title: Immunomodulatory effects of balneotherapy with hae-un-dae thermal water on imiquimod-induced psoriasis-like murine model.
abstract: BACKGROUND
  Balneotherapy, although not a well-established dermatological treatment, is thought to have therapeutic properties for psoriasis and is used as an alternative treatment modality throughout the world.
  
  
  OBJECTIVE
  To evaluate the mechanism underlying the therapeutic immunologic effects of thermomineral water.
  
  
  METHODS
  A murine model of imiquimod-induced psoriasis-like skin inflammation was used for evaluating the therapeutic effects of balneotherapy with Hae-Un-Dae hot spring mineral water. The clinical improvements were evaluated by a dermatologist. Lesional cytokines, including interleukin (IL)-17A, IL-23, and IL-22, were quantitatively measured by real-time reverse transcriptase polymerase chain reaction. Serum levels of interferon-γ, IL-4, IL-5, and IL-17A were measured by enzyme-linked immunosorbent assay. T cell proportions in the spleen were evaluated by flow cytometry, and histopathological evaluation of the skin was also performed.
  
  
  RESULTS
  The mineral water balneotherapy group showed faster improvement in skin erythema and scales than the distilled water bathing group. A substantial reduction was observed in the lesional mRNA levels of IL-17A and IL-23 in the mineral water group. Serum levels of IL-4 and IL-5 were significantly decreased in the mineral water group but not in the distilled water group. Normalized T cell proportions were observed after bathing.
  
  
  CONCLUSIONS
  Balneotherapy showed immunomodulatory effects in a psoriasis-like murine model. Balneotherapy suppressed lesional IL-23 and IL-17A, which are important cytokines in the pathogenesis of psoriasis. These results suggest that balneotherapy can be used as an effective and safe treatment for psoriasis.
authors.affiliation: Department of Dermatology, School of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Bok
authors.initials: YB
authors.lastname: Lee
authors.affiliation: Department of Dermatology, School of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Microbiology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Earth and Environmental Sciences, Korea University, Seoul, Korea.
authors.forename: Seong Taek
authors.initials: ST
authors.lastname: Yun
authors.affiliation: The Korea Central Institute of Hot Springs, Seoul, Korea.
authors.forename: Jong Tae
authors.initials: JT
authors.lastname: Lee
authors.affiliation: Oh&Kim's Aesthetic Clinic, Seoul, Korea.
authors.forename: Hong Jig
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Dermatology, School of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Yu
authors.affiliation: Department of Microbiology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: So Youn
authors.initials: SY
authors.lastname: Woo
authors.affiliation: Department of Dermatology, School of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jin-Wou
authors.initials: JW
authors.lastname: Kim
keywords: Bath; Immunomodulation; Mineral waters; Psoriasis