Updated view of tars for psoriasis: what have we learned over the last decade?

Tars are one of the most effective, unknown, and oldest therapies for psoriasis. They include coal tar (CT) and biomass-derived products. These treatments, particularly the CT, have proven to be cost-effective with long remission times compared to other systemic or topical treatments. However, they have hardly evolved in recent years, as they are not well-embraced by clinicians or patients because of concerns regarding cosmesis and safety. This review summarizes current knowledge about the chemical characterization, mechanism of action, toxicity, and clinical studies supporting the use of tars for psoriasis over the last decade. Trends within these above aspects are reviewed, and avenues of research are identified. CT is rich in polycyclic aromatic hydrocarbons, whereas biomass-derived tars are rich in phenols. While the activation of the aryl hydrocarbon receptor is involved in the antipsoriatic effect of CT, the mechanism of action of biomass-derived products remains to be elucidated. No conclusive evidence exists about the risk of cancer in psoriasis patients under CT treatment. Large, randomized, double-blind, controlled clinical trials are necessary to promote the inclusion of tars as part of modern therapies for psoriasis.

Bioactive Molecules from Myrianthus arboreus, Acer rubrum, and Picea mariana Forest Resources

Forest trees are the world's most important renewable natural resources in terms of their dominance among other biomasses and the diversity of molecules that they produce. Forest tree extractives include terpenes and polyphenols, widely recognized for their biological activity. These molecules are found in forest by-products, such as bark, buds, leaves, and knots, commonly ignored in forestry decisions. The present literature review focuses on in vitro experimental bioactivity from the phytochemicals of Myrianthus arboreus, Acer rubrum, and Picea mariana forest resources and by-products with potential for further nutraceutical, cosmeceutical, and pharmaceutical development. Although these forest extracts function as antioxidants in vitro and may act on signaling pathways involved in diabetes, psoriasis, inflammation, and skin aging, much still remains to be investigated before using them as therapeutic candidates, cosmetics, or functional foods. Traditional forest management systems focused on wood must evolve towards a holistic approach, allowing the use of these extractives for developing new value-added products.

Prediction of the impact induced by Cd in binary interactions with other divalent metals on wild-type and Cd-resistant strains of Dictyosphaerium chlorelloides

The metals present in freshwater have a toxic profile with bioaccumulation and are biomagnified along the aquatic food chain. The metals induce high sensitivity in most aquatic organisms, while others, such as some microalgae species, evolve towards resistance. Therefore, this research predicted through the Combination Index method the binary interaction exposed to divalent metals by inhibiting population growth in a Cd-resistant strain (Dc^RCd100) compared to the wild-type strain (Dc1M^wt) of Dictyosphaerium chlorelloides and evaluate the specific resistance level obtained by Dc^RCd100 to Cd relative to other divalent metals.The results showed that Dc^RCd100 presents resistance compared to Dc1M^wt in individual exposure in the order of Fe²⁺  > Ni²⁺  > Cd²⁺  > Co²⁺  > Zn²⁺  > Cu²⁺  > Hg²⁺ with 50% inhibitory concentration at 72 h of exposure (IC₅₀₍₇₂₎) values 1253, 644.4, 423, 162.7, 141.3, 35.1, and 9.9 µM, respectively. It induces cross-resistance with high antagonistic rates (Combination Index (CI); CI >  > 1) in the Cd/Zn and Cd/Cu. Cd/Ni, its initial response, is antagonistic, and it ends in an additive (CI = 1). Dc^RCd100 showed a lower resistance in Co, and Cd/Fe resistance was reduced individually. The interaction with Hg increased its resistance ten times more than individually.This research highlights the use of the CI as a highly efficient prediction method of the binary metal interactions in wild-type and Cd-resistant strains of D. chlorelloides. It may have the potential for metal accumulation, allowing the development of new methods of bioremediation of metals in effluents, and to monitor the concentration of metals in wastewater, its relative availability, transport, and mechanisms on resistant strains of microalgae.

The 5-HT1A receptor agonist, 8-OH-DPAT, attenuates long-lasting pain in imiquimod-induced psoriasis in mice

Psoriasis pain is a common symptom underestimated and rarely evaluated in psoriasis clinical trials. This work aimed to investigate whether the development of secondary chronic allodynia and hyperalgesia in the imiquimod (IMQ)-induced psoriasis mice model could be modulated by anti-inflammatory agents and compound 48/80 (C48/80) and to determine whether the activation of 5-HT_1A receptor modulates these nociceptive behaviours. C57BL/6 male mice were treated with 5% IMQ for 7 days. The paw withdrawal responses to von Frey filaments (10 and 250 mN) were used to assess the allodynia and hyperalgesia. Nociceptive behaviours were also evaluated using ketorolac 15 mg/kg s.c., adalimumab 10 mg/kg s.c. and C48/80 10 mg/kg i.p. Then, the serum serotonin and the impact of 8-OH-DPAT (1 mg/kg s.c), a 5-HT_1A receptor agonist, on long-lasting pain were examined. Mice receiving IMQ showed enhanced nociception, which decreased with all tested compounds. The serum serotonin in the IMQ group showed a significant decrease (947.042 ng/ml) regarding the control group (1143.68 ng/ml). The pretreatment with 8-OH-DPAT alleviated pain-related behaviours. These results suggest that the long-lasting pain resulting from psoriasis inflammation is also associated with the serotonergic system. The 5-HT1A receptor should be further explored as a potential therapeutic target for psoriasis pain modulation.

Design and validation of quality indicators for drug dispensing in a pediatric hospital

OBJECTIVES

This article presents a methodological strategy to design and validate quality indicators for drug dispensing in a pediatric hospital.

SETTING

The literature evaluation, design, and validation of indicators by experts were carried out from September 2017 to March 2018 in the pharmaceutical services of a pediatric hospital at the Autonomous University of the State of Hidalgo, Mexico.

PRACTICE DESCRIPTION

The design and validation of quality indicators for dispensing allow the evaluation, planning, and follow-up of this activity.

PRACTICE INNOVATION

The development of the indicators follows a holistic vision considering the relationship between the structure on which the pediatric dispensation is based, the involved processes, and the outcomes and provide a simple tool to improve the quality of the dispensing service.

EVALUATION

A methodological investigation for the development of systems and health services in drug dispensing was performed. For the indicator's design, the Mexican standards for establishments dedicated to the sale and supply of drugs, the Good Dispensation Practices, and the Donabedian model were considered. The validation of such indicators was carried out using the Delphi method and the Torgerson mathematical model.

RESULTS

Indicators of structure, process, and results were designed; of the 16 indicators designed, 15 reached the average score of greater than 3.5, and the percentage of experts who qualified each indicator in the highest categories was greater than 50%.

CONCLUSION

The design of indicators guarantees the quality of the dispensing service and can be extrapolated to the pharmaceutical services of any pediatric hospital.

Investigation of the Antibacterial Activity and Subacute Toxicity of a Quercus crassifolia Polyphenolic Bark Extract for its Potential Use in Functional Foods

Oak wood is used in barrels for wine aging. During aging, polyphenols are transferred from the barrels to the liquid. Although the bioactivity of oak polyphenols in wines has been extensively studied, no investigation exists on their toxicological properties, which limits their use as functional safe ingredients for other products. In this work, the chemical composition of a polyphenolic extract of Quercus crassifolia bark (QCBe) was studied by GC-MS. Its antibacterial properties on probiotic and pathogenic bacteria and its subacute-oral toxicity were determined as a way to understand the potential impact from its addition to fermented food as a functional ingredient. QCBe shows a selective inhibition of Escherichia coli compared with Lactobacillus bulgaricus and Streptococcus thermophylus. According to the toxicity evaluation, the subacute no-observed-adverse-effect-level was achieved at 11 mg/kg bw/day, whereas the subacute lowest-observed-adverse-effect-level for kidney damage was at 33 mg/kg bw/day. These results suggest that, given the fact an adverse effect was observed after subacute administration of this extract, further longer term toxicological studies are needed to provide sufficient safety evidence for its use in humans. PRACTICAL APPLICATION: Mexico's yogurt market is growing which creates opportunities for the development of some yogurt products as functional foods. As a first step to evaluate its potential use in yogurt formulation, the antibacterial effect of a Quercus crassifolia polyphenolic extract (QCBe) on probiotic bacteria and its subacute-oral toxicity in rats were studied. A low inhibition on probiotic bacteria growth was observed after QCBe addition to Lactobacillus bulgaricus and Streptococcus thermophylus cultures. Exposure to QCBe for a subacute duration resulted in renal injury in rats at dosages greater than or equal to 33 mg/kg/bw/day. This adverse effect indicates the importance of performing further long-term toxicological assessments prior to the addition of QCBe to a food like yogurt, which is regularly eaten by consumers.

Toxicological evaluation of an aqueous suspension from leaves and stems of Petiveria alliacea L. (Phytolaccaceae)

ETHNOPHARMACOLOGICAL RELEVANCE

Petiveria alliacea L. (Phytolaccaceae) is used in folk medicine due to its antispasmodic, diuretic, hypoglycemic, abortive, anti-inflammatory and anticancerogenic properties. Although P. alliacea is considered toxic by people, its toxicity remains a concern since it is strongly dependent on the extraction method and the part of the plant used during tests. Even if some healers prefer to use the aerial parts in a liquefied form or by chewing them, instead of decoctions or infusions, no toxicological studies exist using whole dried stems and leaves.

MATERIALS AND METHODS

The toxicity of a suspension of the powder from the leaves and stems of P. alliacea was assessed in Sprague Dawley rats by oral administration using two tests: 1) the acute toxic class method, which allows classification of substances according to their intrinsic toxicity and 2) the repeated dose 28-day method, following the guidelines 423 and 407 respectively from the Organization for the Economic Cooperation and Development. Chemical characterization of this powder was performed by GC-MS, UV-fluorescence, proximate and elemental analysis.

RESULTS AND CONCLUSIONS

P. alliacea powder from stems and leaves was classed in the hazard category 5 (LD₅₀ > 2000mg/kg) according to the acute toxicology study. There were no toxicity signs at 1000mg/kg in the repeated dose study, although higher values of total leukocytes were found in the satellite and males of the experimental group, which were attributed to the immunomodulatory properties of this plant. According to GC-MS, the prevailing compounds identified were phytol, (R)-(-)-(Z)-14-methyl-8-hexadecen-1-ol, 1-(2-hydrohyethyl)-1,2,4-triazole and methyl β-dimethylaminoisobutyrate. In conclusion, the oral administration of the P. alliacea powder to Sprague Dawley rats did not result in deaths and was not associated with adverse effects reflected in the general condition, body weights or histopathological abnormalities.

Influence of polyvinylpyrrolidone, microcrystalline cellulose and colloidal silicon dioxide on technological characteristics of a high-dose Petiveria alliacea tablet

PURPOSE

Petiveria alliacea L. (Phytolaccaceae) is a perennial shrub used by its immunomodulatory, anticancerogenic and anti-inflammatory properties. This study determined the influence of polyvinylpyrrolidone (PVP), colloidal silicon dioxide (CSD) and microcrystalline cellulose (MC) on the technological characteristic of a high-dose P. alliacea tablet prepared by the wet granulation method.

METHODOLOGY

The botanical and pharmacognostic analysis of the plant material was firstly performed, followed by a 2³ factorial design considering three factors at two levels: (a) the binder (PVP) incorporated in formulation at 10% and 15% (w/w); (b) the compacting agent (CSD) added at 10% and 15% (w/w) and; (c) the diluent (MC) included at 7.33% and 12.46% (w/w). The analysis of pharmaceutical performance and the accelerated and long-term stability of the best prototype were also completed.

RESULT AND DISCUSSION

The binder, compacting agent and the interaction binder/diluent had a significant impact on breaking force of high-dose P. alliacea tablet. The optimum formula was found to contain 15% (w/w) of CSD, 7.33% (w/w) of MC and 10% (w/w) of PVP. At these conditions, the tablet shows a breaking force of 77.96 N, a friability of 0.39%, a total phenol content of 1.30 mg/tablet and a maximum disintegration time of 6 min.

CONCLUSIONS

The use of adequate amounts of PVP, MC and CSD as per the factorial design allowed the preparation of a tablet suitable for administration, despite the inappropriate flow and compressibility properties of the P. alliacea powder.

Picea mariana polyphenolic extract inhibits phlogogenic mediators produced by TNF-α-activated psoriatic keratinocytes: Impact on NF-κB pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Picea mariana ((Miller) Britton, Sterns, and Poggenburg; Pinaceae) bark has been traditionally used by North American natives for treating topical inflammations. It has been also suggested to improve various inflammatory skin disorders like Psoriasis vulgaris. Extracts from this bark storage protein contain polyphenolic compounds which have well-known antiinflammatory activities. Based on the capacity of polyphenolic compounds to modulate functions of normal human keratinocytes, this study was set up to decipher the mechanisms of action of a chemically characterized polyphenolic extract from Picea mariana bark (BS-EAcf) on lesional keratinocytes of skin with psoriasis vulgaris, a disease driven by the immune system in which TNF-α plays a significant role.

MATERIALS AND METHODS

BS-EAcf corresponds to the ethyl acetate soluble fraction from the hot water extract of Picea mariana bark. BS-EAcf effects were evaluated in normal human (NHK) and psoriatic (PK) keratinocytes stimulated by TNF-α. Cell viability was assessed by lactate deshydrogenase release and propidium iodide (PI) staining. The mechanisms of action of BS-EAcf in keratinocytes were investigated by flow cytometry, ELISAs, RT-PCR and western blot analyses.

RESULTS

PK exhibited a higher response to TNF-α than NHK regarding the ICAM-1 expression and the production of NO, IL-6, IL-8, fractalkine and PGE2, whereas BS-EAcf significantly inhibited this TNF-α-induced increase at concentrations without causing keratinocyte toxicity. Additionally, this extract significantly inhibited the TNF-α-induced release of elafin and VEGF by PK and NHK. Since TNF-α activation of most of these factors is dependent on the NF-κB pathway, this latter was studied in TNF-α-activated PK. BS-EAcf inhibited the TNF-α-induced phosphorylation and degradation of total IκBα as well as phosphorylation of NF-κB p65.

CONCLUSIONS

The ethyl acetate fraction from Picea mariana bark extract showed inhibitory effects of cytokines, chemokines, adhesion molecules, nitric oxide and prostaglandins produced by keratinocytes under TNF-α activation through down-regulating the NF-κB pathway. This study demontrated that this extract could be a potential antiinflammatory agent capable of improving psoriatic skin.

Picea mariana bark: a new source of trans-resveratrol and other bioactive polyphenols

The ethyl acetate soluble fraction obtained from the hot water extract of Picea mariana bark (BS-EAc(f)) has been demonstrated to have anti-inflammatory and antioxidant properties. Thus, in the current study, we isolated and characterised major compounds of this fraction by HPLC, NMR and MS analyses. On the whole, 28 compounds were identified, among which were five neolignans, seven lignans, trans-resveratrol, three phenolic acids and four flavonoids. To the best of our knowledge, 2,3-dihydro-3-(4-hydroxy-3-methoxyphenyl)-2-(hydroxymethyl)-(2S,3S)-1,4-benzodioxin-6-propanol, threo and erythro 3-methoxy-8,4'-oxyneolignan-3',4,7,9,9'-pentol, pallasiin, (±) epi-taxifolin, homovanillyl alcohol, orcinol and 2-[4-(3-hydroxypropyl)-2-methoxyphenoxy]-1,3-propanediol are reported for the first time in the Picea genus. P. mariana dry bark contains at least 104μgg(-1)dw of trans-resveratrol and it could be therefore considered as a new accessible source of this molecule. This study provides novel information about the identity of major compounds present in BS-EAc(f), which is essential for the understanding of the anti-inflammatory and nutraceutical potential of this extract.

Antioxidant, toxicological and antiproliferative properties of Canadian polyphenolic extracts on normal and psoriatic keratinocytes

AIMS OF THE STUDY

In a first attempt for establishing the possible utilization of polyphenolic extracts from barks of Canadian wood species in psoriasis treatment, we aimed to study (a) their antioxidant capacity, (b) their toxicological properties on normal human keratinocytes (NHK), and (c) their effect on the growth of normal and psoriatic keratinocytes (PK).

MATERIALS AND METHODS

Polyphenolic extracts were obtained by 90% ethanolic maceration and hot water extraction (HWE). Scavenging capacity was evaluated towards hydrogen peroxide, hydroxyl, superoxide, nitric oxide and peroxyl radicals. MTT assay and Trypan blue dye exclusion (TBDE) method were used for evaluating the initial toxicity of the most antioxidant extracts on NHK during 24 and 48 h. The effects of extracts on the growth of NHK and PK at non-toxic concentrations were determined after exposure for 48 h.

RESULTS

Yellow birch extract obtained by maceration (YB(Mac)) and black spruce extract obtained by HWE (BS(HWE)) were determined to have the highest antioxidant capacity, but BS(HWE) was less toxic on NHK. Toxicity of extracts on keratinocyte plasma membrane and mitochondria after 24 h was attributed to their content of hydroxycinnamic acids and proanthocyanidins. BS(HWE) inhibited the growth of NHK and non-lesional PK, but was not selective for lesional PK.

CONCLUSION

Given that BS(HWE) presented elevated content of total phenols and flavonoids and showed a low toxicity on NHK as well as an adequate chemical reactivity towards different radicals and some antiproliferative properties, it was considered as the most valuable extract obtained from barks of Canadian wood species.