Dynamic changes of circulating Th1 and Th17 cells in psoriasis patients: a report of 3 cases treated by Chinese herbal medicine

Psoriasis is a chronic inflammatory skin disease, characterized by increased T cell response. Liang-Xue-Jie-Du Decoction (LXJD), a classic Chinese herb formula, have been proved effective for blood-heat type psoriasis by clinical trials. But there is little information related to its role on patients’ T helper cells. Here, we report 3 patients who were diagnosed as blood heat psoriasis and were treated by LXJD for 8 weeks. With evaluating the Psoriasis Area and Severity Index (PASI) and detecting the peripheral lymphocytes by flow cytometry every two weeks, changes of circulating Th1 and Th17 subsets and their association with skin lesions were monitored. As to patient 1, the decrease of Th1 and Th17 cells was detected 2 weeks after the treatment, followed with 83% decrease of PASI at week 4. Patient 2 and 3, a clear decrease of Th1 and Th17 was detected at week 6, accompanying with the improvement of PASI score, achieving PASI70 and PASI90 at week 8, respectively. The results indicated a similar variation trend between the change of PASI score and T cell subsets, which occurred somewhat earlier than obvious recovery of the skin. In addition, though both Th1 and Th17 of the patient 1 rebounded due to upper respiratory infection at week 6, the lesions kept fading away and achieved 90% improvement of PASI (PASI90) at week 8. The phenomena indicated that T helper cells might not be the only target of LXJD. Our individual case reports give a clue on discovering the mechanism of LXJD decoction. Additional studies will be necessary to fully evaluate the role of LXJD decoction in T cell differentiation and psoriatic skin recovery.