{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:06:43Z","timestamp":1784909203492,"version":"3.55.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"Background:<\/jats:bold> Traditional Chinese medicine is effective in the treatment of psoriasis and can significantly reduce skin inflammation and psoriatic lesions with minimal side effects. Shikonin (SHI) and \u03b2,\u03b2-dimethylacryloyl alkannin (DMA), the main active components of Lithospermum erythrorhizon<\/jats:italic>, have strong anti-inflammatory effects. This systematic review aimed to evaluate the efficacy and safety of Lithospermum erythrorhizon<\/jats:italic> and its main active components and to elucidate the potential mechanisms of their action in psoriasis treatment.<\/jats:p>Methods:<\/jats:bold> PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Scientific Journals, Wan Fang, and Chinese Biomedicine databases were systematically searched for articles published between 1 January 1970, and 31 February 2021. We included clinical and preclinical studies that examined the effects of Lithospermum erythrorhizon<\/jats:italic> and its active components on psoriasis. All data were analyzed using RevMan 5.3 software. The Cochrane and SYRCLE\u2019s risk-of-bias tools were used to assess the quality of all studies.<\/jats:p>Results:<\/jats:bold> Eleven clinical trials including 1024 participants and 23 preclinical studies were assessed. Meta-analysis showed that when treating patients with psoriasis, the Chinese herbal medicine (CHM) formulas with Lithospermum erythrorhizon<\/jats:italic> as the sovereign herb can significantly improve psoriatic dermatitis, which can significantly reduce the psoriasis area and severity index (PASI) score (mean difference [MD] = -2.00, 95% confidence interval [CI] [-3.19, -0.80], p<\/jats:italic> = 0.001; I2<\/jats:sup> = 85%). The incidence rates of diarrhea (risk ratio = 0.21, 95% CI [0.06, 0.81], p<\/jats:italic> = 0.02) were higher in the CHM formulas group than in the control group, whereas other adverse events were not significantly different between the two groups (p<\/jats:italic> &gt; 0.05). We evaluated the PASI score of mice on day 7 and found that SHI and DMA also alleviated psoriatic lesions (MD = -3.36, 95% CI [-4.67, -2.05], p<\/jats:italic> &lt; 0.00001, I2<\/jats:sup> = 94%). Furthermore, the epidermal thickness decreased more after SHI or DMA treatment than in the control group (MD = -34.42, 95%CI [-41.25, -27.59], p<\/jats:italic> &lt; 0.00001, I2<\/jats:sup> = 93%). Based on preclinical studies, we also summarized and mapped the mechanisms of SHI and DMA in the treatment of psoriasis.<\/jats:p>Conclusion:<\/jats:bold> Available findings demonstrated that Lithospermum erythrorhizon<\/jats:italic> combined with other conventional treatments is useful in treating psoriasis. Preclinical evidence has shown that the active components of Lithospermum erythrorhizon<\/jats:italic> exhibit a potential anti-inflammatory effect, promote keratinocyte apoptosis, inhibit keratinocyte proliferation and angiogenesis, and block the cell cycle. In summary, our findings suggest that Lithospermum erythrorhizon<\/jats:italic> and its active components can be used to treat psoriasis.<\/jats:p>","DOI":"10.3389\/fphar.2022.781850","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T04:46:57Z","timestamp":1651726017000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Evidence and Potential Mechanism of Action of Lithospermum erythrorhizon and Its Active Components for Psoriasis"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiao","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Ying","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Qiong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kan","family":"Ze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Ting","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Ce","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Le","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Ru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"11724","DOI":"10.1038\/ncomms11724","article-title":"NFATc1 Supports Imiquimod-Induced Skin Inflammation by Suppressing IL-10 Synthesis in B Cells","volume":"7","author":"Alrefai","year":"2016","journal-title":"Nat. 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Pathol."},{"key":"B43","first-page":"667","article-title":"Effects of Shikonin on the Phenotype and Function of Dendritic Cells Derived from Human Peripheral Blood Monocytes","volume":"30","author":"Wang","year":"2014","journal-title":"J. Immunol."},{"key":"B44","unstructured":"Effects of Catalpol, Levo-Shikonin and Paeonol on the Hyperproliferation of HaCaT Cells Induced by KGF\n WangY. L.\n BeijingBeijing University of Chinese Medicine2011"},{"key":"B45","unstructured":"Study on the Molecular Mechanism of Liangxue Jiedu Recipe and \u03b2,\u03b2-dimethylacryloylakine in the Treatment of Psoriasis by Regulating the TLR7\/8 Activation Pathway of Dendritic Cells\n WangY.\n BeijingBeijing University of Chinese Medicine2017"},{"key":"B46","first-page":"563","article-title":"The Inhibitory Effect of Shikonin on the Proliferation and Apoptosis of Keratinocytes","volume":"2003","author":"Wu","year":"2003","journal-title":"China J. Lepr. Skin Dis."},{"key":"B47","first-page":"946","article-title":"Effects of Shikonin on IL-17-induced Keratinocyte Proliferation and Chemokine Expression","volume":"40","author":"Xie","year":"2015","journal-title":"Chin. J. Traditional Chin. Med."},{"key":"B48","unstructured":"Study on the Effect of Shikonin on IL-17 Stimulated HaCaT Cells to Secrete VEGF, IL-6 and IL-23\n XingM.\n Shenyang, Liaoning ProvinceChina Medical University2010"},{"key":"B49","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.intimp.2014.01.027","article-title":"Shikonin Suppresses IL-17-induced VEGF Expression via Blockage of JAK2\/STAT3 Pathway","volume":"19","author":"Xu","year":"2014","journal-title":"Int. Immunopharmacol."},{"key":"B50","first-page":"110","article-title":"Sugar Components in Lithospermum Erythrorhizon","author":"Yi","year":"2005","journal-title":"Foreign Med."},{"key":"B51","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.intimp.2019.04.047","article-title":"Shikonin Induces Apoptosis and Suppresses Growth in Keratinocytes via CEBP-\u03b4 Upregulation","volume":"72","author":"Yu","year":"2019","journal-title":"Int. Immunopharmacol."},{"key":"B52","unstructured":"The Effect of Shikonin on the Production of IFN-R and IL-4 by Peripheral Blood Mononuclear Cells in Patients with Psoriasis Vulgaris\n ZhangH.\n Shenyang, Liaoning ProvinceChina Medical University2011"},{"key":"B53","first-page":"149","article-title":"Clinical Observation on Psoriasis Vulgaris Treated with Zicao Mixture in Different Doses","volume":"17","author":"Zhang","year":"2018","journal-title":"Chin. J. Integr. Traditional Chin. West. Med. 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Dermatovenereology"},{"key":"B58","unstructured":"Study on the Effect of Shikonin on the Biological Behavior of HaCaT Cells Mediated by IL-22 and its Mechanism\n ZhuX. F.\n Yangzhou, Jiangsu ProvinceYangzhou University2013"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2022.781850\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T14:33:50Z","timestamp":1652193230000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2022.781850\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,5]]},"references-count":58,"alternative-id":["10.3389\/fphar.2022.781850"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2022.781850","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,5]]},"article-number":"781850"}}