Re: 건선.. 알로에, 마늘, 생강, 해수욕, 일광욕 등이 효과가 있는 이유

[문형철]

건선은

음식 과민증, 히스타민 과민증 ... 만성염증..

--> 자가면역 염증

기전 : 수지상세포, 대식세포 등 면역세포가 활성 --> T 세포 활성(자가면역) --> 각질세포 염증(피부벽 파괴) --> 피부 세균 포도상구균, 연쇄상구균 증식 --> 영역이 분명한 판상건선이 80~90%..

그래서 피부 세균을 제거하는 마늘, 알로에, 강황 등이 효과가 있을 것으로 추정되어.. 논문을 찾아봤다..

역시 효과가 있다...

당연히 바닷물(소금물) 목욕과 일광욕도 효과가 있을 것으로 추정됨.

논문을 찾아봤다. 역시 효과가 있다..

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093374/

Inflammopharmacology. 2023; 31(3): 1183–1198.

Published online 2023 Mar 30. doi: 10.1007/s10787-023-01178-0

PMCID: PMC10229448

PMID: 36995575

Review of natural compounds for potential psoriasis treatment

Omali Y. Elkhawaga,

 Mohamed M. Ellety, Sheref O. Mofty, Mohamed S. Ghanem, and Abdallah O. Mohamed

Author information Article notes Copyright and License information PMC Disclaimer

Associated DataData Availability Statement

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Abstract

Psoriasis represents an immune-mediated disease with an unclear cause that’s marked by inflammation triggered by dysfunction in the immune system, which results in inflammation in various parts of the skin. There could be obvious symptoms, such as elevated plaques; these plaques may appear differently depending on the type of skin. This disease can cause inflammation in the elbows, lower back, scalp, knees, or other regions of the body. It can begin at any age, although it most commonly affects individuals between the ages of 50 and 60. Specific cells (such as T cells) have been observed to play an obvious role in the pathogenesis of psoriasis, in addition to specific immunological molecules such as TNF-, IL-12, IL-23, IL-17, and other molecules that can aid in the pathogenesis of psoriasis. So, during the past two decades, biologists have created chemical drugs that target these cells or molecules and therefore prevent the disease from occurring. Alefacept, efalizumab, Adalimumab, Ustekinumab, and Secukinumab are a few examples of chemical drugs. It was discovered that these chemical drugs have long-term side effects that can cause defects in the patient's body, such as the development of the rare but life-threatening disorder progressive multifocal leukoencephalopathy (PCL). Its rapidly progressive infection of the central nervous system caused by the JC virus and other drugs may cause increased production of neutralising anti-drug antibodies (ADA) and the risk of infusion reactions like pruritus, flushing, hypertension, headache, and rash. So, our context intends to talk in our review about natural products or plants that may have therapeutic characteristics for this disease and may have few or no side effects on the patient's body.

건선은 

면역 체계의 기능 장애로 인해 유발된 염증이 

피부의 여러 부위에 염증을 일으키는 원인이 불분명한 면역 매개 질환입니다. 

플라크 상승과 같은 명백한 증상이 나타날 수 있으며, 

플라크는 피부 유형에 따라 다르게 나타날 수 있습니다. 

이 질환은 

팔꿈치, 허리, 두피, 무릎 또는 기타 신체 부위에 염증을 일으킬 수 있습니다. 

모든 연령대에서 발병할 수 있지만 

50~60세 사이에 가장 흔하게 발생합니다. 

특정 세포(예: T 세포)가 

건선의 발병에 명백한 역할을 하는 것으로 관찰되었으며, 

건선의 발병에 도움을 줄 수 있는 

TNF-, IL-12, IL-23, IL-17 및 

기타 분자와 같은 특정 면역 분자가 건선의 발병에 관여하는 것으로 밝혀졌습니다. 

따라서 

지난 20년 동안 생물학자들은 

이러한 세포나 분자를 표적으로 삼아 질병의 발생을 예방하는 화학 약물을 개발해 왔습니다. 

알레파셉트, 에팔리주맙, 아달리무맙, 우스테키누맙, 세쿠키누맙이 화학 약물의 몇 가지 예입니다. 

이러한 화학 약물은 

드물지만 생명을 위협하는 질환인 진행성 다초점 백질뇌병증(PCL)의 발병과 같이 

환자의 신체에 결함을 일으킬 수 있는 

장기적인 부작용이 있다는 것이 밝혀졌습니다. 

https://common.health.kr/shared/healthkr/pharmreview/%EA%B1%B4%EC%84%A0%20%EC%B9%98%EB%A3%8C%EC%A0%9C.pdf

JC 바이러스 및 기타 약물에 의한 중추신경계 감염이 빠르게 진행되면 중화 항약물 항체(ADA)의 생성이 증가하고 가려움증, 홍조, 고혈압, 두통, 발진 같은 주입 반응의 위험이 발생할 수 있습니다. 

따라서 

이번 리뷰에서는 

이 질환에 대한 치료 효과가 있고 

환자의 신체에 부작용이 거의 또는 

전혀 없는 천연 제품이나 식물에 대해 이야기하고자 합니다.

Keywords: Psoriasis, Autoimmune, Plant, Natural, Dietary, Phytochemical

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Introduction

Psoriasis represents an autoimmune, persistent inflammatory disease that affects the skin and has a powerful hereditary component. It is distinguished by persistent inflammation, which results in uncontrolled keratinocyte growth and differentiation (Pathogenesis 2019). In accordance with the International Psoriasis Day Collaboration, psoriasis affects 125 million individuals globally, or around 2–3% of the population. According to research, psoriatic arthritis affects 10–30% of psoriasis sufferers. Psoriasis has a detrimental influence on sufferers' quality of life. Even though psoriasis` pathophysiology remains unknown, it is thought to be a T-cell-triggered disorder because of the presence of T-helper cells inside the psoriatic state (Pathogenesis 2019; Theses and Devera 2020; Singhvi et al. 2020). Chronic plaque psoriasis (psoriasis vulgaris), inverse psoriasis, guttate psoriasis, Pustular psoriasis and erythrodermic psoriasis are the two clinical classifications of psoriasis. Chronic psoriasis vulgaris accounts for 80–90% of psoriasis patients. Psoriasis vulgaris can be distinguished by erythematous, well-defined plaques coated with silvery scales. Moreover, it can affect limb extensor surfaces, scalp, and trunk. Inverted psoriasis is characterised by somewhat erosive erythematous patches and plaques in the folds and vaginal regions. This condition is a mix of psoriasis and inflamed arthritis that affects the joints and spine. This happens when there are no particular antibodies in the blood or rheumatoid factor. Because of societal shame and marginalisation, psoriasis patients suffer poor mental and psychological health. Anxiety, sadness, and suicide thoughts are more common in these people (Napolitano, et al. 2016). The major signs of psoriasis appear as itchiness and reddish, flaky skin areas coated in silver scales. Other symptoms include tiny scale areas, cracked skin, itching, pain, swollen or corroded nails, inflammatory and genital sores, stiff joints, and extreme dandruff on the scalp (Global report 2022). Psoriasis is a complex disease influenced by genetic, environmental, and immunological factors. Modifying variables include obesity, illness, trauma, and a lack of active Vitamin D3.

건선은 피부에 영향을 미치는 

자가 면역성, 

지속적인 염증성 질환으로 강력한 유전적 요소가 있습니다. 

건선은 

지속적인 염증으로 인해 

각질 세포의 성장과 분화가 조절되지 않는 것이 특징입니다(병인 2019). 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075909/

국제 건선의 날 공동 캠페인에 따르면 

건선은 전 세계적으로 

1억 2,500만 명, 

즉 인구의 약 2~3%가 앓고 있습니다. 

연구에 따르면 

건선 환자의 10~30%는 

건선성 관절염을 동반한다고 합니다. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297592/

건선 .. 치매 위험성 증가 논문

건선은 

환자의 삶의 질에 해로운 영향을 미칩니다. 

건선의 병태생리는 아직 밝혀지지 않았지만, 

건선 상태 내부에 

T-헬퍼 세포가 존재하기 때문에 

건선은 T세포 유발 질환으로 추정됩니다(병인 2019; 논문 및 데베라 2020; 싱비 외. 2020). 

만성 판상 건선(심상성 건선), 

역 건선, 

구진 건선, 

농포성 건선 및 홍피성 건선은 

건선의 두 가지 임상 분류입니다. 

만성 심상성 건선은 

건선 환자의 80~90%를 차지합니다. 

심상성 건선은 

은빛 비늘로 덮인 홍반성, 잘 정의된 플라크로 구별할 수 있습니다. 

또한 

사지 신근 표면, 

두피 및 몸통에 영향을 미칠 수 있습니다. 

역형 건선은 

주름과 질 부위에 

다소 침식성 홍반성 패치와 플라크가 나타나는 것이 특징입니다. 

이 질환은 

관절과 척추에 영향을 미치는 건선과 

염증성 관절염이 혼합된 상태입니다. 

이는 

혈액이나 류마티스 인자에 특별한 항체가 없을 때 발생합니다. 

건선 환자는 

사회적 수치심과 소외감으로 인해 

정신적, 심리적 건강이 좋지 않습니다. 

불안, 슬픔, 자살 충동을 느끼는 경우가 

더 흔합니다(나폴리타노 등, 2016). 

건선의 주요 증상은 

가려움증과 은빛 비늘로 덮인 

붉고 벗겨지는 피부 부위로 나타납니다. 

다른 증상으로는 

작은 비늘 부위, 갈라진 피부, 가려움증, 통증, 

부어 오르거나 부식된 손톱, 

염증성 및 생식기 궤양, 뻣뻣한 관절, 

두피의 심한 비듬 등이 있습니다(2022년 글로벌 보고서). 

건선은 

유전적, 환경적, 면역학적 요인의 영향을 받는 

복합적인 질환입니다. 

비만, 질병, 외상, 

활성 비타민 D3 부족 등이 변수로 작용합니다.

Pathogenesis

Psoriasis represents a common inflammatory skin condition with a complex pathophysiology that includes a hereditary element, immune dysfunction, and environmental exposures. It is linked to a variety of complications, including psoriatic arthritis, cardiac disease, metabolic syndrome, and obesity. Obesity appears to be a significant predictor for incident psoriasis, aggravates established psoriasis, and may improve the intensity of psoriasis in individuals. (Howell et al. 2019).

It is a genetic skin disease mediated by the immune system. The pathomechanisms at work involve complex communication between the immune system's innate and adaptive systems. T cells communicate with dendritic cells, keratinocytes, and macrophages via cytokines secreted by these cells. Streptococcal infection, smoking, stress, obesity, and alcohol consumption are all examples of environmental triggers (Kamiya et al. 2019).

Psoriasis is linked to a number of complications, including cardiovascular disease, cancer, and depression. For mild to severe psoriasis, corticosteroids, vitamin D mimics, and tazarotene were effective therapies. This illness can indeed be caused by a variety of microorganisms, including in psoriatic skin, where there was a rise in Corynebacterium, Propionibacterium, Streptococcus, and Staphylococcus (Thomas et al. 2021). Nevertheless, in another study, Staphylococci were considerably lower in lesional skin in comparison with healthy controls was a rise in Corynebacterium, Propionibacterium, Streptococcus, and Staphylococcus (Thomas et al. 2021). Nevertheless, in another study, Staphylococci were considerably lower in lesional skin in comparison with healthy controls.

Psoriasis has been linked to fungi, including Malassezia as well as Candida albicans, as well as viruses like the human papillomavirus. Malassezia has been identified as the main preval‎ent fungus in both psoriatic and healthy skin. It has been discovered that disruptions in the adaptive and innate cutaneous immunogenicity are responsible for the formation and maintenance of psoriatic inflammation. Th1 cytokines, including c-interferon (IFN-c), tumour necrosis factor-a (TNF-a), and interleukin (IL)-12, were shown to be raised in psoriatic lesions, but Th2 cytokines (IL-4, IL-5, and IL-10) were not (Blauvelt and Chiricozzi 2018).

In psoriasis vulgaris areas, the bulk of epidermal T cells may generate type 1 cytokines, including INF-c, IL-2, and TNF-a, identifying cytotoxic T-lymphocytes (TC1) as well as TH1 effector populations. Psoriasis was identified as a Th1-type illness based on these findings. However, neither IFN-c nor TNF-a stimulate keratinocyte growth (Spa 2008).

Interleukin-6 (IL-6) and other pro-inflammatory cytokines can activate the hypothalamus-pituitary axis, which has been linked to hypertension, obesity, and insulin resistance. IL-6 can also stimulate the production of C-reactive protein in hepatocytes and, in conjunction with TNF-, alter insulin sensitivity via the insulin signalling system (Liang et al. 2018). The formation of plaque in psoriasis is not isolated to inflammation at the epidermal layer; it is influenced by the keratinocyte’s interaction with many other types of cells (adaptive and innate immune cells, vasculature) across the dermis layer of skin. In certain cases, natural immune system activation caused by intrinsic danger signals or cytokines intermixes with autoinflammatory persistence, whereas in others, T cell-driven autoimmune responses occur. Thus, psoriasis exhibits disease characteristics on an auto-inflammatory basis, with both pathways overlapping and even amplifying each other (Meglio et al. 2014). The aetiology of psoriasis may be divided into two phases: the initiation phase, which may be induced by trauma (the Koebner phenomenon), infections, or medicines; and the maintenance phase, which is defined by continuous clinical development. Psoriasis pathogens originate once keratinocytes are exposed to an external stimulus (infection/stress/obesity/genetically), and as a result, keratinocytes secrete antimicrobial peptides (AMPs) that are overexpressed in psoriatic skin (Lai and Gallo 2009) (Fig. 1).

건선은 

유전적 요소, 면역 기능 장애, 환경 노출 등 

복잡한 병태 생리를 가진 흔한 염증성 피부 질환입니다. 

건선은 

건선성 관절염, 

심장 질환, 

대사 증후군, 

비만을 비롯한 다양한 합병증과 관련이 있습니다. 

비만은 

건선 발병의 중요한 예측 인자이며, 

이미 발생한 건선을 악화시키고, 

개인의 건선 강도를 개선할 수 있는 것으로 보입니다. (Howell 외. 2019).

건선은 

면역 체계에 의해 매개되는 

유전적 피부 질환입니다. 

건선의 병리 메커니즘에는 

면역계의 선천적 시스템과 

후천적 시스템 간의 복잡한 소통이 관여합니다. 

T 세포는 

수지상 세포, 

각질 세포 및 대식세포와 

이들 세포가 분비하는 사이토카인을 통해 소통합니다. 

연쇄상구균 감염, 흡연, 스트레스, 비만, 음주는 

모두 환경적 유발 요인의 예입니다(Kamiya 외. 2019).

건선은 

심혈관 질환, 암, 우울증 등 

여러 가지 합병증과 관련이 있습니다. 

경증에서 중증 건선의 경우 

코르티코스테로이드, 

비타민 D 모방체, 

타자로틴이 효과적인 치료법입니다. 

건선은 

실제로 다양한 미생물에 의해 발생할 수 있으며, 

건선 피부에서는 

코리네박테리움, 

프로피오니박테리움, 

연쇄상구균, 

포도상구균이 증가했습니다(Thomas 외. 2021). 

https://www.nature.com/articles/s41467-019-12253-y

그럼에도 불구하고 또 다른 연구에서는 

건강한 대조군에 비해 병변 피부에서 

코리네박테리움, 프로피오니박테리움, 스트렙토코커스, 포도상구균이 

상당히 낮은 것으로 나타났습니다(Thomas et al. 2021). 

하지만 

다른 연구에서는 건강한 대조군에 비해 병변이 있는 

피부에서 포도상구균이 상당히 낮은 것으로 나타났습니다. 

건선은 

말라세지아, 칸디다 알비칸스 등의 진균과 

인유두종 바이러스 human papillomavirus 와 같은 바이러스와 관련이 있는 것으로 알려져 있습니다. 

말라세지아는 

건선 피부와 건강한 피부 모두에서 

가장 흔한 곰팡이로 확인되었습니다. 

https://www.frontiersin.org/articles/10.3389/fcimb.2020.00112/full

적응성 및 선천성 피부 면역원성의 장애가 

건선 염증의 형성과 유지에 관여하는 것으로 밝혀졌습니다. 

건선 병변에서는 

c-인터페론(IFN-c), 

종양괴사인자-a(TNF-a), 

인터루킨(IL)-12를 포함한 Th1 사이토카인이 증가하는 것으로 나타났지만 

Th2 사이토카인(IL-4, IL-5, IL-10)은 증가하지 않았습니다(Blauvelt and Chiricozzi 2018).



판상 건선 부위에서는 

표피 T 세포의 대부분이 INF-c, IL-2, TNF-a를 포함한 

1형 사이토카인을 생성하여 

세포 독성 T 림프구(TC1)와 

TH1 이펙터 집단을 식별할 수 있습니다. 

이러한 

연구 결과를 바탕으로 

건선은 Th1 유형의 질환으로 확인되었습니다. 

그러나 

IFN-c나 TNF-a는 각질 세포 성장을 자극하지 않습니다(Spa 2008).

인터루킨-6(IL-6) 및 기타 염증성 사이토카인은 

고혈압, 비만 및 인슐린 저항성과 관련이 있는 

시상하부-뇌하수체 축을 활성화할 수 있습니다. 

IL-6는 또한 

간세포에서 

C-반응성 단백질의 생성을 자극하고 

TNF-와 함께 인슐린 신호 체계를 통해 인슐린 감수성을 변화시킬 수 있습니다(Liang 등. 2018). 

건선에서 

플라크의 형성은 

표피층의 염증에만 국한된 것이 아니라 

피부 진피층에 걸쳐 각질 세포와 

다른 여러 유형의 세포(적응성 및 선천성 면역 세포, 혈관 구조)의 상호작용에 의해 영향을 받습니다. 

어떤 경우에는 

내재적 위험 신호 또는 

사이토카인으로 인한 자연 면역 체계 활성화가 

자가 염증 지속성과 혼합되는 반면, 

다른 경우에는 T 세포 중심의 자가 면역 반응이 발생합니다. 

따라서 

건선은 

자가염증에 기반한 질병 특성을 나타내며, 

두 경로가 서로 겹치거나 증폭되기도 합니다(Meglio 외. 2014). 

건선의 병인은 

외상(쾨브너 현상), 

감염 또는 약물에 의해 유발될 수 있는 발병 단계와 

지속적인 임상 발달에 의해 정의되는 유지 단계로 나눌 수 있습니다. 

건선 병원균은 

각질 세포가 

외부 자극(감염/스트레스/비만/유전적)에 노출되면 발생하며, 

그 결과 

각질 세포는 

건선 피부에서 과발현되는 항균 펩타이드(AMP)를 분비합니다(Lai and Gallo 2009)(그림 1).

Fig. 1

Basic pathogenesis of psoriasis

AMP are made up of twelve to fifty amino acids that help the host defend itself by destroying pathogens such as protozoa, bacteria, fungus, and certain viruses.It also has an impact on inflammatory responses by acting as an angiogenic factor, chemotactic mediator, and cell proliferation regulator. Several AMP, including -defensins, S100 proteins, and cathelicidin, are abundantly expressed in psoriatic lesions (Kiel 2004).

AMP는 

12~50개의 아미노산으로 구성되어 

원충, 박테리아, 곰팡이 및 특정 바이러스와 같은 병원균을 파괴하여 

숙주가 스스로를 방어하도록 돕고 

혈관 신생 인자, 화학 작용 매개체 및 세포 증식 조절제로 작용하여 

염증 반응에 영향을 미칩니다. 

건선 병변에는 

-데펜신, S100 단백질, 카테리시딘을 포함한 

여러 AMP가 풍부하게 발현됩니다(Kiel 2004).

The -defensins have been divided into six subtypes known as human neutrophil peptides, or 1-6HNP, of which HNP 1–3 are found in the scales of psoriatic lesions.-Defensins are divided into four subtypes known as 1–4 human -defensins (HD).

HD 1–2 were found to be highly expressed in psoriasis scales and are activated in keratinocytes by TNF- and/or IFN-c (Lande et al. 2014). Furthermore, IL-22 and IL-17A both cause HD 2. LL37, also known as cathelicidin, has been linked to the pathogenesis of psoriasis. Injured keratinocytes secrete LL37, which is then combined with self-genetic materials from those damaged cells to form complexes. LL37 represents one of the two T-cell autoantigens examined in psoriasis. Research revealed specific CD8+ and CD4+ T lymphocytes in two-thirds of individuals with mild to severe plaque psoriasis. LL37-specific T cells produce IFN-, while CD4+ T cells produce IL-22, IL-21, and IL-17. Specific T lymphocytes (LL37) could be detected in skin lesions and blood, and their presence correlates with disease activity (Morizane et al. 2012).

CD8+ T-cells stimulated by LL37 participate in autoantigen detection, epidermotropism, and Th17 cytokine release. The HLA-C*06:02-restricted autoantigen ADAMTSL5 was discovered to be recognised because of a CD8+ T-cell TCR that is autoreactive. This discovery identifies melanocytes as immune target cells. TLR9 in plasmacytoid DCs is activated by LL37 coupled to DNA (pDCs) (Arakawa, et al. 2015). The activation of pDC, characterised by the production of type I IFNs such as IFN- and IFN-, is essential for the formation of the psoriatic plaque. Type I IFN signalling promotes myeloid dendritic cell (mDC) phenotypic development and has been linked to Th1 and Th17 development and role, including the production of IFN- and IL-17, respectively (Morizane and Gallo 2011). LL37–DNA induces pDCs via LL37, and TLR9 bound to RNA induces pDCs through TLR7. Moreover, LL37–RNA complexes work on mDCs via TLR8.

Activated Th17 cells release an excess of IL-17 and TNF-a, which stimulate keratinocytes, increase hyperplasia of the epidermis, attract neutrophils, and cause the generation of antimicrobial peptides (AMP). IL-17 mRNA levels were shown to be elevated in psoriasis lesions but never in non-lesional tissue (Lowes et al. 2008).

IL-17 increased the levels of IL-8 and IL-6 in keratinocytes, which are cytokines that promote inflammation and aggravate psoriasis (Ye et al. 2001).

Furthermore, IL-17 is required for neutrophil preservation and recruitment. Th17 cells are also known to release IL-22, a participant in the IL-10 cytokine family (Wolk et al. 2006). Its expression‎ can be elevated in the area of psoriatic lesions on the skin and decrease in connection with antipsoriatic treatment remission. These data imply that IL-22 stimulates keratinocyte development and plays a significant role in psoriasis pathogenesis.

TNF- (tumor necrosis factor) plays an important role in the pathophysiology of psoriasis (Jacobs and Harrison 1998). TNF- activates the nuclear factor (NF)-jB signalling pathway, which affects lymphocyte and keratinocyte survival, proliferation, and anti-apoptotic activities (Kagami et al. 2010).

TNF- stimulates Th17 to produce proinflammatory cytokines via the NF-jB pathway in psoriatic lesions, and blocking the NF-jB pathway reduces IL-17A production by CD4+ T cells. Both anti-TNF and CsA agents reduced the levels of IFN-c, IL-17A, IL-23p19, and (C–C motif) chemokine ligand 20 in psoriasis lesions, indicating that pro-inflammatory cytokines, particularly IL-17A, are involved in the development of psoriasis (Ghoreschi et al. 2010).

These data imply that the IL-17 family is involved in psoriasis. When IL-23 binds to the receptor complex of IL17, it phosphorylates signal transduction and the promoter of transcription (STAT)3 via Jak2, which is found inside the cytoplasmic domain of the subunit IL-23R. Phospho-STAT3 proteins create homodimers in the nucleus, where they boost the Th17 response by stimulating the production of cytokines such as IL-22, 17A, IL-17F, and IFN-c (Fig. 2).

데펜신은 

인간 호중구 펩타이드 또는 

1-6HNP로 알려진 6가지 아형으로 나뉘며, 

이 중 HNP 1-3은 건선 병변의 비늘에서 발견됩니다.

-데펜신은 1-4 인간 데펜신(HD)으로 알려진 네 가지 아형으로 나뉩니다.

HD 1-2는 

건선 비늘에서 높게 발현되는 것으로 밝혀졌으며 

각질 세포에서 TNF- 및/또는 IFN-c에 의해 활성화됩니다(Lande et al. 2014). 

또한 IL-22와 IL-17A는 

모두 HD 2를 유발합니다. 

카텔리시딘으로도 알려진 LL37은 

건선의 발병과 관련이 있습니다. 

https://www.nature.com/articles/s41467-020-17736-x

손상된 각질 세포는 

LL37을 분비하고, 

이 물질은 손상된 세포의 자가 유전 물질과 결합하여 복합체를 형성합니다. 

LL37은 

건선에서 조사된 

두 가지 T세포 자가 항원 중 하나입니다. 

연구에 따르면 

경증에서 중증의 

판상 건선 환자의 3분의 2에서 

특정 CD8+ 및 CD4+ T 림프구가 발견되었습니다. 

LL37 특이 T 세포는 

IFN-를 생성하고, 

CD4+ T 세포는 IL-22, IL-21, IL-17을 생성합니다. 

특정 T 림프구(LL37)는 

피부 병변과 혈액에서 검출될 수 있으며, 

그 존재는 질병 활성도와 상관관계가 있습니다(모리자네 외. 2012).

LL37에 의해 자극된 

CD8+ T 세포는 

자가 항원 탐지, 

표피 이동성 및 Th17 사이토카인 방출에 참여합니다. 

HLA-C*06:02로 제한된 자가항원 ADAMTSL5는 

자가 반응하는 CD8+ T세포 TCR로 인해 

인식되는 것으로 밝혀졌습니다. 

이 발견은 

멜라닌 세포를 면역 표적 세포로 식별합니다. 

형질세포 DC의 TLR9는 

DNA(pDC)에 결합된 LL37에 의해 활성화됩니다(아라카와 등, 2015). 

IFN- 및 IFN-와 같은 제1형 IFN의 생성을 특징으로 하는 

pDC의 활성화는 

건선 플라크의 형성에 필수적입니다. 

제1형 IFN 신호는 

골수성 수지상 세포(mDC)의 표현형 발달을 촉진하고 

각각 IFN- 및 IL-17 생성을 포함하여 

Th1 및 Th17의 발달 및 역할과 관련이 있습니다(Morizane and Gallo 2011). 

LL37-DNA는 

LL37을 통해 pDC를 유도하고, 

RNA에 결합된 TLR9은 

TLR7을 통해 pDC를 유도합니다. 

또한 LL37-RNA 복합체는 TLR8을 통해 mDC에 작용합니다.

활성화된 Th17 세포는 

각질 세포를 자극하고 

표피의 증식을 증가시키며 

호중구를 유인하고 

항균 펩타이드(AMP)를 생성하는 

IL-17과 TNF-a를 과량 방출합니다. 

IL-17 mRNA 수치는 

건선 병변에서는 증가하지만 

비병변 조직에서는 증가하지 않는 것으로 나타났습니다(Lowes et al. 2008).

IL-17은 

염증을 촉진하고 

건선을 악화시키는 사이토카인인 각질 세포에서 

IL-8과 IL-6의 수치를 증가시켰습니다(Ye 등, 2001).

또한 IL-17은 

호중구 보존 및 모집에 필요합니다. 

Th17 세포는 또한 

IL-10 사이토카인 계열에 속하는 

IL-22를 방출하는 것으로 알려져 있습니다(Wolk et al. 2006). 

피부의 건선 병변 부위에서 발현이 증가하고 

항건선 치료 관해와 관련하여 

감소할 수 있습니다. 

이러한 데이터는 

IL-22가 각질 세포 발달을 자극하고 

건선 발병에 중요한 역할을 한다는 것을 

암시합니다.

TNF-(종양괴사인자)는 

건선의 병태 생리학에서 중요한 역할을 합니다(Jacobs and Harrison 1998). 

TNF-는 

림프구 및 각질 세포의 생존, 증식 및 항 세포 사멸 활동에 영향을 미치는

 핵 인자 (NF)-jB 신호 경로를 활성화합니다 (Kagami et al. 2010).

TNF-는 건선 병변에서 

NF-jB 경로를 통해 Th17을 자극하여 

염증성 사이토카인을 생성하며, 

NF-jB 경로를 차단하면 CD4+ T 세포의 IL-17A 생성이 감소합니다. 

항TNF와 CsA 제제는 

건선 병변에서 IFN-c, IL-17A, IL-23p19 및 

(C-C 모티브) 케모카인 리간드 20의 수준을 감소시켜 

전 염증성 사이토카인, 특히 

IL-17A가 건선 발병에 관여한다는 것을 나타냅니다(Ghoreschi 등. 2010).

이러한 데이터는 

IL-17 계열이 건선에 관여한다는 것을 암시합니다. 

IL-23이 IL17의 수용체 복합체에 결합하면 

하위 단위 IL-23R의 세포질 도메인 내부에 있는 Jak2를 통해 

신호 전달과 전사인자(STAT)3를 인산화합니다. 

포스포-STAT3 단백질은 

핵에서 호모다이머를 생성하여 

IL-22, 17A, IL-17F 및 IFN-c와 같은 

사이토카인의 생성을 자극하여 

Th17 반응을 촉진합니다(그림 2).

Fig. 2

Schematic representation of IL-12 and IL-23, and their receptors and downstream signaling pathways

The missing heritability research that has been linked with psoriasis genetic markers has fueled the epigenetic alterations search. Cytosine and guanine (CpG) methylation, silencing microRNA (miRNA), and long noncoding RNA (lncRNA) represent examples of epigenetic processes that affect gene expression‎ without modifying the chromosomal sequence. More than 971 lncRNAs were identified as being differently expressed in psoriatic patches versus normal skin (Gupta et al. 2016).

건선 유전자 마커와 연관된 유전성 연구의 누락은 후성유전학적 변화 연구에 박차를 가했습니다. 시토신 및 구아닌(CpG) 메틸화, 침묵 마이크로RNA(miRNA), 긴 비코딩 RNA(lncRNA)는 염색체 서열을 수정하지 않고 유전자 발현에 영향을 미치는 후성유전학적 과정의 대표적인 예입니다. 건선 패치와 정상 피부에서 다르게 발현되는 971개 이상의 lncRNA가 확인되었습니다(굽타 외. 2016).

Psoriasis-related genes

IL36RN

By 2011, IL36RN deficiency was discovered in a recessive variety of IL36RN, and familial GPP was identified as a causal gene for GPP (Johnston et al. 2012). The gene IL36RN encodes IL-36 receptor antagonists (IL36Ra), which inhibit the action of IL-36 (including IL-36a, IL-36b, and IL-36c) from the IL-1 family. Those subtypes are extensively expressed in affected lesions and seem to be important regulators for neutrophil chemokines such as CXCL1 and CXCL8 (Blumberg et al. 2007). The mouse homolog of IL36RN, Il1f5, has similarly been demonstrated to cause a skin condition in comparison with GPP in mice; stimulation of neutrophils in GPP may be caused by elevated IL-36 activity caused by IL36Ra malfunction.

CARD14

Caspase recruiting member 14 (CARD14) or (CARMA2) is a scaffold protein that regulates NF-jB signalling via TNF receptor-associated factor 2 (TRAF2). Many mutations accompanied by function gains in CARD14, including p. Gly117Ser, were discovered in GPP (Setta-kaffetzi et al. 2014).

AP1S3 

AP1S3 generates a component of AP-1, a transcription element that affects the expression‎ of keratin in keratinocytes. GPP patients were found to have AP1S3 mutations and may stimulate CXCL8, IL-36, and IL-1b expression‎ via NF-jB signalling malfunctions. It was discovered that the differentiation of specific keratins 1 and 10, which are mostly expressed inside the spinous layers, is reduced in the affected epidermis, whereas keratins 6 and 16 are enhanced. 55 Furthermore, in psoriatic skin, transglutaminase 1, keratin 17, and involucrin are raised, although profilagrin is reduced (Wright 1991).

IL36RN

2011년에는 

열성인 다양한 IL36RN에서 IL36RN 결핍이 발견되었고, 

가족성 GPP가 GPP의 원인 유전자로 확인되었습니다(Johnston 외. 2012). IL36RN 유전자는 IL-36 수용체 길항제(IL-36Ra)를 코딩하며, 이는 IL-1 계열의 IL-36(IL-36a, IL-36b, IL-36c 포함)의 작용을 억제합니다. 이러한 아형은 감염된 병변에서 광범위하게 발현되며 CXCL1 및 CXCL8과 같은 호중구 케모카인의 중요한 조절인자인 것으로 보입니다(Blumberg et al. 2007). IL36RN의 마우스 상동체인 Il1f5는 마우스에서 GPP와 비교하여 피부 질환을 유발하는 것으로 입증되었으며, GPP에서 호중구의 자극은 IL36Ra 기능 장애로 인한 IL-36 활성 상승으로 인해 발생할 수 있습니다.



CARD14

카스파제 모집 멤버 14(CARD14) 또는 (CARMA2)는 TNF 수용체 관련 인자 2(TRAF2)를 통해 NF-jB 신호 전달을 조절하는 스캐폴드 단백질입니다. GPP에서 p. Gly117Ser를 포함하여 CARD14의 기능 향상을 수반하는 많은 돌연변이가 발견되었습니다(세타-카페치 외. 2014).



AP1S3 

AP1S3는 각질 세포에서 각질의 발현에 영향을 미치는 전사 요소인 AP-1의 구성 요소를 생성합니다. GPP 환자는 AP1S3 돌연변이를 가지고 있으며 NF-jB 신호 기능 장애를 통해 CXCL8, IL-36 및 IL-1b 발현을 자극할 수 있는 것으로 밝혀졌습니다. 건선 환자의 표피에서는 주로 가시층 내부에서 발현되는 특정 케라틴 1과 10의 분화가 감소하는 반면, 케라틴 6과 16은 증가한다는 사실이 밝혀졌습니다. 55 또한 건선 피부에서는 프로필라그린은 감소하지만 트랜스글루타미나제 1, 케라틴 17, 인베루크린은 증가합니다(Wright 1991).

Natural sources of psoriasis treatment

Omega-3 sources

A number of studies have explored the efficacy of dietary supplementation using fish oils (Article 2018), partly because fish oil contains high levels of LC-3 PUFAs and partly because of the theory that increased production of pro-inflammatory eicosanoids via ARA is important to the pathophysiology of psoriasis. In humans, -3 PUFAs perform a variety of activities, including restricting and healing inflammatory processes. They have been extensively researched for their capacity to reduce mortality and morbidity in people with cardiovascular disease (Hamilton et al. 1990). PUFAs have been used as a safe adjunct therapy in various skin diseases due to their anti-inflammatory and anti-chemotactic properties. Inhibition of inflammation by ALA and its derivatives is based on barrier function maintenance, stratum corneum maturation and differentiation, proinflammatory eicosanoid inhibition, lamellar body formation, cytokine suppression, and lipoxygenase inhibition (Ricketts et al. 2010).

Resolvens control neutrophil migration in both animals and humans, which may be one of the key anti-inflammatory effects of -3 FAs on psoriasis (Mccusker and Grant-kels 2010). Nevertheless, animal research has indicated the -3 PUFAs' therapeutic benefit for lesions resembling psoriasis, but human studies have yielded conflicting findings (Maurice et al. 1987). According to in vitro studies, adding fish oil to the diets of psoriasis patients results in an increase in plasma EPA-to-ARA ratio and platelets, as well as a significant decrease in LTB4 production by neutrophils (Soyland et al. 1993). Additional advantages of -3 PUFA administration in psoriasis patients include possible hypolipidemic consequences and the avoidance of insulin resistance and obesity. Because psoriasis sufferers are more likely to be overweight than the overall population (Watson 2013), reducing the inflammatory load associated with an elevation in the quantity of fatty tissue might undoubtedly help to treat psoriasis. This is due to increased levels of systemic circulating inflammatory cytokines like IL-6, TNF-, and adiponectin produced by visceral fat activating rapamycin complex 1 (mTORC1) signaling, which is important for controlling T-cell homeostasis as well as proinflammatory signalling of keratinocytes via the NF-B pathway (Timoszuk and Bielawska 2018).

A study was done to explore the effectiveness of petroleum ether that has been extracted from Annona squamosa seed (ASO) for use as an antipsoriatic drug (Bhoir et al. 2018). In mice, the extract, which is mostly composed of PUFAs (LA and OA), inhibits keratinocyte proliferation more effectively than the corticosteroid clobetasol propionate (CP). There was a reduction in inflammatory lesion cytokines (INF-, TNF-, IL6, IL17, and GM-CSF) after ASO administration, and no side effects were seen, indicating that further research into this new antipsoriatic cream for treatment in humans is warranted. PUFA supplementation might help with psoriasis therapy and comorbidity prevention. Even a slight improvement in psoriasis severity caused by PUFA may reduce the use of currently available medications, lowering the risk of adverse effects.

많은 연구에서 

피쉬 오일을 이용한 식이 보충제의 효능을 탐구해 왔는데(2018년 기사), 

이는 부분적으로는 피쉬 오일에 높은 수준의 LC-3 PUFA가 함유되어 있고 

부분적으로는 ARA를 통한 전 염증성 에이코사노이드의 생산 증가가 

건선의 병리 생리학에 중요하다는 이론에 근거한 것입니다. 

인체에서 -3 PUFA는 염증 과정을 제한하고 치유하는 등 다양한 활동을 수행합니다. 이들은 심혈관 질환 환자의 사망률과 이환율을 낮추는 능력에 대해 광범위하게 연구되어 왔습니다(해밀턴 외. 1990). PUFA는 항염증 및 항화학 작용 특성으로 인해 다양한 피부 질환에서 안전한 보조 요법으로 사용되어 왔습니다. 

ALA와 그 유도체에 의한 염증 억제는 

장벽 기능 유지, 

각질층 성숙 및 분화, 염증성 에이코사노이드 억제, 

라멜라체 형성, 

사이토카인 억제, 

리폭시게나제 억제에 기반합니다(Ricketts et al. 2010).

레졸벤은 동물과 사람 모두에서 호중구 이동을 조절하며, 이는 건선에 대한 -3 FA의 주요 항염증 효과 중 하나 일 수 있습니다(Mccusker and Grant-kels 2010). 그럼에도 불구하고 동물 연구에서는 건선과 유사한 병변에 대한 -3 PUFA의 치료 효과가 입증되었지만, 인간 연구에서는 상반된 결과가 나타났습니다(Maurice 외. 1987). 시험관 연구에 따르면, 건선 환자의 식단에 피쉬 오일을 추가하면 혈장 EPA 대 ARA 비율과 혈소판이 증가하고 호중구의 LTB4 생산이 크게 감소합니다(Soyland 외. 1993). 건선 환자에서 -3 PUFA 투여의 추가적인 이점으로는 고지혈증과 인슐린 저항성 및 비만을 예방할 수 있다는 점이 있습니다. 건선 환자는 전체 인구보다 과체중일 가능성이 높기 때문에(Watson 2013), 지방 조직의 양 증가와 관련된 염증 부하를 줄이면 의심할 여지없이 건선 치료에 도움이 될 수 있습니다. 이는 내장 지방 활성화 라파마이신 복합체 1(mTORC1) 신호에 의해 생성되는 IL-6, TNF- 및 아디포넥틴과 같은 전신 순환 염증성 사이토카인 수치가 증가하기 때문인데, 이는 NF-B 경로를 통해 각질 세포의 전 염증성 신호뿐만 아니라 T 세포 항상성을 조절하는 데 중요합니다(Timoszuk and Bielawska 2018).

항소양제로 사용하기 위해 아노나 스콰모사 씨앗(ASO)에서 추출한 석유 에테르의 효과를 알아보기 위한 연구가 수행되었습니다(Bhoir 외. 2018). 생쥐를 대상으로 한 실험에서 이 추출물은 대부분 PUFA(LA 및 OA)로 구성되어 있으며, 코르티코스테로이드 클로베타솔 프로피오네이트(CP)보다 각질 세포 증식을 더 효과적으로 억제하는 것으로 나타났습니다. ASO 투여 후 염증성 병변 사이토카인(INF-, TNF-, IL6, IL17, GM-CSF)이 감소했으며, 부작용은 나타나지 않아 인간을 대상으로 한 이 새로운 건선 치료용 크림에 대한 추가 연구가 필요하다는 것을 시사합니다. PUFA 보충제는 건선 치료와 동반 질환 예방에 도움이 될 수 있습니다. PUFA로 인한 건선 중증도가 약간만 개선되어도 현재 사용 가능한 약물의 사용을 줄여 부작용의 위험을 낮출 수 있습니다.

Vitamin D

The vitamin D system is important for intracellular calcium and bone metabolism, although studies throughout the last 20 years have shown a wide variety of biological activities, including cell differentiation, suppression of cellular development, immunomodulation, and regulation of many other hormonal systems.

This vitamin seems to be a prohormone that is physiologically metabolised to 1,25-dihydroxyvitamin D [1,25(OH)2D] that activates its cellular receptor (VDR or receptor of vitamin D), causing changes in the transcription levels of target genes involved in biological responses (Fig. 3).

비타민 D는 

세포 내 칼슘과 뼈 대사에 중요하지만, 

지난 20년간의 연구를 통해 

세포 분화, 

세포 발달 억제, 

면역 조절 및 기타 여러 호르몬 시스템의 조절을 포함한 

다양한 생물학적 활성이 밝혀졌습니다.

이 비타민은 

생리적으로 1,25-디하이드록시비타민D[1,25(OH)2D]로 대사되어 

세포 수용체(VDR 또는 비타민D 수용체)를 활성화하여 

생물학적 반응에 관여하는 표적 유전자의 전사 수준에 변화를 일으키는 

프로호르몬인 것으로 추정됩니다(그림 3).

Fig. 3

Chemical structures of Vitamin D synthesis and activation

Vitamin D may be derived from animal products like cod liver oil, salmon, tuna, beef, eggs, and chicken breast, as well as milk, yoghurt, and cheese (especially cheddar). Certain mushrooms contain vitamin D2; moreover, some commercially marketed mushrooms contain increased levels of D2 as a result of being purposefully exposed to high levels of UV radiation.

The epidermal keratinocytes are unique in that they not only synthesise vitamin D but also have the enzymatic mechanism to convert vitamin D into its active form, calcitriol (1,25(OH) (Zahoor et al. 2021). The level of epidermal pigment and the exposure intensity both correspond with the passage of time necessary to obtain this optimum previtamin D3 concentration, but they have no effect on the highest level attained. Melanin inside the epidermis can diminish the efficiency of sunlight in creating vitamin D3 within the skin by absorbing UV rays (Maurice et al. 1987; Zahoor et al. 2021) Once generated inside the skin, previtamin D3 undergoes thermal isomerization to vitamin D3. After attaching to specific binding proteins, vitamin D3 is delivered towards the liver organ, where it can be hydroxylated and then transformed into 25-OHD. Vitamin D-binding proteins transport 25-OH D to the kidney, where it is converted to 1,25(OH)2D, the hormonally active form. (Niino et al. 2015). Sunlight destroys any extra vitamin D3 or previtamin D3, therefore excessive sun exposure does not result in vitamin D3 overdose (Niino et al. 2015).

TLRs are activated by bacterial stimuli, which enhance VDR synthesis and 25-hydroxyvitamin D-1-hydroxylase activity. Cathelicidins seem to be proteins that bind to and kill bacteria. Several studies, on the other hand, found that vitamin D and VDR had an effect on both B and T cells, as well as the adaptive immune response (El-domyati et al. 2007). However, vitamin D might alter B-cell activity by limiting differentiation and proliferation, inducing apoptosis, and, lastly, lowering immunoglobulin synthesis, including autoantibodies. Vitamin D may potentially alter T-cell activity by lowering T helper (Th) cell proliferation as well as differentiation and supporting a transition from a pro-inflammatory into a more tolerogenic immunological condition.

Vitamin D has been discovered in research to inhibit the cytokine production required for Th17 and Th1 differentiation, encourage T cells to release IL-10, which is an anti-inflammatory Th2 cytokine, and thus decrease the expression‎ of cytokines such as TNF- and IL-8, IL-2 interferon-y, and decrease the intensity of class II molecules of the main histocompatibility complex that affect dendritic cells (Islands 2005). Such substantial impacts on T-cell growth and cytokine expression‎ contribute to the processes behind vitamin D's therapeutic activity on psoriatic skin. The characteristic clinical signs of erythematous scaling plaques in psoriatic skin are, as previously stated, the outcome of keratinocyte hyperproliferation and aberrant differentiation. The hyperproliferative condition is distinguished by a rising preval‎ence of proliferating basal cells, a shorter keratinocyte cell cycle (36 h against 311 h in normal skin), and a reduced epidermal turnover period (4 days from the basal cell layer to the stratum corneum, versus 28 days in normal tissue) (Trémezaygues and Reichrath 2011).

The abnormal differentiation of the psoriatic area is more severe, as indicated by a postponement in the production of K10 and K1, which are found in healthy skin, as well as K16 and K6 overexpression‎, which is seen in repairing skin. Vitamin D promotes keratinocyte development and growth and guards them against premature death at physiological concentrations; however, at a pharmaceutical (106 m) dose, vitamin D suppresses the proliferation of keratinocytes and has a specific proapoptotic impact (Bernengo 1998).

These impacts on keratinocyte development and proliferation are critical to vitamin D's function in the treatment of psoriasis. Additionally, as previously stated, vitamin D regulates the production of K10 and K10 inside the spinosum stratum, those essential keratins whose expression‎ is postponed in psoriatic skin (Zahoor et al. 2021).

Moreover, vitamin D has already been demonstrated to restore the dispersion of integrins, including ICAM-1, HLA-DR, and CD26, along the dermal-epidermal interface, which is disrupted in lesional skin (Garbicz et al. 2022). It is theorised that the different location of integrins causes keratinocyte overproliferation and loss of adhesive ability in psoriasis (Garbicz et al. 2022). The impact of vitamin D topical therapies on integrin structures in non-lesional, lesional psoriatic, as well as regular-skinned patients was investigated. The staining patterns of the integrin subunit were normalised in lesional psoriatic skin after treatment, but not in non-lesional psoriatic skin before and after treatment. (Meydani et al. 2018).

비타민 D는 

대구 간유, 연어, 참치, 소고기, 달걀, 닭 가슴살과 같은 

동물성 식품과 

우유, 요거트, 치즈(특히 체다 치즈)에서 추출할 수 있습니다. 

특정 버섯에는 비타민 D2가 함유되어 있으며, 

시중에서 판매되는 일부 버섯은 의

도적으로 높은 수준의 자외선에 노출시킨 결과 비타민 D2 수치가 증가합니다.

표피 각질 세포는 

비타민 D를 합성할 뿐만 아니라 

비타민 D를 활성 형태인 칼시트리올(1,25(OH))로 전환하는 

효소 메커니즘을 가지고 있다는 점에서 독특합니다(Zahoor 외. 2021). 

표피 색소의 수준과 노출 강도는 

모두 최적의 프리비타민 D3 농도를 얻는 데 필요한 시간의 경과와 일치하지만, 

도달하는 최고 수준에는 영향을 미치지 않습니다. 

표피 내부의 멜라닌은 

자외선을 흡수하여 

피부 내에서 비타민 D3를 생성하는 햇빛의 효율을 감소시킬 수 있습니다(Maurice 외. 1987; Zahoor 외. 2021) 

피부 내에서 생성된 프리비타민 D3는 

열 이성질화를 거쳐 비타민 D3로 전환됩니다. 

특정 결합 단백질에 부착된 후 

비타민 D3는 간으로 전달되어 

수산화되어 25-OHD로 전환될 수 있습니다. 

비타민 D 결합 단백질은 

25-OH D를 신장으로 운반하여 호르몬 활성 형태인 1,25(OH)2D로 전환합니다. (니노 외. 2015). 햇빛은 여분의 비타민 D3 또는 프리비타민 D3를 파괴하므로 과도한 햇빛 노출은 비타민 D3 과다 복용을 초래하지 않습니다(Niino 외. 2015).

TLR은 

박테리아 자극에 의해 활성화되며, 

이는 VDR 합성과 25-하이드록시비타민 D-1-하이드록실라제 활성을 향상시킵니다. 

카텔리시딘은 

박테리아와 결합하여 

박테리아를 죽이는 단백질로 보입니다. 

한편, 여러 연구에 따르면 

비타민 D와 VDR은 

적응 면역 반응뿐만 아니라 

B세포와 T세포 모두에 영향을 미치는 것으로 나타났습니다(El-domyati 등. 2007). 

그러나 

비타민 D는 

분화와 증식을 제한하고 

세포 사멸을 유도하며 

마지막으로 

자가 항체를 포함한 

면역 글로불린 합성을 낮춤으로써 

B 세포 활동을 변화시킬 수 있습니다. 

비타민 D는 

T 헬퍼(Th) 세포의 증식과 분화를 낮추고 

염증 유발성 면역 상태에서 내인성 면역 상태로 전환하는 것을 지원함으로써 

잠재적으로 T 세포 활동을 변화시킬 수 있습니다.

비타민 D는 

Th17 및 Th1 분화에 필요한 사이토카인 생성을 억제하고, 

T 세포가 

항염증성 Th2 사이토카인인 IL-10을 방출하도록 유도하여

 TNF- 및 IL-8, IL-2 인터페론-y와 같은 

사이토카인의 발현을 감소시키고, 

수지상 세포에 영향을 미치는 

주요 조직 적합성 복합체의 클래스 II 분자의 강도를 

감소시키는 것으로 밝혀졌습니다(Islands 2005). 

이러한 

T세포 성장과 

사이토카인 발현에 대한 상당한 영향은 

건선 피부에 대한 

비타민 D의 치료 작용 과정에 기여합니다. 

건선 피부의 홍반성 비늘 플라크의 특징적인 임상 징후는 

앞서 언급한 바와 같이 

각질 세포 과증식과 

비정상적인 분화의 결과입니다. 

과증식 상태는 

증식하는 기저 세포의 유병률 증가, 

각질 세포 세포 주기 단축(정상 피부의 311시간에 비해 36시간), 

표피 턴오버 기간 감소(기저 세포층에서 각질층까지 4일, 정상 조직에서는 28일)로 구별됩니다(Trémezaygues와 Reichrath 2011).

건선 부위의 비정상적인 분화는 

건강한 피부에서 발견되는 K10과 K1의 생산이 지연되고 

피부 회복에서 볼 수 있는 K16과 K6의 과발현으로 나타나 

건선 부위의 분화가 더 심해집니다. 

비타민 D는 

각질 세포의 발달과 성장을 촉진하고 

생리적 농도에서는 

각질 세포가 조기 사멸하지 않도록 보호하지만, 

약학적 용량(106m)에서는 

각질 세포의 증식을 억제하고 

특정 세포 사멸에 영향을 미칩니다(Bernengo 1998).

The keratinocytes of the skin are unique in being not only the primary source of vitamin D for the body, but in possessing both the enzymatic machinery to metabolize the vitamin D produced to active metabolites (in particular 1,25(OH)2D) and the vitamin D receptor (VDR) that enables the keratinocytes to respond to the 1,25(OH)2D thus generated. Numerous functions of the skin are regulated by vitamin D and/or its receptor. These include inhibition of proliferation, stimulation of differentiation including formation of the permeability barrier, promotion of innate immunity, regulation of the hair follicle cycle, and suppression of tumor formation. Regulation of these actions is exerted by a number of different coregulator complexes including the coactivators vitamin D receptor interacting protein (DRIP) complex also known as Mediator and the steroid receptor coactivator (SRC) family (of which SRC 2 and 3 are found in keratincytes), the inhibitor hairless (Hr), and β-catenin whose impact on VDR function is complex. Different coregulators appear to be involved in different VDR regulated functions. This review will examine the various functions of vitamin D and its receptor in the skin, and explore the mechanisms by which these functions are regulated.

피부의 각질 세포는 체내 비타민 D의 주요 공급원일 뿐만 아니라 생성된 비타민 D를 활성 대사산물(특히 1,25(OH)2D)로 대사하는 효소 메커니즘과 각질 세포가 이렇게 생성된 1,25(OH)2D에 반응하도록 하는 비타민 D 수용체(VDR)를 모두 가지고 있다는 점에서 독특합니다. 피부의 수많은 기능이 비타민 D 및/또는 그 수용체에 의해 조절됩니다. 여기에는 증식 억제, 투과성 장벽 형성을 포함한 분화 촉진, 선천성 면역 촉진, 모낭 주기 조절, 종양 형성 억제 등이 포함됩니다. 이러한 작용의 조절은 매개체라고도 알려진 비타민 D 수용체 상호 작용 단백질(DRIP) 복합체와 스테로이드 수용체 작용제(SRC) 계열(이 중 SRC 2와 3은 각질 세포에서 발견됨), 억제제인 헤어리스(Hr), VDR 기능에 복잡한 영향을 미치는 베타 카테닌을 포함한 다양한 코어 조절제 복합체에 의해 이루어집니다. 서로 다른 핵심 조절 인자가 서로 다른 VDR 조절 기능에 관여하는 것으로 보입니다. 이 리뷰에서는 피부에서 비타민 D와 그 수용체의 다양한 기능을 살펴보고 이러한 기능이 조절되는 메커니즘을 살펴봅니다.

각질 세포의 발달과 증식에 대한 이러한 영향은 

건선 치료에서 비타민 D의 기능에 매우 중요합니다. 

또한 앞서 언급한 바와 같이 

비타민 D는 

건선 피부에서 발현이 지연되는 

필수 케라틴인 스피노섬층 내부의 K10과 K10의 생성을 조절합니다(Zahoor 외. 2021).

또한 비타민 D는 

병변 피부에서 파괴된 피부-표피 계면을 따라

 ICAM-1, HLA-DR 및 CD26을 포함한 

인테그린의 분산을 회복시키는 것으로 이미 입증되었습니다(Garbicz 외. 2022). 

인테그린의 위치가 달라지면 

건선에서 각질 세포가 과증식하고 

접착력이 상실된다는 이론이 있습니다(Garbicz 외. 2022). 

비타민 D 국소 요법이 

비병변성, 병변성 건선 환자뿐만 아니라 

일반 피부 환자의 인테그린 구조에 미치는 영향을 조사했습니다. 

치료 후 병변성 건선 피부에서는 

인테그린 서브유닛의 염색 패턴이 정상화되었지만, 

비병변성 건선 피부에서는 치료 전후에 염색 패턴이 정상화되지 않았습니다. (메이다니 외. 2018).

Vitamin E

https://www.phwr.org/journal/view.html?pn=search&uid=366&vmd=Full

https://www.phwr.org/journal/view.html?pn=search&uid=366&vmd=Full

Vitamin E, which is lipid-soluble, is a powerful antioxidant found in all cell membranes. Vitamin E exists in eight forms in nature (-, -, -, -tocopherols, and also -, -, -tocotrienols), although -tocopherol is the most physiologically active (Ji and Liu 2019). An investigation found a statistically significant drop in vitamin E plasma levels in twenty psoriatic patients when compared to normal individuals. Patients with the most severe illnesses had the lowest vitamin E plasma levels (“48.pdf”. 2022). Vitamin E levels in the blood of seven individuals with psoriatic acral pustulosis or erythrodermic psoriasis, whether or not linked with persistent drinking, were also tested throughout and after the acute stage. Only in individuals with a history of alcohol addiction (n = 5) was vitamin E lowered to levels below the range of normal during the severe psoriatic phase, indicating that vitamin E insufficiency should be explored when pustular psoriasis or erythrodermic is coupled with chronic drinking (Paper 2013a). A new randomised case–control study of 60 patients with autoimmune skin disorders looked at vitamin E levels in tissue and sera. Psoriasis, alopecia areata, and vitiligo patients showed lower tissue and blood vitamin E concentrations than healthy controls (n = 15 in each group, p 0.001). There exists a relationship between the pathophysiology of several autoimmune illnesses and oxidative stress, suggesting that antioxidant medicines may play a role in their therapy (Fairris et al. 1989).

Many investigators reported that the antioxidant combination of vitamin E, selenium, and coenzyme Q (10) was introduced to the diets of individuals having severe psoriasis to eval‎uate its influence on disease progression (Miroddi et al. 2015). In this randomised, double-blind clinical research, twenty-eight cases of severe psoriatic arthritis (PsA) and thirty individuals with erythrodermic psoriasis (EP) were included. EP and PsA patients were assigned at random to either a treatment (antioxidant supplements plus conventional therapy) or control subjects (placebo plus conventional therapy). Throughout the trial period, clinical advancement in the supplemented groups was substantially faster than in the control groups. The patient group treated with conventional medication plus antioxidant supplements had considerably decreased illness severity at 30 days, as measured by subjective grading. The antioxidant mix included 50 mg/day of Coenzyme Q(10) (ubiquinone acetate), 50 mg/day of natural vitamin E (-tocopherol), and 48 mg/day of selenium (aspartate salt).

지용성인 비타민 E는 

모든 세포막에서 발견되는 강력한 항산화제입니다. 

비타민 E는 

자연계에 8가지 형태(-, -, -, -토코페롤 및 -, -, -토코트리에놀)로 존재하지만 

-토코페롤이 생리적으로 가장 활성적입니다(Ji and Liu 2019). 

한 조사에 따르면 

건선 환자 20명의 혈장 내 비타민 E 수치가 정상인과 비교했을 때 

통계적으로 유의미하게 감소한 것으로 나타났습니다. 

가장 심각한 질환을 앓고 있는 환자의 

혈장 비타민 E 수치가 가장 낮았습니다("48.pdf". 2022). 

건선성 농포증 또는 

홍피성 건선 환자 7명의 혈중 비타민 E 수치도 

지속적인 음주와 관련이 있는지 여부에 관계없이 

급성기 내내 그리고 급성기 이후에 검사했습니다. 

알코올 중독 병력이 있는 사람(n = 5)의 경우에만 

중증 건선 단계에서 

비타민 E가 정상 범위 이하로 낮아져 

농포성 건선이나 홍피성 건선이 

만성 음주와 동반된 경우 비타민 E 결핍을 살펴봐야 한다는 것을 시사합니다(논문 2013a). 

자가면역성 피부 질환 환자 60명을 대상으로 한 

새로운 무작위 사례 대조 연구에서는 

조직과 혈청의 비타민 E 수치를 조사했습니다. 

건선, 

원형 탈모증, 

백반증 환자는 건강한 대조군보다 

조직 및 혈중 비타민 E 농도가 낮았습니다(각 그룹에서 n = 15, p 0.001). 

여러 자가 면역 질환의 병태 생리와 

산화 스트레스 사이에는 관계가 있으며, 

이는 항산화 약물이 치료에 중요한 역할을 할 수 있음을 시사합니다(Fairris 외. 1989).

많은 연구자들은 

비타민 E, 

셀레늄, 

코엔자임 Q(10)의 항산화제 조합이 

질병 진행에 미치는 영향을 평가하기 위해 

중증 건선 환자의 식단에 도입되었다고 보고했습니다(Miroddi 등. 2015). 

이 무작위 이중맹검 임상 연구에는 

중증 건선성 관절염(PsA) 환자 28명과 

홍피성 건선(EP) 환자 30명이 참여했습니다. 

EP 및 PsA 환자는 

치료군(항산화 보충제와 기존 치료법) 또는 

대조군(위약과 기존 치료법)에 무작위로 배정되었습니다. 

임상시험 기간 내내 

보충제를 복용한 환자군의 임상적 진전이 

대조군보다 훨씬 더 빨랐습니다. 

기존 약물과 항산화 보충제를 함께 복용한 환자 그룹은 

주관적 등급으로 측정한 결과 

30일 후 질병의 심각도가 상당히 감소했습니다. 

항산화제 혼합물에는 

코엔자임 Q(10)(유비퀴논 아세테이트) 50mg/일, 

천연 비타민 E(-토코페롤) 50mg/일, 

셀레늄(아스파르트산염) 48mg/일이 포함되었습니다.

Aloe vera

Aloe barbadensis Miller (also called Aloe vera Linnaeus) seems to be a succulent tropical plant of the Liliaceae family. Aloe leaf pulp contains 98.5% water, while gel or mucilage contains 99.5% water. Carbohydrates, proteins, mucopolysaccharides, enzymes, anthraquinones, salicylic acid, chromones, vitamins, and minerals also make up the remaining 0.5–1%. (Aghmiuni 2017). Acemannan and Aloe-emodin are antibacterial active ingredients that can help with psoriasis. Furthermore, owing to its keratolytic activity, salicylic acid eliminates psoriatic plaques. Aloe vera gel is employed to treat psoriasis by reducing redness and scaling. It is employed to make topical creams and lotions. (Choonhakarn et al. 2010). Aloe vera also has immunomodulatory, antioxidant, anti-inflammatory, anti-fungal, and anti-tumor properties. It also promotes skin hydration and wound healing by increasing collagen activity. This aids in the healing of the psoriatic skin's negative consequences (Choonhakarn et al. 2010).

In a randomised study of 80 individuals with mild and moderate psoriasis vulgaris, Aloe vera and triamcinolone acetonide (TA, 0.1%) were compared. The average Severity Index of Psoriasis Area (PASI) value decreased by 7.7 in the group using aloe vera and 6.6 in the group using TA after eight weeks of therapy. The TA group's average DLQI (Index of Dermatology Life Quality) declined by 5.8 points, while the Aloe Vera group's decreased by 6.1 points. It was discovered that aloe vera cream was much more effective (Dhanabal et al. 2011). Extracted Aloe vera had 81.95% anti-psoriatic action in micetail models, compared to 87.94% for tazarotene (Divya et al. 2016). Divya et al. created a local nanogel with aloe-emodin (an anthraquinone found in Aloe vera) and acitretin using chitin. Their blood compatibility was demonstrated in vitro. Investigations in Perry's mouse tail as well as skin safety trials showed the formulation's potential effectiveness in psoriasis therapy (Rajiv et al. 2019).

알로에 바바덴시스 밀러(알로에 베라 린네우스라고도 함)는 

백합과의 즙이 많은 열대 식물로 알려져 있습니다. 

알로에 잎 펄프에는 

98.5%의 수분이 함유되어 있고 

젤이나 점액질에는 99.5%의 수분이 함유되어 있습니다. 

탄수화물, 단백질, 점액 다당류, 효소, 

안트라퀴논, 살리실산, 크로몬, 

비타민 및 미네랄도 

나머지 0.5-1%를 구성합니다. (아흐미우니 2017). 

아세만난과 알로에-에모딘은 

건선에 도움이 될 수 있는 

항균 활성 성분입니다. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145703/

또한 

살리실산은 

각질 용해 작용으로 건선 플라크를 제거합니다. 

https://jamanetwork.com/journals/jamadermatology/fullarticle/392029

알로에 베라 젤은 

발적과 각질을 줄여 건선을 치료하는 데 

사용됩니다. 

국소 크림과 로션을 만드는 데 사용됩니다. (춘하칸 외. 2010). 

알로에 베라는 

또한 면역 조절, 항산화, 항염증, 항진균, 항종양 효능을 가지고 있습니다. 

또한 

콜라겐 활성을 증가시켜 

피부 수분 공급과 상처 치유를 촉진합니다. 

이는 건선 피부의 부정적인 결과를 치유하는 데 도움이 됩니다(춘하칸 외. 2010).

경증 및 중등도 판상 건선 환자 80명을 대상으로 한 무작위 연구에서 

알로에 베라와 트리암시놀론 아세토나이드(TA, 0.1%)를 비교했습니다. 

치료 8주 후 

알로에 베라를 사용한 그룹의 

평균 건선 면적 중증도 지수(PASI) 값은 7.7, TA를 사용한 그룹은 

6.6으로 감소했습니다. 

TA 그룹의 평균 피부과 삶의 질 지수(DLQI)는 

5.8점 감소한 반면, 

알로에 베라 그룹은 6.1점 감소한 것으로 나타났습니다. 

알로에 베라 크림이 

훨씬 더 효과적이라는 것이 밝혀졌습니다(다나발 외. 2011). 

추출 알로에 베라는 

마이크로테일 모델에서 

81.95%의 항건선 효과를 보인 반면 

타자로텐은 87.94%에 그쳤습니다(Divya 외. 2016). 

Divya 등은 

알로에 베라에서 발견되는 

안트라퀴논인 알로에-에모딘과 키틴을 사용하여 

아시트레틴으로 국소 나노젤을 만들었습니다. 

이들의 혈액 호환성은 시험관 내에서 입증되었습니다. 페리의 쥐 꼬리 실험과 피부 안전성 실험을 통해 건선 치료에서 이 제제의 잠재적 효과가 입증되었습니다(Rajiv 외. 2019).

Angelica sinensis

Angelica sinensis (Dong Qquai, female ginseng) seems to be a biennial or perennial plant in the family Apiaceae. It is also known as Dong Quy. Something has long been utilised in traditional Chinese medicine (TCM). TCM claims that it stimulates and replenishes blood while also correcting insufficiency. Psoralen, a powerful furocoumarin, is found in Angelica sinensis extract. Psoralens are used in the treatment of psoriasis as they behave as photosensitizers when exposed to UV-A. Patients self-administer PUVA therapy by eating Angelica sinens and then exposing themselves to natural sunlight or UV. After consuming Angelica sinens, UV exposure promotes DNA cross-linking in the epidermis, slowing the frequency of epidermal DNA synthesis (Richard 2020). Furthermore, they produce mitochondrial malfunction, Langerhans cell toxicity, reactive oxygen species formation, and keratinocyte and lymphocyte death (Sivanesan et al. 2009). In a randomised, double-blind study, the PASI score was used to assess the efficacy of psoralen orally plus UV-A in the treatment of plaque psoriasis. After twelve weeks of therapy, two-thirds of patients improved their PASI score by at least 75%, compared to 0% in the placebo plus UV-A group (Kerkhof et al. 2006).

당귀....

안젤리카 시넨시스(동취, 암삼)는 

살구나무과에 속하는 

2년생 또는 다년생 식물로 보입니다. 

동귀라고도 합니다. 

전통 중국 의학(TCM)에서 오랫동안 활용되어 왔습니다. 한의학에서는 혈액을 자극하고 보충하는 동시에 부족함을 바로잡는다고 주장합니다.

 강력한 푸로쿠마린인 소랄렌은 

안젤리카 시넨시스 추출물에서 발견됩니다. 

Psoralens는 

UV-A에 노출되면 광과민제 역할을 하기 때문에 

건선 치료에 사용됩니다. 

환자는 

당귀(안젤리카 시넨스)를 섭취한 후

자연광이나 자외선에 노출하는 방식으로

PUVA 요법을 자가 관리합니다.

안젤리카 시넨스를 섭취한 후

자외선에 노출되면

표피에서 DNA 가교가 촉진되어

표피 DNA 합성 빈도가 느려집니다(Richard 2020).

또한 미토콘드리아 기능 장애,

랑게르한스 세포 독성,

활성 산소 종 형성,

각질 세포 및 림프구 사멸을 유발합니다(Sivanesan 외. 2009).

무작위 이중맹검 연구에서

판상 건선 치료에서

소랄렌 경구제와 UV-A의 효능을 평가하기 위해 PASI 점수를 사용했습니다.

12주 치료 후

환자의 3분의 2가 PASI 점수가 75% 이상 개선된 반면,

위약과 UV-A를 병용한 그룹은 0%에 그쳤습니다(Kerkhof 외. 2006).

Araroba tree (Vataireopsis araroba (Aguiar) Ducke)

Dithranol (synonym: anthralin), an anthracene derivative, is an effective topical therapy for psoriasis. It was derived from chrysarobin, which was taken from the araroba tree's bark, which thrives in the Amazon rain forests. Dithranol suppresses the production of pro-inflammatory cytokines as well as keratinocyte growth. A randomised study on 106 patients with severe psoriasis lesions found that 15:45 min of dithranol quick contact treatment with stepwise increases in dithranol concentration up to 5% once every day for twelve weeks were significantly more effective than the standard care with 50 g/g of calcipotriol ointment twice every day. (Moy et al. 2018).

안트라센 유도체인 디트라놀(동의어: 안트라린)은 

건선에 효과적인 국소 치료법입니다. 

이 성분은 아마존 열대 우림에서 자라는 

아라로바 나무 껍질에서 추출한 

크리사로빈에서 추출한 것입니다. 

디트라놀은 전 염증성 사이토카인의 생성과 각질 세포의 성장을 억제합니다. 중증 건선 환자 106명을 대상으로 한 무작위 연구에 따르면, 12주 동안 매일 1회 디트라놀 농도를 5%까지 단계적으로 증가시키면서 15:45분간 디트라놀 퀵 컨택 치료를 한 결과 칼시포트리올 연고 50g/g을 매일 2회 사용한 표준 치료보다 훨씬 더 효과적인 것으로 나타났습니다. (Moy 외. 2018).

Barberry bark (Mahonia aquifolium (Pursh) Nutt.)

Mahonia aquifolium, sometimes called Oregon grape, is just an evergreen shrub in the Berberidaceae family. It is indigenous to the United States and is employed to treat a variety of inflammatory cutaneous conditions. It has long been used in TCM. The healing effect of Mahonia aquifolium versus psoriasis is due to berberine, an alkaloid found in the plant's extract. Berberine has been demonstrated to have anti-inflammatory effects through a variety of mechanisms, such as the downregulation of lipoxygenase as well as lipid peroxidation, a decrease in the infiltration of T cells in exposure lesions, a decrease in cyclooxygenase activity, resulting in a reduction in the suppression of IL-8, and prostaglandin E2. Berberine suppresses cell development by intercalating into DNA, preventing replication of DNA and cell proliferation. Other alkaloids that inhibit lipoxygenase, such as oxyberberine, jatrorrhizine, corytuberine, and columbamine, contribute to anti-inflammatory action. (Wiesenauer and Lootke 1996). An individual study was carried out to assess the performance of an ointment comprising 10% Mahonia aquifolium bark extract. It was thought to be beneficial in treating moderately severe psoriasis vulgaris (Kost et al. 2001). The Mahonia aquifolium crude extract suppressed IL-8 production, which is significant in the treatment of psoriasis. The crude extract's main components were bisbenzylisoquinoline alkaloids and protoberberine. The first group inhibited the production of IL-1, T cells, TNF-, and TNF- (Ghazisaeedi et al. 2022).

오리건 포도라고도 불리는 마호니아아퀴폴리움은 

베르베리다과에 속하는 상록 관목입니다. 

미국 원산이며 

다양한 염증성 피부 질환을 치료하는 데 사용됩니다. 

전통의학에서 오랫동안 사용되어 왔습니다. 건선에 대한 마호니니아 아쿠아폴리움의 치유 효과는 식물 추출물에서 발견되는 알칼로이드인 베르베린 때문입니다. 

베르베린은 

지질 과산화뿐만 아니라 

리폭시게나제의 하향 조절, 

노출 병변에서 T 세포의 침윤 감소, 

사이클로옥시게나제 활성의 감소로 인한 

IL-8 및 프로스타글란딘 E2의 억제 감소 등 

다양한 메커니즘을 통해 항염증 효과가 있는 것으로 입증된 바 있습니다. 

베르베린은 

DNA에 결합하여 DNA의 복제와 세포 증식을 방지함으로써 

세포 발달을 억제합니다. 

옥시베르베린, 자트로리진, 코리투베린, 콜롬바민과 같이 

리폭시게나제를 억제하는 다른 알칼로이드는 

항염증 작용에 기여합니다. (비제나우어와 루트케 1996). 

https://kr.iherb.com/pr/derma-e-eczema-relief-cream-4-oz-113-g/11075

10%의 마호니아 아쿠아폴리움 껍질 추출물로 구성된 

연고의 성능을 평가하기 위한 

개별 연구가 수행되었습니다. 

이 연고는 

중등도 중증 심상성 건선 치료에 유익한 것으로 여겨졌습니다(Kost 외. 2001). 

마호니아 아쿠아폴리움 원유 추출물은 

건선 치료에 중요한 

IL-8 생성을 억제했습니다. 

조 추출물의 주요 성분은 

비스벤질 이소퀴놀린 알칼로이드와 프로토베르베린입니다. 

첫 번째 그룹은 IL-1, T 세포, TNF- 및 TNF-의 생성을 억제했습니다(Ghazisaeedi 외. 2022).

Basil

The activated version of NF-B has been linked to osteoporosis, psoriasis, septic shock, AIDS, and other inflammatory illnesses (Cyclin 2003). It has previously been reported that "holy basil" possesses chemopreventive properties. Ursolic acid, a tri-terpenoid produced from basil and rosemary, has been demonstrated to limit NF-B activation by inhibiting IKK, which in turn suppresses cyclin D1, COX-2, and matrix metalloproteinase-9 (Woolf 2018).

활성화된 버전의 NF-B는 골다공증, 건선, 패혈성 쇼크, 에이즈 및 기타 염증성 질환과 관련이 있는 것으로 알려져 있습니다(Cyclin 2003). 이전에 '홀리 바질'이 화학 예방 효과가 있다고 보고된 바 있습니다. 바질과 로즈마리에서 생성되는 트리테르페노이드인 우르솔산은 IKK를 억제하여 NF-B 활성화를 제한하고, 이는 다시 사이클린 D1, COX-2, 매트릭스 메탈로프로테이나제-9를 억제하는 것으로 입증되었습니다(Woolf 2018).

Capsicum annum

Capsicum annuum is considered a plant species endemic to southern North America, northern South America, and the Caribbean. Cultivars derived from the native American bird peppers can still be found in the Americas' warmer areas. Some woody types of this species were previously referred to as C. frutescens; however, the characteristics used to differentiate those types are seen in numerous species like C. annuum, but they are not consistently recognised in C. frutescens types. Numerous chemicals, including neuropeptide Y, protein gene product 9.5 (PGP-9.5), nerve growth factor (NGF), CGRP, and SP, have been linked to itchy skin in psoriasis. NGF, PGP 9.5-reactive nerve fibers, and the number of NGF-immunoreactive keratinocytes have been found to be elevated in itch skin and related to itch intensity. TrkA, an NGF high-affinity receptor, is abundantly expressed in the epidermal and dermal nerve fibres, and this corresponds with itch intensity (Henrich et al. 2015). Keratinocytes and nerve fibres in itchy psoriatic skin have higher levels of SP and its receptor expression‎. Furthermore, capsaicin was demonstrated to considerably decrease itch in psoriasis patients, indicating a potential role for this neuropeptide in the aetiology of psoriasis itching (Znajdek-awi 1124).

고추는 북미 남부, 남미 북부 및 카리브해에 고유한 식물 종으로 간주됩니다. 아메리카 토종 새고추에서 파생된 품종은 여전히 아메리카의 따뜻한 지역에서 볼 수 있습니다. 이 종의 일부 나무가 우거진 유형은 이전에 C. 프루테센스로 불렸지만, 이러한 유형을 구분하는 데 사용되는 특성은 C. 아늄과 같은 수많은 종에서 볼 수 있지만 C. 프루테센스 유형에서는 일관되게 인식되지 않습니다.

신경 펩타이드 Y, 

단백질 유전자 제품 9.5(PGP-9.5), 

신경 성장 인자(NGF), 

CGRP, 

SP 등 수많은 화학 물질이 

건선 피부 가려움증과 관련이 있는 것으로 밝혀졌습니다. 

가려움증이 있는 피부에서는 NGF, PGP 9.5 반응성 신경 섬유 및 NGF 면역 반응성 각질 세포의 수가 증가하며 가려움증의 강도와 관련이 있는 것으로 밝혀졌습니다. NGF 고친화성 수용체인 TrkA는 표피 및 진피 신경 섬유에서 풍부하게 발현되며, 이는 가려움 강도와 일치합니다(Henrich 등. 2015). 가려운 건선 피부의 각질 세포와 신경 섬유는 SP와 그 수용체 발현 수준이 더 높습니다. 

또한 

캡사이신은 

건선 환자의 가려움증을 상당히 감소시키는 것으로 입증되어 

건선 가려움증의 원인에서 

이 신경 펩타이드의 잠재적 역할을 시사합니다(Znajdek-awi 1124).

Centella asiatica L.

Guto Kola, Hydrocotyle asiatica L, or Centella asiatica is commonly used in dermatology to treat skin problems.It is a member of the Apiaceae family. The primary ingredients of Centella asiatica are centelloids, as these represent pentacyclic triterpenoids that include madecassoside, asiaticoside, madecassic acid, and asiatic acid. It also includes saponins of the oleanane and isothankunic acid types, such as terminolic acid and centellasaponin D. It has saponins (1–8%) and essential oils (1%) (Sampson et al. 2001).

Centella asiatica has long been used in Ayurvedic medicine to treat a variety of diseases. It was discovered to have tremendous promise as a natural antioxidant and a DNA damage preventer. A research study compared the madecassoside and asiaticoside anti-psoriatic actions on the development of keratinocytes (SVK-14) with dithranol and psoralen. The madecassoside and Asiaticoside IC50 values were discovered to be 8.6 0.1 M and 8.4 0.6, respectively. In addition, the aqueous product of the herb Centella asiatica was shown to be less effective than Psoralea corylifolia seeds. However, the findings were equivalent to dithranol's IC50 value of 5.2 0.4 M (Ouyang et al. 2016).

Madecassoside ointment has been employed in research to examine the impact of madecassoside against imiquimod-induced psoriasis-like dermatitis using BALB/c mice. Il-17 and IL-23 are important in the development of psoriasis. According to real-time PCR results, madecassoside significantly reduced mRNA levels of IL-23 and IL-17. Furthermore, keratinocyte proliferation was reduced using haematoxylin, 5-bromo-2'-deoxyuridine (BrdU), and eosin staining incorporation experiments. The number of Th17 cells was shown to be lower using flow cytometry. Consequently, madecassoside ointment was discovered to be beneficial in the treatment of psoriasis via the IL-17 and IL-23 axes (Genoux and Duffy 2019).

구토 콜라, 히드로코틸 아시아티카 L 또는 센텔라아시아티카는 피부과에서 피부 문제를 치료하기 위해 일반적으로 사용되며 살구과에 속하는 식물입니다. 

병풀(적설초)의 주요 성분은 

센텔로이드로 마데카소사이드, 아시아티코사이드, 마데카식산, 아시아틱산을 포함하는 

5환 트리테르페노이드를 나타냅니다. 

또한 

테르미놀산 및 센텔라사포닌 D와 같은 

올레아난 및 이소탄쿠닉산 유형의 사포닌(1-8%)과 

에센셜 오일(1%)이 포함되어 있습니다(Sampson et al. 2001).

센텔라아시아티카는 

아유르베다 의학에서 오랫동안 

다양한 질병을 치료하는 데 사용되어 왔습니다. 

천연 항산화제 및 

DNA 손상 방지제로서 

엄청난 잠재력을 가지고 있는 것으로 밝혀졌습니다. 

한 연구에서는 

마데카소사이드와 아시아티코사이드가 

각질 세포(SVK-14)의 발달에 미치는 

항 건선 작용을 디트라놀 및 소랄렌과 비교했습니다. 

마데카소사이드와 아시아티코사이드의 IC50 값은 

각각 8.6 0.1 M과 8.4 0.6으로 밝혀졌습니다. 

또한 

센텔라아시아티카 허브의 수성 제품은 

정향나무 씨앗보다 효과가 떨어지는 것으로 나타났습니다. 그러나 이 결과는 디트라놀의 IC50 값인 5.2 0.4 M과 동일했습니다(Ouyang et al. 2016).

https://kr.iherb.com/pr/a-pieu-madecassoside-moisture-gel-cream-1-69-fl-oz-50-ml/109128

마데카소사이드 연고는 

BALB/c 마우스를 사용하여 

이미퀴모드에 의한 건선 유사 피부염에 대한 

마데카소사이드의 영향을 조사하는 연구에 사용되었습니다. 

IL-17과 IL-23은 

건선 발병에 중요한 역할을 합니다. 

실시간 PCR 결과에 따르면 

마데카소사이드는 IL-23과 IL-17의 mRNA 수치를 

유의하게 감소시켰습니다. 

또한 헤마톡실린, 5-브로모-2'-데옥시유리딘(BrdU), 에오신 염색 혼입 실험을 통해 각질 세포 증식이 감소하는 것을 확인했습니다. 유세포 분석법을 사용하여 Th17 세포의 수가 줄어든 것으로 나타났습니다. 결과적으로 마데카소사이드 연고는 IL-17 및 IL-23 축을 통해 건선 치료에 도움이 되는 것으로 밝혀졌습니다(Genoux and Duffy 2019).

Cestrum diurnum

Cestrum diurnum, sometimes termed "wild jasmine," is a member of the family Solanaceae and represents a West Indian plant widely grown as a decorative plant. The plant's leaves contain a strong steroid glycoside that mimics vitamin D action. It includes 1,25-dihydroxycholecalciferol glycosides. Vitamin D3 is normally generated at the skin via UV light-dependent processes or obtained through food. To produce the most activated vitamin D3, 1,25-dihydroxycholecalciferol, vitamin D3 is hydroxylated twice, in the liver and by the kidney (calcitriol) (Prema and Raghuramulu 1994). Topical vitamin D has a therapeutic impact via two mechanisms: the vitamin D receptor-mediated method, which inhibits keratinocyte growth, and the non-genomic mechanism, which stimulates keratinocyte differentiation due to elevated intracellular calcium. As a result, it has now become a localised agent in the treatment of psoriasis.

Research was done to explore the effect of its supplementation on psoriasis. For six months, patients were given vitamin D2 only once every 2 weeks. Both the psoriasis area and the PASI improved after 3 and 6 months. The average PASI improvement was 34.21% versus 1.85% for the placebo. Vitamin D supplementation increased the results of psoriasis therapy (Das et al. 2022). Aurochem Laboratories Pvt. Ltd. markets Cestrum diurnum extract (3 g/g) as an ointment and gel under the brand name PsoriaBan Natural. It has shown up to 89% effectiveness. It has been proven to be helpful in the healing of psoriasis in the face and scalp.

"야생 재스민"이라고도 불리는 

세스트럼 디우눔은 가지과에 속하는 식물로 

관상용 식물로 널리 재배되는 서인도 식물을 대표합니다. 

이 식물의 잎에는 

비타민 D 작용을 모방하는 

강력한 스테로이드 배당체가 함유되어 있습니다. 

여기에는 

1,25-디하이드록시콜레칼시페롤 배당체가 

포함되어 있습니다. 

비타민 D3는 일반적으로 자외선에 의존하는 과정을 통해 피부에서 생성되거나 음식을 통해 섭취할 수 있습니다. 가장 활성화된 비타민 D3인 1,25-디하이드록시콜레칼시페롤을 생성하기 위해 비타민 D3는 간과 신장(칼시트리올)에서 두 번 히드록실화됩니다(Prema and Raghuramulu 1994). 국소 비타민 D는 각질 세포 성장을 억제하는 비타민 D 수용체 매개 방식과 세포 내 칼슘 증가로 인해 각질 세포 분화를 자극하는 비유전체 메커니즘의 두 가지 메커니즘을 통해 치료 효과를 발휘합니다. 그 결과 현재 건선 치료에 국소적으로 사용되는 약제가 되었습니다.

건선에 대한 보충제의 효과를 알아보기 위한 연구가 수행되었습니다. 6개월 동안 환자들에게 2주에 한 번씩만 비타민 D2를 투여했습니다. 3개월과 6개월 후 건선 부위와 PASI가 모두 개선되었습니다. 평균 PASI 개선율은 34.21%였고 위약은 1.85%였습니다. 비타민 D 보충제는 건선 치료 효과를 높였습니다(Das 외. 2022). 는 세스트럼 디우르넘 추출물(3g/g)을 PsoriaBan Natural이라는 브랜드명으로 연고와 젤로 판매하고 있습니다. 최대 89%의 효과를 보였습니다. 얼굴과 두피의 건선 치유에 도움이 되는 것으로 입증되었습니다.

Cloves

Cloves' anti-inflammatory and antioxidant properties are well documented. The active ingredients in cloves are eugenol and isoeugenol. Several studies have demonstrated that these chemicals can inhibit NF-B activation by inhibiting IB breakdown (Murakami et al. 2003). Murakami et al. (Barrea et al. 2018). found that bis-eugenol, but not eugenol, inhibits IB degradation and suppresses inflammatory cytokine production at both the gene and protein levels.

정향의 항염증 및 항산화 특성은 잘 알려져 있습니다. 

정향의 활성 성분은 

유제놀과 이소유제놀입니다. 

여러 연구에 따르면 

이러한 화학 물질이 

IB 분해를 억제하여 

NF-B 활성화를 억제할 수 있다는 사실이 

입증되었습니다(Murakami et al. 2003). (무라카미 외. 2018). 

유게놀은 아니지만 비스-유게놀은 IB 분해를 억제하고 유전자 및 단백질 수준에서 염증성 사이토카인 생성을 억제한다는 사실을 발견했습니다.

Coffee

Coffee is considered one of the most commonly drunk drinks, regardless of location. According to data (Manuscript 2017), only tea and water are more commonly consumed liquids. Coffee, furthermore, is a pharmacologically active fluid. Its composition contains several physiologically active chemicals (Gokcen and Sanlİer 2017). This would include lipids, carbohydrates, nitrogenous chemicals, vitamins, minerals, antioxidants, phenolics, lactones, alkaloid compounds, diterpenes, and caffeine, which accounts for around 1% of all coffee composition. This compound has a variety of medicinal properties and has been shown to inhibit monocyte and neutrophil migration, lower levels of glucose in the blood, have immunosuppressive and anti-inflammatory properties and safeguard from neurodegeneration (Sharif et al. 2017).

Caffeine is the most researched component in coffee. It inhibits Th1/Th2 cell proliferation, as well as the production of pro-inflammatory cytokines like TNF-, IL-1, IL-6, and IL-11, while simultaneously releasing anti-inflammatory markers like adiponectin, IL-4, and IL-10 (Hall et al. 2015). Furthermore, it inhibits cyclin Adenosine Monophosphate (cAMP), which acts as an immunomodulator, increases the production of anti-inflammatory cytokines, and acts as an antagonist of the adenosine receptor. Moreover, the presence of polyphenols in coffee's composition contributes to its anti-inflammatory properties. A subset of these chemicals, particularly chlorogenic acid and its metabolites block pro-inflammatory cytokines, whereas caffeic acid lowers levels of nitrite and eliminates inflammatory symptoms (Zampelas et al. 2018).

According to Zampelas et al. (Fernandez et al. 2012), coffee drinking boosts the body's inflammatory process, which could have a negative correlation with psoriasis severity. According to this study, drinking coffee on a daily basis increased TNF-, CRP, and IL-6 levels, which resulted in severe pathological manifestations of psoriasis. It is crucial to note, however, that this study linked heavy coffee intake (more than 200 mg per day) to psoriasis severity. The hazard of psoriasis was shown to be modestly linked with an elevation in coffee intake, albeit this was not significant statistically among cigarette consumers. It is worth noting that this study may have had a significant limitation: a variety of caffeine sources, such as sweetened beverages and overly processed meals, were tested, which may have influenced the outcomes reached. According to Sharif et al. (Hall et al. 2015), regular coffee consumption increases the level of anti-inflammatory elements while decreasing the synthesis of pro-inflammatory factors (particularly TNF-), which is important in reducing the severity of psoriasis. Several studies have found that the effect of coffee varies depending on the dose. Moderate-intensity coffee consumption up to three cups per day reduces psoriasis manifestations and has an anti-inflammatory impact, whereas greater coffee consumption, particularly more than four cups per day, worsens clinical psoriasis symptoms and is related to a rise in pro-inflammatory chemicals (Ammon and Wahi 1990).

커피는 장소에 관계없이 가장 일반적으로 마시는 음료 중 하나로 꼽힙니다. 데이터(원고 2017)에 따르면 차와 물만 더 일반적으로 소비되는 액체라고 합니다. 또한 커피는 약리학적으로 활성인 액체입니다. 

커피의 성분에는 

여러 가지 생리 활성 화학물질이 포함되어 있습니다(Gokcen and Sanlİer 2017). 

여기에는 

지질, 탄수화물, 질소 화학 물질, 비타민, 미네랄, 

항산화제, 페놀류, 락톤, 알칼로이드 화합물, 디테르펜 및 카페인이 포함되며, 

이는 전체 커피 성분의 약 1%를 차지합니다. 

이 화합물은 다양한 의학적 특성을 가지고 있으며 

단핵구 및 호중구 이동을 억제하고 

혈중 포도당 수치를 낮추며 

면역 억제 및 항염증 작용을 하고 

신경 퇴화를 방지하는 것으로 나타났습니다(Sharif et al. 2017).

카페인은 

커피에서 가장 많이 연구된 성분입니다. 

카페인은 

Th1/Th2 세포 증식과 

TNF-, IL-1, IL-6, IL-11과 같은 전 염증성 사이토카인의 생성을 억제하는 동시에 

아디포넥틴, IL-4, IL-10과 같은 항염증 마커를 방출합니다(Hall et al. 2015). 

또한 면역 조절제 역할을 하는 사이클린 아데노신 모노포스페이트(cAMP)를 억제하고 항염증 사이토카인의 생성을 증가시키며 아데노신 수용체의 길항제로 작용합니다. 또한 커피 성분에 함유된 폴리페놀은 커피의 항염증 작용에 기여합니다. 이러한 화학물질의 일부, 특히 클로로겐산과 그 대사산물은 전 염증성 사이토카인을 차단하는 반면, 카페인산은 아질산염 수치를 낮추고 염증 증상을 제거합니다(Zampelas 등. 2018).

잠펠라스 외(Fernandez 외. 2012)에 따르면 

커피를 마시면 

신체의 염증 과정이 촉진되어 

건선 중증도와 음의 상관관계가 있을 수 있다고 합니다. 

이 연구에 따르면 

매일 커피를 마시면 

TNF-, CRP 및 IL-6 수치가 증가하여 

건선의 심각한 병리학적 증상을 초래했습니다.

 그러나 이 연구는 

커피를 많이 섭취하는 것(하루 200mg 이상)과 

건선의 중증도를 연관시켰다는 점에 

유의해야 합니다. 

건선의 위험은 커피 섭취량 증가와 약간의 연관성이 있는 것으로 나타났지만, 이는 담배 소비자들 사이에서 통계적으로 유의미하지는 않았습니다. 이 연구에는 가당 음료와 지나치게 가공된 음식 등 다양한 카페인 공급원이 테스트되어 결과에 영향을 미쳤을 수 있다는 중대한 한계가 있다는 점에 주목할 필요가 있습니다. 

(홀 등, 2015)에 따르면 

규칙적인 커피 섭취는 

항염증 성분의 수준을 높이는 동시에 

전 염증 인자(특히 TNF-)의 합성을 감소시켜 

건선의 중증도를 낮추는 데 중요한 역할을 한다고 합니다. 

여러 연구에 따르면

 커피의 효과는 섭취량에 따라 달라지는 것으로 나타났습니다. 

하루 3잔 이하의 중간 강도의 커피 섭취는

건선 증상을 줄이고 

항염증 효과가 있는 반면, 

하루 4잔 이상의 커피 섭취는 

임상 건선 증상을 악화시키고 

전 염증성 화학물질의 증가와 관련이 있다고 합니다(Ammon and Wahi 1990).

Curcumin

Curcumin is indeed a polyphenol produced from the yellow spice turmeric, a member of the Zingiberaceae family, with several characteristics. It contains anti-tumor, anti-oxidant, anti-inflammatory, and many other biological properties and is chemically identified as [1,7-bis(4-hydroxy-3-methoxyphenyl)-1, 6-heptadiene-3, 5-dione] (Editor 2017). It's apparent that curcumin's widespread usage in medicine is due to its various qualities, which include anti-inflammatory, antioxidant, anti-proliferative, anti-microbial, and anti-carcinogenic capabilities (Gupta et al. 2011). Curcumin is used to treat a variety of ailments, including rheumatoid arthritis, eye problems (such as uveitis anterior chronica and conjunctivitis), menstrual irregularities, infections in the urinary tract, and gastrointestinal and liver issues (e.g., irritable bowel disease, abdominal pain). It's also utilised as an adjuvant treatment for cancer of the skin, wound repair, and chicken pox (Anand et al. 2007). Dendritic cells have been linked to the early stages of psoriasis. Myeloid dendritic cells secrete IL-23 and IL-12, which stimulate IL-17-producing Th22, Th1, and T cells, resulting in the production of inflammatory cytokines such as IFN-, IL-17, IL-22, and TNF, which trigger the cascade associated with psoriasis inflammation (Skyvalidas 2020).

Curcumin contains anti-oxidative, anti-inflammatory, and immunomodulatory properties and can decrease pro-inflammatory factors, activation of T cells, and proliferation via working on the AP-1, NF-B, and MAPK pathways. It can keep DC immature, which affects cytokine generation, stimulation of responsive T cells, and antigen presentation. Curcumin inhibits the production of IL-17 by CD4+ T cells (Campbell, et al. 2018). Curcumin inhibits the development of imiquimod-induced differentiated HaCaT cells by downregulating pro-inflammatory cytokines TNF-, IL-17, and IFN- (Kang et al. 2016). IFN- and TNF-, as well as IL-23, IL-22, IL-12, and IL-2, returned to normal levels in mice after curcumin administration. This might be because curcumin reduces Kv1.3 channel currents, inhibiting T cell proliferation, or because curcumin influences AP-1, NF-B, and MAPK signalling pathways inside psoriasis mice (He et al. 2015). In an imiquimod-stimulated psoriatic model, curcumin nanohydrogel restored the normally distributed TJs proteins ZO1 and occludin while decreasing iNOS and TNF- production (Zhang, et al. 2019). Following topical application to mice, curcumin reduced inflammatory symptoms, mRNA levels of IL-1, IL-22, IL-17F, IL-17A, and TNF-, and protein expression‎ of CC Chemokine receptor 6 (CCR6) (Kurd et al. 2008).

커큐민은 

실제로 강황과에 속하는 노란색 향신료 

강황에서 생성되는 폴리페놀로, 몇 가지 특징이 있습니다. 

커큐민에는 

항종양, 항산화, 항염증 및 기타 여러 생물학적 특성이 포함되어 있으며 

화학적으로 [1,7-비스(4-하이드록시-3-메톡시페닐)-1, 6-헵타디엔-3, 5-디온]으로 확인됩니다(편집자 2017). 

커큐민이 의학에서 널리 사용되는 것은 항염증, 항산화, 항증식, 항균 및 항암 기능을 포함한 다양한 특성 때문인 것으로 보입니다(굽타 외. 2011). 

커큐민은 

류마티스 관절염, 

눈 문제(전만성 포도막염, 결막염 등), 

생리 불순, 

요로 감염, 

위장 및 간 문제(과민성 대장 질환, 복통) 등 

다양한 질병을 치료하는 데 사용됩니다. 

또한 피부암, 

상처 회복, 

수두에 대한 보조 치료제로도 활용되고 있습니다(Anand 외. 2007). 

수지상 세포는 건선의 초기 단계와 관련이 있습니다. 골수성 수지상 세포는 IL-23과 IL-12를 분비하여 IL-17을 생성하는 Th22, Th1 및 T 세포를 자극하여 건선 염증과 관련된 캐스케이드를 유발하는 IFN-, IL-17, IL-22 및 TNF와 같은 염증성 사이토카인을 생성하게 됩니다(Skyvalidas 2020).

커큐민은 

항산화, 항염증 및 면역 조절 특성을 가지고 있으며 

AP-1, NF-B 및 MAPK 경로에 작용하여 

전 염증 인자, T 세포의 활성화 및 증식을 감소시킬 수 있습니다. 

또한 

사이토카인 생성, 

반응성 T 세포의 자극, 

항원 제시 등에 영향을 미치는 DC를 

미성숙 상태로 유지할 수 있습니다. 

커큐민은 

CD4+ T 세포에 의한 IL-17 생성을 억제합니다(Campbell 등, 2018). 

커큐민은 

전 염증성 사이토카인 TNF-, IL-17 및 IFN-을 하향 조절하여 

이미퀴모드에 의해 유도된 분화 HaCaT 세포의 발달을 억제합니다(Kang et al. 2016). 

커큐민 투여 후 마우스에서 IFN- 및 TNF-, IL-23, IL-22, IL-12 및 IL-2가 정상 수준으로 회복되었습니다. 이는 커큐민이 Kv1.3 채널 전류를 감소시켜 T 세포 증식을 억제하거나 커큐민이 건선 마우스 내부의 AP-1, NF-B 및 MAPK 신호 경로에 영향을 미치기 때문일 수 있습니다(He et al. 2015). 이미퀴모드 자극 건선 모델에서 커큐민 나노하이드로겔은 정상적으로 분포하는 TJs 단백질 ZO1과 오클루딘을 회복시키는 동시에 iNOS와 TNF- 생성을 감소시켰습니다(Zhang 등, 2019). 생쥐에 커큐민을 국소 도포한 결과, 염증 증상, IL-1, IL-22, IL-17F, IL-17A, TNF-의 mRNA 수준, CC 케모카인 수용체 6(CCR6)의 단백질 발현이 감소했습니다(Kurd et al. 2008).

Fennel and anise

As estrogenic agents, fennel (Foeniculum vulgare) and anise (Pimpinella anisum) have been used. They are said to enhance milk supply, induce menstruation, assist delivery, decrease male climacteric symptoms, and boost libido. The major ingredient of anise essential oils and fennel, anethol, was thought to be a powerful estrogenic agent, but subsequent research reveals that the true pharmacologically active molecules are anethol polymers, including dianethol and photoanethol (Sen et al. 1996). Anethole has been demonstrated to inhibit inflammation as well as carcinogenesis. It has been demonstrated to have antioxidant properties. We demonstrated that anethole can limit NF-B activation by inhibiting IB breakdown (Yilmaz et al. 2010).

에스트로겐 제제로 

회향(Foeniculum vulgare)과 아니스(Pimpinella anisum)가 사용되어 왔습니다. 

모유 공급을 강화하고, 

생리를 유도하며, 분만을 돕고, 

남성 갱년기 증상을 완화하고, 

성욕을 증진하는 효과가 있다고 합니다. 

아니스 에센셜 오일과 

회향의 주요 성분인 아네톨은 

강력한 에스트로겐으로 여겨졌지만, 

후속 연구에 따르면 진정한 약리 활성 분자는 

디아네톨과 포토아네톨을 포함한 아네톨 폴리머라는 사실이 밝혀졌습니다(Sen 등. 1996). 

아네톨은 

발암뿐만 아니라 

염증을 억제하는 것으로 입증되었습니다. 

항산화 특성이 있는 것으로 입증되었습니다. 

아네톨은 

IB 분해를 억제하여 

NF-B 활성화를 제한할 수 있다는 것이 입증되었습니다(Yilmaz 외. 2010).

Garlic

Garlic (Allium sativum) is a well-researched, great herbal remedy that has been utilised for millennia to cure a variety of health issues (Pazyar and Feily 2011). Its contents include sulfur-containing molecules such as alliin, enzymes such as alliinase, and chemicals enzymatically synthesised from alliin as allicin. Garlic also contains other elements such as oligosaccharides, flavonoids, arginine, and selenium (Allison et al. 2006). One complicated combination is aged garlic extract (AGE). Allin, cyclophilin, S-methyl-l-cysteine, S-allyl-l-cysteine, S-acetylcysteine, S-allylmercapto-l-cysteine, S-1 propionyl-l-cysteine, fructose-arginine, and beta-chlorogenic are among its constituents. l-Arginine, l-methionine, and l-cysteine are also present. Psoriasis is now associated with the activity of the nuclear transcription factor kappaB. Extensive investigation has revealed this path. Garlic (S-allyl mercapto cysteine, diallyl sulfide, ajoene) can inhibit this transcription factor (Singh and Tripathy 2014).

마늘(알리움 사티붐)은 

수천 년 동안 다양한 건강 문제를 치료하는 데 활용되어 온 

잘 연구된 훌륭한 약초 요법입니다(Pazyar and Feily 2011). 

마늘에는 

알리인과 같은 황 함유 분자, 알리이나아제와 같은 효소, 

알리인에서 알리신으로 효소 합성된 화학 물질이 포함되어 있습니다. 

마늘에는 

올리고당, 플라보노이드, 아르기닌, 셀레늄과 

같은 다른 성분도 포함되어 있습니다(Allison 외. 2006). 

한 가지 복잡한 조합은 

숙성 마늘 추출물(AGE)입니다. 

알린, 사이클로필린, S-메틸-l-시스테인, S-알릴-l-시스테인, S-아세틸시스테인, S-알릴머캅토-l-시스테인, S-1 프로피오닐-l-시스테인, 과당-아르기닌, 베타-클로로겐이 그 구성 성분입니다. l-아르기닌, l-메티오닌, l-시스테인도 존재합니다. 

건선은 

이제 핵 전사 인자 카파B

nuclear transcription factor kappaB의 활동과 

관련이 있습니다. 

마늘(S-알릴 메르캅토 시스테인, 디알릴 설파이드, 아조엔)은 

(S-allyl mercapto cysteine, diallyl sulfide, ajoene)

이 전사인자를 억제할 수 있습니다(Singh and Tripathy 2014).

Gaultheria procumbens L.

Gaultheria procumbens (eastern teaberry, boxberry, checkerberry) seems to be an herbaceous plant that yields essential oils and belongs to the Ericaceae family. These oils include the anti-inflammatory compound methyl salicylate (Jurek and Olszewska 2019). The salicylate, as well as the procyanidin-rich stem extract from Gaultheria procumbens, suppresses pro-inflammatory proteins such as hyaluronidase, COX-2, and lipoxygenase. Models created in vitro showed antioxidant effects. Ex vivo experiments in human neutrophils stimulated with N-formyl-l-methionyl-l-leucyl-l-phenylalanine and lipopolysaccharides reduced the production of cytokines and proteinases, as well as reactive oxygen species (Saha et al. 2014).

갈테리아 프로쿰벤스(동부 티베리, 박스베리, 체커베리)는 

에센셜 오일을 생산하는 초본 식물로 

에센셜 오일은 꿀풀과에 속하는 것으로 보입니다. 

이 오일에는 항염증 화합물인 메틸 살리실레이트가 포함되어 있습니다(Jurek and Olszewska 2019). 살리실레이트와 갈테리아 프로쿰벤스의 프로시아니딘이 풍부한 줄기 추출물은 히알루로니다아제, COX-2, 리폭시게나제 같은 염증성 단백질을 억제합니다. 시험관 내에서 생성된 모델에서 항산화 효과가 나타났습니다. N-포밀-l-메티오닐-l-루실-l-페닐알라닌과 리포다당류로 자극한 인간 호중구의 생체 외 실험에서 사이토카인과 프로테아제, 활성 산소 종의 생성이 감소했습니다(사하 외. 2014).

Ginger

Ginger (Zingiber officinale) would be a blooming medicinal plant with a spicy root or rhizome (plant stem) (Salafzoon 2017). Furthermore, it is extensively utilised in folk medicine due to its numerous health advantages in a variety of conditions, covering chronic conditions such as diabetes (Wang et al. 2011), cancer (Papers 2013b), ulcers (Kukula-koch et al. 2018), Alzheimer's disease (Masuda et al. 2004), cardiovascular disease (Al et al. 1449), and depression (Rabelo et al. 2014). Ginger's positive effect on these disorders is mostly due to its antioxidant (Pkurmaceutical 1933) and anti-inflammatory characteristics (Tjendraputra et al. 2001).

The sharp scent and flavour of new ginger root are caused by active volatile oils (e.g., shogaols, gingerols, and zingerone), which account for around 1–3% of its weight (Article 2001). Ginger also includes antioxidants like vitamin C, vitamin E, lutein, beta-carotene, lycopene, quercetin, genistein, and tannin (Wagesho and Chandravanshi 2015). In addition, ginger includes important nutrients such as manganese, selenium, copper, and zinc (Wagesho and Chandravanshi 2015).

Gingerol, the active component, has already been demonstrated to have chemopreventive properties (Tjendraputra et al. 2001). Gingerol also suppresses the nitric oxide synthase enzyme and cyclooxygenase (COX-2), both of which are recognised to be NF-B regulated (Article 2001). Because gingerol may reduce platelet aggregation, synthesised gingerol analogues with increased potency as platelet aggregation inhibitors, similar to aspirin, may be useful in cardiovascular disease (Getaneh et al. 2021). Since ginger contains anti-inflammatory effects, it is a potential herbal medicine for the treatment of psoriasis.

생강(징기버 오피시날레)은 

매운 뿌리 또는 뿌리줄기(식물 줄기)를 가진 

꽃이 피는 약용 식물입니다(Salafzoon 2017). 

또한 생강은 

당뇨병(왕 외 2011), 

암(논문 2013b), 

궤양(쿠쿨라코흐 외 2018), 

알츠하이머병(마스다 외 2004), 

심혈관 질환(알 외 1449), 

우울증(라벨로 외 2014) 등 

다양한 질환에 대한 수많은 건강상의 이점으로 인해 민간 의학에서 광범위하게 활용되고 있습니다. 

이러한 질환에 대한 

생강의 긍정적인 효과는 

대부분 항산화(Pkurmaceutical 1933)와 항염증 특성(Tjendraputra 외. 2001)에 기인합니다.

생강 뿌리의 날카로운 향과 풍미는 

무게의 약 1-3%를 차지하는 

활성 휘발성 오일(예: 쇼가올, 진저롤, 진저론)에 의해 발생합니다(2001 기사). 

생강에는 

비타민 C, 비타민 E, 루테인, 베타카로틴, 리코펜, 케르세틴, 제니스테인, 탄닌과 같은 

항산화 물질도 포함되어 있습니다(Wagesho와 Chandravanshi 2015). 

또한 생강에는 

망간, 셀레늄, 구리, 아연과 같은 

중요한 영양소가 포함되어 있습니다(Wagesho와 Chandravanshi 2015).

활성 성분인 

진저롤은 

이미 화학 예방 효과가 있는 것으로 입증된 바 있습니다(Tjendraputra 외. 2001). 

진저롤은 또한 

산화질소 합성 효소와 사이클로옥시게나제(COX-2)를 억제하는데, 

이 두 가지 효소는 모두 NF-B에 의해 조절되는 것으로 알려져 있습니다(2001년 기사). 

진저롤은 

혈소판 응집을 감소시킬 수 있으므로 

아스피린과 유사하게 혈소판 응집 억제제로서 

효능이 향상된 합성 진저롤 유사체는 

심혈관 질환에 유용할 수 있습니다(Getaneh 외. 2021). 

생강은 

항염 효과가 있기 때문에 

건선 치료를 위한 잠재적인 약초입니다.

Indigo (Baphicacanthus cusia, Brem.)

TCM considers "Indigo naturalis" to be an important medication. It's a blue powder obtained by grinding the Baphicacanthus cusia plants, fermenting them, and adding lime to them. Forty-two people with chronic plaque psoriasis were given ointment containing 10% indigo once a day for 12 weeks in a randomised placebo-controlled experiment. The used indigo naturalis includes 1.4% indigo and 0.16% indirubin. The indigo therapy alleviated symptoms by 81%, whereas the placebo therapy only reduced symptoms by 26% (Lin et al. 2014). Several investigations using the indigo extract for psoriasis have been conducted. A new randomized, controlled study of 100 psoriasis patients revealed dose-dependent efficacy of indigo extract given twice daily for 8 weeks. The PASI was lowered by 50% with indigo extraction (50 g/g) and 70% with indigo extract (200 g/g). Nasopharyngitis, infections of the upper respiratory tract, and local erythema were reported in certain individuals. There were no severe negative effects noted (Markham et al. 2003). Before and after therapy, punch biopsies revealed normalisation of epidermal appearance as well as a decrease in the main pro-inflammatory cytokine in psoriasis (Markham et al. 2003).

인디고 (바피카칸투스 쿠시아, 브렘)

한의학에서는 "인디고 내추럴리스"를 중요한 약재로 간주합니다. 이는 바피카칸투스 쿠시아 식물을 갈아서 발효시킨 후 석회를 첨가하여 얻은 파란색 분말입니다. 

만성 판상 건선 환자 42명에게 무작위 위약 대조 실험을 통해 하루에 한 번씩 12주 동안 10% 인디고가 함유된 연고를 투여했습니다. 사용된 인디고 내추럴리스에는 1.4%의 인디고와 0.16%의 인디루빈이 함유되어 있습니다. 인디고 요법은 증상을 81% 완화한 반면, 위약 요법은 증상을 26%만 완화하는 데 그쳤습니다(Lin et al. 2014). 건선에 인디고 추출물을 사용한 여러 연구가 진행되었습니다. 건선 환자 100명을 대상으로 한 새로운 무작위 대조 연구에서는 8주 동안 하루 두 번 인디고 추출물을 투여한 결과 용량에 따른 효능이 밝혀졌습니다. PASI는 인디고 추출물(50g/g)을 섭취한 경우 50%, 인디고 추출물(200g/g)을 섭취한 경우 70% 감소했습니다. 특정 개인에게서 비인두염, 상기도 감염, 국소 홍반이 보고되었습니다. 심각한 부작용은 보고되지 않았습니다(Markham et al. 2003). 치료 전후 펀치 생검 결과, 건선의 주요 염증성 사이토카인의 감소뿐만 아니라 표피 외관이 정상화되는 것으로 나타났습니다(Markham 외. 2003).

Lace flower (Ammi visnaga (L.) and Ammi majus (L.))

5-Methoxypsoralen (5-MOP) and furanocoumarins 8-methoxypsoralen (8-MOP) is secluded for therapeutic application from Ammi visnaga (L.) Lam. and Ammi majus (L.) Psoralens are phototoxic chemicals that are photoactivated via ultraviolet A (UVA) light and can induce extremely phototoxic skin responses.

They limit keratinocyte growth and exhibit immunosuppressive effects in the healing environment of PUVA treatment (psoralen and UVA), which is utilized to treat strong inflammatory skin disorders such as psoriasis. Several clinical investigations have demonstrated the effectiveness of systemic PUVA (Vongthongsri et al. 2006), bath PUVA (Amornpinyokeit and Asawanonda 2006), and cream PUVA (0.1% 8-MO) (Bensouilah and Bensouilah 2003) in psoriasis.

5-메톡시소랄렌(5-MOP) 및 후라노쿠마린 8-메톡시소랄렌(8-MOP)은 암미 비스가나(Ammi visnaga (L.) Lam.)와 암미 마주스(Ammi majus (L.))에서 치료용으로 분리한 것으로, 자외선 A(UVA) 빛을 통해 광 활성화되는 광독성 화학물질로 극도의 광독성 피부 반응을 유발할 수 있는 물질입니다.

건선과 같은 강한 염증성 피부 질환을 치료하는데 사용되는 PUVA 치료(소랄렌 및 UVA)의 치유 환경에서 각질 세포 성장을 제한하고 면역 억제 효과를 나타냅니다. 여러 임상 연구를 통해 건선에 대한 전신 PUVA(Vongthongsri 외. 2006), 목욕 PUVA(Amornpinyokeit and Asawanonda 2006), 크림 PUVA(0.1% 8-MO)(Bensouilah and Bensouilah 2003)의 효과가 입증되었습니다.

Matricaria recutita L.

Matricaria chamomile, or Matricaria recutita, is a part of the Asteraceae family. It has traditionally been employed to alleviate digestive issues. Chamazulene seems to be the primary phytochemical accountable for antipsoriatic action. It's a derivative of the oil extraction matrix derived from flowers (Rauf 2021). Chamazulene exerts anti-inflammatory action by suppressing lipoxygenase, which inhibits leukotriene B4 synthesis (LTB4). LTB4 production then increases, resulting in psoriatic plaque. Therefore, Chamazulene's positive impact will be demonstrated by inhibiting LTB4. The flavonoids and apigenin The flower contains quercetin (Bonesi et al. 2018).

Quercetin is an anti-inflammatory, anti-tumor, antiviral, and antibacterial flavonol. It inhibits both IFN-induced STAT-1 stimulation and NF– activation. It reduces the generation of histamine and IgE. It inhibits the enzymes nitric oxide synthase (iNOS), TNF-, and IL. Quercetin works through many processes and might be used to treat psoriasis. Apigenin is indeed a flavone with anti-inflammatory and antioxidant properties. It inhibits NF-B activation and decreases TNF-induced luciferase reporter gene transactivation (Jamalian et al. 2012). It also lowers TNF-, suppresses COX-2, IL-6, and IL-8 expression‎, and inhibits TNF–induced luciferase reporter gene transactivation (Jamalian et al. 2012). It also protects against fungal infections (Silva et al. 2019). Chamomile essential oil inhibits NF-, TNF-, IL-1, IL-6, iNOS, and COX-2 (Gad et al. 2019).

마트리카리아 카모마일 또는 

마트리카리아 레쿠티타는 

국화과에 속하는 식물입니다. 

전통적으로 소화 문제를 완화하는 데 사용되어 왔습니다. 

카마줄렌은 

항소양 작용을 담당하는 

주요 식물성 화학 물질로 보입니다. 

이는 케모마일 꽃에서 추출한 오일 추출 매트릭스에서

파생된 유도체입니다(Rauf 2021). 

차마줄렌은 

류코트리엔 B4(LTB4) 합성을 억제하는 리폭시게나제를 억제하여 

항염증 작용을 합니다. 

그러면 

LTB4 생성이 증가하여 

건선 플라크가 생성됩니다. 

따라서 

차마줄렌의 긍정적인 효과는 

LTB4를 억제함으로써 입증될 수 있습니다. 

플라보노이드와 아피제닌 꽃에는 

케르세틴이 함유되어 있습니다(Bonesi et al. 2018).

케르세틴은 

항염증, 항종양, 항바이러스 및 항균 플라보놀입니다. 

케르세틴은 

IFN에 의한 STAT-1 자극과 NF- 활성화를 

모두 억제합니다. 

히스타민과 IgE의 생성을 감소시킵니다. 

산화질소 합성효소(iNOS), TNF- 및 IL 효소를 억제합니다. 

케르세틴은 

여러 과정을 통해 작용하며 

건선 치료에 사용될 수 있습니다. 

아피제닌은 

실제로 항염증 및 항산화 특성을 가진 플라본입니다. 

아피제닌은 

NF-B 활성화를 억제하고 

TNF에 의한 루시퍼라제 리포터 유전자 전사를 감소시킵니다(Jamalian 외. 2012). 

또한 

TNF-를 낮추고 

COX-2, IL-6 및 IL-8 발현을 억제하며 

TNF 유도 루시퍼라제 리포터 유전자 전사를 억제합니다(Jamalian et al. 2012). 

또한 

곰팡이 감염으로부터 

보호합니다(Silva et al. 2019). 

카모마일 에센셜 오일은 

NF-, TNF-, IL-1, IL-6, iNOS 및 

COX-2를 억제합니다(Gad et al. 2019).

Melaleuca alternifolia

The Melaleuca plant is endemic to Oceania and is utilised in traditional medicine in Australia. -terpinene, -terpineol, terpinen-4-ol, 1,8-cineol, -pinene, terpinolene, sabinene, and limonene are all found in tea plant oil. Sesquiterpenes and aromatic chemicals make up the remainder of the oil. In vivo, tea tree oil also has substantial antibacterial and antifungal properties. Methyl eugenol, terpinen-4-ol, and 1,8-cineol all play important roles in antibacterial action (Pazyar and Yaghoobi 2012). Terpinen-4-ol has been shown to reduce TNF-, IL-1, IL-8, and PGE2 production. It can also influence vasodilation and plasma extravasation (Koh et al. 2002). In a trial of 27 patients to assess the impact of tea oil on weeping or flare induced by histamine, the volume of mean weeping decreased significantly after 10 min of treatment (Khalil et al. 2004). Human and rodent investigations had similar findings. Tea plant oil reduced the susceptibility to flared and wheal histamines. Tea tree oil, on the other hand, has been linked to contact allergies in a small number of people. Freshly extracted oil is a mild to the moderate sensitizer, while oxidation elevates the oil's allergenic action. The oil contains sensitizers such as -terpinene, ascaridole, -phellandrene, -phellandrene, limonene, and trihydroxymenthane. The majority of the responses are caused by direct tea tree oil application (Ali and Blunden 2002), Tea tree oil taken orally can ultimately cause systemic contact dermatitis, cognitive confusion, and coma (Jurek and Olszewska 2019).

멜라루카 식물은 오세아니아 고유종으로 호주의 전통 의학에서 활용되고 있습니다. -테르피넨, -테르피네올, 테르피넨-4-올, 1,8-시네올, -피넨, 테르피놀렌, 사비넨 및 리모넨은 모두 차 식물 오일에서 발견됩니다. 세스퀴테르펜과 방향성 화학 물질이 나머지 오일을 구성합니다. 티트리 오일은 생체 내에서도 상당한 항균 및 항진균 특성을 가지고 있습니다. 메틸 유제놀, 테르피넨-4-올, 1,8-시네올은 모두 항균 작용에 중요한 역할을 합니다(Pazyar and Yaghoobi 2012). 테르피넨-4-올은 TNF-, IL-1, IL-8 및 PGE2 생성을 감소시키는 것으로 나타났습니다. 또한 혈관 확장 및 혈장 유출에도 영향을 미칠 수 있습니다(Koh et al. 2002). 27명의 환자를 대상으로 히스타민에 의해 유발된 울음이나 발적에 대한 티 오일의 영향을 평가하기 위한 실험에서, 10분간 티 오일을 투여한 후 평균 울음의 양이 크게 감소했습니다(Khalil 외. 2004). 인간과 설치류를 대상으로 한 조사에서도 비슷한 결과가 나왔습니다. 차 식물 오일은 플레어 및 밀 히스타민에 대한 감수성을 감소시켰습니다. 반면 티트리 오일은 소수의 사람들에게서 접촉 알레르기와 관련이 있는 것으로 나타났습니다. 갓 추출한 오일은 온화하거나 중간 정도의 감작제이지만 산화를 거치면 오일의 알레르기 작용이 증가합니다. 오일에는 -테르피넨, 아스카리돌, -펠란드렌, -펠란드렌, 리모넨, 트리하이드록시멘테인과 같은 감작제가 함유되어 있습니다. 대부분의 반응은 티트리 오일을 직접 바르면 발생하며(Ali and Blunden 2002), 경구로 섭취한 티트리 오일은 궁극적으로 전신 접촉 피부염, 인지 혼란, 혼수상태를 유발할 수 있습니다(Jurek and Olszewska 2019).

Nigella sativa

Nigella sativa is a popular therapeutic plant that has a long religious and cultural background in Unani, Ayurvedic, Arabic, and Chinese medicine. Many bioactive natural agents, including alpha-hederin, alkaloids, thymoquinone, and saponins, are found in N. sativa and contribute to its wide spectrum of effects as a bronchodilator, diuretic, antidiabetic, analgesic, antihypertensive, antibacterial, antineoplastic, and anti-inflammatory agent, making it a promising therapeutic for dermatological diseases. Thymoquinone (TQ) is the major bioactive ingredient, accounting for 30–40% of essential oils (Arjumand et al. 2019). TQ's high antioxidant and anti-inflammatory actions have prompted much investigation into its wide spectrum of health benefits. The N. sativa treatment has been proven to dramatically decrease inflammation via TQ-mediated secretion of proinflammatory cytokines as well as eosinophils (Arjumand et al. 2019). Several researchers investigated the impact of TQ on attenuating inflammation of the airways in a rat model of allergic asthma (El-mahdy et al. 2005). TQ intraperitoneal administration prior to airway challenge showed a significant reduction in eosinophilia in the lung, serum IgG and IgE levels, and IL-13, IL-4, and IL-5 proinflammatory Th2 cytokines. N. sativa functions as an antioxidant by enhancing free radical defence by inhibiting elastase, lipid peroxidation, and myeloperoxidase (Sethi et al. 2008). Despite downregulating transcription factors such as NF-B and STAT3 and antiapoptotic BCL2, N. sativa increases cellular death by up-regulating proapoptotic caspases 8, 9, and 3 and the B-cell lymphoma 2 associate X protein (BAX) (Forouzanfar et al. 2016). Because of its antibacterial, anticancer, anti-inflammatory, and other qualities, as well as its capacity to cure hypopigmentation through enhanced melanin distribution, N. sativa has high promise for treating a variety of dermatological diseases. N. sativa is a potential treatment for plaque psoriasis since it has few side effects and is widely available.

니겔라 사티바는 

우나니, 아유르베다, 아랍, 중국 의학에서 

오랜 종교적, 문화적 배경을 가진 인기 있는 치료용 식물입니다. 

알파 헤데린, 알칼로이드, 티모퀴논, 사포닌을 비롯한 많은 생리 활성 천연 물질이 니겔라 사티바에서 발견되며 기관지 확장제, 이뇨제, 항당뇨, 진통제, 항고혈압, 항균, 항종양 및 항염증제로서 광범위한 효과를 발휘하여 피부과 질환에 유망한 치료제로 여겨지고 있습니다. 티모퀴논(TQ)은 에센셜 오일의 30~40%를 차지하는 주요 생리 활성 성분입니다(Arjumand et al. 2019). TQ의 높은 항산화 및 항염증 작용으로 인해 광범위한 건강상의 이점에 대한 많은 연구가 진행되었습니다. N. 사티바 치료는 호산구뿐만 아니라 염증성 사이토카인의 TQ 매개 분비를 통해 염증을 극적으로 감소시키는 것으로 입증되었습니다(Arjumand 외. 2019). 몇몇 연구자들은 알레르기 천식의 쥐 모델에서 기도 염증 완화에 대한 TQ의 영향을 조사했습니다(El-mahdy 외. 2005). 기도 챌린지 전에 TQ를 복강 내 투여한 결과 폐의 호산구 증가증, 혈청 IgG 및 IgE 수치, IL-13, IL-4, IL-5 염증성 Th2 사이토카인이 현저히 감소한 것으로 나타났습니다. N. sativa는 엘라스타제, 지질 과산화 및 미엘로퍼옥시다아제를 억제하여 자유 라디칼 방어를 강화함으로써 항산화제로서 기능합니다(Sethi 등. 2008). NF-B 및 STAT3와 같은 전사인자 및 항아포토시스 BCL2를 하향 조절하지만, N. sativa는 세포사멸 촉진 카스파제 8, 9 및 3과 B세포 림프종 2 연관 X 단백질(BAX)을 상향 조절하여 세포 사멸을 증가시킵니다(Forouzanfar et al. 2016). 항균, 항암, 항염증 및 기타 특성뿐만 아니라 멜라닌 분포 개선을 통한 저색소 침착을 치료하는 능력으로 인해 N. sativa는 다양한 피부과 질환 치료에 대한 높은 잠재력을 가지고 있습니다. N. 사티바는 부작용이 적고 널리 이용 가능하기 때문에 판상 건선의 잠재적 치료제로 주목받고 있습니다.

Olibanum (Boswellia serrata, Triana & Planch.)

Frankincense, also known as olibanum, is a yellowish-brown oleo-gum resin extracted from Boswellia species such as Boswellia serrata (Woolley et al. 2012). The genus Boswellia has around 25 species (Balamurugan et al. 2022). Several previous studies reported that 200 patients with mild to moderate psoriasis were given an olibanum ointment containing 5% 3-O-Acetyl-11-keto-boswellic acid three times per day for twelve weeks. The PASI, as well as other blood indicators including leukotriene B4, TNF, VEGF, and PGE2, were dramatically decreased. Contact dermatitis occurred in 13 individuals (6.5%) (Balamurugan et al. 2022).

유향은 

올리바눔이라고도 하며, 

보스웰리아 세라타와 같은 보스웰리아 종에서 추출한 황갈색 올레오검 수지입니다(Woolley 외. 2012). 

보스웰리아 속에는 약 25종이 있습니다(Balamurugan 외. 2022). 

이전의 여러 연구에 따르면 

경증에서 중등도 건선 환자 200명에게 

5% 3-O-아세틸-11-케토-보스웰산이 함유된 올리바눔 연고를 

12주 동안 하루에 세 번씩 투여했다고 합니다. 

그 결과 PASI는 물론 류코트리엔 B4, TNF, VEGF, PGE2를 포함한 다른 혈액 지표가 크게 감소했습니다. 

13명(6.5%)에서 접촉성 피부염이 발생했습니다(Balamurugan 외. 2022).

Pomegrante

Dried pomegranate, or Punica granatum, seeds are a popular culinary spice. Pomegranate extract flavonoids have been shown in atherosclerotic humans and mice to reduce the oxidation of low-density lipoprotein and cardiovascular disease (Aviram and Dornfeld 2001). Pomegranate juice is known to suppress serum angiotensin-converting enzyme activity and lower systolic blood pressure (Schubert et al. 2002). Pomegranate can reduce NF-B activation in vascular endothelium via a unique method, according to new research (Asogwa and Okoye 2019).

말린 석류 또는 

푸니카 그라나툼 씨앗은 인기 있는 

요리 향신료입니다. 

석류 추출물 플라보노이드는 죽상경화성 인간과 쥐에서 저밀도 지단백질과 심혈관 질환의 산화를 감소시키는 것으로 나타났습니다(Aviram and Dornfeld 2001). 석류 주스는 혈청 안지오텐신 전환 효소 활성을 억제하고 수축기 혈압을 낮추는 것으로 알려져 있습니다(슈베르트 외. 2002). 새로운 연구에 따르면 석류는 독특한 방법을 통해 혈관 내피에서 NF-B 활성화를 감소시킬 수 있다고 합니다(Asogwa and Okoye 2019).

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Conclusion

From this review, it has become clear that naturally derived compounds could very likely become key players in future psoriasis treatments. This article has summarised some of the compounds and plants that have been studied to date for their possible anti-psoriasis properties. Many more untapped resources, however, remain in nature. Phytochemicals have been reported to possess numerous health benefits, and ongoing research is being conducted to determine their physiological effects. The traditional use of natural compounds in psoriasis treatment is relatively cheap due to the availability of plants and the simple methods used in product preparation. However, the commercialization of natural compounds for psoriasis treatment may result in the dwindling of natural resources and problems with producing a consistent quality of adulteration. However, the use of synthetic medications has led to a variety of adverse effects, one of which is psoriasis. In recent years, a study in this sector has provided a variety of treatment options for treating psoriasis. The use of herbal medicine is one such expanding strategy. Several herbs have been demonstrated to have anti-psoriatic capabilities, as discussed within this review. Herbal treatment, on the other hand, is currently limited to a restricted subset of psoriasis patients. Herbal extracts may be used in conjunction with synthetic medications to treat psoriasis. The dual use may lead to a lower synthetic drug dosage as well as a recurrence of the negative effects. To guarantee the safety and effectiveness of psoriasis treatment, the standardisation of herbal medicines necessitates regulatory requirements and quality control processes. To assess the therapeutic efficiency of these natural chemicals, more studies with a larger sample size are necessary. Fresh plant resources should also be examined in this region.

이 리뷰를 통해 

자연 유래 화합물이 향후 건선 치료의 핵심이 될 가능성이 

매우 높다는 것이 분명해졌습니다. 

이 글에서는 

지금까지 연구된 화합물과 식물 중 건선 치료 효과가 있는 것으로 

밝혀진 몇 가지를 요약했습니다. 

그러나 아직 개발되지 않은 더 많은 자원이 자연에 남아 있습니다. 

파이토케미컬은 

수많은 건강상의 이점이 있는 것으로 보고되고 있으며, 

그 생리적 효과를 확인하기 위한 연구가 계속 진행 중입니다. 

건선 치료에 천연 화합물을 사용하는 전통적인 방법은 

식물을 구할 수 있고 제품 제조에 사용되는 방법이 간단하기 때문에 상대적으로 저렴합니다. 

그러나 

건선 치료를 위한 천연 화합물의 상업화로 인해 

천연 자원이 줄어들고 일관된 품질의 제품을 생산하는 데 문제가 발생할 수 있습니다. 

그러나 

합성 약물의 사용은 다양한 부작용을 초래했으며, 

그 중 하나가 건선입니다. 

최근 몇 년 동안 이 분야의 연구를 통해 건선 치료를 위한 다양한 치료 옵션이 제공되었습니다. 한약의 사용은 이러한 확장 전략 중 하나입니다. 이 리뷰에서 논의한 바와 같이 여러 허브가 항 건선 기능이 있는 것으로 입증되었습니다. 반면, 허브 치료는 현재 일부 건선 환자에게만 제한적으로 사용되고 있습니다. 허브 추출물은 건선 치료를 위해 합성 약물과 함께 사용할 수 있습니다. 두 가지 약물을 함께 사용하면 합성 약물의 복용량을 줄일 수 있을 뿐만 아니라 부작용이 재발할 수도 있습니다. 건선 치료의 안전성과 효과를 보장하기 위해 한약의 표준화에는 규제 요건과 품질 관리 프로세스가 필요합니다. 이러한 천연 화학 물질의 치료 효과를 평가하기 위해서는 더 많은 표본을 대상으로 한 더 많은 연구가 필요합니다. 이 지역에서는 신선한 식물 자원도 조사해야 합니다.

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Acknowledgements

The authors would like to sincerely thank the Biochemistry division, chemistry Department, Faculty of Sciences, Mansoura University. We wish to express our scientific appreciation to all the staff members for their help in performing fieldwork. Thanks to all of the study participants.

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Author contributions

All the named authors played an active role in the planning and writing of this publication. ME, SM. MG and AM are students working on this project. OE is the supervisor of the study. All the named authors contributed to the final review as it was submitted to the journal be it by analysis of information, organizing of data and construction of text.

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Funding

Open access funding provided by The Science, Technology & Innovation Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank (EKB).

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Data availability

A standardized approach of herbal medicine, is needed to design larger trials which can ensure the effectiveness of the treatment of psoriasis.Moreover, Further studies using newer herpal plant are essential to establish the efficacy of these natural sources.

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Declarations

Conflict of interest

The authors declare no conflict of interest.

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Footnotes

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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