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Archives of Dermatological Research

, Volume 306, Issue 3, pp 211–229 | Cite as

Phytotherapy in the management of psoriasis: a review of the efficacy and safety of oral interventions and the pharmacological actions of the main plants

  • Shiqiang Deng
  • Brian H. May
  • Anthony L. Zhang
  • Chuanjian LuEmail author
  • Charlie C. L. XueEmail author
Review Article

Abstract

This review provides assessments of the efficacy and safety of oral forms of phytotherapy in psoriasis management and discusses the pharmacological actions of the plants that have been frequently used in clinical trials. It employed the methods described in the Cochrane Handbook. Ten randomized controlled trials that compared a plant-based intervention with placebo or a pharmacotherapy in the treatment of psoriasis vulgaris and used Psoriasis Area Severity Index (PASI) as an outcome measure were included. Superiority to placebo was found in two out of three studies. In six out of seven studies, the effect of the phytotherapy was reported as comparable to the pharmacotherapy in the short term when assessed as PASI 50. The safety of the phytotherapies was discussed. The most commonly used plants were Oldenlandia diffusa, Rehmannia glutinosa and Salvia miltiorrhiza. Experimental studies on extracts and compounds derived from these plants have reported anti-inflammatory, anti-proliferative and other actions of relevance to psoriasis management. These properties may account for the apparent actions of some of the phytotherapies used in these clinical studies. These plants and their active constituents appear to warrant further research attention in the search for future medications for psoriasis.

Keywords

Psoriasis Phytotherapy Herbal medicine Review Safety Adverse events Anti-inflammatory Anti-proliferative Oldenlandia diffusa Rehmannia glutinosa Salvia miltiorrhiza 

Abbreviations

α-SMA

α-Smooth muscle actin

AEs

Adverse events

AP-1

Activating protein-1

APP

Anti-psoriatic pharmacotherapy

Bax

Bcl-2-associated X protein

Bcl-2 family proteins

B cell lymphoma 2 family of apoptosis regulator proteins

BUN

Blood urea nitrogen

CAT

Catalase

CD

Circular dichroism

CE

Cornified envelope

CD4+ T cells

T-cell surface glycoprotein CD4

CHK

Cultured human keratinocytes

CI

Confidence interval

COX-2

Cyclooxygenase-2

CYP

Cytochrome P450

DLQI

Dermatology Life Quality Index

ERK/RSK2

Extracellular signal-regulated protein/ribosomal S6 kinase 2 kinase

FLI

Fos-like immunoreactive neurons

GSH-Px

Glutathione peroxidase

GSK 3β

Glycogen synthase kinase 3 beta

HaCaT

Immortalized human keratinocytes cells

HeLa cells

A cell from a sample taken from a woman called Henrietta Lacks and was named using the two initials of her first (He) and last (La) names

ICAM-1

Intercellular adhesion molecule 1

IFN

Interferon

IgE

Immunoglobulin E

IκB

IkappaB kinase

IKK

IκBα kinase

IL

Interleukin

iNOS

Inducible nitric oxide synthase

JNK

c-Jun N-terminal kinase

MCP-1

Monocyte chemotactic protein-1

mRNA

Messenger RNA

MD

Mean difference

NO

Nitric oxide

NS

Not stated

MCP

Monocyte chemotactic protein

NF-κB

Nuclear factor kappa-light-chain-enhancer of activated B cells

NIK

NF-κB-inducing kinase

PARP

Poly(ADP-ribose) polymerase

PASI

Psoriasis Area Severity Index

PDI

Psoriasis Disability Index

PGA

Physician’s Global Assessment

PGE2

Prostaglandin E2

PPAR

Peroxisome proliferator-activated receptor

PT

Phytotherapy

R-HepG2

Human hepatoma cell line

RAGE

Receptor for advanced glycation end products

RevMan

Review Manager Software

RCT

Randomized controlled trial

ROS

Reactive oxygen species

RR

Relative risk

THP1

Human monocytic cell line

TNF-α

Tumour necrosis factor-alpha

WBC

White blood cell

Notes

Acknowledgments

We acknowledge funding support provided by Guangdong Provincial Academy of Chinese Medical Sciences, China, Department of Innovation, Industry, Science and Research, Australian Government for the Australian Postgraduate Award (APA), the International Science and Technology Cooperation Program of China; and The Financial Industry Technology Research and Development Program of Guangdong Province, China that made this research possible.

Conflict of interest

The authors declare that they have no conflict of interest. This article is not under submission to another journal. All authors have contributed to the paper.

Supplementary material

403_2013_1428_MOESM1_ESM.doc (71 kb)
Supplementary material 1 (DOC 71 kb)

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© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.School of Health Sciences, and Traditional and Complementary Medicine Program, College of Science Engineering and Health, RMIT Health Innovations Research Institute (HIRi)RMIT UniversityBundooraAustralia
  2. 2.Guangdong Provincial Academy of Chinese Medical Sciences and Guangdong Provincial Hospital of Chinese MedicineGuangzhouPeople’s Republic of China

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