Successful treatment of immune-related lichenoid dermatitis by Weiling decoction in a patient with non-small cell lung cancer: A case report and review of literature.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have emerged as a revolutionary therapy in advanced squamous non-small cell lung cancer (sqNSCLC) and ushered a new era of immunotherapy. Despite of remarkable outcomes, a wide spectrum of immune-related adverse events (irAEs) was reported, among which cutaneous reactions were the most common. Cutaneous irAEs were mainly managed by glucocorticoids, whereas prolonged use of glucocorticoids may cuase kinds of side effects, especially in elderly paitients, and diminish the anti-tumor efficacy of ICIs, thus finding a safe and effective alternative approach to managing cutaneous irAEs is imperative. CASE SUMMARY: A 71-year-old man who was diagnosed with advanced sqNSCLC suffered from sporadic maculopapulars one week later after the fifth cycle of sintilimab treatment, and the skin lesions had been deteriorating rapidly. Skin biopsy revealed epidermal parakeratosis with a dense band-like lymphocytic infiltrate and acanthosis, indicating a diagnosis of immune-induced lichenoid dermatitis. Oral administration of traditional Chinese herbal formula modified Weiling decoction significantly alleviated the symptoms of the patient. The dosage of Weiling decoction were maintained for about three months without recurrence of cutaneous adverse reactions and any other side effects. The patient refused to receive further anti-tumor medication and stayed alive without disease progression at follow up. CONCLUSION: We present modified Weiling decoction successfully ameliorates immune-induced lichenoid dermatitis in a patient with sqNSCLC for the first time. This report indicates that Weiling decoction may be an effective and safe complementary or alternative approach for the treatment of cutaneous irAEs. Further investigation of the underling mechanism is required in the future.

2,3,5,4'-tetrahydroxystilbence-2-O-ß-D-glucoside attenuates hepatic steatosis via IKKß/NF-κB and Keap1-Nrf2 pathways in larval zebrafish.

With the improvement of people's living standards and the change of dietary habits, Non-alcoholic fatty liver disease (NAFLD) has gradually become one of the liver diseases that endanger human health around the world. However, there are no particularly effective drugs for NAFLD in the current market. Therefore, new drug candidates which could provide high efficacy and low toxicity are needed valuable for the prevention and treatment of NAFLD. 2,3,5,4'-tetrahydroxystilbence-2-O-ß-D-glucoside (TSG) is extracted from Polygonum multiflorum Thunb., and has been widely used to treat a variety of chronic diseases in China. Recently, TSG has been reported to exert various biological activities in many studies, such as lipid-lowering, anti-inflammatory and anti-oxidant activities, which indicate that TSG may have the effect of improving NAFLD. After feeding 5% high cholesterol diet to 5 days post fertilization larval zebrafish for 10 days, hepatic steatosis larval zebrafish model was established successfully. Then the effect of TSG on the improvement of hepatic steatosis larval zebrafish was studied. Moreover, the potential mechanism of TSG on anti-NAFLD effect were studied using RT-qPCR methods from multiple pathogenesis aspects of lipogenesis, lipid-lowering, inflammation, and oxidant stress. To conclude, TSG attenuates hepatic steatosis via regulating lipid metabolism related pathway, IKKß/NF-κB anti-inflammatory pathway and Keap1-Nrf2 anti-oxidant pathway.