Table1_Medicinal Plant Extracts and Natural Compounds for the Treatment of Cutaneous Lupus Erythematosus: A Systematic Review.docx

Cutaneous lupus erythematosus (CLE) is a group of autoimmune connective tissue disorders that significantly impact quality of life. Current treatment approaches typically use antimalarial medications, though patients may become recalcitrant. Other treatment options include general immunosuppressants, highlighting the need for more and more targeted treatment options. The purpose of this systematic review was to identify potential compounds that could be repurposed for CLE from natural products since many rheumatologic drugs are derived from natural products, including antimalarials. This study was registered with PROSPERO, the international prospective register of systematic reviews (registration number CRD42021251048). We comprehensively searched Ovid Medline, Cochrane Library, and Scopus databases from inception to April 27th, 2021. These terms included cutaneous lupus erythematosus; general plant, fungus, bacteria terminology; selected plants and plant-derived products; selected antimalarials; and JAK inhibitors. Our search yielded 13,970 studies, of which 1,362 were duplicates. We screened 12,608 abstracts, found 12,043 to be irrelevant, and assessed 565 full-text studies for eligibility. Of these, 506 were excluded, and 59 studies were included in the data extraction. The ROBINS-I risk of bias assessment tool was used to assess studies that met our inclusion criteria. According to our findings, several natural compounds do reduce inflammation in lupus and other autoimmune skin diseases in studies using in vitro methods, mouse models, and clinical observational studies, along with a few randomized clinical trials. Our study has cataloged evidence in support of potential natural compounds and plant extracts that could serve as novel sources of active ingredients for the treatment of CLE. It is imperative that further studies in mice and humans are conducted to validate these findings.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=251048.

皮肤红斑狼疮（CLE）是一组严重影响生活质量的自身免疫性结缔组织疾病。目前的治疗方法通常采用抗疟疾药物，尽管患者可能会出现耐药性。其他治疗选择包括一般的免疫抑制剂，凸显了需要更多且更具有针对性的治疗方案的必要性。本次系统综述的目的是为了从天然产物中识别出可能被重新用于治疗CLE的潜在化合物，因为许多风湿病药物均来源于天然产物，包括抗疟疾药物。本研究已在PROSPERO国际前瞻性系统综述注册处注册（注册号：CRD42021251048）。我们全面检索了从创刊至2021年4月27日的Ovid Medline、Cochrane图书馆和Scopus数据库。检索关键词包括皮肤红斑狼疮；植物、真菌、细菌的一般术语；特定的植物和植物提取物；特定的抗疟疾药物；以及JAK抑制剂。我们的搜索结果产生了13,970项研究，其中1,362项为重复研究。我们筛选了12,608篇摘要，发现12,043篇与主题无关，并对565篇全文研究进行了资格评估。其中，506篇被排除，59项研究被纳入数据提取。我们使用了ROBINS-I偏倚风险评估工具来评估符合我们纳入标准的研究。根据我们的研究结果，在体外方法、小鼠模型和临床观察性研究中，以及一些随机临床试验中，几种天然化合物确实可以减少狼疮和其他自身免疫性皮肤疾病的炎症。我们的研究已对潜在的天然化合物和植物提取物进行了梳理，这些提取物可作为治疗CLE的新活性成分来源。进行小鼠和人类进一步研究以验证这些发现至关重要。系统综述注册：https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=251048。