmed, Embase, Web of Science, Google Scholar, Cochrane, Scopus, and sciences direct database were searched from the beginning to September 2022. All human studies that examined the effect of hydrotherapy, balneotherapy, and spa therapy on sleep disorders were published in the form of a full article in English. In the end, only 18 of the 189 articles met the criteria for analysis. Most studies have shown that balneotherapy, spa therapy, and hydrotherapy may by affecting some hormones such as histamine, serotonin, sympathetic nerves, and regulating body temperature led to increased quality and quantity of sleep. Also, the results obtained from Downs and Black show that 3 studies were rated as very good, 7 studies as good, 7 studies as fair, and 1 study as weak. The results of studies also showed that hydrotherapy leads to an improvement in the PSQI score index. Nevertheless, more clinical trials are needed to determine the mechanism of action of hydrotherapy on sleep disorders.
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Affiliation(s)
- Arezoo Moini Jazani
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamidreza Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hossein Ayati
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Departman of Medical History, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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Moini Jazani A, Ayati MH, Nadiri AA, Nasimi Doost Azgomi R. Efficacy of hydrotherapy, spa therapy, and balneotherapy for psoriasis and atopic dermatitis: a systematic review. Int J Dermatol 2023; 62:177-189. [PMID: 35347724 DOI: 10.1111/ijd.16080] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/23/2021] [Accepted: 01/03/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) and psoriasis are chronic inflammatory diseases that have significant skin complications. OBJECTIVE The purpose of this systematic study was to evaluate the evidence obtained from human studies on the effects of hydrotherapy, spa therapy, and balneotherapy in psoriasis and atopic dermatitis. METHODS The present systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements. Also, for this study databases such as Embase, PubMed, Scopus ProQuest, and sciences direct database were searched from the beginning to April 2021. RESULTS All human studies that examined the effect of balneotherapy, spa therapy, and hydrotherapy on psoriasis and atopic dermatitis were published in the form of a full article in English. In the end, only 22 of the 424 articles met the criteria for analysis. Most studies have shown that balneotherapy, spa therapy, and hydrotherapy may reduce the effects of the disease by reducing inflammation and improving living conditions. In addition, the results of the Downs and Black score show that seven studies received very good scores, three studies received good scores, nine studies received fair scores, and three studies received poor scores. CONCLUSIONS The results of studies also showed that hydrotherapy leads to an improvement in the PASI score index. Nevertheless, more clinical trials are needed to determine the mechanism of action of hydrotherapy on these diseases.
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Affiliation(s)
- Arezoo Moini Jazani
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hossein Ayati
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.,Department of Medical History, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Allah Nadiri
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.,Department of Earth Sciences, Faculty of Natural Sciences, University of Tabriz, Tabriz, East Azarbaijan, Iran
| | - Ramin Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
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Mind-Body Interventions as Alternative and Complementary Therapies for Psoriasis: A Systematic Review of the English Literature. ACTA ACUST UNITED AC 2021; 57:medicina57050410. [PMID: 33922733 PMCID: PMC8146919 DOI: 10.3390/medicina57050410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/13/2022]
Abstract
Objective: Conventional therapeutic methods for psoriasis include topical and systemic drugs, phototherapy, and biologic agents. Despite the fact that these treatment methods, and especially biologic agents, are met with a considerable reduction in disease activity, they can sometimes be costly and are nonetheless accompanied by high risks of adverse events, ranging from mild to debilitating. Therefore, complementary and alternative medicine (CAM), especially mind-and-body interventions, such as acupuncture, psychotherapy, climatotherapy, and cupping may provide a cheaper and potentially beneficial outcome for these patients. Methods: We performed a systematic review of articles pertaining to acupuncture, cupping, psychotherapy and meditation, as well climatotherapy and balneotherapy in the management of psoriasis, by using the PubMED, Medline and Google Academic research databases and reference cross-checking. Results: 12 articles on acupuncture, 9 on dry or wet cupping, 27 concerning meditation, hypnosis or psychotherapy, and 34 regarding climate therapy or balneotherapy were found. Discussion and Conclusions: Currently, there is a lack of evidence in the English literature to support acupuncture as an effective alternative therapy for psoriasis, whereas cupping has been described in the majority of instances to result in Koebner phenomenon and clinical worsening. Stress management therapies such as psychotherapy, hypnosis, and meditation have shown promising results as complementary treatment methods. Climatotherapy and balneotherapy have already been proven as effective means of achieving clinical improvement in psoriasis. Further research is still needed to verify the usefulness of the lesser studied treatment methods.
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Luo Y, Chen J, Kuai L, Zhang Y, Ding X, Luo Y, Ru Y, Xing M, Li H, Sun X, Li B, Li X. Chinese Herbal Medicine for Psoriasis: Evidence From 11 High-Quality Randomized Controlled Trials. Front Pharmacol 2021; 11:599433. [PMID: 33551804 PMCID: PMC7862748 DOI: 10.3389/fphar.2020.599433] [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] [Received: 08/27/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Chinese herbal medicine (CHM) provides a theoretical basis for the treatment of psoriasis with considerable benefits and a low toxicity. The purpose of this quantitative study was to show high-quality evidence of the efficacy and safety of CHM for the treatment of psoriasis to promote its clinical application. Methods: Several databases were systematically searched including PubMed, Embase, Cochrane Central Register of Controlled Trials, China Network Knowledge Infrastructure, Chinese Scientific Journals Database, and Wan Fang Database. High-quality randomized controlled trials that compared CHM with non-CHM interventions were included. The RevMan5.3 software was used to calculate risk ratios (RR) at 95% confidence intervals (CI) and conduct the meta-analysis. Results: Altogether, 1,215 patients participated in this study, including 711 in the experimental group and 504 in the control group. The psoriasis area severity index (PASI) score of the CHM group was significantly lower than that of the placebo group (MD, −4.02; 95% CI, −6.71 to −1.34; p = 0.003). To achieve PASI-60 and PASI-75, the arrival rate of the CHM group was higher than that of the placebo group (PASI-60: RR, 3.52; 95% CI, 1.17 to 10.61; p = 0.03; PASI-75: RR, 9.87; 95% CI, 3.11 to 31.31; p = 0.0001). Furthermore, the efficacy rate was higher in patients receiving CHM than in those receiving placebo (RR, 1.72; 95% CI, 1.01 to 2.93; p = 0.04). The results suggested a greater impact of CHM in improving the dermatology life quality index (DLQI) of patients (MD, −2.12; 95% CI, −3.75 to −0.49; p = 0.01). Regarding pruritus severity, there was no significant difference between the two groups (MD, −1.90; 95% CI, −3.79 to −0.01; p = 0.05). The meta-analysis revealed that the recurrence rate (RR, 0.74; 95% CI, 0.32 to 1.71; p = 0.48) and proportion of adverse events (RR, 1.36; 95% CI, 0.95 to 1.93; p = 0.09) associated with using CHM were similar to those associated with using a placebo. Conclusion: CHM appears safe and effective in the treatment of psoriasis and has a great positive impact on the DQLI of patients; however, CHM could not completely eliminate skin lesions, improve pruritus severity, and reduce the recurrence rate.
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Affiliation(s)
- Yue Luo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jiale Chen
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Le Kuai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Ying Zhang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiaojie Ding
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Luo
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yi Ru
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Meng Xing
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongjin Li
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoying Sun
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai Dermatology Hospital, Tongji University, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
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