T h e r a p e u t i c I n d e x 255 • Nummular dermatitis • Dyshidrotic dermatitis (pompholyx) • Pityriasis alba Directions for Use Take a sufficient quantity of the cream and apply evenly on the affected area, twice daily till signs and symptoms resolve. Adverse Effects No adverse effects have been reported. Contraindications No known contraindications. Special Precautions To be prescribed as per the physician’s discretion in children younger than 12 years and pregnant and lactating women, as the product’s safety is not established in these groups. Presentation Lamitube of 30 g. Pharmacological Actions of Principal Ingredients 1. Anti-inflammatory action: An in vitro study demonstrates the anti-inflammatory activity of Cassia tora and Sesamum indicium extracts using sPLA2 ELISA assay in THP-1 cell lines. These extracts significantly reduced the level of secretory phospholipase A2 (sPLA2), an enzyme responsible for the release of arachidonic acid that leads to eicosanoid production. The reduction in the sPLA2 level blocks this important inflammation pathway, producing the antiinflammatory effect. An in vitro study suggests that Cassia tora, Mallotus philippinensis, Ocimum sanctum, and Boswellia serrata extracts help upregulate the GR gene expression; GR is an important mediator in the anti-inflammatory effect exerted by glucocorticoids. The glucocorticoids facilitate the downregulation of the expression of target genes that encode several proinflammatory proteins. Boswellia serrata, Mallotus philippinensis, and Ocimum sanctum extracts were observed to exert an antiinflammatory effect by inhibiting the key mediators of inflammation namely interleukins (especially, IL-6) and TNF-α. In an in vitro model of lipopolysaccharide (LPS)-stimulated COX-2 production in THP-1 cells, Boswellia serrata extract significantly inhibited the expression of the COX-2 gene. Preparations of Boswellia serrata extract have been shown to have potent anti-inflammatory effect in in vivo experimental models, when used topically. In a double-blind clinical study, a topical formulation of Boswellia serrata extract showed promising results in the treatment of psoriasis and erythematous eczema. Boswellia serrata formulation reduced scaling (in 70% of the cases), erythema (in 50% of the cases), and itching (in 60% of the cases) and prevented worsening of symptoms in the patients. In an in vitro study on LPS and recombinant mouse interferon (IFN)-γ–induced murine macrophage-like cell line (RAW 264.7), compounds present in the glandular hairs of Mallotus philippinensis inhibited nitric oxide (NO) production and inducible NO synthase (iNOS) gene expression and downregulated the expression of the COX2, IL-6, and IL-1β gene expression. This shows the potent anti-inflammatory and immunoregulatory effects of Mallotus philippinensis. Vegecort® (cream)
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