Psoriasis relapse following biologic therapy: current status Article

Wang Wenqiu, Li Chengxin, Wang Rui

Chinese Journal of Dermatology 2025,58(11 ):1090 -1095. DOI:10.35541/cjd.20230301

Abstract （594）

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Tyrosine kinase 2 inhibitors for plaque psoriasis: mechanisms of action and advances in clinical research Article

Yuan Liyan, Yu Xiaoling, Wang Xiaohua, Yang Bin

Chinese Journal of Dermatology 2025,58(11 ):1095 -1098. DOI:10.35541/cjd.20220740

Abstract （436）

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Two cases of erythrodermic psoriasis treated with apremilast Article

Qi Yushuo, Yu Xiaohong, Wang Zhiyi, Li Yuzhen, Song Zhiqi

Chinese Journal of Dermatology 2025,58(11 ):1083 -1085. DOI:10.35541/cjd.20230542

Abstract （251）

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Efficacy and safety of spesolimab in the treatment of six cases of generalized pustular psoriasis: a retrospective analysis Article

Yu Jinlei, Wu Qiaofang, Sun Yuexin, Bao Jun, Zhou Ying

Chinese Journal of Dermatology 2025,58(11 ):1080 -1082. DOI:10.35541/cjd.20240440

Abstract （232）

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Three cases of painful skin ulcers following inappropriate self-use of methotrexate by patients with psoriasis Article

Wang Ruizhe, Wang Huiping, Luo Suju

Chinese Journal of Dermatology 2025,58(11 ):1087 -1089. DOI:10.35541/cjd.20220288

Abstract （229）

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Severe plaque psoriasis in a case of Down syndrome Article

Wei Feng, Zhao Yike, Zhang Xiaoguang, Rong Rong, Li Yanling

Chinese Journal of Dermatology 2025,58(11 ):1085 -1086. DOI:10.35541/cjd.20230105

Abstract （186）

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Biologics combined with glucocorticoids for the treatment of generalized pustular psoriasis of pregnancy: a case report Article

He Jianping, Cheng Hao

Chinese Journal of Dermatology 2025,58(10 ):988 -989. DOI:10.35541/cjd.20230644

Abstract （168）

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Psoriasis-atopic dermatitis overlap phenotype: immune dysregulation mechanisms and emerging clinical insights Article

Song Zhiqiang, He Yuanxiong, Chen Anqi

Chinese Journal of Dermatology 2025,58(11 ):1009 -1014. DOI:10.35541/cjd.20250219

Abstract （100）

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Therapeutic strategies for psoriasis: current status and progress Article

Sun Qing

Chinese Journal of Dermatology 2025,58(11 ):1003 -1008. DOI:10.35541/cjd.20250262

Abstract （84）

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Comparative analysis of clinical characteristics between psoriasis-atopic dermatitis overlap phenotype and psoriasis vulgaris: a single-center retrospective exploratory study Article

He Yuanxiong, Deng Sisi, Song Zhiqiang

Chinese Journal of Dermatology 2025,58(11 ):1027 -1033. DOI:10.35541/cjd.20250416

Abstract （71）

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Save 【Abstract】 Objective To analyze the clinical characteristics between patients with psoriasis-atopic dermatitis overlap （PAO） and those with psoriasis vulgaris （PSO）, and to enhance the understanding of the diagnosis and treatment of this overlap phenotype. Methods A retrospective exploratory study was conducted on clinical data from patients who were diagnosed with PAO or PSO at the Department of Dermatology, Southwest Hospital, Army Medical University between January 2018 and June 2025. Clinical characteristics, laboratory examination results, comorbidities, and treatment regimens were compared between the two groups. Categorical data were compared using the chi-square test or Fisher's exact test; for non-normally distributed measurement data, intergroup comparisons were conducted using the Mann-Whitney U test. Results A total of 103 PSO patients and 13 PAO patients were included. Patients in the PAO group were older than those in the PSO group （M ［Q1, Q3］:63.00 ［54.00, 71.50］ years vs. 50.00 ［38.00, 61.00］ years; Z = 2.75, P = 0.006］. No significant differences were found between the two groups in terms of gender distribution, body mass index, disease duration, personal or family history of atopic diseases （all P > 0.05）. Skin lesions involved the whole body in both PAO and PSO groups, with the trunk and limbs being commonly affected sites, and no significant difference in the lesion distribution was observed （P > 0.05）. Compared with the PSO group, the PAO group had fewer plaque lesions （5/13 ［38.5%］ vs. 70/103 ［68.0%］）, but more eczematous changes such as erosions and exudation, as well as scratches and crusts due to pruritus （all P < 0.05）. Laboratory tests revealed that the PAO group showed increased peripheral blood neutrophil counts, eosinophil counts, serum IgE levels, eosinophil-to-lymphocyte ratios （ELRs）, and neutrophil-to-lymphocyte ratios （NLRs） compared with the PSO group （all P < 0.05）; moreover, the proportions of patients with elevated eosinophil counts （5/13 ［38.5%］ vs. 8/103 ［7.8%］, P < 0.001） and those with elevated serum IgE levels （10/13 ［76.9%］ vs. 39/103 ［37.9%］, P = 0.014） were significantly higher in the PAO group than in the PSO group. Compared with the PSO group, the PAO group had a higher overall comorbidity rate （11/13 ［84.6%］ vs. 52/103 ［50.5%］, P = 0.035）, including a higher prevalence of hypertension. Regarding topical treatments, no significant differences were found in the use frequency of topical glucocorticoids （96 ［93.2%］ vs. 11 ［84.6%］） or vitamin D3 analogs between the two groups （both P > 0.05）; for systemic treatments, immunosuppressants such as cyclosporine （4/13 ［30.8%］ vs. 2/103 ［1.9%］, P = 0.001） and Tripterygium wilfordii （4/13 ［30.8%］ vs. 7/103 ［6.8%］, P = 0.021） were more commonly used in the PAO group compared with the PSO group; for targeted therapies, the PSO group received interleukin （IL）-17A inhibitors （13 cases, 12.6%）, IL-23 inhibitors （4 cases, 3.9%）, or tumor necrosis factor-α inhibitors （5 cases, 4.9%）, while the PAO group received Janus kinase inhibitors （2 cases, 15.4%） or an IL-23 inhibitor （1 case, 7.7%）. Conclusions PAO exhibited characteristics of both PSO and atopic dermatitis, with distinct differences in skin manifestations, laboratory findings, and treatment approaches compared with PSO. Topical glucocorticoids were the primary topical treatment for PAO, while systemic treatment was centered on immunosuppressants, highlighting the need for personalized treatment strategies.

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Clinical efficacy and safety of a domestic calcipotriol/betamethasone dipropionate ointment in the treatment of stable plaque psoriasis: a multicenter, randomized, double-blind, controlled study Article

Xia Lixin, Xiang Guang, Diao Qingchun, Huang Kun, Zhang Shoumin, Li Shanshan, Li Yumei, Song Zhiqiang, Sun Qing, Yang Xiumin, Pan Meng, Shi Yuling, Guo Shuping, Wang Huiping, Lei Tiechi, Zhou Xiaoyong, Geng Songmei, Hou Suchun, Su Juan, Cui Yong, Chen Rixin, Feng Yanyan, Feng Hongxia, Xia Rushan, Meng Zudong, Yin Fang, Wang Jingjing, Gao Xinghua

Chinese Journal of Dermatology 2025,58(11 ):1020 -1026. DOI:10.35541/cjd.20250379

Abstract （60）

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Save 【Abstract】 Objective To evaluate the clinical equivalence between a domestic calcipotriol/betamethasone dipropionate ointment and the originator product in the treatment of stable plaque psoriasis. Methods A multicenter, randomized, double-blind, three-arm, parallel-group, active- and placebo-controlled study was conducted, and 449 patients aged 18 - 65 years with stable plaque psoriasis were enrolled from 25 hospitals （such as the First Affiliated Hospital of China Medical University）. Eligible patients had a baseline physician's global assessment （PGA） score of ≥ 3 points, baseline body surface area （BSA） involvement of 5% - 30%, and a target lesion psoriasis area and severity index （TL-PASI） for plaque elevation of ≥ 3 points. Participants were randomly assigned in a 2:2:1 ratio to the test group （n = 179）, reference group （n = 180）, and placebo group （n = 90）, and applied the domestic calcipotriol/betamethasone dipropionate ointment, originator product, and ointment base respectively, once daily in the evening for 4 weeks. Efficacy and safety were assessed at weeks 1, 2, and 4. The primary efficacy endpoints were the treatment success rates and clinical success rates in each group at week 4. The per-protocol set （PPS） was used for the primary efficacy analysis, and the intention-to-treat （ITT） set for supplementary efficacy analysis. Equivalence between the test and reference preparations was tested using the Cochran-Mantel-Haenszel method adjusted for randomization strata. Superiority of the test and reference preparations over the placebo was also tested. Measurement data were compared among the 3 groups using analysis of variance or non-parametric tests, while treatment success rates, clinical success rates, and incidence rates of adverse reactions were compared using the chi-square test. Results The ITT, PPS, and safety sets included 447, 420, and 448 patients, respectively. In the ITT set, patients were aged 43.6 ± 12.8 years, including 320 （71.6%） males and 127 （28.4%） females, and the disease duration was 11.21 ± 9.05 years; 316 （70.7%） had a PGA score of 3 points and 131 （29.3%） had a PGA score of 4 - 5 points. No significant differences in the baseline characteristics （including age, sex, disease duration and disease severity） were observed among the 3 groups （all P > 0.05）. Based on the PPS analysis, the treatment success rates were 57.9% （99/171） in the test group, 50.3% （86/171） in the reference group, and 7.7% （6/78） in the placebo group, and the clinical success rates were 57.9% （99/171）, 50.3% （86/171）, and 10.3% （8/78）, respectively; both the test and reference groups were superior to the placebo group in both treatment and clinical success rates （all P < 0.001）; the rate differences for treatment success （90% confidence interval ［CI］: -1.3% - 16.4%） and clinical success （90% CI: -1.3% - 16.3%） between the test and reference groups were entirely within the pre-defined equivalence margin （-20% - 20%）. Subgroup analyses by baseline PGA scores: for patients with a baseline PGA score of 3 points, the treatment success rates in the test, reference, and placebo groups were 60.8% （73/120）, 52.1% （62/119）, and 11.1% （6/54）, respectively, and the corresponding clinical success rates were 61.7% （74/120）, 53.8% （64/119）, and 13% （7/54）, respectively; the test and reference groups did not differ significantly in treatment or clinical success rates （both P > 0.05）, but both showed higher success rates than the placebo group （all P < 0.001）; the results of statistical comparisons among the 3 groups in patients with a baseline PGA score of 4 - 5 points were consistent with those observed in patients with a baseline PGA score of 3 points. The percentage reductions in PGA and TL-PASI scores from baseline to weeks 1, 2, and 4 showed significant differences among the 3 groups, which were significantly higher in the test and reference groups than in the placebo group （all P < 0.001）, but did not differ between the test and reference groups （all P > 0.05）. The primary adverse reactions were local skin reactions, such as pruritus, pain, and erythema. The incidence rates of adverse reactions were 8.9% （16/179） in the test group, 7.3% （13/179） in the reference group, and 7.8% （7/90） in the placebo group, with no significant difference among the 3 groups （P > 0.05）. Conclusions The domestic calcipotriol/betamethasone dipropionate ointment demonstrated clinical equivalence to the originator product in the treatment of stable plaque psoriasis, and the two agents exhibited comparable efficacy for patients with varying degrees of disease severity, and were comparable in the speed and degree of clinical improvement, with similar favorable safety profiles.

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Interleukin-27 exerts a protective effect against psoriasis by inhibiting the secretion of interleukin-17A from T cells: a mechanistic study Article

Lan Zhiyi, Chen Zeyu, Zhao Zihan, Zhang Xilin, Gu Jun, Shi Yuling,

Chinese Journal of Dermatology 2025,58(11 ):1034 -1041. DOI:10.35541/cjd.20240437

Abstract （52）

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Save 【Abstract】 Objective To investigate the specific mechanisms underlying the protective effect of interleukin （IL）-27 in the pathogenesis of psoriasis. Methods Five skin tissue samples from healthy individuals and 6 lesional skin samples from psoriasis patients were collected, and IL-27 expression was determined by immunohistochemical staining. Il27ra gene knockout （KO） mice were constructed. Psoriasis-like mouse models were established with topical imiquimod in 5 wild-type （WT） mice and 6 KO mice. Mouse skin lesions were evaluated using the modified Psoriasis Area and Severity Index （mPASI）, and lesional skin tissues were collected for hematoxylin and eosin （HE） staining to observe changes in epidermal thickness. Single-cell suspensions were prepared with skin lesions and skin-draining lymph nodes of 4 WT mice and 3 KO mice, and changes in immune cells （including T cells, γδ T cells, and neutrophils） were analyzed using flow cytometry. Additionally, skin-draining lymph node cells were isolated from 9 normal WT mice, and IL-17A expression was stimulated using a T-cell receptor agonist （CD3/28 activating antibodies, αCD3/28） or cytokines （IL-23 + IL-1β）, followed by the addition of IL-27; peripheral blood mononuclear cells （PBMCs） were isolated from 6 psoriasis patients, and IL-17A expression was stimulated using the T-cell receptor agonist, followed by the addition of IL-27; the effect of IL-27 on IL-17A expression in T cells was analyzed using flow cytometry and enzyme-linked immunosorbent assay （ELISA）. Measurement data were compared between two groups using the t test. Results Immunohistochemical staining revealed a significant reduction in IL-27 expression in psoriatic lesions （mean fluorescence intensity: 9.85 ± 3.07） compared with the normal skin （19.45 ± 2.51, t = 5.60, P < 0.001）. Animal experiments demonstrated that the KO mice exhibited significantly aggravated psoriasis-like skin inflammation （mPASI: 4.00 ± 0.89） and significantly increased epidermal thickness （115.50 ± 7.69 μm） compared with the WT mice （mPASI: 2.80 ± 0.84, t = 2.28, P = 0.049; epidermal thickness: 92.26 ± 8.76 μm, t = 4.70, P = 0.001）; compared with the WT mice, the KO mice showed significantly increased proportions of T cells （11.22% ± 2.76% vs. 7.08% ± 0.85%） and dermal γδ T cells （4.78% ± 0.39% vs. 2.78% ± 0.49%） among live cells in the lesions （t = 2.91, 2.75, respectively, both P < 0.05）, as well as significantly increased proportions of Th17, IL-17+ γδ T, Th22, and IL-22+ γδ T cells in the skin-draining lymph nodes （all P < 0.05）, but no significant difference in the proportion of neutrophils in the lesions （WT: 13.57% ± 8.36%, KO: 14.43% ± 9.13%; t = 0.13, P = 0.902）. Experiments with different stimuli showed that IL-27 significantly suppressed T-cell receptor agonist-induced IL-17A expression in murine γδ T cells （αCD3/28 group: 1.00 ± 0.11, αCD3/28 + IL-27 group: 0.76 ± 0.13; t = 3.54, P = 0.004）, while there was no significant difference in IL-17A expression between cells induced by IL-23 + IL-1β with the IL-27 co-culture and those without （t = 1.34, P > 0.05）. ELISA showed that IL-27 significantly reduced the IL-17A concentration in the culture supernatant of draining lymph node cells stimulated by the T-cell receptor agonist （αCD3/28 group: 1 535.00 ± 97.76 pg/ml, αCD3/28 + IL-27 group: 1 030.00 ± 287.90 pg/ml, t = 3.29, P = 0.031）, but did not reduce the IL-17A concentration induced by IL-23 + IL-1β （t = 0.09, P > 0.05）. Flow cytometry indicated that IL-27 significantly inhibited the T-cell receptor agonist-induced IL-17A expression in T cells from psoriasis patients （αCD3/28 group: 4.28 ± 3.25, αCD3/28 + IL-27 group: 3.04 ± 2.65, t = 4.46, P = 0.007）. Conclusion IL-27 appeared to play a protective role in psoriasis by suppressing IL-17A secretion from T cells.

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A cross-sectional study on knowledge, treatment needs, and optimization of chronic disease management pathways regarding biologics in patients with psoriasis Article

Wang Fan, Xing Xiaoyi, Wang Rui, Liu Huan, Liu Qian, Yu Chen

Chinese Journal of Dermatology 2025,58(11 ):1059 -1063. DOI:10.35541/cjd.20250269

Abstract （47）

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Save 【Abstract】 Objective To explore the cognitive characteristics, influencing factors, and treatment needs regarding biologic agents among patients with psoriasis. Methods A cross-sectional study was conducted. Patients with psoriasis attending the Department of Dermatology, Xijing Hospital, Air Force Medical University were selected from October to December 2022, and from June to December 2023. A self-designed electronic questionnaire was used for investigation, covering demographic characteristics, psoriasis history （disease types, disease duration, previous treatments, etc.）, biologics knowledge （sources of awareness, core cognitive dimensions）, and treatment needs. Results The valid questionnaire response rate reached 93.2% （439/471）. The ages of enrolled patients were 35.95 ± 12.57 years, and the disease duration was 7.90 ± 3.26 years. Psoriasis vulgaris was the predominant type （363 cases, 82.69%）. The overall awareness rate of biologics slightly increased from 68.62% （105/153） in 2022 to 72.38% （207/286） in 2023 （P > 0.05）. Primary information sources included new media （WeChat/internet） platforms （168 cases, 53.84%） and peer-to-peer sharing （115 cases, 36.86%）, while physician counseling merely accounted for 9.29% （29 cases）（P < 0.001）. Insufficient knowledge of biologics was manifested primarily as poor awareness of comorbidities （47.60%, 209/439） and treatment monitoring protocols （22.32%, 98/439）. Core concerns regarding biologic therapy included safety （73.34%, 322/439）, economic burden （65.14%, 286/439）, and long-term efficacy （63.55%, 279/439）; 60.13% （264/439） of the patients expected rapid improvement of skin symptoms. As for treatment modalities, 90.20% （396/439） of the patients preferred regimens with extended dosing intervals. Conclusions The patients with psoriasis demonstrated an imbalance in their cognitive structure regarding biologic agents. Their treatment needs exhibited multidimensional characteristics, emphasizing not only rapid clearance of skin lesions but also greater importance of treatment safety and cost-effectiveness.

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Characteristics of psoriatic arthritis: a cross-sectional study based on a cohort of 530 patients Article

Gao Jingya, Wang Yiyi, Hu Hongxiang, Peng Xiya, Yang Min, Zhang Lingyan, Tang Jing, Xiao Yue, Hao Dan, Zhou Xingli, Yan Wei, Li Wei

Chinese Journal of Dermatology 2025,58(11 ):1053 -1058. DOI:10.35541/cjd.20250198

Abstract （45）

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Save 【Abstract】 Objective To investigate disease characteristics of patients with psoriatic arthritis （PsA） based on the PsA cohort in West China Hospital, so as to provide a reference for clinicians in its diagnosis, treatment, and evaluation strategy formulation. Methods A cross-sectional study was carried out, and a descriptive analysis was conducted on clinical data from PsA patients who were treated at the Department of Dermatology, West China Hospital, Sichuan University between April 2, 2020, and January 21, 2025. Demographic characteristics, clinical manifestations, laboratory and imaging findings, and treatment modalities were analyzed. Results A total of 530 PsA patients were included, of whom 332 （62.6%） were males and 198 （37.4%） were females, with ages of 44.1 ± 12.4 years. Skin lesions preceded joint symptoms in 452 patients （85.3%）, with time intervals （M ［Q1, Q3］） of 8.0 （3.0, 15.0） years. Overweight or obesity was observed in 319 patients （60.2%）, and 188 （35.5%） had comorbid fatty liver. Peripheral joint involvement was common （485 cases, 91.5%）, with the proximal interphalangeal joints being most frequently affected by tenderness （172 cases, 35.5%） and swelling （119 cases, 24.5%）; the number of enthesitis cases identified by ultrasonography （116 cases, 23.9%） was significantly higher than that by clinical examination （82 cases, 15.5%）; axial joint involvement was observed in 258 patients （48.7%）, with the sacroiliac joints most commonly affected （201 cases, 77.9%）. Regarding treatment, conventional systemic drugs were predominant in the treatment of psoriasis prior to the diagnosis of PsA; after the diagnosis of PsA, the number of patients receiving targeted therapies increased to 334 （63.0%）, with interleukin-17 inhibitors being the most common （140 cases, 26.4%）, followed by tumor necrosis factor-α inhibitors （106 cases, 20.0%） and Janus kinase inhibitors （39 cases, 7.4%）. Conclusions PsA predominantly affects males over 40 years old and is characterized by preceding skin lesions, delayed diagnosis, and multiple comorbidities. High-frequency ultrasound has advantages in the early detection of peripheral enthesitis. Further attention is needed for managing comorbidities such as fatty liver and obesity-related metabolic conditions.

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Efficacy and safety of biologics in plaque psoriasis patients with thrombocytopenia: a single-center retrospective cohort study Article

Wang Xiaoyu, Zhang Qian, Ma Yi, Zhang Hua, Li Jun, Dong Fei, Wang Wenhui

Chinese Journal of Dermatology 2025,58(11 ):1075 -1079. DOI:10.35541/cjd.20230400

Abstract （45）

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Investigations into the mechanisms underlying the regulatory effect of EPHA2 on keratinocyte proliferation and differentiation via ERK pathway in psoriasis Article

Jiang Xingyu, Yu Zengyang, Ma Rui, Shi Rongcan, Huang Dawei, Wang Yuanyuan, Cai Jiangluyi, Shi Yuling,

Chinese Journal of Dermatology 2025,58(11 ):1042 -1052. DOI:10.35541/cjd.20240655

Abstract （42）

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Save 【Abstract】 Objective To investigate the expression of ephrin type-A receptor 2 （EPHA2） in psoriatic lesions and its effect on the proliferation and differentiation of normal human epidermal keratinocytes （NHEKs）. Methods The GDS4602 dataset from the Gene Expression Omnibus （GEO） database was analyzed to determine EPHA2 gene expression changes in psoriatic lesions. Skin tissue samples were collected from 3 psoriasis patients and 3 healthy controls, and EPHA2 expression was determined in the skin tissues by immunofluorescence staining. Twelve female BALB/c mice were randomly divided into 3 groups （4 mice in each group）: a normal control group （receiving no treatment）, an imiquimod group （topically treated with 62.5 mg of imiquimod 5% cream）, and an imiquimod + ALWⅡ-41-27 group （topically treated with 62.5 mg of imiquimod 5% cream, followed by intraperitoneal injections of the EPHA2 inhibitor ALWⅡ-41-27 at a dose of 20 mg·kg?1·d?1）; after 6 days of treatment, dorsal skin samples were harvested for hematoxylin-eosin （HE） staining, immunofluorescence staining was performed to determine the expression of EPHA2 and phosphorylated extracellular signal-regulated kinase 1/2 （p-ERK1/2）, and real-time fluorescence-based quantitative PCR （qPCR） was conducted to determine the mRNA expression of the nuclear proliferation antigen Ki67, involucrin （Ivl）, loricrin （Lor）, and keratin 10 （Krt10）. In vitro cultured NHEKs were divided into a control group （receiving no treatment）, an M5 group （treated with 10 ng/ml M5 cytokines ［including interleukin-17A, interleukin-22, interleukin-1α, oncostatin M and tumor necrosis factor-α］）, an ALWⅡ-41-27 group （treated with 1 μmol/L ALWⅡ-41-27）, and an M5 + ALWⅡ-41-27 group （treated with 10 ng/ml M5 and 1 μmol/L ALWⅡ-41-27）; after 24 hours of treatment, the 5-ethynyl-2'-deoxyuridine （EdU） assay was performed to assess cellular proliferative activity, Western blot analysis to determine the expression of EPHA2, ERK and their phosphorylated proteins, and qPCR to determine the mRNA expression of KI67, IVL, LOR, and KRT10. One-way analysis of variance, Dunnett's T3 test, two-independent-sample t test, and paired t test were used for statistical analysis. Results GEO database analysis revealed upregulated EPHA2 expression in psoriatic lesions compared with normal skin tissues from healthy controls （t = 21.07, P < 0.001）. Immunofluorescence staining showed increased EPHA2 expression in skin tissues from psoriasis patients and mouse models of psoriasis compared with those from healthy controls and normal control mice, respectively （both P < 0.01）. In the animal experiments, the imiquimod group showed thicker epidermis, increased Ki67 mRNA expression, decreased mRNA expression of Ivl, Lor, and Krt10, and elevated p-ERK1/2 expression compared with the normal control group and imiquimod + ALWⅡ-41-27 group （all P < 0.05）. In the cell experiments, the M5 group showed an increased proportion of EdU-positive cells （35.61% ± 1.18% vs. 24.83% ± 0.60% and 12.49% ± 1.52%, t = 8.12, 12.00, P = 0.015, 0.001, respectively）, increased KI67 mRNA expression, and decreased mRNA expression of IVL, LOR, and KRT10 compared with the control group and M5 + ALWⅡ-41-27 group （all P < 0.05）; Western blot analysis revealed that the expression levels of EPHA2, p-EPHA2, and p-ERK1/2 in NHEKs were significantly higher in the M5 group than in the control group and M5 + ALWⅡ-41-27 group （all P < 0.05）, but there was no significant difference in the ERK1/2 protein expression among groups （P > 0.05）. Conclusion EPHA2 expression was upregulated in psoriatic lesions, which may promote keratinocyte proliferation and inhibit its differentiation, possibly via the ERK pathway.

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Huanglian Jiedu decoction combined with Xijiao Dihuang decoction for the treatment of psoriasis via influencing fibroblast activation-mediated keratinocyte proliferation: a mechanistic study Article

Peng Youhua, Gao Guiyun, Liu Chao, Li Jinglin, Zhang Mengyao, Dai Jing, Chen Yao, Liu Junqi, Wang Xudong

Chinese Journal of Dermatology 2025,58(11 ):1064 -1074. DOI:10.35541/cjd.20250033

Abstract （40）

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Save 【Abstract】 Objective To explore the mechanisms of action of Huanglian Jiedu decoction combined with Xijiao Dihuang decoction （HLJDT-XJDH） in regulating fibroblasts in the treatment of psoriasis. Methods A mouse model of psoriasis was established by topical application of imiquimod 5% cream on the shaved back; HLJDT-XJDH at different doses of 7.7 and 30.6 g/kg was administered via gavage for intervention, and methotrexate （2 mg/kg） served as a positive control; after 7 days, the severity of skin lesions was assessed using the psoriasis area and severity index （PASI）, while histopathological changes of skin tissues were evaluated using hematoxylin-eosin （HE） staining and Baker scoring. For in vitro experiments, fibroblasts were divided into a control group, a model group, a low-dose （5% drug-containing serum） intervention group, and a high-dose （20% drug-containing serum） intervention group; cells in the control group were cultured with 20% normal rat serum for 24 hours; in the model group, cells cultured with 20% normal rat serum were stimulated with 5 ng/ml tumor necrosis factor （TNF）-α and 50 ng/ml interleukin （IL）-17A for 24 hours to mimic fibroblasts during the occurrence of psoriasis; cells in the low- and high-dose intervention groups received the same stimulation as the model group, and were cultured for 24 hours with 5% and 20% HLJDT-XJDH-containing serum, respectively, but not with the 20% normal rat serum. After the above treatment, these cells were co-cultured with keratinocytes （HaCaT cells） using a Transwell system. In addition, on the basis of the control group, fibroblasts were divided into the model group, 20% drug-containing serum intervention group, and 20% drug-containing serum intervention + OE-SFRP2 group; TNF-α and IL-17A were used to stimulate the cells to simulate the psoriatic state; the treatment in the 20% drug-containing serum intervention group was carried out as previously described; in the 20% drug-containing serum intervention + OE-SFRP2 group, cells were transfected with the vector for 48 hours to establish an overexpression model, followed by culture with 20% drug-containing serum for 24 hours, without co-culture with HaCaT cells.. Cell counting kit-8 （CCK-8） assay was performed to assess cell viability, flow cytometry to measure apoptosis rates, enzyme-linked immunosorbent assay （ELISA） to detect levels of inflammatory cytokines （TNF-α, IL-1β, IL-6） as well as chemokine ligand （CXCL） 1 and CXCL12 in mouse serum or cell culture supernatant, qPCR to determine the mRNA expression of inflammatory cytokines, chemokines, cell cycle- and proliferation-related factors, as well as SFRP2 in mouse skin tissues or cells, and Western blot analysis to determine the protein expression of SFRP2, Wnt3a, and β-catenin in fibroblasts. One-way analysis of variance was employed for intergroup comparisons, and post-hoc analysis was conducted using Tukey′s test. Results In vivo mouse experiments showed that compared with the normal control group, the model group exhibited typical psoriatic characteristics in skin morphology, including significant inflammatory infiltration in skin tissues and marked epidermal thickening; compared with the normal control group, the serum levels of TNF-α （531.16 ± 28.27 pg/ml vs. 239.58 ± 10.39 pg/ml）, IL-1β （111.40 ± 5.16 pg/ml vs. 80.35 ± 3.87 pg/ml）, and IL-6 （109.17 ± 4.84 pg/ml vs. 71.73 ± 2.04 pg/ml） significantly increased in the model group, along with their mRNA expression levels in mouse skin tissues （all P < 0.001）; compared with the model group, the treatment group showed alleviated psoriatic manifestations, and significant reductions in the levels of inflammatory factors TNF-α （low-dose, high-dose, and positive control groups: 420.80 ± 29.30 pg/ml, 322.33 ± 9.40 pg/ml, 322.97 ± 12.16 pg/ml, respectively）, IL-1β （98.69 ± 4.49 pg/ml, 89.02 ± 1.56 pg/ml, 88.88 ± 2.08 pg/ml, respectively）, and IL-6 （94.07 ± 3.76 pg/ml, 80.54 ± 3.30 pg/ml, 83.21 ± 3.18 pg/ml, respectively）, as well as in their mRNA expression levels （all P < 0.001）. In in vitro fibroblast experiments, compared with the control group, the model group exhibited a significant elevation in the supernatant levels of IL-1β （126.42 ± 3.56 pg/ml vs. 34.81 ± 0.44 pg/ml）, IL-6 （459.44 ± 9.35 pg/ml vs. 115.51 ± 7.26 pg/ml）, CXCL1 （2 434.88 ± 127.63 pg/ml vs. 762.85 ± 30.60 pg/ml） and CXCL12 （3 542.14 ± 35.86 pg/ml vs. 2 095.86 ± 45.12 pg/ml）, the expression levels of their mRNAs （all P < 0.001）, as well as the protein expression levels of SFRP2, Wnt3a, and β-catenin; after intervention with HLJDT-XJDH-containing serum, all the above indices significantly decreased （all P < 0.001）. However, when 20% drug-containing serum intervention was administered simultaneously, the expression of inflammatory factors and chemokines in fibroblasts was significantly higher in the SFRP2 overexpression group than in the non-overexpression group （all P < 0.01）. When fibroblasts were co-cultured with HaCaT cells, the model group showed significantly increased cell viability but a decreased apoptosis rate of HaCaT cells compared with the control group, while the low- and high-dose intervention groups showed significantly decreased cell viability but increased apoptosis rates of HaCaT cells compared with the model group （all P < 0.05）. Conclusion HLJDT-XJDH may exert therapeutic effects in psoriasis by downregulating the SFRP2/Wnt/β-catenin signaling pathway, thereby inhibiting fibroblast activation and inflammatory process, which subsequently suppresses the proliferation of keratinocytes and the activation of inflammatory cells.

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Treatment and diagnosis of generalized pustular psoriasis: advances, challenges, and prospects Article

Shao Shuai, Wang Gang

Chinese Journal of Dermatology 2025,58(11 ):1015 -1019. DOI:10.35541/cjd.20250249

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