Zeitschrift für Phytotherapie 2023; 44(02): 52-60
DOI: 10.1055/a-2039-0454
Forschung

Die Möglichkeiten der Phytotherapie bei entzündlichen Hautkrankheiten

Phytotherapy for Inflammatory Skin Diseases
Ute Wölfle
1   Forschungszentrum skintegral, Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg
,
Julia Hoffmann
1   Forschungszentrum skintegral, Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg
,
Christoph Schempp
1   Forschungszentrum skintegral, Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg
› Author Affiliations

Zusammenfassung

In den letzten Jahren wurden einige neue pflanzliche Arzneimittel, Medizinprodukte und Hautpflegemittel für die topische Behandlung von entzündlichen Hauterkrankungen entwickelt. Besonders gut belegt ist die Wirksamkeit von Inhaltsstoffen aus dem Süßholz bei der atopischen Dermatitis und von Indigo-Extrakten bei der Psoriasis. Ein neuer vielversprechender Therapieansatz zur äußerlichen Behandlung einer geschädigten Hautbarriere sind Bitterstoffe, die an Bitterstoff-Rezeptoren der Haut binden und die Keratin- und Lipidsynthese der Keratinozyten anregen. Weitere pflanzliche Wirkstoffe für die Behandlung von Rosazea und Akne vulgaris werden ebenfalls besprochen, wie z. B. Extrakte aus dem Grüntee, der Blutwurz oder dem Hopfen.

Abstract

During the last years, several new herbal drugs, medical products and cosmetics were developed for the treatment of inflammatory skin diseases. The best studied botanicals are licorice extract for atopic dermatitis and indigo extract for psoriasis. Bitter agents are new promising active ingredients for the topical treatment of skin conditions with an impaired skin barrier. Bitter agents bind to epidermal bitter taste receptors that stimulate the formation of keratins and lipids in keratinocytes. Herbal extracts for the treatment of rosacea and acne vulgaris are also discussed, e. g., from green tea, tormentil rhizome, and hops.



Publication History

Article published online:
24 April 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Reuter J, Wölfle U, Weckesser S. et al. Which plant for which skin disease? Part 1: Atopic dermatitis, psoriasis, acne, condyloma and Herpes simplex. J Dtsch Dermatol Ges – JDDG 2010; 8: 788-796 DOI: 10.1111/j.1610-0387.2010.07496.x.
  • 2 Reuter J, Wölfle U, Korting HC. et al. Which plant for which skin disease? Part 2: Dermatophytes, chronic venous insufficiency, photoprotection, actinic keratoses, vitiligo, hair loss, cosmetic indications. J Dtsch Dermatol Ges – JDDG 2010; 8: 866-873 DOI: 10.1111/j.1610-0387.2010.07472.x.
  • 3 Hoffmann J, Wölfle U, Schempp C. Phytotherapie bei entzündlichen Hauterkrankungen. Akt Dermatol 2019; 45: 325-331
  • 4 Hoffmann J, Gendrisch F, Schempp CM. et al. New herbal biomedicines for the topical treatment of dermatological disorders. Biomedicines 2020; 8: 27 DOI: 10.3390/biomedicines8020027.
  • 5 Vieira BL, Lim NR, Lohman ME. et al. Complementary and alternative medicine for atopic dermatitis: An evidence-based review. Am J Clin Dermatol 2016; 17: 557-581 DOI: 10.1007/s40257-016-0209-1.
  • 6 Leuner K, Kraus M, Boehnke WH et al. Hyperforin-haltige Dermatika bei Neurodermitis. Dtsch Apotheker Ztg 2010; 150 (19): 45. Im Internet: https://www.deutsche-apotheker-zeitung.de/daz-az/2010/daz-19-2010/hyperforin-haltige-dermatika-bei-neurodermitisZugriff: 17.03.2023
  • 7 Wölfle U, Seelinger G, Schempp CM. Topical application of St. John’s wort (Hypericum perforatum). Planta Med 2014; 80: 109-120 DOI: 10.1055/s-0033-1351019.
  • 8 Schempp CM, Windeck T, Hezel S. et al. Topical treatment of atopic dermatitis with St. John’s wort cream – a randomized, placebo controlled, double blind half-side comparison. Phytomedicine 2003; 10: 31-37 DOI: 10.1078/1433-187X-00306.
  • 9 Heinrich U, Tronnier H. Johanniskraut-Extrakt zur Pflege der atopischen Haut. Kosmet Med 2003; 24: 3-4
  • 10 Yang R, Wang L, Yuan B. et al. The pharmacological activities of licorice. Planta Med 2015; 81: 1654-1669 DOI: 10.1055/s-0035-1557893.
  • 11 Lee YM, Hirota S, Jippo-Kanemoto T. et al. Inhibition of histamine synthesis by glycyrrhetinic acid in mast cells cocultured with Swiss 3T3 fibroblasts. Int Arch Allergy Immunol 1996; 110: 272-277 DOI: 10.1159/000237298.
  • 12 Afnan Q, Adil MD, Nissar-Ul A. et al. Glycyrrhizic acid (GA), a triterpenoid saponin glycoside alleviates ultraviolet-B irradiation-induced photoaging in human dermal fibroblasts. Phytomedicine 2012; 19: 658-664 DOI: 10.1016/j.phymed.2012.03.007.
  • 13 Farrukh MR, Nissar U-A, Kaiser PJ. et al. Glycyrrhizic acid (GA) inhibits reactive oxygen Species mediated photodamage by blocking ER stress and MAPK pathway in UV-B irradiated human skin fibroblasts. J Photochem Photobiol B 2015; 148: 351-357 DOI: 10.1016/j.jphotobiol.2015.05.003.
  • 14 Yu H, Li H, Li Y. et al. Effect of isoliquiritigenin for the treatment of atopic dermatitis-like skin lesions in mice. Arch Dermatol Res 2017; 309: 805-813 DOI: 10.1007/s00403-017-1787-3.
  • 15 Kühnl J, Roggenkamp D, Gehrke SA. et al. Licochalcone A activates Nrf2 in vitro and contributes to licorice extract-induced lowered cutaneous oxidative stress in vivo. Exp Dermatol 2015; 24: 42-47 DOI: 10.1111/exd.12588.
  • 16 Song NR, Kim J-E, Park JS. et al. Licochalcone A, a polyphenol present in licorice, suppresses UV-induced COX-2 expression by targeting PI3K, MEK1, and B-Raf. Int J Mol Sci 2015; 16: 4453-4470 DOI: 10.3390/ijms16034453.
  • 17 Sulzberger M, Worthmann A-C, Holtzmann U. et al. Effective treatment for sensitive skin: 4-t-butylcyclohexanol and licochalcone A. J Eur Acad Dermatol Venereol JEADV 2016; 30: 9-17 DOI: 10.1111/jdv.13529.
  • 18 Adult Atopiclair Study Group. Abramovits W, Boguniewicz M. A multicenter, randomized, vehicle-controlled clinical study to examine the efficacy and safety of MAS063DP (Atopiclair) in the management of mild to moderate atopic dermatitis in adults. J Drugs Dermatol JDD 2006; 5: 236-244
  • 19 Angelova-Fischer I, Rippke F, Richter D. et al. Stand-alone emollient treatment reduces flares after discontinuation of topical steroid treatment in atopic dermatitis: A double-blind, randomized, vehicle-controlled, left-right comparison study. Acta Derm Venereol 2018; 98: 517-523 DOI: 10.2340/00015555-2882.
  • 20 Seiwerth J, Tasiopoulou G, Hoffmann J. et al. Anti-inflammatory effect of a novel topical herbal composition (VEL-091604) consisting of gentian root, licorice root and willow bark extract. Planta Med 2019; 85: 608-614 DOI: 10.1055/a-0835-6806.
  • 21 Wölfle U, Hoffmann J, Haarhaus B. et al. Anti-inflammatory and vasoconstrictive properties of Potentilla erecta – A traditional medicinal plant from the northern hemisphere. J Ethnopharmacol 2017; 204: 86-94 DOI: 10.1016/j.jep.2017.03.058.
  • 22 Hoffmann J, Wölfle U, Schempp CM. et al. Gerbstoffe aus Potentilla officinalis wirken entzündungshemmend im UV-Erythem-Test und bei Anwendung auf atopischer Haut. J Dtsch Dermatol Ges – JDDG 2016; 14: 917-923 DOI: 10.1111/ddg.12792_g.
  • 23 Saller R, Melzer J, Uehleke B. et al. Phytotherapeutische Bittermittel. Schweiz Zschr Ganzheitsmed 2009; 21: 200-205
  • 24 Wölfle U, Elsholz FA, Kersten A. et al. Expression and functional activity of the bitter taste receptors TAS2R1 and TAS2R38 in human keratinocytes. Skin Pharmacol Physiol 2015; 28: 137-146 DOI: 10.1159/000367631.
  • 25 Wölfle U, Haarhaus B, Seiwerth J. et al. The herbal bitter drug Gentiana lutea modulates lipid synthesis in human keratinocytes in vitro and in vivo. Int J Mol Sci 2017; 18: 1814 DOI: 10.3390/ijms18081814.
  • 26 Wölfle U, Schempp CM. Bitterstoffe – von der traditionellen Verwendung bis zum Einsatz an der Haut. Z Phytother 2018; 39: 210-215 DOI: 10.1055/a-0654-1711.
  • 27 Morse NL, Clough PM. A meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries?. Curr Pharm Biotechnol 2006; 7: 503-524
  • 28 Farahnik B, Sharma D, Alban J. et al. Topical botanical agents for the treatment of psoriasis: A systematic review. Am J Clin Dermatol 2017; 18: 451-468 DOI: 10.1007/s40257-017-0266-0.
  • 29 Gamret AC, Price A, Fertig RM. et al. Complementary and alternative medicine therapies for psoriasis: A systematic review. JAMA Dermatol 2018; 154: 1330-1337 DOI: 10.1001/jamadermatol.2018.2972.
  • 30 Waller JM, Dreher F, Behnam S. et al. ‛Keratolytic’ properties of benzoyl peroxide and retinoic acid resemble salicylic acid in man. Skin Pharmacol Physiol 2006; 19: 283-289 DOI: 10.1159/000093984.
  • 31 van de Kerkhof PCM, van der Valk PGM, Swinkels OQJ. et al. A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: a randomized controlled trial of supervised treatment of psoriasis vulgaris in a day-care setting. Br J Dermatol 2006; 155: 800-807 DOI: 10.1111/j.1365-2133.2006.07393.x.
  • 32 Markham T, Rogers S, Collins P. Narrowband UV-B (TL-01) phototherapy vs oral 8-methoxypsoralen psoralen-UV-A for the treatment of chronic plaque psoriasis. Arch Dermatol 2003; 139: 325-328
  • 33 Vongthongsri R, Konschitzky R, Seeber A. et al. Randomized, double-blind comparison of 1 mg/L versus 5 mg/L methoxsalen bath-PUVA therapy for chronic plaque-type psoriasis. J Am Acad Dermatol 2006; 55: 627-631 DOI: 10.1016/j.jaad.2006.05.024.
  • 34 Amornpinyokeit N, Asawanonda P. 8-Methoxypsoralen cream plus targeted narrowband ultraviolet B for psoriasis. Photodermatol Photoimmunol Photomed 2006; 22: 285-289 DOI: 10.1111/j.1600-0781.2006.00249.x.
  • 35 Bernstein S, Donsky H, Gulliver W. et al. Treatment of mild to moderate psoriasis with Reliéva, a Mahonia aquifolium extract – a double-blind, placebo-controlled study. Am J Ther 2006; 13: 121-126
  • 36 Lin Y-K, Chang C-J, Chang Y-C. et al. Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis. Arch Dermatol 2008; 144: 1457-1464 DOI: 10.1001/archderm.144.11.1457.
  • 37 Cheng H-M, Wu Y-C, Wang Q. et al. Clinical efficacy and IL-17 targeting mechanism of indigo naturalis as a topical agent in moderate psoriasis. BMC Complement Altern Med 2017; 17: 439 DOI: 10.1186/s12906-017-1947-1.
  • 38 Lin Y-K, See L-C, Huang Y-H. et al. Comparison of indirubin concentrations in indigo naturalis ointment for psoriasis treatment: a randomized, double-blind, dosage-controlled trial. Br J Dermatol 2018; 178: 124-131 DOI: 10.1111/bjd.15894.
  • 39 Antiga E, Bonciolini V, Volpi W. et al. Oral curcumin (Meriva) is effective as an adjuvant treatment and is able to reduce IL-22 serum levels in patients with psoriasis vulgaris. BioMed Res Int 2015; 2015: 283634 DOI: 10.1155/2015/283634.
  • 40 Heng MC, Song MK, Harker J. et al. Drug-induced suppression of phosphorylase kinase activity correlates with resolution of psoriasis as assessed by clinical, histological and immunohistochemical parameters. Br J Dermatol 2000; 143: 937-949
  • 41 Reddy S, Aggarwal BB. Curcumin is a non-competitive and selective inhibitor of phosphorylase kinase. FEBS Lett 1994; 341: 19-22
  • 42 Varma SR, Sivaprakasam TO, Mishra A. et al. Imiquimod-induced psoriasis-like inflammation in differentiated Human keratinocytes: Its evaluation using curcumin. Eur J Pharmacol 2017; 813: 33-41 DOI: 10.1016/j.ejphar.2017.07.040.
  • 43 Nardo VD, Gianfaldoni S, Tchernev G. et al. Use of curcumin in psoriasis. Open Access Maced J Med Sci 2018; 6: 218-220 DOI: 10.3889/oamjms.2018.055.
  • 44 Schrott E. Weihrauch. Bielefeld: Aurum/Kamphausen;; 2007
  • 45 Majeed M, Nagabhushanam K, Natarajan S. et al. Clinical evaluation of AKBBA in the management of psoriasis. Clinical Dermatology 2014; 2: 17-24
  • 46 Leuner K, Kazanski V, Müller M. et al. Hyperforin – a key constituent of St. John’s wort specifically activates TRPC6 channels. FASEB J Off Publ Fed Am Soc Exp Biol 2007; 21: 4101-4111 DOI: 10.1096/fj.07-8110com.
  • 47 Leuner K, Kraus M, Woelfle U. et al. Reduced TRPC channel expression in psoriatic keratinocytes is associated with impaired differentiation and enhanced proliferation. PLoS One 2011; 6: e14716 DOI: 10.1371/journal.pone.0014716.
  • 48 Najafizadeh P, Hashemian F, Mansouri P. et al. The evaluation of the clinical effect of topical St Johns wort (Hypericum perforatum L.) in plaque type psoriasis vulgaris: a pilot study. Australas J Dermatol 2012; 53: 131-135 DOI: 10.1111/j.1440-0960.2012.00877.x.
  • 49 Mansouri P, Mirafzal S, Najafizadeh P. et al. The impact of topical Saint John’s Wort (Hypericum perforatum) treatment on tissue tumor necrosis factor-alpha levels in plaque-type psoriasis: A pilot study. J Postgrad Med 2017; 63: 215-220 DOI: 10.4103/0022-3859.201423.
  • 50 Gendrisch F, Haarhaus B, Krieger N. et al. The effect of herbal medicinal products on psoriasis-like keratinocytes. Biomolecules 2021; 11: 371 DOI: 10.3390/biom11030371.
  • 51 Fisk WA, Lev-Tov HA, Clark AK. et al. Phytochemical and botanical therapies for rosacea: A systematic review. Phytother Res 2015; 29: 1439-1451 DOI: 10.1002/ptr.5432.
  • 52 Domingo DS, Camouse MM, Hsia AH. et al. Anti-angiogenic effects of epigallocatechin-3-gallate in human skin. Int J Clin Exp Pathol 2010; 3: 705-709
  • 53 Weber TM, Ceilley RI, Buerger A. et al. Skin tolerance, efficacy, and quality of life of patients with red facial skin using a skin care regimen containing Licochalcone A. J Cosmet Dermatol 2006; 5: 227-232 DOI: 10.1111/j.1473-2165.2006.00261.x.
  • 54 Jovanovic Z, Angabini N, Ehlen S. et al. Efficacy and tolerability of a cosmetic skin care product with trans-4-t-butylcyclohexanol and Licochalcone A in subjects with sensitive skin prone to redness and rosacea. J Drugs Dermatol 2017; 16: 605-610
  • 55 Ferrari A, Diehl C. Evaluation of the efficacy and tolerance of a topical gel with 4% quassia extract in the treatment of rosacea. J Clin Pharmacol 2012; 52: 84-88 DOI: 10.1177/0091270010391533.
  • 56 Sudhapriyadhars G. Topical glucocorticoid – a review. J Pharm Sci Res 2014; 6: 244-246
  • 57 Sauermann G, Jaspers S, Hoppe U. et al. Influence of NO-synthase antagonists in Rosacea patients [Posterabstract]. J Invest Dermatol 1997; 108: 657
  • 58 Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust 1990; 153: 455-458
  • 59 Enshaieh S, Jooya A, Siadat AH. et al. The efficacy of 5% topical tea tree oil gel in mild to moderate acne vulgaris: a randomized, double-blind placebo-controlled study. Indian J Dermatol Venereol Leprol 2007; 73: 22-25
  • 60 Elsaie ML, Abdelhamid MF, Elsaaiee LT. et al. The efficacy of topical 2% green tea lotion in mild-to-moderate acne vulgaris. J Drugs Dermatol 2009; 8: 358-364
  • 61 Weber N, Biehler K, Schwabe K. et al. Hop extract acts as antioxidant with antimicrobial effects against Propionibacterium acnes and Staphylococcus aureus . Molecules 2019; 24: 223 DOI: 10.3390/molecules24020223.