Clinical efficacy and IL-17 targeting mechanism of Indigo naturalis as a topical agent in moderate psoriasis.
Clinical efficacy and IL-17 targeting mechanism of Indigo naturalis as a topical agent in moderate psoriasis.
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DOI：
10.1186/s12906-017-1947-1
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发表时间：
2017-09-02
影响因子：
--
通讯作者：
Chris Huang C
中科院分区：
文献类型：
--
作者：
Cheng HM;Wu YC;Wang Q;Song M;Wu J;Chen D;Li K;Wadman E;Kao ST;Li TC;Leon F;Hayden K;Brodmerkel C;Chris Huang C
靛蓝是一种传统的中药成分，长期以来被认为是几种炎症性疾病的治疗方法，包括牛皮癣。然而，由于缺乏对其化学实体的了解，其机制尚不清楚。我们采取了一种不同的方法来应对这一挑战，研究了天然靛蓝治疗的分子特征和受影响的途径。在一项随机、双盲、安慰剂对照的临床研究中，使用靛蓝作为局部单药治疗中度斑块型银屑病在中国队列中（n = 24）。患者接受靛蓝天然软膏（n = 16）或匹配的安慰剂（n = 8）治疗，每天两次，持续8周，随访1周。在第8周，与安慰剂（0.0%）相比，Indigo naturalis治疗的患者的银屑病面积和严重程度指数（PASI）评分较基线有显著改善（56.3%的患者有75%的改善[PASI 75]反应）。通过基线皮肤活检建立了中度牛皮癣的基因表达特征，其中包括白细胞介素(IL)-17通路的上调，这是一个关键成分；靛蓝处理导致大多数这些特征基因恢复正常，包括IL-17途径的下调。利用体外角质细胞测定，观察到天然靛蓝的一种成分色氨酸对il -17的抑制作用。本研究证实了天然靛蓝治疗中度牛皮癣的临床疗效，为了解中药靶向机制提供了新的实验医学途径。NCT01901705。本文的在线版本（10.1186/s12906-017-1947-1）包含补充材料，可供授权用户使用。
Indigo naturalis is a Traditional Chinese Medicine (TCM) ingredient long-recognized as a therapy for several inflammatory conditions, including psoriasis. However, its mechanism is unknown due to lack of knowledge about the responsible chemical entity. We took a different approach to this challenge by investigating the molecular profile of Indigo naturalis treatment and impacted pathways. A randomized, double-blind, placebo-controlled clinical study was conducted using Indigo naturalis as topical monotherapy to treat moderate plaque psoriasis in a Chinese cohort (n = 24). Patients were treated with Indigo naturalis ointment (n = 16) or matched placebo (n = 8) twice daily for 8 weeks, with 1 week of follow-up. At week 8, significant improvements in Psoriasis Area and Severity Index (PASI) scores from baseline were observed in Indigo naturalis-treated patients (56.3% had 75% improvement [PASI 75] response) compared with placebo (0.0%). A gene expression signature of moderate psoriasis was established from baseline skin biopsies, which included the up-regulation of the interleukin (IL)-17 pathway as a key component; Indigo naturalis treatment resulted in most of these signature genes returning toward normal, including down-regulation of the IL-17 pathway. Using an in vitro keratinocyte assay, an IL-17-inhibitory effect was observed for tryptanthrin, a component of Indigo naturalis. This study demonstrated the clinical efficacy of Indigo naturalis in moderate psoriasis, and exemplified a novel experimental medicine approach to understand TCM targeting mechanisms. NCT01901705. The online version of this article (10.1186/s12906-017-1947-1) contains supplementary material, which is available to authorized users.
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影响因子：
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