title: A pilot study evaluating the clinical and immunomodulatory effects of an orally administered extract of Dendrobium huoshanense in children with moderate to severe recalcitrant atopic dermatitis.
abstract: Atopic dermatitis (AD) is a common inflammatory skin disorder for which few safe and effective systemic treatments are available. To test the clinical and immunomodulatory effects of a crude polysaccharide fraction isolated from Dendrobium huoshanense for the treatment of AD, we conducted a pilot, uncontrolled case series study. Twenty-seven patients aged 4-18 years (mean∓SD, 10.82±4.4) with AD that had not responded to topical therapy were treated with polysaccharide derived from D. huoshanense for 4 weeks and followed-up for another 4 weeks. Progression of AD was determined with the Lund-Browder chart for children, the Investigator's Global Atopic Dermatitis Assessment (IGADA), and the Scoring Atopic Dermatitis (SCORAD) at weeks 0, 2, 4, and 8. Serum levels of cytokines were evaluated. Safety was determined with laboratory and clinical tests. The lesion area, IGADA score, total SCORAD result, and score for sleeplessness decreased significantly from weeks 0 to 4, but did not change significantly between weeks 4 and 8. The scores for subjective symptoms and pruritus decreased significantly from week 0 to week 4 and increased significantly from week 4 to week 8. Serum levels of IL-5, IL-13, IFN-gamma, and TGF-beta1 decreased significantly between weeks 0 and 4 and between weeks 0 and 8. No significant difference in the levels of IL-10 was found. The polysaccharide from D. huoshanense reduced the levels of some cytokines associated with AD and had beneficial effects on symptoms. No serious adverse effects occurred when it was administered orally for 4 weeks.
authors.affiliation: Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan. kgwu@vghtpe.gov.tw
authors.forename: K-G
authors.initials: KG
authors.lastname: Wu
authors.forename: T-H
authors.initials: TH
authors.lastname: Li
authors.forename: C-J
authors.initials: CJ
authors.lastname: Chen
authors.forename: H-I
authors.initials: HI
authors.lastname: Cheng
authors.forename: T-Y
authors.initials: TY
authors.lastname: Wang
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D031667:Dendrobium / Q000737:chemistry; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects / Q000302:isolation & purification; D008297:Male; D010865:Pilot Projects; D010936:Plant Extracts / Q000008:administration & dosage* / Q000009:adverse effects; D011134:Polysaccharides / Q000008:administration & dosage* / Q000009:adverse effects / Q000302:isolation & purification; D011537:Pruritus / Q000276:immunology / Q000517:prevention & control; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000276:immunology / Q000517:prevention & control; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D016207:Cytokines; D007155:Immunologic Factors; D010936:Plant Extracts; D011134:Polysaccharides