Immunomodulatory Effects of Balneotherapy with Hae-Un-Dae Thermal Water on Imiquimod-Induced Psoriasis-Like Murine Model

Abstract

BackgroundBalneotherapy, although not a well-established dermatological treatment, is thought to have therapeutic properties for psoriasis and is used as an alternative treatment modality throughout the world.ObjectiveTo evaluate the mechanism underlying the therapeutic immunologic effects of thermomineral water.MethodsA murine model of imiquimod-induced psoriasis-like skin inflammation was used for evaluating the therapeutic effects of balneotherapy with Hae-Un-Dae hot spring mineral water. The clinical improvements were evaluated by a dermatologist. Lesional cytokines, including interleukin (IL)-17A, IL-23, and IL-22, were quantitatively measured by real-time reverse transcriptase polymerase chain reaction. Serum levels of interferon-γ, IL-4, IL-5, and IL-17A were measured by enzyme-linked immunosorbent assay. T cell proportions in the spleen were evaluated by flow cytometry, and histopathological evaluation of the skin was also performed.ResultsThe mineral water balneotherapy group showed faster improvement in skin erythema and scales than the distilled water bathing group. A substantial reduction was observed in the lesional mRNA levels of IL-17A and IL-23 in the mineral water group. Serum levels of IL-4 and IL-5 were significantly decreased in the mineral water group but not in the distilled water group. Normalized T cell proportions were observed after bathing.ConclusionBalneotherapy showed immunomodulatory effects in a psoriasis-like murine model. Balneotherapy suppressed lesional IL-23 and IL-17A, which are important cytokines in the pathogenesis of psoriasis. These results suggest that balneotherapy can be used as an effective and safe treatment for psoriasis.

A Critical Evaluation of Dead Sea Therapy in the Management of Psoriasis

“…A major disadvantage of using these reported benefits is that most trials were carried out on animal models with few trials on human patients [3,5,13,26]. The number of well designed RCT is small and hence the findings are open to question [3].…”

“…In addition, immuno-modulatory effects of DS balneotherapy were assessed in an experimentally induced psoriasis murine model [13]. Experimental animals were treated with thermo-mineral water.…”

Balneotherapy in Kangal hot spring with fish

“…One of the promising alternative therapies for psoriasis is balneotherapy. This treatment offers a natural, multifactorial, complementary, nontoxic alternative to the traditional pharmacologic treatments of psoriasis and has almost no adverse effects during and after treatment 2,4,7,8 .…”

“…The efficacy of spa therapy for inflammatory skin diseases and the mechanisms are only partly understood, and presumably incorporate chemical, thermal, mechanical and immunomodulatory effects 2,5 . The chemical components of this thermal water, including sulfur, magnesium, and selenium, are thought to have beneficial effects on the skin.…”

“…Balneotherapy is referred to as an alternative therapeutic method based on the use of thermomineral waters including bathing 1,2 . Mineral waters are natural solutions formed under specific geologic conditions and characterized by a "chemico-physical dynamism."…”