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Kim SB, Ryu HY, Nam W, Lee SM, Jang MR, Kwak YG, Kang GI, Song KS, Lee JW. The Neuroprotective Effects of Dendropanax morbifera Water Extract on Scopolamine-Induced Memory Impairment in Mice. Int J Mol Sci 2023; 24:16444. [PMID: 38003650 PMCID: PMC10671129 DOI: 10.3390/ijms242216444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
This study investigated the neuroprotective effects of Dendropanax morbifera leaves and stems (DMLS) water extract on scopolamine (SCO)-induced memory impairment in mice. First, we conducted experiments to determine the protective effect of DMLS on neuronal cells. Treatment with DMLS showed a significant protective effect against neurotoxicity induced by Aβ(25-35) or H2O2. After confirming the neuroprotective effects of DMLS, we conducted animal studies. We administered DMLS orally at concentrations of 125, 250, and 375 mg/kg for 3 weeks. In the Y-maze test, SCO decreased spontaneous alternation, but treatment with DMLS or donepezil increased spontaneous alternation. In the Morris water-maze test, the SCO-treated group showed increased platform reach time and decreased swim time on the target platform. The passive avoidance task found that DMLS ingestion increased the recognition index in short-term memory. Furthermore, memory impairment induced by SCO reduced the ability to recognize novel objects. In the Novel Object Recognition test, recognition improved with DMLS or donepezil treatment. In the mouse brain, except for the cerebellum, acetylcholinesterase activity increased in the SCO group and decreased in the DMLS and donepezil groups. We measured catalase and malondialdehyde, which are indicators of antioxidant effectiveness, and found that oxidative stress increased with SCO but was mitigated by DMLS or donepezil treatment. Thus, our findings suggest that ingestion of DMLS restored memory impairment by protecting neuronal cells from Aβ(25-35) or H2O2-induced neurotoxicity, and by reducing oxidative stress.
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Affiliation(s)
- Sung Bae Kim
- Korea Conformity Laboratories, Incheon 21999, Republic of Korea; (S.B.K.); (H.Y.R.); (W.N.); (S.M.L.); (G.I.K.); (K.S.S.)
| | - Hyun Yeoul Ryu
- Korea Conformity Laboratories, Incheon 21999, Republic of Korea; (S.B.K.); (H.Y.R.); (W.N.); (S.M.L.); (G.I.K.); (K.S.S.)
| | - Woo Nam
- Korea Conformity Laboratories, Incheon 21999, Republic of Korea; (S.B.K.); (H.Y.R.); (W.N.); (S.M.L.); (G.I.K.); (K.S.S.)
| | - So Min Lee
- Korea Conformity Laboratories, Incheon 21999, Republic of Korea; (S.B.K.); (H.Y.R.); (W.N.); (S.M.L.); (G.I.K.); (K.S.S.)
| | - Mi Ran Jang
- Huons Foodience Co., Ltd., Geumsan-gun 32724, Republic of Korea; (M.R.J.); (Y.G.K.)
| | - Youn Gil Kwak
- Huons Foodience Co., Ltd., Geumsan-gun 32724, Republic of Korea; (M.R.J.); (Y.G.K.)
| | - Gyoo Il Kang
- Korea Conformity Laboratories, Incheon 21999, Republic of Korea; (S.B.K.); (H.Y.R.); (W.N.); (S.M.L.); (G.I.K.); (K.S.S.)
| | - Kyung Seok Song
- Korea Conformity Laboratories, Incheon 21999, Republic of Korea; (S.B.K.); (H.Y.R.); (W.N.); (S.M.L.); (G.I.K.); (K.S.S.)
| | - Jae Won Lee
- Korea Conformity Laboratories, Incheon 21999, Republic of Korea; (S.B.K.); (H.Y.R.); (W.N.); (S.M.L.); (G.I.K.); (K.S.S.)
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Lommatzsch M, Criée CP, de Jong CCM, Gappa M, Geßner C, Gerstlauer M, Hämäläinen N, Haidl P, Hamelmann E, Horak F, Idzko M, Ignatov A, Koczulla AR, Korn S, Köhler M, Lex C, Meister J, Milger-Kneidinger K, Nowak D, Pfaar O, Pohl W, Preisser AM, Rabe KF, Riedler J, Schmidt O, Schreiber J, Schuster A, Schuhmann M, Spindler T, Taube C, Christian Virchow J, Vogelberg C, Vogelmeier CF, Wantke F, Windisch W, Worth H, Zacharasiewicz A, Buhl R. [Diagnosis and treatment of asthma: a guideline for respiratory specialists 2023 - published by the German Respiratory Society (DGP) e. V.]. Pneumologie 2023; 77:461-543. [PMID: 37406667 DOI: 10.1055/a-2070-2135] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
The management of asthma has fundamentally changed during the past decades. The present guideline for the diagnosis and treatment of asthma was developed for respiratory specialists who need detailed and evidence-based information on the new diagnostic and therapeutic options in asthma. The guideline shows the new role of biomarkers, especially blood eosinophils and fractional exhaled NO (FeNO), in diagnostic algorithms of asthma. Of note, this guideline is the first worldwide to announce symptom prevention and asthma remission as the ultimate goals of asthma treatment, which can be achieved by using individually tailored, disease-modifying anti-asthmatic drugs such as inhaled steroids, allergen immunotherapy or biologics. In addition, the central role of the treatment of comorbidities is emphasized. Finally, the document addresses several challenges in asthma management, including asthma treatment during pregnancy, treatment of severe asthma or the diagnosis and treatment of work-related asthma.
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Affiliation(s)
- Marek Lommatzsch
- Zentrum für Innere Medizin, Abt. für Pneumologie, Universitätsmedizin Rostock
| | | | - Carmen C M de Jong
- Abteilung für pädiatrische Pneumologie, Abteilung für Pädiatrie, Inselspital, Universitätsspital Bern
| | - Monika Gappa
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus Düsseldorf
| | | | | | | | - Peter Haidl
- Abteilung für Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
| | - Eckard Hamelmann
- Kinder- und Jugendmedizin, Evangelisches Klinikum Bethel, Bielefeld
| | | | - Marco Idzko
- Abteilung für Pulmologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien
| | - Atanas Ignatov
- Universitätsklinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum Magdeburg
| | - Andreas Rembert Koczulla
- Schön-Klinik Berchtesgadener Land, Berchtesgaden
- Klinik für Innere Medizin Schwerpunkt Pneumologie, Universitätsklinikum Marburg
| | - Stephanie Korn
- Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg
| | - Michael Köhler
- Deutsche Patientenliga Atemwegserkrankungen, Gau-Bickelheim
| | - Christiane Lex
- Klinik für Kinder- und Jugendmedizin, Universitätsmedizin Göttingen
| | - Jochen Meister
- Klinik für Kinder- und Jugendmedizin, Helios Klinikum Aue
| | | | - Dennis Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München
| | - Oliver Pfaar
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Sektion für Rhinologie und Allergie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg
| | - Wolfgang Pohl
- Gesundheitszentrum Althietzing, Karl Landsteiner Institut für klinische und experimentelle Pneumologie, Wien
| | - Alexandra M Preisser
- Zentralinstitut für Arbeitsmedizin und Maritime Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Klaus F Rabe
- Pneumologie, LungenClinic Großhansdorf, UKSH Kiel
| | - Josef Riedler
- Abteilung für Kinder- und Jugendmedizin, Kardinal Schwarzenberg Klinikum Schwarzach
| | | | - Jens Schreiber
- Universitätsklinik für Pneumologie, Universitätsklinikum Magdeburg
| | - Antje Schuster
- Klinik für Allgemeine Pädiatrie, Neonatologie und Kinderkardiologie, Universitätsklinikum Düsseldorf
| | | | | | - Christian Taube
- Klinik für Pneumologie, Universitätsmedizin Essen-Ruhrlandklinik
| | | | - Christian Vogelberg
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | | | | | - Wolfram Windisch
- Lungenklinik Köln-Merheim, Lehrstuhl für Pneumologie, Universität Witten/Herdecke
| | - Heinrich Worth
- Pneumologische & Kardiologische Gemeinschaftspraxis, Fürth
| | | | - Roland Buhl
- Klinik für Pneumologie, Zentrum für Thoraxerkrankungen, Universitätsmedizin Mainz
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Rzepczyk S, Świderski P, Sommerfeld-Klatta K, Tezyk A, Łukasik-Głębocka M, Zielińska-Psuja B, Żaba Z, Żaba C. Causes of Death during the Intravenous Infusion of Dimethylsulphoxide and Hydrogen Peroxide in the Course of Alternative Medicine Therapy. TOXICS 2023; 11:652. [PMID: 37624158 PMCID: PMC10457729 DOI: 10.3390/toxics11080652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023]
Abstract
Unconventional (alternative, natural) medicine in Poland and worldwide includes hundreds of non-scientifically verified "treatment" modalities. Among the most popular are biological therapies using chemical or natural compounds administered with injection or drip infusion. The latter has found the most excellent use in treating rheumatological and dermatological diseases and certain types of cancer. Vitamin infusions, curcumin, glutathione, perhydrol and dimethylsulphoxide (DMSO) have gained popularity among clients of natural medicine clinics. The present study aims to analyse the case of a 37-year-old woman who was administered infusions containing perhydrol and DMSO (0.5 mL 0.04% hydrogen peroxide/0.5 mL p.d.a DMSO in saline) due to a MTHFR A1298C mutation. After having the next infusion, the woman complained of nausea and then became unconscious. Subsequently, she suffered respiratory and cardiac arrest. Adequate resuscitation was undertaken. After being taken to the hospital, the patient was in critical condition and died due to increasing multiple-organ failure. Initially, there was suspected DMSO poisoning as it was the only compound to have been administered as an intravenous infusion. However, it was not until the analysis of the secured evidence that it became clear that the patient had also been given an intravenous solution of hydrogen peroxide, H2O2, and that there had been a mistake in preparing the intravenous perhydrol solution. The autopsy concluded that the immediate cause of death was an acute cardiopulmonary failure due to the toxic effects of intravenously administered hydrogen peroxide. This conclusion was established after the toxicological testing of the evidence and biological material secured during the patient's treatment and autopsy. Products containing DMSO and perhydrol are not included in the lists of medicinal/therapeutical forms and preparations and thus are not authorised for marketing in Poland. In the case of perhydrol, apart from the topical use of diluted preparations for washing and cleansing wounds, no data on therapeutic use exist in the available scientific literature. Furthermore, "DMSO and perhydrol therapy" cannot even be considered a placebo effect, as both are toxic compounds which could, at most, cause poisoning symptoms rather than improve health.
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Affiliation(s)
- Szymon Rzepczyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Paweł Świderski
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Karina Sommerfeld-Klatta
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Artur Tezyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Magdalena Łukasik-Głębocka
- Department of Emergency Medicine, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznan, Poland
| | - Barbara Zielińska-Psuja
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Zbigniew Żaba
- Department of Emergency Medicine, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
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Ogbu CE, Oparanma C, Ogbu SC, Ujah OI, Okoli ML, Kirby RS. Trends in the Use of Complementary and Alternative Therapies among US Adults with Current Asthma. EPIDEMIOLOGIA 2023; 4:94-105. [PMID: 36975618 PMCID: PMC10048134 DOI: 10.3390/epidemiologia4010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Complementary and Alternative Medicines/Therapies (CAM) are commonly used by US asthma adults, yet little is known about recent trends in their use. Our aim was to report trends in CAM use among US adults with current asthma. We conducted a serial cross-sectional study using nationally representative data from the BRFSS Asthma Call-Back Survey (ACBS) collected between 2008 and 2019 (sample size per cycle, 8222 to 14,227). The exposure was calendar time, as represented by ACBS cycle, while the main outcomes were use of at least one CAM and eleven alternative therapies. We analyzed CAM use overall and by population subgroups based on age, gender, race/ethnicity, income, and daytime and night-time asthma symptoms. Our findings show that there was an increase in the use of at least one CAM from 41.3% in 2008 to 47.9% in 2019 (p-trend < 0.001) and an upward trend in the use of herbs, aromatherapy, yoga, breathing exercises, homeopathy, and naturopathy (p-trend < 0.05). However, the use of vitamins, acupuncture, acupressure, reflexology, and other CAM therapies remained stable (p-trend > 0.05). These trends varied according to population characteristics (age, sex, race, income) and asthma symptoms. In conclusion, our study suggests that CAM use among US adults with current asthma is either increasing or stable, and further studies are needed to explore the factors influencing these trends.
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Affiliation(s)
- Chukwuemeka E Ogbu
- Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Chisa Oparanma
- Department of Medicine, Kharkiv National Medical University, 61022 Kharkiv, Ukraine
| | - Stella C Ogbu
- Department of Biomedical Science, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Otobo I Ujah
- Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Menkeoma L Okoli
- Department of Internal Medicine, Christus Health, Texas A&M University, Longview, TX 75601, USA
| | - Russell S Kirby
- Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
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Chen YJ, Shimizu Bassi G, Wang Y, Yang YQ. Research hotspot and frontier analysis of traditional Chinese medicine in asthma using bibliometric methods from 1991 to 2021. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2022; 1:185-197. [PMID: 37779535 PMCID: PMC10509992 DOI: 10.1016/j.jacig.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/30/2022] [Accepted: 07/31/2022] [Indexed: 10/03/2023]
Abstract
Traditional Chinese medicine (TCM) has been successfully used to treat asthmatic conditions for centuries. Nevertheless, the current hotspots and research frontiers on TCM for asthma have not been systematically investigated on the basis of bibliometric analysis. In this study, a scientometric analysis (1991-2021) was carried out on 3081 journal articles obtained from the Web of Science Core Collection database to explore the basic characteristics, research hotspots, and frontiers of TCM in asthma research. The results revealed the following: (1) Research on TCM in asthma has received widespread attention since the beginning of the 21st century; perhaps 2009 was an important turning point. TCM in asthma research shows a trend of interdisciplinary development. (2) Well-known universities/institutions in China, the United States, and South Korea have conducted the main body of current TCM research in asthma. JingCheng Dong (Fudan University, China) and XiuMin Li (Mount Sinai School of Medicine, USA) are the top 2 leading authors in this field. However, there is still a lack of international cooperation in the field of TCM in asthma research, and the influence of researchers in China and South Korea still needs improvement. (3) The Journal of Allergy and Clinical Immunology ranks first in the research field on the influence of TCM in asthma. (4) Hotspots and frontiers of TCM in asthma are provided according to the timeline analyses of the research. In the former, complementary medicine, alternative treatment, allergic rhinitis, airway remodeling, Dietary Approach to Stop Hypertension diet, and eosinophilic esophagitis are in the exploratory stage. In the latter, pharmacology, essential oil, gut microbiota, and oxidative stress were investigated from 2006 until late 2021 as period B, which contradicts period A (1991-2005). Moreover, limitations of this bibliometric analysis and the study of TCM research in asthma still exist, which are sufficiently important to warrant further investigations. Finally, we propose the significant importance of the real quintessence and characteristics of TCM in clinical and future research.
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Affiliation(s)
- Yan-Jiao Chen
- Shanghai Research Institute of Acupuncture and Meridian, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Gabriel Shimizu Bassi
- Shanghai Research Institute of Acupuncture and Meridian, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Yu Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong-Qing Yang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Sangeethalaxmi MJ, Hankey A. Design and implementation of a highly efficacious new yoga breathing and relaxation protocol for asthma: A discussion and summary. J Ayurveda Integr Med 2022; 14:100628. [PMID: 36008210 PMCID: PMC10105224 DOI: 10.1016/j.jaim.2022.100628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 10/15/2022] Open
Abstract
Asthma presents a global problem to health of high prevalence; often life-long, typical onset in late teenage years, and no hope of reversal. Also, problems of long-term management with drugs present patients with endless suffering: poor quality of life due to reduced pulmonary function and associated psychological problems. There is thus great need for more effective management, and identification of any possible route to cure. Yoga therapy offers a promising alternative. Studies of specially designed yoga protocols over the past 40 years have shown benefits for all the above problem areas. However, challenges have led to high dropout levels. Some postures may have been too difficult for all to perform, while overall yoga modules may have required too much time for all patients to practice regularly. Despite patients with asthma feeling that Yoga brings benefits, few have practiced it with enough persistence to gain control of their condition. This short communication summarizes two recent papers describing, (a) the development of a short, easy to practise yoga module, and (b) assessment of its efficacy in all three areas by a 90-day randomized control trial. The module's five carefully selected components include four breathing practices and a relaxation exercise, which could be done by anyone, even those new to yoga. Popularity with participants led to zero dropouts, while its efficacy proved extremely high in all areas assessed. These results also offer insights into developing further easily-practised yoga adjuvant therapy modules for chronic conditions other than asthma.
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Kang SW, Kim KI, Bu Y, Lee BJ, Jung HJ. Therapeutic Potential of Chungsangboha-tang for the Treatment of Asthma: A Review of Preclinical and Clinical Studies. J Clin Med 2022; 11:jcm11144035. [PMID: 35887796 PMCID: PMC9320585 DOI: 10.3390/jcm11144035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 01/25/2023] Open
Abstract
In traditional Korean medicine, Chungsangboha-tang (CSBHT) and its modified forms are used to treat various respiratory disorders, including asthma. This study aimed to identify research trends, clarify the effectiveness of CSBHT and related prescriptions, and lay a foundation for future research. We conducted a literature review using PubMed, Embase, Google Scholar, Oriental Medicine Advanced Searching Integrated System, National Digital Science Links, Korean Medical Database, Wanfang Data, and Chinese National Knowledge Infrastructure databases. We analyzed 25 studies, including 5 in vitro studies, 6 animal studies, and 14 human studies. Many studies evaluated the efficacy of CSBHT and its related prescriptions, including experimental studies on its effectiveness in asthma. The main mechanism of action involves the anti-inflammatory effect caused by the regulation of various immune cells, cytokines, and chemokines. In addition, clinical trials on asthma reported the benefits of CSBHT and its related prescriptions. However, there has been no randomized controlled study of clinical trials on the clinical effectiveness of CSBHT in asthma. Therefore, large-scale randomized controlled studies should be conducted in the future.
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Affiliation(s)
- Sung-Woo Kang
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Seoul 02447, Korea; (S.-W.K.); (K.-I.K.)
| | - Kwan-Il Kim
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Seoul 02447, Korea; (S.-W.K.); (K.-I.K.)
| | - Youngmin Bu
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Seoul 02447, Korea;
| | - Beom-Joon Lee
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Seoul 02447, Korea; (S.-W.K.); (K.-I.K.)
- Department of Internal Medicine (Pulmonary & Allergy System), Kyung Hee University Medical Center, 23 Kyungheedae-ro, Seoul 02447, Korea
- Correspondence: (B.-J.L.); (H.-J.J.)
| | - Hee-Jae Jung
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Seoul 02447, Korea; (S.-W.K.); (K.-I.K.)
- Department of Internal Medicine (Pulmonary & Allergy System), Kyung Hee University Medical Center, 23 Kyungheedae-ro, Seoul 02447, Korea
- Correspondence: (B.-J.L.); (H.-J.J.)
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Therapeutic Potential of Ajwa Dates (Phoenix dactylifera) Extract in Prevention of Benzo(a)pyrene-Induced Lung Injury through the Modulation of Oxidative Stress, Inflammation, and Cell Signalling Molecules. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136784] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chronic respiratory diseases are a leading cause of lung-related death worldwide. The vital factors causing lung pathogenesis include consistent exposure to tobacco smoke, air pollution, and occupational risks. Regarding the significant morbidity and mortality linked to lung pathogenesis, there are neither conclusive treatments nor wholly preventive strategies. In the present study, the protective mechanism of Ajwa date extract (ADE), on Benzopyrene [B(a)P]-induced lung injury in animal models was investigated using antioxidant, lipid peroxidation, anti-inflammatory activities, angiogenesis, histopathological studies, and apoptosis assays. B(a)P treatment significantly decreased the level of antioxidant enzymes such as catalase (Cat) (13.4 vs. 24.7 U/mg protein), Superoxide dismutase (SOD) (38.5 vs. 65.7 U/mg protein), Glutathione peroxidase (GPx) (42.4 vs. 57.3 U/mg protein) and total antioxidant capacity (TAC) (49.8 vs. 98.7 nM) as compared to the treatment group (p < 0.05). B(a)P treatment led to increased expression of pro-inflammatory markers such as TNF-α (88.5 vs. 72.6 pg/mL), IFN-γ (4.86 vs. 3.56 pg/mL), interleukin-6 (IL-6) (109.6 vs. 85.4 pg/mL) and CRP (1.84 vs. 0.94 ng/mL) as compared to the treatment group (p < 0.05). The data shows a significant increase in lipid peroxidation and angiogenesis factors such as vascular endothelial growth factor (VEGF) by B(a)P treatment (p < 0.05). However, ADE treatment showed an improvement of these factors. In addition, ADE treatment significantly ameliorated histopathological changes, collagen fiber deposition, and expression pattern of VEGF and Bax proteins. Furthermore, the flow cytometry data demonstrated that B(a)P intoxication enhanced the apoptosis ratio, which was significantly improved with ADE treatment. Finally, we may infer that Phyto-constituents of ADE have the potential to protect against B(a)P-induced lung pathogenesis. Therefore, Ajwa dates might be used to develop a possible potent alternative therapy for lung pathogenesis.
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Umar HI, Saliu TP, Josiah SS, Ajayi A, Danjuma JB. In silico studies of bioactive compounds from selected African plants with inhibitory activity against nitric oxide synthase and arginase implicated in asthma. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2021. [DOI: 10.1186/s43042-021-00175-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Abstract
Background
It is a known fact that arginine is a common substrate for arginase and nitric oxide synthase (NOS). However, an imbalance between both enzymes could lead to a change in airway responses. Reports suggest that increased activities of both enzymes could lead to airway hyper-responsiveness. Thus, the requests for NOS inhibitors that can also inhibit arginase as the elevated activities of both enzymes have detrimental consequence on airways in asthma. Bioactive compounds from Azadirachta indica, Crinum glaucum, and Mangifera indica are documented for anti-inflammatory, immunomodulatory, anti-histaminic, smooth-muscle relaxants, and anti-allergic potentials. However, the mechanisms of action of these bioactive compounds in conferring the aforementioned protections are not well characterized. The objective of this present study is to assess in silico inhibitory potentials of these bioactive compounds against NOS and arginase via binding at their active sites. The crystal structures of NOS and arginase were retrieved from the protein database, while the bioactive compounds were retrieved from PubChem. Drug-likeness of the selected bioactive compounds was assessed using DruLiTo software. The successful compounds were docked with active sites of enzymes using AutoDock Vina docking software, and the docked complexes were analyzed using LigPlot and protein-ligand profiler web server.
Results
The findings of the study revealed that the bioactive compounds from A. indica, C. glaucum, and M. indica were able to interact with the active sites of NOS and arginase with the exception of gallic acid (from M. indica) and nimbandiol (from A. indica); these compounds showed differential binding energies (kcal/mol) and a number of them had higher binding energies than l-arginine when docked with NOS.
Conclusion
Conclusively, the in silico analysis proposes that these compounds could prove to be probable anti-asthmatic drugs.
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Luković E, Perez-Zoghbi JF, Zhang Y, Zhu Y, Sang S, Emala CW. Ginger metabolites and metabolite-inspired synthetic products modulate intracellular calcium and relax airway smooth muscle. Am J Physiol Lung Cell Mol Physiol 2021; 321:L912-L924. [PMID: 34549600 PMCID: PMC8616613 DOI: 10.1152/ajplung.00271.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 11/22/2022] Open
Abstract
Asthma affects millions of people worldwide and its prevalence is increasing. It is characterized by chronic airway inflammation, airway remodeling, and pathologic bronchoconstriction, and it poses a continuous treatment challenge with very few new therapeutics available. Thus, many asthmatics turn to plant-based complementary products, including ginger, for better symptom control, indicating an unmet need for novel therapies. Previously, we demonstrated that 6-shogaol (6S), the primary bioactive component of ginger, relaxes human airway smooth muscle (hASM) likely by inhibition of phosphodiesterases (PDEs) in the β-adrenergic (cyclic nucleotide PDEs), and muscarinic (phospholipase C, PLC) receptor pathways. However, oral 6S is extensively metabolized and it is unknown if the resulting metabolites remain bioactive. Here, we screened all the known human metabolites of 6S and several metabolite-based synthetic derivatives to better understand their mechanism of action and structure-function relationships. We demonstrate that several metabolites and metabolite-based synthetic derivatives are able to prevent Gq-coupled stimulation of intracellular calcium [Ca2+]i and inositol trisphosphate (IP3) synthesis by inhibiting PLC, similar to the parent compound 6S. We also show that these compounds prevent recontraction of ASM after β-agonist relaxation likely by inhibiting PDEs. Furthermore, they potentiate isoproterenol-induced relaxation. Importantly, moving beyond cell-based assays, metabolites also retain the functional ability to relax Gq-coupled-contractions in upper (human) and lower (murine) airways. The current study indicates that, although oral ginger may be metabolized rapidly, it retains physiological activity through its metabolites. Moreover, we are able to use naturally occurring metabolites as inspiration to develop novel therapeutics for brochoconstrictive diseases.
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Affiliation(s)
- Elvedin Luković
- Department of Anesthesiology, Columbia University, New York, New York
| | | | - Yi Zhang
- Department of Anesthesiology, Columbia University, New York, New York
| | - Yingdong Zhu
- Laboratory for Functional Foods and Human Health, Center for Excellence in Post-Harvest Technologies, North Carolina Agricultural and Technical State University, North Carolina Research Campus, Kannapolis, North Carolina
| | - Shengmin Sang
- Laboratory for Functional Foods and Human Health, Center for Excellence in Post-Harvest Technologies, North Carolina Agricultural and Technical State University, North Carolina Research Campus, Kannapolis, North Carolina
| | - Charles W Emala
- Department of Anesthesiology, Columbia University, New York, New York
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11
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Wang SN, Yan JL, Wu SX, Wu L, Zheng YC, Shou JS, Xu YJ. Effects of Dingchuan Decoction on Lung Function and Clinical Effectiveness Rate in Children with Asthma: A Systematic Review and Meta-Analysis. Complement Med Res 2021; 28:533-544. [PMID: 34261065 DOI: 10.1159/000512669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 10/23/2020] [Indexed: 11/19/2022]
Abstract
Dingchuan decoction (DCD) is a traditional Chinese prescription for asthma that remains popular today. To systematically evaluate the effect of DCD on lung function, clinical effectiveness rate, and safety in children with asthma, significant databases were searched for randomized controlled trials from their inception to September 9, 2019. Randomized controlled trials assessing the effect of DCD on lung function and clinical effectiveness rate in children with asthma were included in this meta-analysis. The methodological quality of the included trials was assessed using the Cochrane risk of bias tool. RevMan 5.3 was used for data analysis. Fourteen studies with 1,384 children were reviewed. FEV1 improvement rate (mean difference [MD] 12.50, 95% confidence interval [CI] 8.72-16.29), PEF improvement rate (MD 14.28, 95% CI 11.08-17.49), and clinical effectiveness rate (relative risk 1.19, 95% CI 1.14-1.25) significantly increased in the DCD group when compared to simple conventional medication. Four trials suggest that DCD is safe for children. In conclusion, the use of DCD combined with conventional medication improves lung function and clinical effectiveness rate better than simple conventional medication. However, the selected trials lack blinding and large-scale studies. Therefore, to better manage DCD in clinical practice, more randomized controlled trials and large-scale studies are required for further evaluation.
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Affiliation(s)
- Sheng-Nan Wang
- Department of Intensive Care, Guangzhou People's Hospital of Tianhe District, Tianhe District Hospital of the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jia-Li Yan
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shao-Xing Wu
- Department of Respiration, The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lei Wu
- Evidence-Based Medicine and Clinical Research Serve Group, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China
| | - Yan-Chan Zheng
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jian-Shun Shou
- Department of Intensive Care, Guangzhou People's Hospital of Tianhe District, Tianhe District Hospital of the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yin-Ji Xu
- Department of Respiration, The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China
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12
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Therapeutic effects of Nigella sativa on asthma, a systematic review of clinical trial. PHYSIOLOGY AND PHARMACOLOGY 2021. [DOI: 10.52547/phypha.26.2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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13
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Ai M, Lin S, Zhang M, Wu T, Yang N, Li Y, Li L. Cirsilineol attenuates LPS-induced inflammation in both in vivo and in vitro models via inhibiting TLR-4/NFkB/IKK signaling pathway. J Biochem Mol Toxicol 2021; 35:e22799. [PMID: 33949057 DOI: 10.1002/jbt.22799] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 01/03/2023]
Abstract
The anti-inflammatory activity of cirsilineol in in vivo condition was assessed by measuring the relative organ weight, lung dry/wet weight ratio, protein concentration, and infiltration of inflammatory cells in bronchoalveolar lavage fluid. We estimated the myeloperoxidase activity and levels of cytokines, chemokines, and inflammatory markers to analyze the efficacy of cirsilineol against lipopolysaccharide (LPS)-induced lung inflammation. Furthermore, we quantified the gene expression of NFkB/IKK signaling molecules in cirsilineol-treated and untreated acute lung injury mice to confirm the anti-inflammatory property of cirsilineol. The lung histology was assessed with hematoxylin and eosin staining. Apart from in vivo experiments, in vitro tests with LPS-stimulated RAW 264.7 macrophages were also performed. Cell viability assay was performed in the presence and absence of LPS in RAW 264.7 macrophages to determine the cytotoxic effect of cirsilineol against macrophages. Reverse-transcription polymerase chain reaction (RT-PCR) analysis was done to analyze the gene expression of inflammatory markers in LPS-treated RAW 264.7 macrophages to prove that cirsilineol effectively inhibits inflammation in vitro. The results of our study prove that cirsilineol effectively inhibits inflammation in both in vivo and in vitro conditions. RT-PCR analysis results of NFkB/IKK signaling molecules clearly illustrate that cirsilineol inhibited the expression of NFkB/IKK signaling protein and thereby prevented inflammation in in vivo condition, and it is further confirmed with the results of inflammatory protein expression in vitro model. The lung histopathological studies authentically confirm that cirsilineol potentially prevented the mice from LPS-induced lung inflammation.
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Affiliation(s)
- Meimei Ai
- Department of Emergency, First Affiliated Hospital of Air Force Military Medical University (Xijing Hospital), Xian, Shaanxi, China
| | - Shusheng Lin
- Department of Intensive Care Unit, Huaian Hospital of Huai'an City, Huai'an, Jiangsu, China
| | - Meixia Zhang
- Department of Nursing, First Affiliated Hospital of Air Force Military Medical University (Xijing Hospital), Xian, Shaanxi, China
| | - Tieli Wu
- Pneumology Department, Jilin Medical College Affiliated Hospital, Jilin, China
| | - Nan Yang
- Day Observation Ward, First Hospital of Jilin University, Changchun, Jilin, China
| | - Yu Li
- Department of Health Examination, Peace Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
| | - Li Li
- Department of Emergency, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing, China.,Institute of Sepsis, Beijing University of Traditional Chinese Medicine, Beijing, China
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14
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Santana FPR, Thevenard F, Gomes KS, Taguchi L, Câmara NOS, Stilhano RS, Ureshino RP, Prado CM, Lago JHG. New perspectives on natural flavonoids on COVID-19-induced lung injuries. Phytother Res 2021; 35:4988-5006. [PMID: 33928690 PMCID: PMC8242604 DOI: 10.1002/ptr.7131] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/11/2021] [Accepted: 04/06/2021] [Indexed: 12/21/2022]
Abstract
The SARS-CoV-2 virus, responsible for COVID-19, spread rapidly worldwide and became a pandemic in 2020. In some patients, the virus remains in the respiratory tract, causing pneumonia, respiratory failure, acute respiratory distress syndrome (ARDS), and sepsis, leading to death. Natural flavonoids (aglycone and glycosides) possess broad biological activities encompassing antiinflammatory, antiviral, antitumoral, antiallergic, antiplatelet, and antioxidant effects. While many studies have focused on the effects of natural flavonoids in experimental models, reports based on clinical trials are still insufficient. In this review, we highlight the effects of flavonoids in controlling pulmonary diseases, particularly the acute respiratory distress syndrome, a consequence of COVID-19, and their potential use in coronavirus-related diseases. Furthermore, we also focus on establishing a relationship between biological potential and chemical aspects of related flavonoids and discuss several possible mechanisms of action, pointing out some possible effects on COVID-19.
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Affiliation(s)
- Fernanda Paula R Santana
- Department of Bioscience, Federal University of São Paulo, Santos, São Paulo, Brazil.,Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Fernanda Thevenard
- Center of Natural Sciences and Humanities, Federal University of ABC, São Paulo, São Paulo, Brazil
| | - Kaio S Gomes
- Center of Natural Sciences and Humanities, Federal University of ABC, São Paulo, São Paulo, Brazil
| | - Laura Taguchi
- Department of Bioscience, Federal University of São Paulo, Santos, São Paulo, Brazil
| | - Niels Olsen S Câmara
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Roberta S Stilhano
- Department of Physiological Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, São Paulo, Brazil
| | - Rodrigo P Ureshino
- Department of Biological Science, Federal University of São Paulo, Diadema, São Paulo, Brazil
| | - Carla Maximo Prado
- Department of Bioscience, Federal University of São Paulo, Santos, São Paulo, Brazil
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15
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Kim SB, Seo YS, Kim HS, Lee AY, Chun JM, Kim WJ, Moon BC, Kwon BI. Root extract of Angelica reflexa B.Y.Lee reduces allergic lung inflammation by regulating Th2 cell activation. JOURNAL OF ETHNOPHARMACOLOGY 2021; 269:113752. [PMID: 33359858 DOI: 10.1016/j.jep.2020.113752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 12/11/2020] [Accepted: 12/19/2020] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditionally, the roots of Angelica reflexa B.Y.Lee (AR) have been used to treat cough, phlegm, neuralgia, and arthralgia in Northeast Asia. AIM OF THE STUDY The anti-asthmatic effect of AR root extract (ARE) was determined using a murine airway allergic inflammation model and the primary T cell polarization assay. MATERIALS AND METHODS To evaluate the anti-asthmatic effect of ARE, inflammatory cell infiltration was determined histologically and inflammatory mediators were measured in bronchoalveolar lavage fluid (BALF). Furthermore, the effects of AREs on Th2 cell differentiation and activation were determined by western blotting and flow cytometry. RESULTS Asthmatic phenotypes were alleviated by ARE treatment, which reduced mucus production, inflammatory cell infiltration (especially eosinophilia), and type 2 cytokine levels in BALF. ARE administration to mice reduced the number of activated Th2 (CD4+CD25+) cells and level of GATA3 in the lungs. Furthermore, ARE treatment inhibited the differentiation of Th2 cells in primary cell culture systems via interferon regulatory factor 4 (IRF4) signaling. CONCLUSIONS Our findings indicate that the anti-asthmatic effect of AREs is mediated by the reduction in Th2 cell activation by regulating IRF4.
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Affiliation(s)
- Sung Bae Kim
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, 58245, Republic of Korea; Bio Technology Division, Korea Conformity Laboratories (KCL), Incheon, 21999, Republic of Korea
| | - Yun-Soo Seo
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, 58245, Republic of Korea
| | - Hyo Seon Kim
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, 58245, Republic of Korea
| | - A Yeong Lee
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, 58245, Republic of Korea
| | - Jin Mi Chun
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, 58245, Republic of Korea
| | - Wook Jin Kim
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, 58245, Republic of Korea
| | - Byeong Cheol Moon
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, 58245, Republic of Korea
| | - Bo-In Kwon
- Department of Pathology, College of Korean Medicine, Sangji University, Wonju-si, Gangwon-do, 26339, Republic of Korea; Research Institute of Korean Medicine, Sangji University, Wonju-si, Gangwon-do, 26339, Republic of Korea.
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16
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Aro AO, Famuyide IM, Elisha IL, Kabongo-Kayoka PN, McGaw LJ, Kahler-Venter CP. Differentiation of Tarchonanthus camphoratus L. and Tarchonanthus parvicapitulatus P.P.J. Herman (Asteraceae) using electron microscopy, and comparison of their biological activities. JOURNAL OF ETHNOPHARMACOLOGY 2021; 267:113620. [PMID: 33246114 DOI: 10.1016/j.jep.2020.113620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/03/2020] [Accepted: 11/22/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tarchonanthus camphoratus L. complex has numerous medicinal uses amongst the sub-Saharan African populace, including treatment for bronchospasm. This study focused on providing scientific rationale for the traditional use of the extracts of T. camphoratus and T. parvicapitulatus. T. camphoratus L. complex has been published under diverse names by various taxonomists. Tarchonanthus parvicapitulatus was one of the newly described taxa, leaving Tarchonanthus camphoratus L. sens. strict. as a homogenous taxon. However, some of the morphological characters used tend to overlap, making it difficult to identify the different taxa. AIMS The aim of this study was to evaluate the bronchodilatory, antioxidant and toxicological properties of the leaves of T. camphoratus L. and T. parvicapitulatus. This study also aimed to use scanning electron microscopy (SEM) to assess the differences between T. camphoratus L. and T. parvicapitulatus. MATERIALS AND METHODS Thin layer chromatography (TLC) with vanillin as visualizing agent was used to qualitatively compare the phytoconstituents of the plant acetone extracts. The free radical scavenging antioxidant qualitative assay was done by spraying TLC plates with DPPH free radical. The bronchodilatory effects of the aqueous extracts were assessed using pre-contracted guinea pig trachea. The effects of the extracts of T. camphoratus L. and T. parvicapitulatus on superoxide and ATP production was also investigated on isolated human neutrophils. A micromorphology study was done using scanning electron microscopy to study the leaves. RESULTS Different compounds were visualized on the TLC plates with more than 40 compounds of intermediate polarity. The TLC plates sprayed with DPPH revealed the presence of 20 and 23 antioxidant compounds for T. camphoratus and T. parvicapitulatus respectively. Upon pre-contraction of the tracheal smooth muscles, the aqueous extracts of T. parvicapitulatus significantly relaxed the trachea while the relaxation observed for T. camphoratus was not significant. All the tested concentrations had a dose dependent inhibitory effect on superoxide production. The crude extract of T. parvicapitulatus at the highest concentration (10 mg/ml) significantly decreased ATP production while a non-significant increase in ATP production was observed for T. camphoratus at the highest concentration (10 mg/ml) when compared with the control. The micromorphology study was useful in revealing the presence of trichomes on the upper leaf surface of the studied taxa. CONCLUSIONS The results obtained from this study showed that the studied plant extracts had bronchodilatory effects on contracted guinea pig trachea and could also inhibit the production of free radicals including superoxide anions. To the best of our knowledge, this is the first report on the bronchodilatory activity of T. camphoratus and T. parvicapitulatus. The micromorphological studies were useful in distinguishing between the two species, confirming that T. camphoratus L. and T. parvicapitulatus are different taxa. This study provides evidence to support the traditional use of T. camphoratus and T. parvicapitulatus in managing bronchospasm.
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Affiliation(s)
- A O Aro
- Department of Agriculture and Animal Health, Faculty of Agriculture and Environmental Sciences, University of South Africa, Florida Campus, South Africa.
| | - I M Famuyide
- Phytomedicine Programme, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
| | - I L Elisha
- Phytomedicine Group, Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Private Bag X680 Arcadia, 0001, Pretoria, South Africa; Drug Development Section, Biochemistry Division, National Veterinary Research Institute, P.M.B. 01, Vom Plateau State, Nigeria.
| | - P N Kabongo-Kayoka
- Department of Agriculture and Animal Health, Faculty of Agriculture and Environmental Sciences, University of South Africa, Florida Campus, South Africa.
| | - L J McGaw
- Phytomedicine Programme, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
| | - C P Kahler-Venter
- Department of Pharmacology and Therapeutics, School of Medicine, Sefako Makgatho University of Health Sciences, Ga-rankuwa, South Africa.
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17
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Serhal S, Saini B, Bosnic-Anticevich S, Krass I, Wilson F, Armour C. Medication Adherence in a Community Population with Uncontrolled Asthma. PHARMACY 2020; 8:pharmacy8040183. [PMID: 33036454 PMCID: PMC7711630 DOI: 10.3390/pharmacy8040183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 12/12/2022] Open
Abstract
It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management in those most at risk—a population with clinically uncontrolled asthma. Participants (n = 363) were recruited from Australian community pharmacies, and a dispensed medication history report for the previous 12 months was collected to examine medication adherence and factors affecting adherence. Information was also collected regarding participant asthma control and asthma/allergic rhinitis (if applicable) management. The participants’ mean asthma control score was 2.49 (± 0.89 SD, IQR = 1.20) (score ≥ 1.5 indicative of poorly controlled asthma), and 72% were either non-adherent or yet to initiate preventer therapy. Almost half had been prescribed high doses of inhaled corticosteroid and 24% reported use of oral corticosteroids. Only 22% of participants with concomitant allergic rhinitis were using first line treatment. A logistic regression model highlighted that participant health care concession status and hospital admissions were associated with better adherence. Suboptimal medication management is evident in this at-risk population.
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Affiliation(s)
- Sarah Serhal
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- Correspondence: ; Tel.: +61-4-1495-9883
| | - Bandana Saini
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Ines Krass
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Frances Wilson
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
| | - Carol Armour
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
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18
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Mathias GP, Panigrahi T, Shanbagh S, Sadhana V, P. B, K. R, Sethu S, Ghosh A, Pidathala C, Ghosh A. Combination of Aqueous Extracts of Phyllanthus niruri, Boerhavia diffusa,and Picrorhiza kurroaor Zingiber officinalealone Inhibit Intracellular Inflammatory Signaling Cascade. J Herb Med 2020. [DOI: 10.1016/j.hermed.2020.100378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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19
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Topcu A, Løkke A, Eriksen L, Nielsen LP, Dahl R. The impact of reflexology and homeopathy added to conventional asthma treatment on markers of airway inflammation - a randomised study. Eur Clin Respir J 2020; 7:1726153. [PMID: 32166008 PMCID: PMC7054942 DOI: 10.1080/20018525.2020.1726153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/15/2020] [Indexed: 11/29/2022] Open
Abstract
Background Asthma is a common chronic airway disease associated with hyperresponsiveness and airway inflammation. Anti-inflammatory medication especially inhaled corticosteroids are important for control of airway inflammation, decrease of airway hyperresponsiveness and lung function variability, reduce asthma symptoms, and improve lung function as well as quality of life. Most studies investigating the influence of complementary and alternative medicine (CAM) in asthma measure clinical effectiveness, but only few evaluate the impact on markers of airway inflammation. Objective The aim of this study was to investigate the effect of reflexology and homeopathy added to conventional treatment on different markers of airway inflammation in asthma. Methods Eighty-four patients with asthma were randomized to receive conventional treatment alone or conventional treatment with addition of homeopathy or reflexology in a single center, investigator blinded, controlled, one-year trial. During the study period, patients regularly consulted their general practitioner for evaluation and asthma treatment. At randomization, and after 6 and 12 months, methacholine challenge test and measurement of exhaled nitric oxide were performed. Blood samples were collected for eosinophil count and measurement of serum eosinophil cationic protein. Results No significant differences between groups for any of the inflammatory markers were demonstrated. Methacholine responsiveness improved in all three groups but improvements were not statistically significant within and between groups. Conclusions This randomized controlled study of reflexology and homeopathy failed to show significant improvement on selected markers of inflammation and airway hyperresponsiveness in asthma.
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Affiliation(s)
- Ayfer Topcu
- Department of Medicine, The Regional Hospital in Horsens, Horsens, Denmark
| | - Anders Løkke
- Department of Medicine, Little Belt Hospital, Vejle, Denmark
| | | | - Lars Peter Nielsen
- Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark
| | - Ronald Dahl
- Global Medical Expert, GSK, Copenhagen, Denmark
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20
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Yang H, Zhang C, Gan W, Chen J, Wu J, Xiao W, Yang Y, Zhao K, Sun Z, Xie X, Huang Q. A randomized controlled trial study protocol for Xiao-Qing-Long decoction in the treatment of refractory asthma: Study protocol clinical trial (spirit compliant). Medicine (Baltimore) 2020; 99:e18911. [PMID: 32000396 PMCID: PMC7004712 DOI: 10.1097/md.0000000000018911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION People with refractory asthma (RA) often seek help from Chinese medicine due to dissatisfaction with conventional treatments. External cold and internal fluid syndrome is the most common type of asthma and the Chinese herbal medicine formula Xiao-Qing-Long (XQL) decoction is commonly prescribed for patients with asthma with this syndrome. However, there is no direct evidence to support the efficacy and safety of XQL decoction for RA treatment and its potential mechanism is still unclear. METHODS We propose a double-blind, placebo-controlled, randomized superiority trial. After a 2-week run-in period, 112 eligible participants will be recruited and randomly allocated to an experimental group or control group in a 1:1 ratio. Patients in the experimental group will take XQL decoction, while patients in the control group will receive a matched placebo. Symbicort Turbuhaler and Montelukast sodium tablets will be provided as the basic treatment for the 2 groups. All participants will receive 4 weeks of treatment and 12 weeks of follow-up. The primary outcome is the mean change in the asthma control test score from the baseline to 4 weeks posttreatment. The secondary outcomes include quality of life, lung function, curative effect of traditional Chinese medicine, and rescue medication used. This trial will also include analyses of the associations between intestinal microbiota and RA treatment. Any side effects of the treatment will be recorded. DISCUSSION The results of this trial will provide consolidated evidence of the effect of XQL decoction for RA and the potential mechanism by which XQL decoction acts, which will inform treatment options for patients with RA.
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Affiliation(s)
| | | | | | - Jun Chen
- Department of Critical Care Medicine
| | - Jianying Wu
- Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Xiao
- Department of Respiratory Medicine
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21
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Effect of pranayama breathing technique on asthma control, pulmonary function, and quality of life: A single-blind, randomized, controlled trial. Complement Ther Clin Pract 2019; 38:101081. [PMID: 32056817 DOI: 10.1016/j.ctcp.2019.101081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/06/2019] [Accepted: 12/17/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study evaluated the effect of pranayama on asthma control, pulmonary function, and quality of life in people with asthma. METHODS Pranayama was applied to the pranayama group for 20 min once daily for 1 month, and relaxation was applied to the relaxation group similarly in addition to the standard treatment. The outcome measurement tools used were the Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), pulmonary function test (PFT), and patient observation chart. RESULTS The pranayama group had significantly higher ACT score, overall AQLQ score, and subscale scores than the relaxation group (p < 0.05). However, there was no significant difference between the groups in terms of PFT parameters and peak expiratory flow values (p > 0.05). CONCLUSION Pranayama improved asthma control and asthma-related quality of life in people with asthma, but it did not show a significant difference in PFT values.
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Elsheikh MS, Mohamed NH, Alsharkawy AAA. Improvement of asthma control after laser acupuncture and its impact on exhaled 8-isoprostane as an oxidative biomarker in chronic bronchial asthma. Respir Med 2019; 156:15-19. [PMID: 31382164 DOI: 10.1016/j.rmed.2019.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/16/2019] [Accepted: 07/24/2019] [Indexed: 11/15/2022]
Abstract
Traditional medicine may not control bronchial asthma. Many patients have uncontrolled symptoms and the underlying ongoing inflammation is persistent. OBJECTIVE to assess efficacy of laser acupuncture in improving asthma symptoms and underlying oxidative stress through monitoring exhaled 8-isoprostane. METHOD 48 asthmatic (case group) received successive low level laser acupuncture sessions to stimulate acupoints for chronic asthma and 24 asthmatics received deactivated laser acupuncture sessions (control group). Asthma symptoms, asthma control questionnaire, concentration of 8-Isoprostane in exhaled breath condensate and airway resistance were assessed before and after laser acupuncture therapy. RESULTS After the completion of the course of laser acupuncture therapy, we observed significant improvement of asthma symptoms. Asthma control questionnaire improved from 9.7 ± 3.3 to 21.8 ± 3.6 (p 0.001). EBC 8-Isoprostane dropped from 14.7 ± 5.4 to 8.1 ± 5.0 (p 0.001). The airway resistance at R5 and R20 significantly decreased from 116.6 ± 25.8 & 124.5 ± 31.2 to 101.5 ± 25.6 &110.9 ± 29.9 respectively (p 0.001). Control patients who received sham acupuncture therapy did not show such improvement. CONCLUSION Laser acupuncture is an effective modality in treating bronchial asthma as evidenced by improved symptoms, airway resistance, and oxidative biomarkers.
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Affiliation(s)
- Mai S Elsheikh
- Complementary Medicine Department, National Research Center, Giza, Egypt.
| | - Nagwa H Mohamed
- Complementary Medicine Department, National Research Center, Giza, Egypt
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Kim EJ, Simonson J, Jacome S, Conigliaro J, Hanchate AD, Hajizadeh N. Disparities in complementary alternative medicine use and asthma exacerbation in the United States. J Asthma 2019; 57:866-874. [PMID: 31045459 DOI: 10.1080/02770903.2019.1614615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Complementary and alternative medicines (CAM) are associated with poor asthma medication adherence, a major risk factor for asthma exacerbation. However, previous studies showed inconsistent relationships between CAM use and asthma control due to small sample sizes, demographic differences across populations studied, and poor differentiation of CAM types.Methods: We examined associations between CAM use and asthma exacerbation using a cross-sectional analysis of the 2012 National Health Interview Survey. We included adults ≥18 years with current asthma (n = 2,736) to analyze racial/ethnic differences in CAM use as well as the association between CAM use and both asthma exacerbation and emergency department (ED) visit for asthma exacerbation across racial/ethnic groups. We ran descriptive statistics and multivariable logistic regressions.Result: Blacks (OR = 0.63 [0.49-0.81]) and Hispanics (OR = 0.66 [0.48-0.92]) had decreased odds of using CAM compared to Whites. Overall, there was no association between CAM use and asthma exacerbation (OR = 0.99 [0.79-1.25]) but the subgroup of 'other complementary approaches' was associated with increased odds of asthma exacerbation among all survey respondents (1.90 [1.21-2.97]), Whites (OR = 1.90 [1.21-2.97]), and Hispanics (OR = 1.43 [0.98-2.09). CAM use was associated with decreased odds of an ED visit for asthma exacerbation (OR = 0.65 [0.45-0.93]). These associations were different among racial/ethnic groups with decreased odds of ED visit among Whites (OR = 0.50 [0.32-0.78]) but no association among Blacks and Hispanics.Conclusion: We found that both CAM use and the association between CAM use and asthma exacerbation varied by racial/ethnic group. The different relationship may arise from how CAM is used to complement or to substitute for conventional asthma management.
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Affiliation(s)
- Eun Ji Kim
- Division of General Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, USA.,Center for Health Innovations and Outcomes Research Feinstein, Institute for Medical Research, Manhasset, New York, USA
| | - Joseph Simonson
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
| | - Sonia Jacome
- Center for Health Innovations and Outcomes Research Feinstein, Institute for Medical Research, Manhasset, New York, USA
| | - Joseph Conigliaro
- Division of General Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, USA.,Center for Health Innovations and Outcomes Research Feinstein, Institute for Medical Research, Manhasset, New York, USA
| | - Amresh D Hanchate
- Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Negin Hajizadeh
- Center for Health Innovations and Outcomes Research Feinstein, Institute for Medical Research, Manhasset, New York, USA.,Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
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24
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Hannane A, Misane L, Devouassoux G, Colin C, Letrilliart L. Asthma patients' perception on their care pathway: a qualitative study. NPJ Prim Care Respir Med 2019; 29:9. [PMID: 30940806 PMCID: PMC6445145 DOI: 10.1038/s41533-019-0121-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 03/04/2019] [Indexed: 01/29/2023] Open
Abstract
Because of insufficient asthma control in many patients, the collaboration between stakeholders is regarded as a promising strategy to improve asthma outcomes. This study explored the perceptions of French adult asthma patients on their care pathway. We conducted a qualitative study based on the interviews of 30 asthma patients aged 18–40 years, recruited in French primary care. We performed a thematic analysis of the data collected, using the NVivo software. According to the patients, the stakeholders involved in asthma management included those visible to healthcare professionals (patient, general practitioner, specialist(s), pharmacist, physiotherapist, family and friends) and those concealed by the patients (complementary and alternative practitioners); other stakeholders, such as nurses and occupational physicians, were not involved. Asthma management at diagnosis and follow-up phases proved to be unstructured, and were associated with poor patient education. This was supported by patients’ ambivalence (in relation to illness and treatments), poor communication between patients and healthcare professionals (lack of listening and use of inappropriate vocabulary by physicians, underreporting of alternative medicine use by patients) and weak cooperation between professionals (limited to interaction between the general practitioner and the specialist, either pulmonologist or allergist). Asthma management would probably benefit from a more coordinated care pathway at each phase of the disease that is consistent with the expectations and goals of the patients. It should be based on improved organization (involvement of other healthcare professionals and the patient as partners) and processes (regular follow-up, specific tools such as peak flow meter or action plan).
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Affiliation(s)
- Anissa Hannane
- Univ. Lyon, Université Claude Bernard Lyon 1, Collège universitaire de médecine générale, F-69008, Lyon, France
| | - Lilia Misane
- Univ. Lyon, Université Claude Bernard Lyon 1, Collège universitaire de médecine générale, F-69008, Lyon, France
| | - Gilles Devouassoux
- Univ. Lyon, Université Claude-Bernard Lyon 1, Lyon, F-69008, France.,Hôpital de la Croix-Rousse, Service de pneumologie, Hospices Civils de Lyon, Lyon, France
| | - Cyrille Colin
- Unité d'Evaluation Médico-Economique, Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, 69003, Lyon, France.,Univ. Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, F-69008, Lyon, France
| | - Laurent Letrilliart
- Univ. Lyon, Université Claude Bernard Lyon 1, Collège universitaire de médecine générale, F-69008, Lyon, France. .,Univ. Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, F-69008, Lyon, France.
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25
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Kim SB, Lee AY, Chun JM, Lee AR, Kim HS, Seo YS, Moon BC, Kwon BI. Anthriscus sylvestris root extract reduces allergic lung inflammation by regulating interferon regulatory factor 4-mediated Th2 cell activation. JOURNAL OF ETHNOPHARMACOLOGY 2019; 232:165-175. [PMID: 30552991 DOI: 10.1016/j.jep.2018.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Anthriscus sylvestris L. Hoffmann (AS) is a perennial plant that grows in Asia and Eastern Europe. Its dried root is used to treat conditions such as asthma, bronchitis, and cough. AIM OF THE STUDY The present study investigated the anti-inflammatory effects of whole AS extract (ASE) on allergic lung inflammation in vitro and in vivo as well as the underlying mechanisms. MATERIALS AND METHODS We used an ovalbumin (OVA)-induced asthma mouse model and in vitro primary T helper (Th)2 polarization system. Five groups of 8-week-old female C57BL/6 mice were divided into the following groups: saline control, or OVA-induced allergic asthma with vehicle, ASE (100 or 200 mg/kg), or dexamethasone (5 mg/kg) treatment for 7 days. RESULTS ASE attenuated mucus secretion in airway epithelial cells, inflammatory cell infiltration, eosinophilia, and Th2 cytokine levels in bronchoalveolar lavage fluid. Mice administered ASE showed reductions in the activated cluster of differentiation 4+ T cell population and GATA-binding protein-3 gene expression in the lung, and diminished Th2 cell differentiation and activation in vitro. Furthermore, ASE-treated mice showed decreased interleukin-6 and interferon regulatory factor (IRF)4 expression, with corresponding reductions in nitric oxide levels in the lungs of asthmatic mice and in stimulated RAW cells. CONCLUSION ASE exerts anti-asthmatic effects by inhibiting IRF4 expression and thereby suppressing Th2 cell activation.
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Affiliation(s)
- Sung-Bae Kim
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.
| | - A Yeong Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.
| | - Jin Mi Chun
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - A Reum Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.
| | - Hyo Seon Kim
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.
| | - Yun Soo Seo
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.
| | - Byeong Cheol Moon
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.
| | - Bo-In Kwon
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea; Department of Pathology, College of Korean Medicine, Sangji University, Wonju-si, Gangwon-do 26339, Republic of Korea.
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26
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Esparham A, Misra SM, Misra S, Sibinga E, Culbert T, Kemper K, McClafferty H, Vohra S, Rosen L. Pediatric Integrative Medicine: Vision for the Future. CHILDREN-BASEL 2018; 5:children5080111. [PMID: 30127308 PMCID: PMC6111895 DOI: 10.3390/children5080111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022]
Abstract
Pediatric integrative medicine (PIM) is of significant interest to patients, with 12% of the general pediatric population and up to 80% of children with chronic conditions using PIM approaches. The field of PIM has evolved over the past 25 years, approaching child health with a number of guiding principles: preventive, context-centered, relationship-based, personalized, participatory, and ecologically sustainable. This manuscript reviews important time points for the field of PIM and reports on a series of meetings of PIM leaders, aimed at assessing the state of the field and planning for its future. Efforts in the first decade of the 2000s led to increased visibility in academic and professional pediatric organizations and through international listservs, designed to link those interested in and practicing PIM, all of which continue to flourish. The PIM leadership summits in recent years resulted in specific goals to advance PIM further in the following key areas: research, clinical practice, professional education, patient and family education, and advocacy and partnerships. Additionally, goals were developed for greater expansion of PIM professional education, broader support for pediatric PIM research, and an expanded role for PIM approaches in the provision of pediatric care.
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Affiliation(s)
- Anna Esparham
- Division of Child Neurology-Headache Section, Children's Mercy Hospital, University of Missouri School of Medicine-Kansas City, Kansas City, MO 64108, USA.
| | | | - Sanghamitra Misra
- Mobile Clinic Program, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77054, USA.
| | - Erica Sibinga
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
| | - Timothy Culbert
- Integrative Medicine, Prairie Care, University of Minnesota Medical School, Chaska, MN 55318, USA.
| | - Kathi Kemper
- Department of Pediatrics, College of Medicine, Ohio State University, Columbus, OH 43210, USA.
| | - Hilary McClafferty
- Department of Medicine, Arizona Center for Integrative Medicine, University of Arizona, Tucson, AZ 85724, USA.
| | - Sunita Vohra
- Integrative Health Institute, CARE Program, PedCAM Network, Department of Pediatrics, Medicine, and Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2C8, Canada.
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Jiang W, Ma Z, Zhang H, Lynn HS, Xu B, Zhang X, Bi R, Fu J, Chen Y, Xiao Z, Zhang Z, Lu Z. Efficacy of Jia Wei Yang He formula as an adjunctive therapy for asthma: study protocol for a randomized, double blinded, controlled trial. Trials 2018; 19:355. [PMID: 29973284 PMCID: PMC6032802 DOI: 10.1186/s13063-018-2739-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/08/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Over the past two or three decades, the prevalence of asthma has significantly increased worldwide; therefore, effective treatment without side effects is of utmost importance. Traditional Chinese medicine (TCM) plays a vital role in reducing symptoms and improving the quality of life in persistent-asthma patients. The aim of this study is to evaluate the efficacy of the Jia Wei Yang He (JWYH) formula in the treatment of asthma and to explore the relationship between the airway microbiome and TCM treatment in asthma patients. METHODS/DESIGN This multicenter, parallel-arm, randomized, double-blinded, placebo-controlled trial will assess the efficacy of JWYH in asthma patients with usual care. Persistent-asthma patients without life-threatening disease will be enrolled on a random basis and are equally assigned to a high- or a low-dose JWYH plus usual care group, or a placebo plus usual care group. Patients are followed up for 4 months. Accordingly, 240 patients will yield sufficient statistical power to determine a difference between groups. Based on modified intent-to-treat (mITT) analyses, the three groups will be compared at 4 weeks after the beginning of treatment. The primary efficacy measurement is the mean change in the Asthma Control Test (ACT) score from baseline to 4 weeks post treatment. Secondary outcomes include forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), and asthma exacerbations. This trial also includes analyses of the associations between airway microbiome and asthma treatment. DISCUSSION In this study, a randomized clinical trial design is described. The results are based on several outcomes that estimate the efficacy of the JWYH formula and prospective links between the airway microbiome and asthma treatment. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03299322 . Registered on 3 October 2017.
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Affiliation(s)
- Wenhan Jiang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
| | - Zifeng Ma
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
| | - Huiyong Zhang
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
| | - Henry S. Lynn
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
| | - Beiqi Xu
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
| | - Xiao Zhang
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
| | - Rongrong Bi
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
| | - Jiyou Fu
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
| | - Yue Chen
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Zhen Xiao
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
| | - Zhijie Zhang
- Department of Epidemiology, School of Public Health, Fudan University, 130 Dongan Road, No.8 building, Xuhui District, Shanghai, People’s Republic of China
| | - Zhenhui Lu
- Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.1 building, Xuhui District, Shanghai, People’s Republic of China
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28
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von Bonin D, Klein SD, Würker J, Streit E, Avianus O, Grah C, Salomon J, Wolf U. Speech-guided breathing retraining in asthma: a randomised controlled crossover trial in real-life outpatient settings. Trials 2018; 19:333. [PMID: 29941003 PMCID: PMC6019518 DOI: 10.1186/s13063-018-2727-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 06/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Breathing retraining techniques have received increased attention in the management of asthma, because there is growing evidence of the usefulness of such methods in improving quality of life, reducing symptoms and reducing bronchodilator use. Our study investigated the effect of anthroposophic therapeutic speech (ATS), which uses sounds and syllabic rhythm to improve articulation, breathing and cardiorespiratory interaction, in patients with asthma in a real-life outpatient setting. Methods In a randomised controlled crossover trial, patients with asthma in three centres in Switzerland and Germany were randomised to either receive 11 ATS sessions or to wait. Subsequently, patients changed either to wait or to receive ATS. Primary outcomes were changes from the beginning to the end of each phase in the Asthma Quality of Life Questionnaire (AQLQ) and spirometry parameters. Secondary outcomes were changes in inhaled glucocorticoids, the Asthma Control Test (ACT), peak flow and asthma exacerbations. Results Altogether, 63 patients were randomised, of which 56 were enrolled and 49 completed the study. Statistically significant differences between the ATS groups and waiting control groups were found for the overall AQLQ score (d = 0.86, p = 0.001) and the domain scores for symptoms, activity limitation and emotional function as well as ACT score (d = 0.53, p = 0.048). No significant differences were observed in spirometry parameters, inhaled glucocorticoids, peak flow and days without asthma exacerbation per week. No serious adverse events occurred during ATS sessions. Conclusions ATS significantly improves asthma control and quality of life in patients with asthma. Whether ATS may improve lung function remains to be shown. Trial registration ClinicalTrials.gov NCT02501824. Retrospectively registered on 8 July 2015. Electronic supplementary material The online version of this article (10.1186/s13063-018-2727-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dietrich von Bonin
- Institute of Complementary Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.,Present address: Branch organisation of Swiss Arts Therapy associations, OdA ARTECURA, Utzigen, Switzerland
| | - Sabine D Klein
- Institute of Complementary Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Jana Würker
- Institute of Complementary Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.,, Present address: Dresden, Germany
| | - Eva Streit
- Klinik Arlesheim, Arlesheim, Switzerland
| | - Oliver Avianus
- Gemeinschaftskrankenhaus Havelhöhe, Clinic for Anthroposophical Medicine, Berlin, Germany
| | - Christian Grah
- Gemeinschaftskrankenhaus Havelhöhe, Clinic for Anthroposophical Medicine, Berlin, Germany
| | | | - Ursula Wolf
- Institute of Complementary Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.
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29
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Baptist AP, Busse PJ. Asthma Over the Age of 65: All's Well That Ends Well. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:764-773. [PMID: 29747982 PMCID: PMC5951417 DOI: 10.1016/j.jaip.2018.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/29/2018] [Accepted: 02/03/2018] [Indexed: 12/11/2022]
Abstract
Asthma in older adults (often classified as those 65 years or older) is relatively common, underdiagnosed, and suboptimally treated. It is an important health problem, as the population of the United States continues to age. Unfortunately, asthma morbidity and mortality rates are highest in this age group. Alterations in the innate and adaptive immune responses occur with aging, and contribute to pathophysiologic differences and subsequent treatment challenges. The symptoms of asthma may differ from those in younger populations, and often include fatigue. There are unique factors that can complicate asthma management among older adults, including comorbidities, menopause, caregiver roles, and depression. Pharmacologic therapies are often not as effective as in younger populations, and may have greater side effects. Spirometry, peak flow measurements, and asthma education are typically underused, and may contribute to delays in diagnosis as well as worse outcomes. There are specific strategies that health care providers can take to improve the care of older adults with asthma.
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Affiliation(s)
- Alan P Baptist
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, Mich.
| | - Paula J Busse
- Icahn School of Medicine at Mount Sinai, New York, NY
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30
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Kao ST, Kuo YH, Wang SD, Hong HJ, Lin LJ. Analogous corticosteroids, 9A and EK100, derived from solid-state-cultured mycelium of Antrodia camphorata inhibit proinflammatory cytokine expression in macrophages. Cytokine 2018; 108:136-144. [PMID: 29605763 DOI: 10.1016/j.cyto.2018.03.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 12/13/2022]
Abstract
Antrodia camphorata mycelium is used in traditional Chinese medicine in Taiwan. The wild-type mycelium is rare and expensive, so a solid-state-cultured mycelium of A. camphorata (SCMAC) has been developed. Previous studies have found SCMAC to have anti-inflammatory effects. However, the immunomodulatory effects of SCMAC and of its active phytosterol compounds EK100 and 9A on asthma remain unknown. In this study, BALB/c mice were repeatedly exposed to Dermatogoides pteronyssinus (Der p) at 1-week intervals and were orally administered crude SCMAC extract before the Der p challenge. The mice were sacrificed 72 h after the last challenge to examine the airway remodeling, inflammation, and expression profiles of cytokines and various genes. Then, 30-µg/mL Der p-stimulated MH-S cells with 9A or EK100 were collected for real-time PCR analysis, and the effects of 9A and EK100 on macrophages were evaluated. The crude extract reduced Der p-induced airway hyperresponsiveness, total serum immunoglobulin E levels, and recruitment of inflammatory cells to the bronchoalveolar lavage fluid through cytokine downregulation and Th1/Th2/Th17 response modulation. Additionally, 9A and EK100 inhibited IL-1β and IL-6 expression in alveolar macrophages. These results indicate that the pharmacologically active compounds in a crude SCMAC extract exert synergistic effects on multiple targets to relieve asthma symptoms.
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Affiliation(s)
- Shung-Te Kao
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
| | - Yueh-Hsiung Kuo
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical University, Taichung 40402, Taiwan; Department of Biotechnology, Asia University, Taichung 41354, Taiwan.
| | - Shulhn-Der Wang
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
| | - Hong-Jye Hong
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
| | - Li-Jen Lin
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
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31
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Lee IS, Cho DH, Kim KS, Kim KH, Park J, Kim Y, Jung JH, Kim K, Jung HJ, Jang HJ. Anti-inflammatory effects of embelin in A549 cells and human asthmatic airway epithelial tissues. Immunopharmacol Immunotoxicol 2018; 40:83-90. [PMID: 29299941 DOI: 10.1080/08923973.2017.1414836] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Allergic asthma is the most common type in asthma, which is defined as a chronic inflammatory disease of the lung. In this study, we investigated whether embelin (Emb), the major component of Ardisia japonica BL. (AJB), exhibits anti-inflammatory effects on allergic asthma via inhibition of NF-κB activity using A549 cells and asthmatic airway epithelial tissues. METHODS Inflammation was induced in A549 cells, a human airway epithelial cell line, by IL-1β (10 ng/ml) treatment for 4 h. The effects of Emb on NF-κB activity and COX-2 protein expression in inflamed airway epithelial cells and human asthmatic airway epithelial tissues were analyzed via western blot. The secretion levels of NF-κB-mediated cytokines/chemokines, including IL-4, 6, 9, 13, TNF-α and eotaxin, were measured by a multiplex assay. RESULTS Emb significantly blocked NF-κB activity in IL-1β-treated A549 cells and human asthmatic airway epithelial tissues. COX-2 expression was also reduced in both IL-1β-treated A549 cells and asthmatic tissues Emb application. Emb significantly reduced the secretion of IL-4, IL-6 and eotaxin in human asthmatic airway epithelial tissues by inhibiting activity of NF-κB. CONCLUSIONS The results of this study suggest that Emb may be used as an anti-inflammatory agent via inhibition of NF-κB and related cytokines.
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Affiliation(s)
- In-Seung Lee
- a College of Korean Medicine , Kyung Hee University , Seoul , Republic of Korea.,b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
| | - Dong-Hyuk Cho
- b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea.,c Department of Biological Sciences in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
| | - Ki-Suk Kim
- a College of Korean Medicine , Kyung Hee University , Seoul , Republic of Korea
| | - Kang-Hoon Kim
- a College of Korean Medicine , Kyung Hee University , Seoul , Republic of Korea.,b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
| | - Jiyoung Park
- a College of Korean Medicine , Kyung Hee University , Seoul , Republic of Korea.,b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
| | - Yumi Kim
- a College of Korean Medicine , Kyung Hee University , Seoul , Republic of Korea.,b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
| | - Ji Hoon Jung
- a College of Korean Medicine , Kyung Hee University , Seoul , Republic of Korea
| | - Kwanil Kim
- b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea.,c Department of Biological Sciences in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
| | - Hee-Jae Jung
- b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea.,c Department of Biological Sciences in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
| | - Hyeung-Jin Jang
- a College of Korean Medicine , Kyung Hee University , Seoul , Republic of Korea.,b Department of Science in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea.,c Department of Biological Sciences in Korean Medicine , Graduate School, Kyung Hee University , Seoul , Republic of Korea
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Abstract
High-quality systematic reviews of use of herbal or homeopathic remedies in children often suffer from design flaws, such as not following PRISMA guidelines, inconsistent outcome measurements, and paucity of high-quality studies. Herbal remedies have modest demonstrated benefits with insufficient evidence to recommend any particular supplement. Homeopathic remedies have no role in treatment of pediatric conditions, and have been associated with great harm in infants given homeopathic teething products. Two types of herbal supplements are associated with high risk in adolescents, energy drinks and adulterated weight-loss products. Parents should be counseled about risks of these products.
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Paudyal P, Jones C, Grindey C, Dawood R, Smith H. Meditation for asthma: Systematic review and meta-analysis. J Asthma 2017; 55:771-778. [PMID: 28853958 DOI: 10.1080/02770903.2017.1365887] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To conduct a comprehensive review and meta-analysis of the effectiveness of meditation on a variety of asthma outcomes. METHODS We searched MEDLINE, EMBASE, CINAHL, PsycINFO and AMED in June 2016 to identify randomized controlled trials (RCTs) investigating the effectiveness of meditation in adults with asthma. No restriction was put on language or year of publication. Study quality was assessed using The Cochrane Risk of Bias Assessment Tool. Meta-analysis was carried out using RevMan 5.3. RESULTS Four RCTs involving 201 patients met the inclusion criteria. Quality of studies was inconsistent with only one study reporting adequate allocation concealment. Disease-specific quality of life was assessed in two trials; a pooled result involving 62 intervention and 65 control participants indicated a significant improvement in quality of life in the meditation group compared to the control group (SMD 0.40, 95% CI 0.05-0.76). A pooled result from all four studies indicated the uncertain effect of meditation in forced expiratory volume in 1 s (FEV1) (SMD -0.67, 95% CI -2.17 to 0.82). Results from the individual trials suggest that meditation may be helpful in reducing perceived stress and the use of short-term rescue medication. CONCLUSION Our review suggests that there is some evidence that meditation is beneficial in improving quality of life in asthma patients. As two out of four studies in our review were of poor quality, further trials with better methodological quality are needed to support or refute this finding.
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Affiliation(s)
- Priyamvada Paudyal
- a Department of Primary Care and Public Health , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Christina Jones
- b Department of Clinical Medicine , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Caroline Grindey
- a Department of Primary Care and Public Health , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Rusha Dawood
- a Department of Primary Care and Public Health , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Helen Smith
- c Family Medicine and Primary Care , Lee Kong Chian School of Medicine , Singapore , Singapore
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Patients' experiences of breathing retraining for asthma: a qualitative process analysis of participants in the intervention arms of the BREATHE trial. NPJ Prim Care Respir Med 2017; 27:56. [PMID: 28983084 PMCID: PMC5629205 DOI: 10.1038/s41533-017-0055-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/29/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022] Open
Abstract
Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retraining delivered by digital versatile disc (DVD) or face-to-face sessions with a respiratory physiotherapist) took part in semi-structured telephone interviews about their experiences. Interviews were analysed using thematic analysis. Breathing retraining was perceived positively as a method of asthma management. Motivations for taking part included being asked, to enhance progress in research, to feel better/reduce symptoms, and to reduce medication. Participants were positive about the physiotherapist, liked having the materials tailored, found meetings motivational, and liked the DVD and booklet. The impact of breathing retraining following regular practice included increased awareness of breathing and development of new habits. Benefits of breathing retraining included increased control over breathing, reduced need for medication, feeling more relaxed, and improved health and quality of life. Problems included finding time to practice the exercises, and difficulty mastering techniques. Breathing retraining was acceptable and valued by almost all participants, and many reported improved wellbeing. Face to face physiotherapy was well received. However, some participants in the DVD group mentioned being unable to master techniques. Patients with asthma taught how to change their unconscious breathing patterns generally like non-pharmacological interventions. Researchers in the UK, led by Mike Thomas from the University of Southampton, interviewed 16 people about their experiences in a trial that tested breathing retraining exercises delivered by DVD or face-to-face sessions with a respiratory physiotherapist. Overwhelmingly, trial participants reported that breathing retraining sessions gave them greater control over their symptoms, helped them relax, improved their quality of life and reduced the need for medications. Some participants who received DVD instruction said they had trouble mastering the techniques, and many in both groups found it hard to find time to practice the exercises. Overall, however, patients were positive about the experience. The authors conclude that breathing exercises are likely to be a well-received method of asthma management.
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Koshak A, Koshak E, Heinrich M. Medicinal benefits of Nigella sativa in bronchial asthma: A literature review. Saudi Pharm J 2017; 25:1130-1136. [PMID: 30166900 PMCID: PMC6111118 DOI: 10.1016/j.jsps.2017.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/09/2017] [Indexed: 02/06/2023] Open
Abstract
Nigella sativa L. (NS) seeds, known as black seed, is a spice and a traditional herbal medicine used in various diseases including bronchial asthma. This review aimed to assess the studies supporting the medicinal use of NS in asthma and to highlight future research priorities. Various medical databases were searched for the effects of NS and its active secondary metabolites in asthma inflammation and outcomes. There were fourteen preclinical studies describing multiple effects of NS in animal or cellular models of asthma including bronchodilation, anti-histaminic, anti-inflammatory, anti-leukotrienes and immunomodulatory effects. Furthermore, seven clinical studies showed improvements in different asthma outcomes including symptoms, pulmonary function and laboratory parameters. However, often these studies are small and used ill-defined preparations. In conclusion, NS could be therapeutically beneficial in alleviating airway inflammation and the control of asthma symptoms, but the evidence remains scanty and is often based on poorly characterised preparations. Accordingly, well-designed large clinical studies using chemically well characterised NS preparation are required.
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Key Words
- ACT, Asthma Control Test
- Asthma
- Black seed
- Clinical studies
- FEV1, forced expiratory volume in one second
- FeNO, fractional exhaled nitric oxide
- GINA, Global Initiative for Asthma
- IL, Interleukin
- IgE, Immunoglobulin E
- NS, Nigella sativa L.
- Nigella sativa
- RDBCT, Randomised Double-Blinded Clinical Trial
- RDBPCT, Randomised Double-Blinded Placebo-Controlled Clinical Trial
- RSBPCT, Randomised Single-Blinded Placebo-Controlled Clinical Trial
- Th1, Type 1 T helper (Th1) cells
- Th2, Type 2 T helper (Th2) cells
- Traditional medicine
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Affiliation(s)
- Abdulrahman Koshak
- Research Cluster Biodiversity and Medicines, UCL School of Pharmacy, University College London, London, UK.,Department of Natural Products & Alternative Medicine, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Emad Koshak
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Michael Heinrich
- Research Cluster Biodiversity and Medicines, UCL School of Pharmacy, University College London, London, UK
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Brinkhaus B, Roll S, Jena S, Icke K, Adam D, Binting S, Lotz F, Willich SN, Witt CM. Acupuncture in Patients with Allergic Asthma: A Randomized Pragmatic Trial. J Altern Complement Med 2017; 23:268-277. [PMID: 28287818 DOI: 10.1089/acm.2016.0357] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although the available evidence is insufficient, acupuncture is used in patients suffering from chronic asthma. The aim of this pragmatic study was to investigate the effectiveness of acupuncture in addition to routine care in patients with allergic asthma compared to treatment with routine care alone. METHODS Patients with allergic asthma were included in a randomized controlled trial and randomized to receive up to 15 acupuncture sessions over 3 months or to a control group receiving routine care alone. Patients who did not consent to randomization received acupuncture treatment for the first 3 months and were followed as a cohort. All trial patients were allowed to receive routine care in addition to study treatment. The primary endpoint was the asthma quality of life questionnaire (AQLQ, range: 1-7) at 3 months. Secondary endpoints included general health related to quality of life (Short-Form-36, SF-36, range 0-100). Outcome parameters were assessed at baseline and at 3 and 6 months. RESULTS A total of 1,445 patients (mean age 43.8 [SD 13.5] years, 58.7% female) were randomized and included in the analysis (184 patients randomized to acupuncture and 173 to control, and 1,088 in the nonrandomized acupuncture group). In the randomized part, acupuncture was associated with an improvement in the AQLQ score compared to the control group (difference acupuncture vs. control group 0.7 [95% confidence interval (CI) 0.5-1.0]) as well as in the physical component scale and the mental component scale of the SF-36 (physical: 2.5 [1.0-4.0]; mental 4.0 [2.1-6.0]) after 3 months. Treatment success was maintained throughout 6 months. Patients not consenting to randomization showed similar improvements as the randomized acupuncture group. CONCLUSIONS In patients with allergic asthma, additional acupuncture treatment to routine care was associated with increased disease-specific and health-related quality of life compared to treatment with routine care alone.
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Affiliation(s)
- Benno Brinkhaus
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stephanie Roll
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Susanne Jena
- 2 Department for Medical Statistics and Informatics, Universität Freiburg , Freiburg, Germany
| | - Katja Icke
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniela Adam
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sylvia Binting
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Lotz
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan N Willich
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia M Witt
- 1 Institute for Social Medicine , Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany .,3 Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich , Zurich, Switzerland
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Kohn CM, Paudyal P. A systematic review and meta-analysis of complementary and alternative medicine in asthma. Eur Respir Rev 2017; 26:26/143/160092. [PMID: 28143878 DOI: 10.1183/16000617.0092-2016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/18/2016] [Indexed: 11/05/2022] Open
Abstract
Asthma is a chronic, inflammatory lung disease affecting around 235 million people worldwide. Conventional medications in asthma are not curative and patients have significant concerns regarding their side-effects. Consequently, many asthma patients turn to complementary and alternative medicine (CAM) for a more holistic approach to care. We systematically reviewed the available evidence on the effectiveness of CAM in the management of asthma in adults.We searched the MEDLINE, EMBASE, CINAHL, AMED and Cochrane databases for randomised controlled trials published in English between 1990 and 2016 investigating the effectiveness of oral or topical CAM in asthmatic adults. The quality of the studies was assessed using the Cochrane Risk of Bias Assessment Tool.In all, 23 eligible trials were identified covering 19 different CAMs. Overall, there was limited evidence on the effectiveness of CAM in adult asthma as most CAMs were only assessed in a single trial. CAMs with multiple trials provided null or inconsistent results. Many of the trials were rated as having high risk of bias.The existing evidence is insufficient to recommend any of the oral and topical CAMs in the management of asthma in adults.
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Affiliation(s)
- Charlotte M Kohn
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Priyamvada Paudyal
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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Koshak A, Wei L, Koshak E, Wali S, Alamoudi O, Demerdash A, Qutub M, Pushparaj PN, Heinrich M. Nigella sativa Supplementation Improves Asthma Control and Biomarkers: A Randomized, Double-Blind, Placebo-Controlled Trial. Phytother Res 2017; 31:403-409. [PMID: 28093815 DOI: 10.1002/ptr.5761] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/19/2016] [Accepted: 11/28/2016] [Indexed: 11/10/2022]
Abstract
Poor compliance with conventional asthma medications remains a major problem in achieving asthma control. Nigella sativa oil (NSO) is used traditionally for many inflammatory conditions such as asthma. We aimed to investigate the benefits of NSO supplementation on clinical and inflammatory parameters of asthma. NSO capsules 500 mg twice daily for 4 weeks were used as a supplementary treatment in a randomized, double-blind, placebo-controlled trial in asthmatics (clinicaltrials.gov: NCT02407262). The primary outcome was Asthma Control Test score. The secondary outcomes were pulmonary function test, blood eosinophils and total serum Immunoglobulin E. Between 1 June and 30 December 2015, 80 asthmatics were enrolled, with 40 patients in each treatment and placebo groups. After 4 weeks, ten patients had withdrawn from each group. Compared with placebo, NSO group showed a significant improvement in mean Asthma Control Test score 21.1 (standard deviation = 2.6) versus 19.6 (standard deviation = 3.7) (p = 0.044) and a significant reduction in blood eosinophils by -50 (-155 to -1) versus 15 (-60 to 87) cells/μL (p = 0.013). NSO improved forced expiratory volume in 1 second as percentage of predicted value by 4 (-1.25 to 8.75) versus 1 (-2 to 5) but non-significant (p = 0.170). This randomized, double-blind, placebo-controlled trial demonstrated that NSO supplementation improves asthma control with a trend in pulmonary function improvement. This was associated with a remarkable normalization of blood eosinophlia. Future studies should follow asthmatics for longer periods in a multicentre trial. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Abdulrahman Koshak
- Research Cluster Biodiversity and Medicines, UCL School of Pharmacy, University College London, London, UK.,Department of Natural Products & Alternative Medicine, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Li Wei
- Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| | - Emad Koshak
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Siraj Wali
- Respiratory Unit, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omer Alamoudi
- Respiratory Unit, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Majdy Qutub
- Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Peter Natesan Pushparaj
- Centre of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Michael Heinrich
- Research Cluster Biodiversity and Medicines, UCL School of Pharmacy, University College London, London, UK
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Anti-Inflammatory Effects of Ginsenoside Rg3 via NF- κB Pathway in A549 Cells and Human Asthmatic Lung Tissue. J Immunol Res 2016; 2016:7521601. [PMID: 28116321 PMCID: PMC5223042 DOI: 10.1155/2016/7521601] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/04/2016] [Accepted: 12/04/2016] [Indexed: 01/20/2023] Open
Abstract
Objective. There is limited information of the anti-inflammatory effects of Rg3 on inflamed lung cells and tissues. Therefore, we confirmed the anti-inflammatory mechanism of ginsenoside Rg3 in inflamed human airway epithelial cells (A549) and tissues whether Rg3 regulates nuclear factor kappa B (NF-κB) activity. Methods. To induce the inflammation, IL-1β (10 ng/ml) was treated to A549 cells for 4 h. The effects of Rg3 on NF-κB activity and COX-2 expression were evaluated by western blotting analysis in both IL-1β-induced inflamed A549 cell and human asthmatic airway epithelial tissues. Using multiplex cytokines assay, the secretion levels of NF-κB-mediated cytokines/chemokines were measured. Result. Rg3 showed the significant inhibition of NF-κB activity thereby reduced COX-2 expression was determined in both IL-1β-induced inflamed A549 cell and human asthmatic airway epithelial tissues. In addition, among NF-κB-mediated cytokines, the secretion levels of IL-4, TNF-α, and eotaxin were significantly decreased by Rg3 in asthma tissues. Even though there was no significant difference, IL-6, IL-9, and IL-13 secretion showed a lower tendency compared to saline-treated human asthmatic airway epithelial tissues. Conclusion. The results from this study demonstrate the potential of Rg3 as an anti-inflammatory agent through regulating NF-κB activity and reducing the secretion of NF-κB-mediated cytokines/chemokines.
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Serpico MR, Boyle BM, Kemper KJ, Kim SC. Complementary and Alternative Medicine Use in Children With Inflammatory Bowel Diseases: A Single-Center Survey. J Pediatr Gastroenterol Nutr 2016; 63:651-657. [PMID: 26960176 DOI: 10.1097/mpg.0000000000001187] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The prevalence of inflammatory bowel diseases (IBD) and use of complementary and alternative medicine (CAM) are both common and increasing. The definition of CAM therapy among both practitioners and patients is variable. The aim of our study was to update our understanding of how pediatric IBD patients use, perceive, and define CAM therapies. METHODS We surveyed families of patients with IBD followed in the Gastroenterology Division at Nationwide Children's Hospital in summer 2014 during a routine clinic visit. The survey included questions about the following demographic and disease information; use and side effects associated with prior conventional therapies (CT); and attitudes toward, and use of CAM. RESULTS The questionnaire was completed by 104 of 118 patients approached (14 ± 3 years; 43% women). Patients had previously used an average of 3 CT. CAM therapy was used by 84% of patients surveyed, although only 24% of patients/families considered themselves to be using CAM. Common CAM therapies included vitamins/supplements, stress management techniques, and/or dietary changes. Factors associated with using specific CAM therapies included self-reported prior CT-related side effects (P < 0.01) and moderate/severe disease activity (P < 0.01). Most families (77%) desired to learn more about CAM. CONCLUSIONS Patients seen in a tertiary care center for pediatric IBD frequently integrated CAM therapies into their treatment regimen. Patients with prior side effects from CT or more severe disease were more likely to use CAM. Given the high prevalence of CAM use, pediatric gastrointestinal physicians should be knowledgeable and open to discussions about CAM therapies with their patients.
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Affiliation(s)
- Mark R Serpico
- *Division of Gastroenterology, Nationwide Children's Hospital, Columbus †Boonshoft School of Medicine, Wright State University, Dayton ‡Department of Pediatrics §Center for Integrative Health and Wellness, The Ohio State University College of Medicine, Columbus, OH
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Abstract
Asthma is a common long-term condition that remains poorly controlled in many people despite the availability of pharmacological interventions, evidence-based treatment guidelines and care pathways.(1) There is considerable public interest in the use of non-pharmacological approaches for the treatment of asthma.(2) A survey of people with asthma reported that many have used complementary and alternative medicine, often without the knowledge of their clinical team.(3) Such interventions include breathing techniques, herbal products, homeopathy and acupuncture. The role of breathing exercises within the management of asthma has been controversial, partly because early claims of effectiveness were exaggerated.(4) UK national guidance and international guidelines on the management of asthma have included the option of breathing exercise programmes as an adjuvant to pharmacological treatment.(5,6) Here we discuss the types of breathing exercises used and review the evidence for their effectiveness.
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42
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Evidences of Herbal Medicine-Derived Natural Products Effects in Inflammatory Lung Diseases. Mediators Inflamm 2016; 2016:2348968. [PMID: 27445433 PMCID: PMC4942669 DOI: 10.1155/2016/2348968] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 06/07/2016] [Indexed: 12/13/2022] Open
Abstract
Pulmonary inflammation is a hallmark of many respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), and acute respiratory syndrome distress (ARDS). Most of these diseases are treated with anti-inflammatory therapy in order to prevent or to reduce the pulmonary inflammation. Herbal medicine-derived natural products have been used in folk medicine and scientific studies to evaluate the value of these compounds have grown in recent years. Many substances derived from plants have the biological effects in vitro and in vivo, such as flavonoids, alkaloids, and terpenoids. Among the biological activities of natural products derived from plants can be pointed out the anti-inflammatory, antiviral, antiplatelet, antitumor anti-allergic activities, and antioxidant. Although many reports have evaluated the effects of these compounds in experimental models, studies evaluating clinical trials are scarce in the literature. This review aims to emphasize the effects of these different natural products in pulmonary diseases in experimental models and in humans and pointing out some possible mechanisms of action.
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Karam M, Kaur BP, Baptist AP. A modified breathing exercise program for asthma is easy to perform and effective. J Asthma 2016; 54:217-222. [PMID: 27285510 DOI: 10.1080/02770903.2016.1196368] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Breathing exercises are used by some asthmatic patients, yet are often difficult to perform and time-consuming. This study evaluated a simple, modified breathing exercise program regarding ease to perform and effectiveness as an adjunctive therapy. METHODS Subjects age 18 to 65 with a current diagnosis of persistent asthma were enrolled. A program that incorporated three different breathing exercises (yoga pranayama techniques, diaphragmatic breathing and pursed lip breathing) was taught to subjects. The program was designed to be completed in less than 10 minutes per day. Subjects completed the Asthma Control Test (ACT) and mini-Asthma Quality of Life Questionnaire (AQLQ) at baseline and at 1-month follow-up. They also completed a survey that asked them to rate the effectiveness and difficulty of the exercises, and whether they would recommend them in the future. RESULTS A total of 74 subjects were enrolled in this study. The intervention improved breathing for 52.9% of the subjects, while 67.6% felt that their daily activity was improved and 66.1% noted that the exercises allowed decreased use of a rescue inhaler. Most subjects (80.9%) recommended breathing exercises as a complementary therapy for asthma and 79.4% of the subjects stated the exercises took less than 10 minutes per day total. Overall, ACT scores improved significantly (p = 0.002) with a statistically non-significant improvement in AQLQ scores. CONCLUSION A simple program of breathing exercises was found to be effective and could be completed in less than 10 minutes per day. Furthermore, there was a statistically significant improvement in ACT scores post-exercise.
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Affiliation(s)
- Marilyn Karam
- a Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan , Ann Arbor , MI , USA.,d Division of Allergy and Clinical Immunology, American University of Beirut Medical Center , Beirut , Lebanon
| | - Bani P Kaur
- b Department of Internal Medicine , Spectrum Health , Grand Rapids , MI , USA
| | - Alan P Baptist
- a Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan , Ann Arbor , MI , USA.,c Center for Managing Chronic Disease, Department of Health Behavior and Health Education, University of Michigan School of Public Health , Grand Rapids , MI , USA
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Misra SM. The Current Evidence of Integrative Approaches to Pediatric Asthma. Curr Probl Pediatr Adolesc Health Care 2016; 46:190-4. [PMID: 26832885 DOI: 10.1016/j.cppeds.2015.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 12/27/2022]
Abstract
Asthma is a complex, multifactorial, and inflammatory chronic condition, and many children who are diagnosed with asthma integrate complementary therapies into their overall care. Due to the chronic nature of asthma, potentially negative side effects of long-term use of allopathic medications, and desire for natural approaches, patients and their families turn toward complementary therapies. Up to 89% of parents use complementary and alternative medicine (CAM) to treat their child's asthma. This article reviews the current evidence on the most commonly used complementary therapies for pediatric asthma.
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Ward CE, Baptist AP. Characteristics of Complementary and Alternative Medicine (CAM) use among older adults with asthma. J Asthma 2016; 53:546-52. [PMID: 26786384 PMCID: PMC4962544 DOI: 10.3109/02770903.2015.1116090] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE A growing number of asthma patients are using Complementary and Alternative Medicine (CAM). Prior studies have not examined CAM use among the older adult population. METHODS Data from the 2011 Behavioral Risk Factor Surveillance Survey (BRFSS), a national telephone survey, and the Asthma Call-Back survey (ACBS), a survey conducted among BRFSS individuals reporting asthma, were used for the analyses. The study population consisted of 7685 individuals aged 55 years or older with current asthma. The relationship of CAM use with demographic and asthma outcomes was analyzed using logistic regression. RESULTS CAM use was reported by 39% (3030). Breathing techniques were the most commonly reported CAM therapy. Demographic factors associated with CAM use include female gender (OR 1.36, p < 0.002), having at least a college education (OR 1.76, p < 0.001), cost barrier to healthcare (OR 1.43, p < 0.001), and living in the West (OR 1.31, p < 0.01). An inverse relationship was noted between income and CAM use. Those who had received an asthma action plan (OR 1.29, p < 0.005), current smokers (OR 1.35, p < 0.02), or impaired asthma control (as defined by symptoms affecting sleep, symptoms limiting activities, and rescue medication use) were more likely to use CAM (OR 1.37, p < 0.001; OR 1.38, p < 0.001; and OR 1.2, p < 0.046, respectively). CONCLUSIONS A large proportion of asthmatic older adults use CAM. In addition, older adults with asthma who use CAM have decreased asthma control, and further studies are needed to determine a causal role.
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Affiliation(s)
- Claire E. Ward
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI
| | - Alan P. Baptist
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI,
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Shergis JL, Wu L, Zhang AL, Guo X, Lu C, Xue CC. Herbal medicine for adults with asthma: A systematic review. J Asthma 2016; 53:650-9. [PMID: 27172294 DOI: 10.3109/02770903.2015.1101473] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Many people with asthma use herbal medicines to help reduce symptoms and improve asthma control. OBJECTIVE To update the systematic review and meta-analysis of randomised controlled trials of herbal medicine for adult asthma. DATA SOURCES Nine English and Chinese databases were searched (PubMed, Embase, CINAHL, CENTRAL, AMED, CBM, CNKI, CQVIP, Wanfang). STUDY SELECTIONS Herbal medicines combined with routine pharmacotherapies compared with the same pharmacotherapies alone or placebo. Cochrane Risk of Bias Tool and GRADE Summary of Findings tables were used to evaluate methodological quality. RESULTS Twenty-nine (29) studies involving 3,001 participants were included. Herbal interventions used multi-ingredients such as licorice root, crow-dipper, astragali, and angelica. Compared with routine pharmacotherapies alone, herbal medicines as add-on therapy improved lung function (FEV1: MD 7.81%, 95% CI 5.79, 9.83, I(2) = 63%; PEFR: MD 65.14 L/min, 95% CI 58.87, 71.41, I(2) = 21%); asthma control (MD 2.47 points, 95% CI 1.64, 3.29, I(2) = 55%); reduced salbutamol usage (MD -1.14 puffs/day, 95% CI -2.20, -0.09, I(2) = 92%); and reduced acute asthma exacerbations over one year (MD -1.20, 95% CI -1.82, -0.58, one study). Compared with placebo plus pharmacotherapies herbal medicines as add-on therapy improved lung function (FEV1: MD 15.83%, 95% CI 13.54, 18.12 and PEFR: MD 55.20 L/min, 95% CI 33.41, 76.99). Other outcomes were not reported in these placebo studies. Included studies were low to moderate quality. Adverse events were rare. CONCLUSIONS Herbal medicines combined with routine pharmacotherapies improved asthma outcomes greater than pharmacotherapies alone. Included studies did not blind participants therefore more studies that address such weaknesses are warranted.
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Affiliation(s)
- Johannah L Shergis
- a China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University , Melbourne , Australia
| | - Lei Wu
- b Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical College, Guangzhou University of Chinese Medicine , Guangzhou , China
| | - Anthony L Zhang
- a China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University , Melbourne , Australia
| | - Xinfeng Guo
- b Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical College, Guangzhou University of Chinese Medicine , Guangzhou , China
| | - Chuanjian Lu
- b Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical College, Guangzhou University of Chinese Medicine , Guangzhou , China.,c Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome , Guangzhou , China
| | - Charlie C Xue
- a China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University , Melbourne , Australia.,b Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical College, Guangzhou University of Chinese Medicine , Guangzhou , China
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Rossi E, Picchi M, Bartoli P, Panozzo M, Cervino C, Nurra L. Homeopathic therapy in pediatric atopic diseases: short- and long-term results. HOMEOPATHY 2016; 105:217-224. [PMID: 27473542 DOI: 10.1016/j.homp.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 03/04/2016] [Accepted: 03/09/2016] [Indexed: 10/22/2022]
Abstract
AIM To study the outcomes of atopic diseases in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy) and related long-term results after approximately an 8-year period. MATERIALS AND METHODS Our data derive from an observational longitudinal study carried out on 857 pediatric patients who consecutive visited from 1998 to 2014. Children with atopic diseases were 325 (37.9%), 126 (39%) suffered from atopic dermatitis, 72 (22%) from allergic rhinitis, and 127 (39%) from asthma. Moreover, a long-term study was conducted on a subset of 107/165 patients, consecutively visited from 1998 to 2006, and with ≥5 years follow-up. The study also investigated the evolution of overall symptoms in those patients with a complex atopic symptomatology. RESULTS 75.8% of atopic children had moderate or major improvement (67.1% with asthma as the primary disease; 84.2% rhinitis; 84.2% dermatitis). At re-evaluation after 5-10 years, complete remission of atopic symptoms was obtained in 70.1% of the children: 84.2% in dermatitis; 48.1% in allergic rhinitis; 71.4% in asthma. Children with two or three atopic diseases at the first visit were completely cured in 40% of cases. CONCLUSION The results seem to confirm that homeopathic medicine produces positive therapeutic response in atopic children.
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Affiliation(s)
- Elio Rossi
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy.
| | - Marco Picchi
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
| | - Paola Bartoli
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
| | | | - Chiara Cervino
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
| | - Linda Nurra
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
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Berg J, Morphew T, Tran J, Kilgore D, Galant SP. Prevalence of Complementary and Alternative Medicine Usage in Vietnamese American Asthmatic Children. Clin Pediatr (Phila) 2016; 55:157-64. [PMID: 26276762 PMCID: PMC5920538 DOI: 10.1177/0009922815599394] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the frequency and type of complementary and alternative medicine (CAM) therapy, as well as characteristics associated with CAM usage. A survey about parental preferences and beliefs regarding CAM usage was distributed to 5 schools with predominantly low socioeconomic Vietnamese children. For the 360 Vietnamese children previously diagnosed with asthma whose families responded, most preferred conventional therapy as prescribed by the physician. The prevalence of CAM usage was 38.1%. Common CAM therapies were steam inhalation, creams/topical oils, foods, prayer, oil inhalation, massage, herbal medication, coining, and cupping. Significant predictors of CAM usage were older age (11-12 years) (P = .038), English language of survey response (P = .001), environmental tobacco smoke exposure (P = .001), fear of long-term medication usage, and perception of asthma as a condition related to genetics (P = .023). These findings suggest that assessing CAM therapy will provide a more holistic approach to asthma therapy.
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Affiliation(s)
- Jill Berg
- University of California, Irvine, CA, USA
| | | | - Jackie Tran
- Orange County Asian & Pacific Islander Community Alliance, Garden Grove, CA, USA
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Nik Nabil WN, Zhou W, Shergis JL, Mansu S, Xue CC, Zhang AL. Management of respiratory disorders in a Chinese medicine teaching clinic in Australia: review of clinical records. Chin Med 2015; 10:31. [PMID: 26535052 PMCID: PMC4630930 DOI: 10.1186/s13020-015-0063-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/26/2015] [Indexed: 12/27/2022] Open
Abstract
Background People seek Chinese medicine (CM) treatments for a variety of respiratory disorders, e.g., asthma and upper respiratory tract infection (URTI). No previous studies have reviewed the data available in medical records from Australian clinics. This study aims to identify the characteristics of patients with respiratory disorders who visited a CM teaching clinic at RMIT University in Melbourne, Australia. Methods Primary data from January 2010 to December 2011 were collected from patient records in a CM teaching clinic at RMIT University. Patient data, including demographics, primary complaint, clinical history, lifestyle, CM treatment, and adverse events, were analyzed with descriptive statistics and the Chi square test using SPSS version 21.0. Results From 1677 clinical records we identified 261 patients with respiratory disorders. The patients made a total of 842 visits (mean: 3.2 visits/patient; range: 1–34 visits) during the study period. The mean age of the patients was 38.5 ± 17.9 years, and the majority were female (65.5 %). The most common respiratory disorders were URTI (27.8 %), cough (20.8 %), hay fever or allergic rhinitis (18.6 %), sinus congestion (11.2 %), and asthma (7.6 %). Acupuncture was given at almost all visits (97.5 %) and was frequently combined with herbs (64.0 %). Fifteen adverse events were reported, but none were considered severe. Conclusion In the CM teaching clinic, respiratory conditions were a common presenting complaint of patients, and were safely treated with a combination of acupuncture and herbs. Electronic supplementary material The online version of this article (doi:10.1186/s13020-015-0063-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wan Najbah Nik Nabil
- Traditional and Complementary Medicine Research Program, Discipline of Chinese Medicine, School of Health Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Wenyu Zhou
- Traditional and Complementary Medicine Research Program, Discipline of Chinese Medicine, School of Health Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Johannah Linda Shergis
- Traditional and Complementary Medicine Research Program, Discipline of Chinese Medicine, School of Health Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Suzi Mansu
- Traditional and Complementary Medicine Research Program, Discipline of Chinese Medicine, School of Health Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Charlie Changli Xue
- Traditional and Complementary Medicine Research Program, Discipline of Chinese Medicine, School of Health Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Anthony Lin Zhang
- Traditional and Complementary Medicine Research Program, Discipline of Chinese Medicine, School of Health Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
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Abstract
Medications that provide quick relief of symptoms and that control airway inflammation are the mainstays of asthma treatment. However, adherence to these medications is suboptimal. The inconvenience and costs associated with obtaining these prescription-only medications are factors that contribute to poor adherence. The Food and Drug Administration recently requested public comment on a new paradigm whereby specific prescription-only medications could be made available over the counter, provided that conditions for their safe use could be established. Many organizations expressed opposition, including the American Thoracic Society and other societies representing patients with respiratory diseases. These organizations cited unsubstantiated benefits and unnecessary risks as reasons to oppose greater over-the-counter availability of current prescription-only medications. This article examines the rationale for, and potential ramifications of, making asthma medications available for nonprescription use.
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