2.Systemic treatment of pityriasis rubra pilaris with an IL-17 inhibitor
Klara Cvenkel ; Mateja Dolenc Voljc
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):17-17
Pityriasis rubra pilaris (PRP) is a rare and challenging dermatological condition that often mimics other skin disorders, complicating diagnosis and management. This case is unique due to the patient’s comorbidities, which restricted treatment options and required a shift from conventional therapy to biologic treatment.
A 57-year-old male presented with a three-week history of an itchy rash on the face, neck, and upper extremities after sun exposure. Initial treatment with topical corticosteroids was ineffective, and the condition progressed to involve the trunk and lower extremities with erythroderma. Additional findings included hyperkeratosis of the palms and soles, psoriatic plaques on the elbows, and thickened toenails with onychomycosis. Histopathology revealed superficial psoriasiform dermatitis, consistent with PRP. Methotrexate (12.5 mg/week) was initiated, leading to initial improvement. However, a relapse occurred after five months, and due to elevated liver enzymes, a dose increase was not feasible. Secukinumab, an IL-17A inhibitor, was subsequently recommended by the clinic consilium. Already after one month, significant improvement was observed, and near-complete remission was achieved by four months. The patient continues treatment with secukinumab with a satisfactory clinical response and minimal residual symptoms.
This case underscores the complexities of diagnosing and managing PRP, particularly when comorbidities limit standard treatment options. The successful use of secukinumab, despite the failure of conventional therapy, demonstrates the potential of biologics in managing PRP, especially in refractory cases. It highlights the importance of personalized treatment strategies in optimizing outcomes for patients with complex dermatological conditions.
Human ; Male ; Middle Aged: 45-64 Yrs Old ; Biological Therapy ; Pityriasis Rubra Pilaris
3.Total glucosides of Rhizoma Smilacis Glabrae: a therapeutic approach for psoriasis by regulating Th17/Treg balance.
Yingzhan TANG ; Jingyi YU ; Wen ZHAO ; Juyan LIU ; Hongying PENG ; Haoran ZHANG ; Zhenzhou JIANG ; Qinwei YU ; Luyong ZHANG
Chinese Journal of Natural Medicines (English Ed.) 2023;21(8):589-598
Total glucosides of Rhizoma Smilacis Glabrae (RSG) are selective immunosuppressants that exhibit primary efficacy in the treatment of rheumatoid arthritis through targeted inhibition of activated T cells. In this study, we aimed to investigate the potential application of RSG in the treatment of psoriasis and elucidate its mechanism of action and material basis. Our findings revealed significant improvements upon administration of RSG in an imiquimod (IMQ)-induced psoriasis model. These improvements were characterized by a remarkable increase in the number of tail scales in mice and a substantial amelioration of skin erythema, ulceration, and flaking. By transcriptome sequencing and T-cell flow sorting assay, we identified notable effects of RSG on the modulation of various cellular processes. Specifically, RSG prominently down-regulated the Th17/Treg ratio in damaged skin tissues and reduced the proportion of G2 phase cells. Furthermore, RSG exhibited a stimulatory effect on the proliferation and differentiation of epithelial cells. Of particular interest, we discovered that β-sitosterol, sitostenone, stigmasterol, smiglanin, and cinchonain Ib displayed potent inhibitory effects on the IL-17-mediated inflammatory response in HaCaT cells. In summary, our study highlights the therapeutic potential of RSG in the treatment of psoriasis, attributed to its ability to regulate the Th17/Treg balance. These findings contribute to the development of new indications for RSG and provide a solid theoretical foundation for further exploration in this field.
Animals
;
Mice
;
T-Lymphocytes, Regulatory
;
Psoriasis/drug therapy*
;
Arthritis, Rheumatoid
;
Biological Assay
;
Glucosides/pharmacology*
4.Anti-hepatitis B virus activities of natural products and their antiviral mechanisms.
Wanyu DENG ; Fu CHEN ; Yue ZHAO ; Ming ZHOU ; Min GUO
Chinese Journal of Natural Medicines (English Ed.) 2023;21(11):803-811
Chronic hepatitis B (CHB) infections caused by the hepatitis B virus (HBV) continue to pose a significant global public health challenge. Currently, the approved treatments for CHB are limited to interferon and nucleos(t)ide analogs, both of which have their limitations, and achieving a complete cure remains an elusive goal. Therefore, the identification of new therapeutic targets and the development of novel antiviral strategies are of utmost importance. Natural products (NPs) constitute a class of substances known for their diverse chemical structures, wide-ranging biological activities, and low toxicity profiles. They have shown promise as potential candidates for combating various diseases, with a substantial number demonstrating anti-HBV properties. This comprehensive review focuses on the current applications of NPs in the fight against HBV and provides a summary of their antiviral mechanisms, considering their impact on the viral life cycle and host hepatocytes. By offering insights into the world of anti-HBV NPs, this review aims to furnish valuable information to support the future development of antiviral drugs.
Humans
;
Hepatitis B virus
;
Hepatitis B, Chronic/drug therapy*
;
Antiviral Agents/therapeutic use*
;
Biological Products/therapeutic use*
;
Hepatocytes
5.Discovery and bioassay of disubstituted β-elemene-NO donor conjugates: synergistic enhancement in the treatment of leukemia.
Junlong ZHU ; Xiaoying JIANG ; Xinyu LUO ; Yuan GAO ; Rui ZHAO ; Junjie LI ; Hong CAI ; Xiawen DANG ; Xiangyang YE ; Renren BAI ; Tian XIE
Chinese Journal of Natural Medicines (English Ed.) 2023;21(12):916-926
Natural products are essential sources of antitumor drugs. One such molecule, β-elemene, is a potent antitumor compound extracted from Curcuma wenyujin. In the present investigation, a series of novel 13,14-disubstituted nitric oxide (NO)-donor β-elemene derivatives were designed, with β-elemene as the foundational compound, and subsequently synthesized to evaluate their therapeutic potential against leukemia. Notably, the derivative labeled as compound 13d demonstrated a potent anti-proliferative activity against the K562 cell line, with a high NO release. In vivo studies indicated that compound 13d could effectively inhibit tumor growth, exhibiting no discernible toxic manifestations. Specifically, a significant tumor growth inhibition rate of 62.9% was observed in the K562 xenograft tumor mouse model. The accumulated data propound the potential therapeutic application of compound 13d in the management of leukemia.
Humans
;
Mice
;
Animals
;
Cell Line, Tumor
;
Nitric Oxide Donors/pharmacology*
;
Sesquiterpenes/pharmacology*
;
Leukemia/drug therapy*
;
Biological Assay
;
Cell Proliferation
6.The perspectives of biologics in the treatment of chronic rhinosinusitis with nasal polyps.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(11):853-855
Chronic rhinosinusitis with nasal polyps (CRSwNP) remains the most difficult-to-treat subtype in the world. Biologics have shown positive results, especially in reducing nasal polyp size and improving patient-reported outcomes. The development of biologics has the potential to fulfill the unmet medical needs of treatment.
Humans
;
Biological Products/therapeutic use*
;
Rhinitis/drug therapy*
;
Nasal Polyps/drug therapy*
;
Sinusitis/drug therapy*
;
Cytokines
;
Chronic Disease
7.Clinical analysis of 10 cases of multi-center tumor necrosis factor receptor-associated periodic syndrome.
Ming Sheng MA ; Zhi YANG ; Cai Hui ZHANG ; Yao Yao SHANGGUAN ; Yong Zhen LI ; Mei Fang ZHU ; Cui BAI ; Yu ZHOU ; Qiu Ye ZHANG ; Hai Guo YU ; Xiao Chuan WU ; Wen Jie ZHENG ; Jun YANG ; Hong Mei SONG
Chinese Journal of Pediatrics 2023;61(12):1098-1102
Objective: To summarize the clinical characteristics of tumour necrosis factor receptor-associated periodic syndrome (TRAPS) in children. Methods: The clinical manifestations, laboratory tests, genetic testing and follow-up of 10 children with TRAPS from May 2011 to May 2021 in 6 hospitals in China were retrospectively analyzed. Results: Among the 10 patients with TRAPS, including 8 boys and 2 girls. The age of onset was 2 (1, 5) years, the age of diagnosis was (8±4) years, and the time from onset to diagnosis was 3 (1, 7) years. A total of 7 types of TNFRSF1A gene variants were detected, including 5 paternal variations, 1 maternal variation and 4 de novo variations. Six children had a family history of related diseases. Clinical manifestations included recurrent fever in 10 cases, rash in 4 cases, abdominal pain in 6 cases, joint involvement in 6 cases, periorbital edema in 1 case, and myalgia in 4 cases. Two patients had hematological system involvement. The erythrocyte sedimentation rate and C-reactive protein were significantly increased in 10 cases. All patients were negative for autoantibodies. In the course of treatment, 5 cases were treated with glucocorticoids, 7 cases with immunosuppressants, and 7 cases with biological agents. Conclusions: TRAPS is clinically characterized by recurrent fever accompanied by joint, gastrointestinal, skin, and muscle involvement. Inflammatory markers are elevated, and autoantibodies are mostly negative. Treatment mainly involves glucocorticoids, immunosuppressants, and biological agents.
Male
;
Child
;
Female
;
Humans
;
Child, Preschool
;
Receptors, Tumor Necrosis Factor, Type I/genetics*
;
Retrospective Studies
;
Hereditary Autoinflammatory Diseases/drug therapy*
;
Glucocorticoids/therapeutic use*
;
Biological Factors/therapeutic use*
;
Immunosuppressive Agents/therapeutic use*
;
Autoantibodies
;
Familial Mediterranean Fever/diagnosis*
;
Mutation
8.Equivalence of combined decoction and mixed single decoctions of Gegen Qinlian Decoction in alleviating chemotherapy-associated diarrhea.
Min LI ; Xiao-Qin YANG ; Yan-Fen CHENG ; Shu-Yang WU ; Liang ZOU ; Yi-Han WU ; Jin-Ming ZHANG
China Journal of Chinese Materia Medica 2023;48(11):2968-2980
This study compared the chemical profiles, component content, dry paste yield, and pharmacological effects of samples obtained from the mixed single decoctions and the combined decoction of Gegen Qinlian Decoction(GQD), aiming to provide an experimental foundation for evaluating the equivalence of the two decocting methods and the suitability of TCM formula granules in clinical application. The same decoction process was used to prepare the combined decoction and mixed single decoctions of GQD. Ultra-performance liquid chromatography coupled with Q-Exactive Orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap MS) was employed to compare the chemical profiles between the two groups. High-performance liquid chromatography(HPLC) was used to compare the content of nine characteristic components between the two groups. Then, a delayed diarrhea mouse model induced by irinotecan was established to compare the pharmacological effects of the two groups on chemotherapy-induced diarrhea. The UPLC-Q-Exactive Orbitrap MS in ESI~+ and ESI~- modes identified 59 chemical components in the compound decoction and mixed single decoctions, which showed no obvious differences in component species. The content of baicalin and wogonoside was higher in the compound decoction, while that of puerarin, daidzein-8-C-apiosylglucoside, berberine, epiberberine, wogonin, glycyrrhizic acid, and daidzein was higher in the mixed single decoctions. Further statistical analysis revealed no significant difference in the content of the nine characteristic components between the compound decoction and the mixed single decoctions. The dry paste yield had no significant difference between the two groups. Compared with the model group, both compound decoction and mixed single decoctions alleviated the weight loss and reduced diarrhea index in mice. Both of them lowered the levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), cyclooxygenase-2(COX-2), intercellular adhesion molecule-1(ICAM-1), interleukin-10(IL-10), malondialdehyde(MDA), and nitric oxide(NO) in the colon tissue. Furthermore, they significantly increased the levels of glutathione peroxidase(GSH-Px) and superoxide dismutase(SOD). Hematoxylin-eosin(HE) staining showed that colon tissue cells were tightly arranged with clear nuclei in both groups without obvious difference. The compound decoction and mixed single decoctions showed no significant differences in chemical component species, content of nine characteristic components, dry paste yield, or the pharmacological effects on alleviating chemotherapy-induced diarrhea. The findings provide a reference for evaluating the flexibility and superiority of combined or single decocting method in the preparation of TCM decoctions or formula granules.
Animals
;
Mice
;
Biological Products
;
Chromatography, High Pressure Liquid
;
Coleoptera
;
Cyclooxygenase 2
;
Diarrhea/drug therapy*
;
Antineoplastic Agents
9.Eligibility of C-BIOPRED severe asthma cohort for type-2 biologic therapies.
Zhenan DENG ; Meiling JIN ; Changxing OU ; Wei JIANG ; Jianping ZHAO ; Xiaoxia LIU ; Shenghua SUN ; Huaping TANG ; Bei HE ; Shaoxi CAI ; Ping CHEN ; Penghui WU ; Yujing LIU ; Jian KANG ; Yunhui ZHANG ; Mao HUANG ; Jinfu XU ; Kewu HUANG ; Qiang LI ; Xiangyan ZHANG ; Xiuhua FU ; Changzheng WANG ; Huahao SHEN ; Lei ZHU ; Guochao SHI ; Zhongmin QIU ; Zhongguang WEN ; Xiaoyang WEI ; Wei GU ; Chunhua WEI ; Guangfa WANG ; Ping CHEN ; Lixin XIE ; Jiangtao LIN ; Yuling TANG ; Zhihai HAN ; Kian Fan CHUNG ; Qingling ZHANG ; Nanshan ZHONG
Chinese Medical Journal 2023;136(2):230-232
10.Application of traditional Chinese medicine theory in modern traditional Chinese medicine nano-preparation: taking tumor treatment as an example.
Zhu-Yuan LIU ; Ju-Yuan LUO ; Yang LU ; Shou-Ying DU
China Journal of Chinese Materia Medica 2023;48(6):1455-1462
With Zang-Fu organs, meridians, Qi and blood, and body fluid as the physiological and pathological basis, traditional Chinese medicine(TCM) theory is guided by the holistic concept and characterized by syndrome differentiation. It has made significant contributions to human health maintenance and disease prevention. Modern TCM preparation is developed on the basis of inheriting and developing TCM preparations using modern science and technology under the guidance of TCM theory. At present, the incidence and mortality of common tumors are increasing. TCM has rich clinical experience in the treatment of tumors. However, in the current stage, some TCM preparations have a tendency to deviate from the guidance of TCM theory. With the modernization of TCM, it is worth considering how TCM theory guides modern TCM preparations. Taking tumor treatment as an example, this paper introduced the development of TCM nano-preparation under the influence of modern nanotechnology, summarized the research on the development of modern TCM nano-preparation from the aspects of TCM holistic concept, TCM treatment principles, and TCM theory application, and discussed the application prospect of TCM nano-preparation in overall therapy, drug pairing, carrier selection, and targeted substance selection under the guidance of TCM theory. This paper provides new references for further developing the combination of tradition and modernization of TCM nano-preparation.
Humans
;
Medicine, Chinese Traditional
;
Drugs, Chinese Herbal/therapeutic use*
;
Biological Products
;
Nanotechnology
;
Neoplasms/drug therapy*


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