Adult ; Aged ; Baths ; Child ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Psoriasis ; pathology ; therapy ; Tacrolimus ; therapeutic use

OBJECTIVETo evaluate the effect of combined herbal medicine therapy on the expression of psoriasis-associated antigen (Pso p27) in patients with psoriasis vulgaris.

METHODSFifteen psoriasis vulgaris patients were included in the study and they were all treated with combined herbal medicine therapy for 12 weeks. Both psoriasis area and severity index (PASI) score and plaque index (PI) score were evaluated before and after treatment, while skin biopsies from selected lesions and uninvolved skin near the lesions were performed. Expression of Pso p27 in the target skin and surrounding uninjured skins were analysed using immunofluorescence method.

RESULTSThe PASI score and PI score decreased after the combined herbal medicine therapy in both acute and silent stages (P < 0.01), so did the positive cells of Pso p27 and the intensity of fluorescein stain (P < 0.05).

CONCLUSIONThe combined herbal medicine therapy is effective in treating psoriasis vulgaris in both acute and silent stages, which may be resulted from its inhibition of the expression of Pso p27.

Adult ; Aged ; Antigens ; immunology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Psoriasis ; drug therapy ; immunology ; pathology ; Young Adult

OBJECTIVE: To determine the role of Tripterygium wilfordii multiglycoside (TGW) in the treatment of psoriatic dermatitis from a cellular immunological perspective. METHODS: Mouse models of psoriatic dermatitis were established by imiquimod (IMQ). Twelve male BALB/c mice were assigned to IMQ or IMQ₊TGW groups according to a random number table. Histopathological changes in vivo were assessed by hematoxylin and eosin staining. Ratios of immune cells and cytokines in mice, as well as PAM212 cell proliferation in vitro were assessed by flow cytometry. Pro-inflammatory cytokine expression was determined using reverse transcription quantitative polymerase chain reaction. RESULTS: TGW significantly ameliorated the severity of IMQ-induced psoriasis-like mouse skin lesions and restrained the activation of CD45⁺ cells, neutrophils and T lymphocytes (all P<0.01). Moreover, TGW significantly attenuated keratinocytes (KCs) proliferation and downregulated the mRNA levels of inflammatory cytokines including interleukin (IL)-17A, IL-23, tumor necrosis factor α, and chemokine (C-X-C motif) ligand 1 (P<0.01 or P<0.05). Furthermore, it reduced the number of γ δ T17 cells in skin lesion of mice and draining lymph nodes (P<0.01). CONCLUSIONS TGW improved psoriasis-like inflammation by inhibiting KCs proliferation, as well as the associated immune cells and cytokine expression. It inhibited IL-17 secretion from γ δ T cells, which improved the immune-inflammatory microenvironment of psoriasis.
Male ; Animals ; Mice ; Tripterygium ; Psoriasis/drug therapy* ; Keratinocytes ; Skin Diseases/metabolism* ; Cytokines/metabolism* ; Imiquimod/metabolism* ; Dermatitis/pathology* ; Disease Models, Animal ; Mice, Inbred BALB C ; Skin/metabolism*

Using anti-T6 and anti-HLA-DR monoclonal antibodies, this study was designed to attain what would do to epidermal Langerhans cell (LC) markers in psoriatic patients when two remedies, etretinate and UVB, having controversial effects on LC were put to use simultaneously. In normal and psoriatic subjects, HLA-DR+ LC was approximately 80% of T6+ LC and a single dose of UVB equivalent to minimal erythema dose (MED), reduced LC membrane markers to approximately 30% of non-irradiated control. The recovery of LC membrane markers, after a single dose of UVB exposure were significantly faster in the group of etretinate treated psoriatic subject than only UVB irradiated psoriatic control. Taken together, seemed to exert prompt recovery of normalization of the number of LC from the depletion following the UVB.
Adult ; Antibodies, Monoclonal ; Antigens, Differentiation, T-Lymphocyte/analysis ; Drug Therapy, Combination ; Etretinate/*therapeutic use ; Female ; HLA-DR Antigens/analysis ; Humans ; Immunohistochemistry ; Langerhans Cells/*drug effects/pathology/radiography ; Male ; Middle Aged ; Psoriasis/pathology/therapy ; *Ultraviolet Therapy

OBJECTIVETo observe the efficacy oand safety of Compound E-Bei ointment (CEBO) in treating plaque psoriasis.

METHODSAdopting block-randomized, open, positive Western medicine and placebo parallel group controlled method, a total of 120 enrolled patients were administered orally with Saoxuan Pill, and randomized into three groups respectively treated with external application of CEBO, Daivonex, or vehicle control twice a day for 4 weeks. The changes of erythema, infiltration, scaly eruption, pruritus and the area of lesion were evaluated, the safety and the initiating time of symptom improvement (ITSI) were observed as well.

RESULTSObservation on local lesion showed that the scores of erythema, infiltration, scaly eruption, pruritus were significantly improved in difference between the CEBO group and the Daivonex group (P < 0.01). But in the placebo control group, significant improvement was only shown in scaly eruption scores (P < 0.01), so, the improvement in skin lesion in the placebo group was significantly inferior to that in the other two groups (P < 0.01). The ITSI of pruritus was shorter in CEBO group than that in the Daivonex group and the placebo group (P < 0.01), but that of other symptoms showed insignificant difference between the CEBO group and the Daivonex group, as for comparing in ITSI of erythema, infiltration, scaly eruption and pruritus, it was significantly shorter in the CEBO group and Daivonex group than that in the placebo group respectively (P < 0.01). The occurrence of adverse events in the CEBO group had insignificant difference to that in the Daivonex group, but the recurrence rate in the former was significantly lower than that in the latter (P < 0.05).

CONCLUSIONCEBO can effectively improve the symptoms of skin lesion in patients with plaque psoriasis, the clinical efficacy is not inferior to that of positive Western medicine.

Administration, Cutaneous ; Adolescent ; Adult ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Ointments ; Phytotherapy ; Psoriasis ; drug therapy ; pathology ; Skin ; drug effects ; pathology ; Treatment Outcome ; Young Adult

Adult ; Animals ; Colitis ; chemically induced ; pathology ; Colon ; pathology ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Indigo Carmine ; Indoles ; administration & dosage ; adverse effects ; Male ; Middle Aged ; Phytotherapy ; Psoriasis ; drug therapy ; Rats ; Rats, Sprague-Dawley

Infliximab, the monoclonal antibody to tumor necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease and rheumatoid arthritis. Infliximab treatment has adverse events including infusion reactions, opportunistic infections, and the potential for the event such as reactivation of latent tuberculosis. Cutaneous adverse reactions of TNF-alpha agents include skin rash, urticaria, pruritus, lupus-like eruption, and injection site reactions. Most of all, psoriasis or psoriasiform dermatitis induced by infliximab treatment for Crohn's disease is rarely reported in Korea. We report a case of psoriasis induced by infliximab treatment for Crohn's disease with a review of world literature.
Anti-Inflammatory Agents/*adverse effects/therapeutic use ; Antibodies, Monoclonal/*adverse effects/therapeutic use ; Colonoscopy ; Crohn Disease/diagnosis/*drug therapy ; Female ; Humans ; Psoriasis/*chemically induced/pathology/therapy ; Ultraviolet Rays ; Young Adult

OBJECTIVETo explore the mechanism of Chinese medicinal therapy for cooling blood and removing stasis (CBRS) in treating psoriasis of blood-heat syndrome type by observing its clinical efficacy and impact on serum level of cytokines.

METHODSChanges of psoriasis area and severity index (PASI) scores, scores of syndrome and serum levels of tumor necrosis factor alpha (TNF-alpha, Th1 cytokine) and interleukin-10 (IL-10, Th2 cytokine) in 32 psoriatic patients before and after treatment were observed.

RESULTSThe total effective rate after 4 weeks of treatment and 8 weeks of treatment was 65.63% (21/32 cases) and 75.00% (24/32 cases) respectively. Scores of PASI and syndrome all improved after treatment (P < 0.05). And comparison of TNF-alpha level before and after treatment also showed significant difference (P < 0.05) , whereas that of IL-10 was insignificant (P > 0.05). Moreover, a positive correlation was found between PASI scores and secreting level of TNF-alpha in patients with psoriasis (r = 0.3709, P < 0.05).

CONCLUSIONChinese therapy for CBRS could play its effect in treating psoriasis by way of reducing TNF-alpha level.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Cytokines ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Psoriasis ; blood ; drug therapy ; immunology ; pathology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Young Adult

OBJECTIVE: To observe the effect of fire needling on psoriasis-like lesion and the signal transducer and activator of transcription 3 (STAT3) pathway in mice and compare the therapeutic effect between different interventions of fire needling therapy (surrounding technique of fire needling, fire needling at "Dazhui" [GV 14] and "Zusanli" [ST 36]). METHODS: Thirty male BALB/c mice were randomized into a blank group, a model group, a dexamthasone group, a surrounding technique group and an acupoint group, 6 mice in each one. Except the blank group, the mice in the rest groups were established as psoriasis-like lesion model by topical application with imiquimod cream, once daily, consecutively for 8 days. From day 4 to day 8, in the dexamthasone group, gastric infusion with 0.2 mL dexamthasone was administered, once daily. On day 4, 6 and 8, in the surrounding technique group, fire needling was exerted around the skin lesion; and fire needling was applied to "Dazhui" (GV 14) and "Zusanli" (ST 36) in the acupoint group, once a day. The changes in skin lesion on the dorsal parts of mice were observed in each group to score the psoriasis area and severity index (PASI). Using HE staining, the dermal morphological changes and epidermal thickness were observed in the mice of each group. The positive expression of proliferating cell-associated antigen Ki-67 was determined by immunofluorescence. Immunohistochemistry method was used to determine the expressions of , and T cells of skin tissue in each group. Using real-time PCR, the expressions of interleukin (IL)-17, IL-22, tumor necrosis factor α(TNF-α) mRNA were determined. Western blot method was adopted to determine the protein expressions of STAT3 and p-STAT3 in skin tissue in each group. RESULTS: Compared with the blank group, the scores of each item and the total scores of PASI, as well as the epidermal thickness were all increased in the mice of the model group (P<0.01). Except for the erythema scores of the dexamethasone group and the surrounding technique group, the scores of each item and the total scores of PASI, as well as the epidermal thickness were all decreased in each intervention group as compared with the model group (P<0.01). The infiltration scores and the total scores in the dexamethasone group and the acupoint group were lower than those in the surrounding technique group respectively (P<0.01, P<0.05). In comparison with the blank group, Ki-67 positive cell numbers and the numbers of , and T cells in skin tissue were increased in the mice of the model group (P<0.01). Ki-67 positive cell numbers and the numbers of , and T cells were reduced in each intervention group as compared with the model group (P<0.01), and the numbers of and T cells in the acupoint group were less than the surrounding technique group (P<0.01). Compared with the blank group, the mRNA expressions of IL-17, IL-22 and TNF-α and the ratio of p-STAT3 to STAT3 were all increased in the model group (P<0.01). The mRNA expressions of IL-17, IL-22 and TNF-α and the ratio of p-STAT3 to STAT3 were all decreased in each intervention group as compared with the model group (P<0.01, P<0.05). The mRNA expressions of IL-17, IL-22 and TNF-α in the acupoint group, as well as mRNA expression of IL-17 in the surrounding technique group were all lower than the dexamethasone group (P<0.01), while, the mRNA expression of IL-22 in the acupoint group was lower than the surrounding technique group (P<0.01). CONCLUSION Fire needling therapy improves skin lesion severity in imiquimod induced psoriasis-like lesion of the mice, which is probably related to the inhibition of STAT3 pathway activation and the decrease of Th17 inflammatory factors expression. The systemic regulation of fire needling at "Dazhui" (GV 14) and "Zusanli" (ST 36) is superior to the local treatment.
Animals ; Dexamethasone/therapeutic use* ; Imiquimod/metabolism* ; Interleukin-17/metabolism* ; Ki-67 Antigen/metabolism* ; Male ; Mice ; Mice, Inbred BALB C ; Psoriasis/drug therapy* ; RNA, Messenger/metabolism* ; STAT3 Transcription Factor/pharmacology* ; Skin/pathology* ; Tumor Necrosis Factor-alpha/metabolism*

OBJECTIVE: Psoriasis is a common chronic inflammatory skin disease that is prone to recurrence, and the proinflammatory factor, cysteine-rich protein 61 (Cyr61), is important in its pathophysiology. Long-term clinical practice has shown that Sancao Formula (SC), a Chinese herbal compound, is effective in the treatment of psoriasis, but the precise mechanism remains unknown. In this study, we investigate the mechanism by which SC extract alleviates imiquimod (IMQ)-induced psoriasis. METHODS: The expression of Cyr61 in psoriatic lesions and normal healthy skin was detected using immunohistochemical analysis to investigate the biological role of Cyr61 in models of psoriatic inflammation. A psoriatic mouse model was established by topical application of IMQ, and the effect of topical application of SC extract was evaluated using the psoriasis area and severity index (PASI) score, hematoxylin-eosin staining, and histopathological features of the skin. Next, a HaCaT cell inflammation model was established using interferon-γ (IFN-γ), and the effect of SC extract on the mRNA and protein levels of Cyr61 and intercellular cell adhesion molecule-1 (ICAM-1) was confirmed using Western blot and quantitative real-time polymerase chain reaction analyses. RESULTS: Immunohistochemical staining showed that the expression of Cyr61 in psoriatic lesions was higher than that in normal skin samples (78.26% vs 41.18%, P < 0.05), and the number of Cyr61-positive cells in psoriatic lesions was also significantly higher than in normal skin (18.66 ± 2.51 vs 4.33 ± 1.52, P < 0.05). Treatment in mice with IMQ-induced psoriasis showed that SC extract could significantly improve the inflammatory phenotype, PASI score (10.875 ± 0.744 vs 3.875 ± 0.582, P < 0.05), and pathological features compared with those in IMQ model group; SC treatment was also associated with decreased levels of Cyr61 and ICAM-1. In the IFN-γ-induced inflammatory cell model, the mRNA and protein levels of Cyr61 and ICAM-1 were upregulated, while the SC extract downregulated the levels of Cyr61 and ICAM-1. CONCLUSION The results provide a theoretical basis for the involvement of Cyr61 in the pathogenesis of psoriasis, and suggest that SC should be used to target Cyr61 for the prevention of psoriasis recurrence.
Animals ; China ; Cysteine-Rich Protein 61/metabolism* ; Disease Models, Animal ; Drugs, Chinese Herbal/therapeutic use* ; Imiquimod/adverse effects* ; Inflammation/drug therapy* ; Intercellular Adhesion Molecule-1/genetics* ; Interferon-gamma ; Mice ; Mice, Inbred BALB C ; Psoriasis/pathology* ; RNA, Messenger/therapeutic use*