Efficacy of oxymatrine for treatment and relapse suppression of severe plaque psoriasis: results from a single-blinded randomized controlled clinical trial

Zhou, Hui; Shi, Huijuan; Yang, Jianhong; Chen, W.-G.; Xia, Lijuan; Song, Huali; Bo, K.-P.; Ma, Wenjing

doi:10.1111/bjd.15316

Cited by 20 publications

(20 citation statements)

References 38 publications

(62 reference statements)

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“…Oxymatrine has been used to treat solid tumours, with a dose of 1000–1500 mg intravenously, once daily for 30–45 days . Moreover, our preliminary clinical findings indicated that oral 0·6 g daily oxymatrine had little effect but intravenous administration produced a significant effect . Furthermore, studies have shown that the absolute bioavailability of oxymatrine by the oral route was very low .…”

Section: Methodsmentioning

confidence: 65%

Oxymatrine therapy inhibited epidermal cell proliferation and apoptosis in severe plaque psoriasis

Shi

Zhou

et al. 2019

Br J Dermatol

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SummaryBackgroundPsoriasis is a chronic skin disorder that manifests as epidermal keratinocyte hyperplasia.ObjectivesWe examined the effect of oxymatrine treatment on cell proliferation and apoptosis in skin lesions of psoriasis.Patients and methodsPatients with severe plaque psoriasis were treated with oxymatrine or with acitretin. The skin lesions were stained with proliferating cell nuclear antigen (PCNA), Ki‐67 and Bcl‐2, as well as examined by terminal deoxynucleotidyl transferase‐mediated dUTP nick‐end labelling (TUNEL). We performed correlations of the Psoriasis Area and Severity Index (PASI) and the proliferation and apoptosis index.ResultsOxymatrine significantly reduced the psoriasis lesions as demonstrated by the reduced PASI score after treatment [6·91; 95% confidence interval (CI) 5·00–8·81, P < 0·001]. In the oxymatrine group, the mitotic index was 26·15 (95% CI 24·80–27·49) before oxymatrine treatment, decreasing to 14·52 (95% CI 13·82–15·25; P < 0·001) after treatment, but remained higher than the normal group (6·24; 95% CI 5·87–6·61, P < 0·001). Oxymatrine also inhibited the proliferation of epidermal cells in the skin lesion as indicated by the reduced proliferation index after treatment (P < 0·01). In addition, oxymatrine treatment reduced cellular apoptosis as shown by increased Bcl‐2 expression and a decrease in TUNEL‐positive cells. The PASI score was positively correlated with mitotic index, proliferation index and apoptotic index (TUNEL), but negatively correlated with Bcl‐2 expression.ConclusionsOxymatrine treatment reduced proliferation but inhibited apoptosis of cells in the skin lesion. The balance between cell proliferation and turnover may contribute to the significant alleviation of psoriasis by oxymatrine. What's already known about this topic? Psoriasis manifests as epidermal keratinocyte hyperplasia with proliferation, keratinocyte maturation and turnover rates.Current drugs for psoriasis may inhibit cell proliferation but could not adjust the balance of cell division, differentiation and apoptosis. What does this study add? We studied the efficacy of oxymatrine in the treatment of psoriasis and analysed the correlation of skin lesions, proliferation and apoptosis index before and after oxymatrine treatment. What is the translational message? Our study has demonstrated that oxymatrine is effective in the treatment of severe plaque psoriasis.It has comparable efficacy with acitretin.Because acitretin treatment was sometimes associated with metabolic abnormalities, our study suggests oxymatrine therapy as an alternative treatment for psoriasis in the context of acitretin allergy or adverse reactions.

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Section: Methodsmentioning

confidence: 65%

Oxymatrine therapy inhibited epidermal cell proliferation and apoptosis in severe plaque psoriasis

Shi

Zhou

et al. 2019

Br J Dermatol

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“…Oxymatrine is a quinolizidine alkaloid isolated from the Chinese medicine Sophora flavescens and adopted to treat chronic viral hepatitis, plaque psoriasis, and arrhythmia [ 67 , 68 , 69 ]. Besides the findings of beneficial actions, it is proved to worsen liver damage.…”

Section: Molecular Mechanisms Involved In Tcm-induced Oxidative Hementioning

confidence: 99%

Molecular Mechanisms Involved in Oxidative Stress-Associated Liver Injury Induced by Chinese Herbal Medicine: An Experimental Evidence-Based Literature Review and Network Pharmacology Study

Zhang

Wang

et al. 2018

IJMS

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Oxidative stress, defined as a disequilibrium between pro-oxidants and antioxidants, can result in histopathological lesions with a broad spectrum, ranging from asymptomatic hepatitis to hepatocellular carcinoma in an orchestrated manner. Although cells are equipped with sophisticated strategies to maintain the redox biology under normal conditions, the abundance of redox-sensitive xenobiotics, such as medicinal ingredients originated from herbs or animals, can dramatically invoke oxidative stress. Growing evidence has documented that the hepatotoxicity can be triggered by traditional Chinese medicine (TCM) during treating various diseases. Meanwhile, TCM-dependent hepatic disorder represents a strong correlation with oxidative stress, especially the persistent accumulation of intracellular reactive oxygen species. Of note, since TCM-derived compounds with their modulated targets are greatly diversified among themselves, it is complicated to elaborate the potential pathological mechanism. In this regard, data mining approaches, including network pharmacology and bioinformatics enrichment analysis have been utilized to scientifically disclose the underlying pathogenesis. Herein, top 10 principal TCM-modulated targets for oxidative hepatotoxicity including superoxide dismutases (SOD), malondialdehyde (MDA), glutathione (GSH), reactive oxygen species (ROS), glutathione peroxidase (GPx), Bax, caspase-3, Bcl-2, nuclear factor (erythroid-derived 2)-like 2 (Nrf2), and nitric oxide (NO) have been identified. Furthermore, hepatic metabolic dysregulation may be the predominant pathological mechanism involved in TCM-induced hepatotoxic impairment.

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“…36 Furthermore, OMT improved lesions in patients with severe psoriasis without obvious toxicity. 37 CCK8 assays confirmed no obvious toxicity of OMT-LIP to NP cells, indicating that both OMT and OMT-LIP are safe within a reasonable concentration gradient (Figure 3A). Furthermore, OMT-LIP obviously repressed IL-1β-induced apoptosis detected by fluorescence microscope and flow cytometry, as shown in Figure 3B-D.…”

Section: Discussionmentioning

confidence: 92%

<p>Oxymatrine Liposomes for Intervertebral Disc Treatment: Formulation, in vitro and vivo Assessments</p>

Wang

Ding

Zhang

et al. 2020

DDDT

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Intervertebral disc degeneration (IVDD) is the main cause of modern low back pain, leading to high societal economic costs. To find an effective medical treatment for this disease, oxymatrine liposomes (OMT-LIP) were prepared with the pH-gradient method. Materials and Methods: Nucleus pulposus (NP) cells from Sprague-Dawley rats were used for the cell experiments. Kunming mice were used for in vivo imaging. LIP were employed to deliver OMT, and the particle size, ζ-potential, morphology, in vitro stability and in vitro release characteristics were evaluated. The OMT-LIP targeting effect was measured by in vivo imaging. Cell Counting Kit-8 assays were used to detect the cytotoxicity of OMT and OMT-LIP on NP cells. Therapeutic efficacy was measured by Western blot, real-time quantitative polymerase chain reaction, and apoptosis assays. Radiologic analysis was performed to evaluate the therapeutic effects in vivo. Results: Orthogonal test results revealed that the mass ratio of egg yolk phosphatidylcholine to cholesterol was the key factor to effectively trap OMT in LIP. Optimal OMT-LIP showed multivesicular structure with entrapment efficiency of 73.4 ± 4.1%, particle size of 178.1 ± 2.9 nm, and ζ-potential of -13.30 ± 2.34 mV. OMT-LIP manifested excellent stability in vitro and presented significantly longer sustained release compared to OMT solution in phosphatebuffered saline (pH 7.4). OMT-LIP conspicuously increased OMT accumulation in the degenerative disc, attenuated NP cell apoptosis, reduced the expression of matrix metalloproteinases 3/9 and interleukin-6, and decreased degradation of type II collagen. In in vivo study, X-ray demonstrated that OMT-LIP inhibited IVDD. Conclusion: OMT-LIP may be a useful treatment to alleviate disc inflammation and IVDD.

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Efficacy of oxymatrine for treatment and relapse suppression of severe plaque psoriasis: results from a single-blinded randomized controlled clinical trial

Abstract: Treatment with oxymatrine effectively ameliorated severe plaque psoriasis, and was accompanied by only minor adverse effects.

Cited by 20 publications

References 38 publications

Oxymatrine therapy inhibited epidermal cell proliferation and apoptosis in severe plaque psoriasis

Oxymatrine therapy inhibited epidermal cell proliferation and apoptosis in severe plaque psoriasis

Molecular Mechanisms Involved in Oxidative Stress-Associated Liver Injury Induced by Chinese Herbal Medicine: An Experimental Evidence-Based Literature Review and Network Pharmacology Study

<p>Oxymatrine Liposomes for Intervertebral Disc Treatment: Formulation, in vitro and vivo Assessments</p>

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