Effect of Coptischinensis, Glycyrrhiza uralensis, and Fermented Glycine max Extract as Proactive Therapy for Atopic Dermatitis

Round 1

Reviewer 1 Report

This is a very interesting article, well readable and understandable.

Congrets to the authors.

As an observation I advise the authors to mention the herbal products used for obtaining the extract (ex roots of G. uralensis, seeds of Glycine max etc).

Author Response

Thank you for your kindly review and your suggestion. We totally agree with your comment and have incorporated this suggestion throughout our paper. As your suggestion, we have listed the medicinal part for each herb.

 

Coptis chinensis > Rhizome of Coptis chinensis

Glycyrrhiza uralensis > Rhizome of Glycyrrhiza uralensis

fermented Glycine max > fermented Semen of Glycine max

Author Response File: Author Response.docx

Reviewer 2 Report

The study is rigorous and ambitious. There is no doubt that interesting results have been achieved in vivo. It is an experiment in which three extracts of plants recognized for their medicinal power are combined. But it is not clear, the role of each one in the final result. Could it be due only to the action of Coptis? Synergistic action needs more discussion. Or remarking that it is a preliminary work in which it is necessary to continue deepening.

 

Author Response

Thank you for your kindly review and your suggestion. We totally agree with your comment and have incorporated this suggestion throughout our paper. As your suggestion, we remarked that it is necessary to continue deepening in the last paragraph of discussion part.

 

‘We investigated the lipid barrier recovery effect and effect of modulating inflammatory response and Th2 differentiation response of 3Hb. However, additional studies on the role of each herb will be needed, and further studies will be needed to see if there is a synergistic effect of the 3Hb.’

Author Response File: Author Response.docx

Reviewer 3 Report

Review for “Effect of Coptis chinensis, Glycyrrhiza uralensis, and fermented 2 Glycine max extract as proactive therapy for atopic dermatitis”

 

1. 1, l. 40: “epidermis primarily”, add “is” in between the words.
2. 2, l. 45, 46: “of SCs”, better: “of the SC”
3. 2, l. 48: changed “in transepidermal water loss” to “of transepidermal water loss”

p.2, l. 50: “damage to the skin barrier causes dry skin, rise in pH”, better: “damage to the skin barrier results in dry skin, an elevated pH”

1. 2, l. 50-51: “Itching further impairs the skin barrier and increases TEWL, and pH.” Please explain and/or add a citation.
2. 2, l. 51-53: Please be more precise and describe which skin diseases you mean in particular.
3. 2, l. 59: “Hence, recovery of FLG is key for the treatment of allergic diseases [7].” In the first sentence you talk about AD and then you switch to allergic diseases. Please make your train of thought clear which brings you to allergic diseases.
4. 2, l. 63: “each three herbs are” change to “each of the three aforementioned herbs is”
5. 3, l. 64: “response to skin diseases”, please specify.
6. 3, l. 139: “lipid lamella“ change to lipid lamellae
7. 4, l. 181: Do you mean standard error or standard deviation?
8. 10, l. 318: “Therefore, defects in the lipid barrier are believed to cause skin diseases, including allergic diseases”. This should be differentiated and framed a bit more cautious. Which exact skin diseases are promoted by such conditions? Defects on the epidermal barrier do not directly cause allergic diseases, but when the epidermal barrier function is impaired, allergens can penetrate the skin easier and thus facilitate sensitization in people not yet sensitized as well as elicitation in sensitized individuals. Please make this clearer. Also, the role of AD should be emphasized in this paragraph (l. 315-322). It further would help if the aim of the study would be once again mentioned alongside a very short summary of the key findings of the study.
9. 10, l. 324: “In traditional Korean medicine, Hataedock treatment is used to remove “fetal heat,” which is a cause of AD.” Please use a citation here and specify.
10. 11, l. 343: “This causes sensitization and allergic reactions due to the increased infiltration of external allergens.” Please be more specific. Allergens can penetrate the skin easier due to an impaired barrier function, but this does not automatically cause sensitization.
11. 12, l. 400 following: Please mention how your results gained with the skin of mice can be transferred regarding human skin (which they can’t, to my understanding. Be a bit more careful with drawing conclusions to humans from the results in mice) . This leads to further research desiderates. What are the next steps recommended? What is the outlook? The last sentence of the discussion should be moved and developed further. Please make the points mentioned above overall clearer.

 

 

 

 

Author Response

Thank you for your kindly review and your suggestion. We totally agree with your comment and have incorporated this suggestion throughout our paper. As your suggestion, we corrected the context to more clarify and wrote the citation. And in the last part, we mentioned that it is necessary to make sure that it works the same way on human skin.

 

Point 1: 1, l. 40: “epidermis primarily”, add “is” in between the words.

Response 1: Thank you for your kindly suggestion. We changed the words.

 

Point 2: 2, l. 45, 46: “of SCs”, better: “of the SC”

Response 2: Thank you for your kindly suggestion. We changed the words.

 

Point 3: 2, l. 48: changed “in transepidermal water loss” to “of transepidermal water loss”

Response 3: Thank you for your kindly suggestion. We changed the words.

 

Point 4: 2, l. 50: “damage to the skin barrier causes dry skin, rise in pH”, better: “damage to the skin barrier results in dry skin, an elevated pH”

Response 4: Thank you for your kindly suggestion. We changed the sentence.

 

Point 5: 2, l. 50-51: “Itching further impairs the skin barrier and increases TEWL, and pH.” Please explain and/or add a citation.

Response 5: Thank you for your kindly suggestion. As your suggestion, we wrote a citation.

 

Point 6: 2, l. 51-53: Please be more precise and describe which skin diseases you mean in particular.

Response 6: Thank you for your kindly suggestion. We changed it to Atopic dermatitis for more precise.

 

Point 7: 2, l. 59: “Hence, recovery of FLG is key for the treatment of allergic diseases [7].” In the first sentence you talk about AD and then you switch to allergic diseases. Please make your train of thought clear which brings you to allergic diseases.

Response 7: Thank you for your kindly suggestion. We changed it to Atopic dermatitis for more clearer.

 

Point 8: 2, l. 63: “each three herbs are” change to “each of the three aforementioned herbs is”

Response 8: Thank you for your kindly suggestion. We changed the words.

 

Point 9: 3, l. 64: “response to skin diseases”, please specify.

Response 9: Thank you for your kindly suggestion. We changed it to Atopic dermatitis for more specifing.

 

Point 10: 3, l. 139: “lipid lamella“ change to lipid lamellae

Response 10: Thank you for your kindly suggestion. We changed the words.

 

Point 11: 4, l. 181: Do you mean standard error or standard deviation?

Response 11: Thank you for your kindly suggestion. We means standard error. As you point out, I added the sentence 'Data were presented as the means ± standard error' to the text.

 

Point 12: 10, l. 318: “Therefore, defects in the lipid barrier are believed to cause skin diseases, including allergic diseases”. This should be differentiated and framed a bit more cautious. Which exact skin diseases are promoted by such conditions? Defects on the epidermal barrier do not directly cause allergic diseases, but when the epidermal barrier function is impaired, allergens can penetrate the skin easier and thus facilitate sensitization in people not yet sensitized as well as elicitation in sensitized individuals. Please make this clearer. Also, the role of AD should be emphasized in this paragraph (l. 315-322). It further would help if the aim of the study would be once again mentioned alongside a very short summary of the key findings of the study.

Response 12: Thank you for your kindly suggestion. We changed the sentence to ‘Therefore, defects in the lipid barrier can facilitate sensitization by increasing antigen permeability, which can lead to AD.’ for more clarifying.

 

Point 13: 10, l. 324: “In traditional Korean medicine, Hataedock treatment is used to remove “fetal heat,” which is a cause of AD.” Please use a citation here and specify.

Response 13: Thank you for your kindly suggestion. We added citation.

 

Point 14: 11, l. 343: “This causes sensitization and allergic reactions due to the increased infiltration of external allergens.” Please be more specific. Allergens can penetrate the skin easier due to an impaired barrier function, but this does not automatically cause sensitization.

Response 14: Thank you for your kindly suggestion. We changed the sentence (‘This increases the probability of sensitization and allergic reactions due to increased penetration of external allergens.). 

 

Point 15: 12, l. 400 following: Please mention how your results gained with the skin of mice can be transferred regarding human skin (which they can’t, to my understanding. Be a bit more careful with drawing conclusions to humans from the results in mice) . This leads to further research desiderates. What are the next steps recommended? What is the outlook? The last sentence of the discussion should be moved and developed further. Please make the points mentioned above overall clearer.

Response 15: Thank you for your kindly suggestion. We added the sentence(‘We sought to confirm whether 3Hb extract can act as a proactive therapy in AD through this animal experiment. However, study will be needed on whether 3Hb extract works the same way in human skin.’) to emphasize the need.

Author Response File: Author Response.docx