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.
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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
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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.
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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.
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S. Deng and B. H. May made equal contributions to the study.
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Deng, S., May, B.H., Zhang, A.L. et al. Phytotherapy in the management of psoriasis: a review of the efficacy and safety of oral interventions and the pharmacological actions of the main plants. Arch Dermatol Res 306, 211–229 (2014). https://doi.org/10.1007/s00403-013-1428-4
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DOI: https://doi.org/10.1007/s00403-013-1428-4