Chinese herbal medicine for psoriasis: evaluation of clinical evidence and investigation of the anti-psoriatic effects of specific Chinese medicinal herbs
Creators: name: Deng, Shiqiang
Publisher: name: RMIT University
Year: 2024

description: Psoriasis is a chronic and recurrent skin disease that affects 1-5% of the population. Conventional medical treatments can have significant side effects. There is, as yet, no curative regimen for the disease. Around half of psoriasis patients use complementary and alternative medicine including herbal medicine (HM). Consequently, the efficacy and safety of these HMs needs to be systematically evaluated. <br>The project aimed to evaluate the clinical efficacy and safety of HM for psoriasis, identify the promising herbs for psoriasis, investigate the anti-psoriatic actions of the most promising herbs, and develop an in silico method for investigating their biological targets and pathways. <br>Study quality assessments, systematic reviews and meta-analyses were undertaken in the first component of the project. This component firstly analysed clinical trials of HMs used internally and the second part focussed on topical HMs. Due to the diversity of topical HMs, the second part was further divided into three sections based on their intervention types: single herb, multi-ingredient herbal formula, and HM plus anti-psoriatic pharmacotherapy (APP). Based on 39 studies, 12 herbs were selected as promising for psoriasis: Oldenlandia, Rehmannia, Salvia, Aloe, Indigo, Camptotheca, Mahonia, Sophora, Lithospermum, Cnidium, Dictamnus and borneol.<br>The second component of the study focussed on the likely mechanisms of action of the identified herbs. <br>Firstly, for each of the main herbs, their relevant biological properties were reviewed. This identified evidence for anti-inflammatory, anti-proliferative, anti-angiogenic, wound healing/skin repair and/or anti-pruritic actions for extracts of the plants and/or their bioactive constituents. Then, 482 compounds contained in the short-listed herbs and their associated species were identified using Encyclopaedia of TCM and other sources. Then 350 biological targets were located with HIT database for these compounds. 70 targets of APPs were identified from the DrugBank database from 20 APPs approved by FDA. They mainly included NR3C1, COX (1, 2), RAR (α, β, γ-1), RXR-α &amp; RXR-β, CD2, TNF and VDR. The 350 biological targets were filtered by the 70 APP targets. Ten targets were common to the APPs and the herbs. After excluding the Cytochrome family of enzymes, 9 APP-like herbs were identified: Oldenlandia, Rehmannia, Salvia, Aloe, Indigo, Camptotheca, Mahonia, Sophora, Lithospermum. <br>The database PANTHER was used to identify biological processes and pathways that involved targets of the four identified herbs: Salvia, Rehmannia, Indigo and Camptotheca. The main pathways were Apoptosis signalling pathway, Angiogenesis, Gonadotropin releasing hormone receptor pathway, Inflammation mediated by chemokine and cytokine signalling pathway, and Interleukin signalling pathway, which are primarily related to inflammation, proliferation and angiogenesis. <br>The project identified promising herbs for psoriasis which showed potential APP-like actions and identified their likely mechanisms of action. The in silico rapid identification approach which was based on the results of meta-analyses of clinical trial outcomes was proposed as a more general method for adding value to the results of systematic reviews of herbal medicines and as an large-scale analysis solution to identifying directions for clinical trials and drug discovery. <br><br><br>