Psoriasis affects over 125 million people worldwide, causing red, scaly patches that can be painful, itchy, and long-lasting. While treatments like acitretin (a common oral drug) help slow skin cell overgrowth, they often come with side effects—from dry skin to liver issues—and don’t work for everyone. For decades, traditional Chinese medicine (TCM) has used matrine (an active compound from the herb Sophora flavescens) to treat inflammation and skin conditions. But how does matrine work for psoriasis, and could it boost the effects of acitretin? A 2019 study from researchers at Peking University Third Hospital set out to find answers.
What the Study Investigated
The team focused on two key questions:
- Can matrine alone reduce psoriatic skin cell overgrowth?
- Does combining matrine with acitretin enhance treatment effects—and if so, how?
Psoriasis happens when skin cells (keratinocytes) divide too quickly and build up on the skin’s surface. The study looked at cell cycle arrest (stopping cells from dividing) and autophagy (a cellular “cleanup” process that breaks down damaged parts) as potential mechanisms. It also explored the PI3K/Akt/mTOR pathway—a critical signaling route that controls cell growth and autophagy.
How They Tested It
Researchers used two main models:
- Lab-grown skin cells: HaCaT cells (a non-cancerous human keratinocyte line) to study matrine’s effects on cell growth, cycle, and autophagy.
- Psoriasis-like mice: Mice treated with imiquimod cream (which induces red, scaly skin similar to psoriasis) to test matrine and acitretin in a living organism.
They used simple but powerful tools:
- MTS assays to measure cell growth.
- Flow cytometry to track cell cycle stages and apoptosis (cell death).
- Transmission electron microscopy (TEM) to see autophagosomes (small “trash bags” for cellular waste).
- Western blotting to measure protein levels (e.g., LC3II/I, Beclin1 for autophagy; cyclin D1 for cell division).
Key Results: Matrine Works—And Combines Well With Acitretin
The study uncovered three major findings:
1. Matrine Alone Inhibits Skin Cell Overgrowth and Induces Autophagy
When tested on HaCaT cells, matrine:
- Slowed cell growth: Higher doses (0.2–1.6 mg/mL) and longer exposure (24–72 hours) led to more growth inhibition—without causing toxic cell death (apoptosis) at lower doses.
- Arrested the cell cycle: Matrine kept cells stuck in the G0/G1 phase (the “resting” stage before division), which slows overgrowth. At 0.4 mg/mL, 60% of cells were arrested (vs. 39% in untreated cells).
- Triggered autophagy: Matrine-treated cells had 7x more autophagosomes (TEM results) and higher levels of autophagy markers like LC3II/I and Beclin1. This means cells were better at cleaning up damaged parts—critical for reducing psoriatic inflammation.
2. Matrine + Acitretin Is More Effective Than Either Drug Alone
The combo outperformed single-drug treatments in both cells and mice:
- Stronger cell growth inhibition: At 48 hours, the combo reduced cell growth to 59% (vs. 74% for matrine alone, 80% for acitretin alone).
- Deeper cell cycle arrest: 75% of cells were stuck in G0/G1 (vs. 65% for matrine, 44% for acitretin).
- More autophagy: Higher LC3II/I levels (a key autophagy marker) and fewer “waste” proteins (p62) than single drugs.
- Blocked the PI3K/Akt/mTOR pathway: The combo downregulated this growth-promoting pathway more than either drug alone—meaning it better controlled cell division and boosted autophagy.
3. The Combo Reduced Psoriasis Symptoms in Mice
In mice with psoriasis-like skin, the matrine + acitretin combo:
- Lowered inflammation scores: The cumulative score (redness + scaling + thickening) was 1.5 (vs. 2.4 for matrine alone, 2.9 for acitretin alone).
- Increased autophagy in skin: Skin samples showed higher LC3 levels (autophagy marker) than single-drug or untreated groups.
What This Means for Psoriasis Treatment
Acitretin is effective but has downsides: higher doses mean more side effects (dryness, hair loss, liver stress). Matrine’s ability to enhance acitretin’s effects could let doctors use lower doses of acitretin—reducing side effects while improving results.
The study also confirms that autophagy is a key target for psoriasis treatment. Matrine’s ability to boost this process helps cells “reset” and reduces the rapid growth that causes scaly patches.
Conclusion
This research from Peking University Third Hospital adds strong evidence that matrine is a promising treatment for psoriasis—both on its own and paired with acitretin. By targeting cell cycle arrest and autophagy through the PI3K/Akt/mTOR pathway, the combo could offer a safer, more effective alternative to current therapies.
While more human trials are needed, the study bridges traditional Chinese medicine and modern science—offering hope for millions living with psoriasis.
Original study by Wei-Wei Jiang, Yi-Meng Wang, Xiao-Yu Wang, Qian Zhang, Si-Man Zhu, and Chun-Lei Zhang from the Department of Dermatology at Peking University Third Hospital, published in the Chinese Medical Journal in 2019.
DOI: https://doi.org/10.1097/CM9.0000000000000412
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