Chinese and Western Herbal Medicines for the Topical Treatment of Psoriasis - a critical review of Efficacy and Safety

Introduction This critical review of randomized controlled trials (RTCs) was conducted to evaluate the efficacy and safety of herbal products used in the topical treatment of psoriasis. Method Selected databases were systematically searched using keywords. RCTs focusing on mild to moderate psoriasis using herbal topical treatments in comparison either to standard medications or placebo were included. The methodological and reporting quality of included trials was assessed through Cochrane Risk of Bias 2.0 tool (ROB2) and Consolidated Standards of Reporting Trials (CONSORT) 2010 statement (with elaborations for herbal interventions), respectively. Meta-analysis was conducted via Review Manager (RevMan) 5.4 software. 14 RCTs published from 2010 to 2020 were included in this review. Results There is some evidence to suggest that topical herbal treatments are useful in the treatment of psoriasis. The meta-analysis favoured herbal treatment over conventional medicines and placebo and the herbal treatments caused fewer side effects. Indigo naturalis, Hypericum perforatum L. oil (Hypericaceae) and Curcuma longa L. Zingiberaceae (Turmeric) were particularly promising, due to their possible anti-inflammatory effects. Conclusions There is some evidence to suggest the use of topical herbal medicines in the treatment of psoriasis. However, the quality of included RCTs was poor and at a higher risk of bias in many domains. Therefore, larger, better designed and long-term RCTs should be conducted to enhance the quality of the evidence

Non-redundant functions of group 2 innate lymphoid cells

Protective immunity relies on the interplay of innate and adaptive immune cells with complementary and redundant functions. Innate lymphoid cells (ILCs) have recently emerged as tissue-resident, innate mirror images of the T cell system, with which they share lineage-specifying transcription factors and effector machinery. Located at barrier surfaces, ILCs are among the first responders against invading pathogens and thus could potentially determine the outcome of the immune response. However, so far it has not been possible to dissect the unique contributions of ILCs to protective immunity owing to limitations in specific targeting of ILC subsets. Thus, all of the available data have been generated either in mice lacking the adaptive immune system or with tools that also affect other immune cell subsets. In addition, it has been proposed that ILCs might be dispensable for a proper immune response because other immune cells could compensate for their absence. Here we report the generation of a mouse model based on the neuromedin U receptor 1 (Nmur1) promoter as a driver for simultaneous expression of Cre recombinase and green fluorescent protein, which enables gene targeting in group 2 ILCs (ILC2s) without affecting other innate and adaptive immune cells. Using Cre-mediated gene deletion of Id2 and Gata3 in Nmur1-expressing cells, we generated mice with a selective and specific deficiency in ILC2s. ILC2-deficient mice have decreased eosinophil counts at steady state and are unable to recruit eosinophils to the airways in models of allergic asthma. Further, ILC2-deficient mice do not mount an appropriate immune and epithelial type 2 response, resulting in a profound defect in worm expulsion and a non-protective type 3 immune response. In total, our data establish non-redundant functions for ILC2s in the presence of adaptive immune cells at steady state and during disease and argue for a multilayered organization of the immune system on the basis of a spatiotemporal division of labour