5.5 Trattamenti non biologic
7. Principi att
7.5 Acido Betulinico
L’acido betulinico è un acido carbossilico triterpenico pentaciclico presente in natura (Rios, et al., 2018), estratto da molte piante come la Betulla (O'Connel, et al., 1988) (Galgon, et al., 1999), la Peonia (Ikuta, et al., 1995) (Kamiya, et al., 1997).
L’acido betulinico possiede molteplici proprietà biologiche, tra cui attività antiinfiammatoria (Jingbo, et al., 2015) (Laavola, et al., 2016), antitumorale (Wang, et al., 2012), anti- angiogenica (Dehelean, et al., 2011), antiossidante (Yi, et al., 2014), antipsoriasica.
Gli effetti terapeutici antipsoriasici sono dovuti alla sua azione inibitoria sulla produzione di citochine (Jingbo, et al., 2015) (Kim, et al., 2016); In particolare inibisce:
- lo sviluppo delle cellule Th17 e delle cellule T γδ, attenuando la lesione cutanea (Xie, et al., 2018);
- l’espressione genica delle citochine proinfiammatorie; - NFkB nella lesione psoriasica.
Anche se saranno necessari studi futuri per approfondire ulteriormente i meccanismi alla base dei suoi effetti, l’acido betulinico potrebbe essere un potenziale farmaco naturale per il tratta- mento della psoriasi.
Conclusioni
La psoriasi è stata a lungo oggetto di ricerca nel campo della dermatologia. La qualità di vita dei pazienti affetti è fortemente compromessa a causa delle manifestazioni cliniche caratteriz- zate da desquamazione, prurito, secchezza e bruciore a livello delle zone del corpo interessate. La psoriasi va considerata una patologia infiammatoria multisistemica perché può coinvolgere più organi; infatti tanto più vaste sono le parti della pelle interessate e gli anni di convivenza con le lesioni, tanto maggiore è il rischio di sviluppare altre malattie. Nonostante l'utilizzo di diversi farmaci e terapie fisiche per il controllo della malattia, queste strategie sono limitate all'uso a breve termine a causa della loro efficacia transitoria, costi elevati e gravi effetti colla- terali. Alcuni farmaci antipsoriasici possono incrementare, ad esempio il rischio cardiovasco- lare, e l’associazione di terapie cardiovascolari potrebbe peggiorare la psoriasi. Le piante me- dicinali, rispetto ai farmaci biologici, rappresentano un’alternativa più conveniente dal punto di vista economico e vengono somministrati attraverso percorsi diversi. Pertanto, potrebbero diventare delle promettenti alternative terapeutiche per il trattamento della psoriasi. Una delle principali limitazioni degli studi effettuati sulle piante risulta essere la scarsa informazione sulla composizione chimica delle preparazioni. Negli ultimi anni sono state effettuate nume- rose ricerche per confermare l’efficacia dei trattamenti naturali, ma gli studi effettuati sono nelle fasi iniziali. Poiché sempre più pazienti affetti da psoriasi si rivolgono verso l’utilizzo di trattamenti a base di sostanze naturali, sono necessari studi clinici controllati randomizzati più rigorosi per determinare con maggiore precisione la sicurezza e l'efficacia di queste terapie.
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