Flavonoids have a benzo-γ-pyrone basic structure and consist of myriad polyphenolic compounds. Flavonoids work as secondary metabolites by encouraging plant to adapt to environment, producing pigmentation and protecting the plant against pathogens [23]. Flavonoid is a multi-functional phytochemical presenting substantial characteristics that can be exploited for therapeutic agents targeting on various diseases, pharmaceutically. Flavonoids are believed as pivotal components for daily supplement [23]. Various flavonoid-enriched functional foods have been reported to have an anti-inflammatory function, e.g. Astragali Radix, green tea, Ginkgo Folium [24]. Studies have demonstrated that theses functional foods perform anti-inflammatory properties by blocking the inflammatory mediators, e.g. NO, COX-2, TNF-α, IL-1β, IL-6, IL-15 and interferon-γ [25]. Therefore, these functional foods are likely to modulate TLRs, NF-κB, AP-1, and IRFs inflammatory signaling pathways, as well as to suppress intracellular inflammatory signaling molecules [25].
The categorization of flavonoids is divided into six major subclasses, namely anthocyanins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones [23]. Nepetin is a natural flavone. The immune-modulatory functions of nepetin are documented. Chen et al. (2018) reported inhibitory effect of nepetin in retinal pigment epithelial cells (ARPE-19 cells) by down-regulating IL-1β via altering NF-κB and MAPK signaling pathways in regulating retinal diseases [17]. The presence of nepetin attenuated COX-1 and COX-2 productions in cultured RAW 264.7 cells after 24 hours of treatment [26]. Furthermore, Ji et al. (2020) found that nepetin suppressed degranulation and generation of leukotriene C4 and inhibited prostaglandin D2 in antigen-stimulated bone marrow derived mast cells by blocking Akt and NF-κB transduction [18].
Inflammation is critical in responding to infection or pathogen by activating expression of cytokine and/or inflammatory mediator, aiming to recruit T-cells and myeloid cells [5]. The inflammatory mediators, i.e. NO, has been confirmed to be monitored by inducible isoforms of iNOS and COX-2 during inflammation [27]. Abnormal production of inflammatory mediators has been noticed after external stimulus: this abnormality is associated with various immune-related diseases, as well as tumorigenesis in different cell types [9]. Several lines of evidence have reported that atopic dermatitis is closely associated with inflammation [28, 29]. LPS, a well-studied external stimulus, leads to accelerate apoptotic rate of human keratocytes, as well as to trigger production of inflammatory mediators [30]. Here, we have shown that an application of nepetin in cultured keratinocytes could reduce LPS-induced cell death. Moreover, nepetin inhibited LPS-induced expression/production of iNOS, COX-2, PGES2 and NO. Thitilertdecha et al. (2019) found that nepetin exhibited suppressive function on early T-cell activation by altering cell death rate [31]. Makino et al. (2008) reported that the herbal formulae mitigated atopic dermatitis-like symptoms in skin, and the herbal treatment decreased the expressions of IL-4 and IFN-γ mRNAs [32]. Interestingly, these herbal formulae all contained nepetin as major chemical. Taken together, the aforementioned results suggest that nepetin, or its parental herb Saussureae Involucratae Herba, has the potential pharmaceutical value in treating skin atopic dermatitis.
Chinese herbal medicines have been well-recognized clinically and widely recommended for treatment of atopic dermatitis [33, 34]. However, there is no scientific evidence, or proposed action mechanism, to support the utilization of herbal medicine, and therefore patients and/or consumers are still concerned about the efficacy and safety [35]. Bioactive agents identified and isolated from natural resources have drawn great attention with precise mechanism and lower side effects, as compared to the synthesized medicine. Therefore, herbal medicine is playing critical function in drug discovery. Having an increase usage of herbal products in clinics for atopic dermatitis, active chemicals have been isolated for such treatment, e.g. methoxsalen isolated from Ammi majus and capsaicin isolated from chill pepper [36]. Despite nepetin has shown positive function in responding to inflammatory progression in vitro, animal and more controlled clinical data are required to further confirm the efficacy and safety of this plant-isolated chemical in dermatology.