The Study Of Auricular Therapy With Daivobet In Treatment For Psoriasis On Urine Metabolomics

Backgroud:Psoriasis is a common chronic and recurrent skin disease which has the main performance of erythema or plaques covered with white scales.It can be classified 4 types by clinical manifestation, and types of erythrodermic and arthropathica psoriasis may have the risk of disability and death. At present, there is no radical cure for psoriasis with Western Medicine, but TCM therapy, especially Auricular Therapy,is proved that has advantages of reliable results, little side-effect and so on.With the rapid modern technology development,Metabolomics is more and more used in disease researches and plays the important role in the study of TCM.Objective:The study is intended to find what had changed in psoriasis patients for urine metabolomics after the counter measure of auricular therapy with Daivobet. Aim to approach the characteristics of patients who have psoriasis and the drug action mechanism from urine metabolomics, to provide the high level of evidence for Chinese with western medicine therapy of psoriasis.Methods:From Feb 2014 to Jan 2015,38 patients with psoriasis came from outpatient of Guangdong Provincial Hospital of TCM and Guangzhou Red Cross Hospital were divided into treatment group and control group.Both of them were given the topical Daivobet treatment for 4 weeks, and the treatment group also adopted the therapy of auricular. On the first and last week of the treatment, all of the patients need to be collected fasting midstream urine 10ml in the morning. And then using the technique of UPLC/Q-TOF MS to discover what had changed in psoriasis patients for urine metabolomics, finally to identify the potential biomarkersin before and after the treatment.Results:The study was divided into two groups, which had 21 patients in intervention group and 17 in another group for control, at the same time,32 cases of healthy were taken into the healthy-control group. After the UPLC/Q-TOF MS analysis, metabolomics can be well separated from psoriasis patients and the healthy, as well as the intervention group and control group after 4 weeks treatment. And the treatment group were more close to heathy persons than the control group. Otherwise, through the data-stratification analysis, it was found that psoriasis had a good relationship with the severity, TCM syndromes and disease outcome, but had nothing to do with course of the disease. Last, it was proved that auricular therapy and Daivobet was related to the metabolism of amino acid, lipids,vitamin, etc. From metabolomics levels,3b,12a-Dihydroxy-5a-cholanoic acid and gamma-Carboxyglutamic acid were well reflected in synergistic action of auricular therapy.Conclusion:There were significant differences in urine metabolomics between psoriasis patients and healthy persons. After treatment of auricular therapy with Daivobet, the differences of urine metabolomics changed obviously, and tended to the level of heathy persons. And what we found in this study may provide higher level evidence of metabolomics about psoriasis for TCM and Western medicine treatment.