- 2024-09-24
- Annals of medicine 56(1)
- Chunxiao Wang
- Panpan Yang
- Jiao Wang
- Liu Liu
- Jiale Chen
- Xiaoce Cai
- Miao Zhang
- Naixuan Lin
- Sihan Wang
- Yuanting Yu
- Linge Li
- Xin Li
Study Design
- Type
- Review
- Population
- patients with psoriasis
- Methods
- Systematic review and meta-analysis of seven databases
Background
Indigo naturalis is effective against psoriasis. Indigo, indirubin and tryptanthrin, the main active components of indigo naturalis, have anti-inflammatory properties.Objective
To evaluate the efficacy and safety of indigo naturalis and its active components in the treatment of psoriasis.Methods
Seven databases were searched for studies of indigo naturalis and its active components for the treatment of psoriasis.Results
The findings demonstrated a higher response rate in the Chinese herbal medicine (CHM) formula groups than in the control group for Psoriasis Area and Severity Index 60 (PASI60) (Rate difference [RD] = 0.22, p < .0001). Among all adverse events, only the incidence of gastrointestinal adverse reactions was higher in the CHM formula group than in the control group (RD = 0.09, p < .0001). In preclinical in vivo studies, indirubin showed better performance in improving the phenotype of psoriasis-like mice compared to that in controls, including the PASI score (mean difference [MD] = -3.58, p < .0001), epidermal thickness (MD = -29.13, p < .0001), interleukin-(IL) 17 A mRNA expression (MD = -2.27, p = .0066) and IL-23 mRNA (MD = -5.36, p = .01).Conclusion
Indigo naturalis combined with conventional treatments is useful for treating psoriasis. Indigo naturalis display anti-proliferative, anti-inflammatory and anti-angiogenic effects by regulating the TAK1, JAK3/STAT3, Wnt/β-catenin, Akt/PKB, FAK and AP-1/c-Jun pathway.