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Clinical efficacy and IL-17 targeting mechanism of Indigo naturalis as a topical agent in moderate psoriasis.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords

Gene expression

Indigo naturalis

Mechanism of action

Psoriasis

Journal Title bmc complementary and alternative medicine
Publication Year Start




PMID- 28865459
OWN - NLM
STAT- MEDLINE
DA  - 20170903
DCOM- 20170908
LR  - 20170908
IS  - 1472-6882 (Electronic)
IS  - 1472-6882 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Sep 02
TI  - Clinical efficacy and IL-17 targeting mechanism of Indigo naturalis as a topical 
      agent in moderate psoriasis.
PG  - 439
LID - 10.1186/s12906-017-1947-1 [doi]
AB  - BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: This study demonstrated the clinical efficacy of Indigo
      naturalis in moderate psoriasis, and exemplified a novel experimental medicine
      approach to understand TCM targeting mechanisms. TRIAL REGISTRATION: NCT01901705 
      .
FAU - Cheng, Hui-Man
AU  - Cheng HM
AD  - Department of Integration of Traditional Chinese and Western Medicine, China
      Medical University Hospital, Taichung, Taiwan.
AD  - School of Chinese Medicine, College of Chinese Medicine, China Medical
      University, Taichung, Taiwan.
FAU - Wu, Yang-Chang
AU  - Wu YC
AD  - Chinese Medicine Research and Development Center, China Medical University
      Hospital, Taichung, Taiwan.
AD  - Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical
      University, Kaohsiung, Taiwan.
FAU - Wang, Qingmin
AU  - Wang Q
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Song, Michael
AU  - Song M
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Wu, Jackson
AU  - Wu J
AD  - Department of Integration of Traditional Chinese and Western Medicine, China
      Medical University Hospital, Taichung, Taiwan.
AD  - College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
FAU - Chen, Dion
AU  - Chen D
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Li, Katherine
AU  - Li K
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Wadman, Eric
AU  - Wadman E
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Kao, Shung-Te
AU  - Kao ST
AD  - School of Chinese Medicine, College of Chinese Medicine, China Medical
      University, Taichung, Taiwan.
AD  - Department of Internal Chinese Medicine, China Medical University Hospital,
      Taichung, Taiwan.
FAU - Li, Tsai-Chung
AU  - Li TC
AD  - Department of Public Health, College of Public Health, China Medical University, 
      Taichung, Taiwan.
FAU - Leon, Francisco
AU  - Leon F
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Hayden, Karen
AU  - Hayden K
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Brodmerkel, Carrie
AU  - Brodmerkel C
AD  - Janssen Research & Development, LLC, Spring House, PA, USA.
FAU - Chris Huang, C
AU  - Chris Huang C
AD  - Janssen Research & Development, LLC, Spring House, PA, USA. [email protected]
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170902
PL  - England
TA  - BMC Complement Altern Med
JT  - BMC complementary and alternative medicine
JID - 101088661
RN  - 0 (Interleukin-17)
RN  - 0 (Plant Extracts)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Indigofera/*chemistry
MH  - Interleukin-17/genetics/*immunology
MH  - Male
MH  - Middle Aged
MH  - Plant Extracts/*administration & dosage
MH  - Psoriasis/*drug therapy/genetics/immunology
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5581407
OTO - NOTNLM
OT  - Gene expression
OT  - Indigo naturalis
OT  - Mechanism of action
OT  - Psoriasis
EDAT- 2017/09/04 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/09/04 06:00
PHST- 2017/03/22 [received]
PHST- 2017/08/23 [accepted]
AID - 10.1186/s12906-017-1947-1 [doi]
AID - 10.1186/s12906-017-1947-1 [pii]
PST - epublish
SO  - BMC Complement Altern Med. 2017 Sep 2;17(1):439. doi: 10.1186/s12906-017-1947-1.