Review of the use of high potencies in basic research on homeopathy

The preventive effect on respiratory tract infections of Oscillococcinum®. A cost-effectiveness analysis

BACKGROUND

Anas barbariae hepatis et cordis extractum 200K (Oscillococcinum®) is used to treat and prevent seasonal colds and airway inflammatory affections, improve symptom control, and reduce the frequency of respiratory tract infection (RTI) episodes. The objective of this controlled observational study is to investigate, from the Italian National Health Service (NHS) point of view, the role of Anas barbariae hepatis et cordis extractum 200K in preventing RTIs and estimate the annual average cost per patient due to visits and medicines in a real-world setting, investigating whether this method of treatment can bring savings for the NHS.

METHODS

Data from a single center from 2002 to 2011 were used. The analysis examined 455 patients who suffered from respiratory diseases. Of the total number of patients, 246 were treated with Anas barbariae hepatis et cordis extractum 200K while 209 were not treated (Control group). All the data concerning RTI episodes, pharmacological treatments, and pneumological visits were extracted from the database.

RESULTS

It was found that, regardless of the diagnosis, the frequency of RTI episodes was always lower in patients treated with Anas barbariae hepatis et cordis extractum 200K; the difference between the numbers of events occurring was statistically significant in every class of patients (p<0.001). The costs that the NHS had to incur were significantly lower in the classes of patients treated (p<0.001).

DISCUSSION

The results indicate that Anas barbariae hepatis et cordis extractum 200K has a preventive effect on the onset of RTI episodes. The analysis shows that treating patients with Anas barbariae hepatis et cordis extractum 200K lowers costs for the NHS; this is primarily due to the fact that the medication causes fewer episodes of RTI to develop. This study suggests that the treatment with Anas barbariae hepatis et cordis extractum 200K could be helpful in preventing RTIs and improving the health status of patients who suffer from respiratory diseases, and it could lead to savings to the Italian NHS.

Homeopathic treatments modify inflammation but not behavioral response to influenza antigen challenge in BALB/c mice

BACKGROUND

Influenza affects thousands of people worldwide every year, motivating the development of new therapies. In this work, the effects of two homeopathic preparations (influenza biotherapies and thymulin) were chosen following two different rationales: isotherapy and endo-isotherapy models. The homeopathic effects were evaluated individually considering the inflammatory and behavioral responses against influenza virus antigen were studied in BALB/c mice.

METHODS

Male adult mice were treated orally and blindly for 21 days with highly diluted influenza virus or with thymulin, and were divided in two sets of experiments. The first series of experiments aimed to describe their behavior, using an open field (OF) device. In the second series, mice were challenged subcutaneously with influenza hemagglutinin antigen (7 μg/200 μl) at day 21. At day 42, behavior and inflammation response were evaluated.

RESULTS

No behavioral changes were seen in OF tests at any time point after treatments. Flow cytometry and morphometry revealed significant changes in T and B cell balance after influenza antigen challenge, varying according to treatment.

CONCLUSION

The results show that both homeopathic treatments induced subtle changes in acquired immune anti-viral response regulation. A deeper understanding of the mechanism could elucidate their possible use in influenza epidemiological situations.

Does homeopathic medicine have a preventive effect on respiratory tract infections? A real life observational study

BACKGROUND

Homeopathic medicine is a branch of integrative medicine that has been gaining increasing popularity. However, its clinical application remains controversial. To improve the understanding of homeopathy, observational studies-which monitor the effects of homeopathy in real-life clinical settings-are a helpful adjunct to randomized controlled trials. The goal of this controlled observational study was to investigate the role of the homeopathic medicine in preventing respiratory tract infections (RTIs).

METHODS

This retrospective analysis of patients' medical records focused on a single centre from 2002 to 2011, and examined 459 patients, out of whom 248 were treated with homeopathic medicine (specific extract of duck liver and heart) and 211 were not treated. All patients were followed-up for at least 1 year, and up to a maximum of 10 years.

RESULTS

A significant reduction in the frequency of onset of RTIs was found in both the homeopathic medicine and untreated groups. The reduction in the mean number of RTI episodes during the period of observation vs. the year before inclusion in the study was significantly greater in the homeopathic-treated group than in untreated patients (-4.76 ± 1.45 vs. -3.36 ± 1.30; p = 0.001). The beneficial effect of the homeopathic medicine was not significantly related to gender, age, smoking habits or concomitant respiratory diseases when compared to the effect observed in untreated patients.

CONCLUSION

These results suggest that homeopathic medicine may have a positive effect in preventing RTIs. However, randomized studies are needed before any firm conclusion can be reached.

Evidence of an Epigenetic Modification in Cell-cycle Arrest Caused by the Use of Ultra-highly-diluted Gonolobus Condurango Extract

Objectives:

Whether the ultra-highly-diluted remedies used in homeopathy can effectively bring about modulations of gene expressions through acetylation/deacetylation of histones has not been explored. Therefore, in this study, we pointedly checked if the homeopathically-diluted anti-cancer remedy Condurango 30C (ethanolic extract of Gonolobus condurango diluted 10^-60 times) was capable of arresting the cell cycles in cervical cancer cells HeLa by triggering an epigenetic modification through modulation of the activity of the key enzyme histone deacetylase 2 vis-a-vis the succussed alcohol (placebo) control.

Methods:

We checked the activity of different signal proteins (like p21^WAF, p53, Akt, STAT3) related to deacetylation, cell growth and differentiation by western blotting and analyzed cell-cycle arrest, if any, by fluorescence activated cell sorting. After viability assays had been performed with Condurango 30C and with a placebo, the activities of histone de-acetylase (HDAC) enzymes 1 and 2 were measured colorimetrically.

Results:

While Condurango 30C induced cytotoxicity in HeLa cells in vitro and reduced HDAC2 activity quite strikingly, it apparently did not alter the HDAC1 enzyme; the placebo had no or negligible cytotoxicity against HeLa cells and could not alter either the HDAC 1 or 2 activity. Data on p21^WAF, p53, Akt, and STAT3 activities and a cell-cycle analysis revealed a reduction in DNA synthesis and G1-phase cell-cycle arrest when Condurango 30C was used at a 2% dose.

Conclusion:

Condurango 30C appeared to trigger key epigenetic events of gene modulation in effectively combating cancer cells, which the placebo was unable to do.

Homeopathic Oscillococcinum® for preventing and treating influenza and influenza-like illness

BACKGROUND

Influenza is a highly infectious viral disease that is particularly common in the winter months. Oscillococcinum® is a patented homeopathic medicine that is made from a 1% solution of wild duck heart and liver extract, which is then serially diluted 200 times with water and alcohol.

OBJECTIVES

To determine whether homeopathic Oscillococcinum® is more effective than placebo in the prevention and/or treatment of influenza and influenza-like illness in adults or children.

SEARCH METHODS

We searched CENTRAL (2014, Issue 8), MEDLINE (1966 to August week 4, 2014), MEDLINE In-Process & Other Non-Indexed Citations (4 September 2014), AMED (2006 to September 2014), Web of Science (1985 to September 2014), LILACS (1985 to September 2014) and EMBASE (1980 to September 2014). We contacted the manufacturers of Oscillococcinum® for information on further trials.

SELECTION CRITERIA

Randomised, placebo-controlled trials of Oscillococcinum® in the prevention and/or treatment of influenza and influenza-like illness in adults or children.

DATA COLLECTION AND ANALYSIS

Three review authors independently extracted data and assessed risk of bias in the eligible trials.

MAIN RESULTS

No new trials were included in this 2014 update. We included six studies: two prophylaxis trials (327 young to middle-aged adults in Russia) and four treatment trials (1196 teenagers and adults in France and Germany). The overall standard of trial reporting was poor and hence many important methodological aspects of the trials had unclear risk of bias. There was no statistically significant difference between the effects of Oscillococcinum® and placebo in the prevention of influenza-like illness: risk ratio (RR) 0.48, 95% confidence interval (CI) 0.17 to 1.34, P value = 0.16. Two treatment trials (judged as 'low quality') reported sufficient information to allow full data extraction: 48 hours after commencing treatment, there was an absolute risk reduction of 7.7% in the frequency of symptom relief with Oscillococcinum® compared with that of placebo (risk difference (RD) 0.077, 95% CI 0.03 to 0.12); the RR was 1.86 (95% CI 1.27 to 2.73; P value = 0.001). A significant but lesser effect was observed at three days (RR 1.27, 95% CI 1.03 to 1.56; P value = 0.03), and no significant difference between the groups was noted at four days (RR 1.11, 95% CI 0.98 to 1.27; P value = 0.10) or at five days (RR 1.06, 95% CI 0.96 to 1.16; P value = 0.25). One of the six studies reported one patient who suffered an adverse effect (headache) from taking Oscillococcinum®.

AUTHORS' CONCLUSIONS

There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum®.

High-dilution effects revisited. 1. Physicochemical aspects

Several lines of evidence suggest that homeopathic high dilutions (HDs) can effectively have a pharmacological action, and so cannot be considered merely placebos. However, until now there has been no unified explanation for these observations within the dominant paradigm of the dose-response effect. Here the possible scenarios for the physicochemical nature of HDs are reviewed. A number of theoretical and experimental approaches, including quantum physics, conductometric and spectroscopic measurements, thermoluminescence, and model simulations investigated the peculiar features of diluted/succussed solutions. The heterogeneous composition of water could be affected by interactive phenomena such as coherence, epitaxy and formation of colloidal nanobubbles containing gaseous inclusions of oxygen, nitrogen, carbon dioxide, silica and, possibly, the original material of the remedy. It is likely that the molecules of active substance act as nucleation centres, amplifying the formation of supramolecular structures and imparting order to the solvent. Three major models for how this happens are currently being investigated: the water clusters or clathrates, the coherent domains postulated by quantum electrodynamics, and the formation of nanoparticles from the original solute plus solvent components. Other theoretical approaches based on quantum entanglement and on fractal-type self-organization of water clusters are more speculative and hypothetical. The problem of the physicochemical nature of HDs is still far from to be clarified but current evidence strongly supports the notion that the structuring of water and its solutes at the nanoscale can play a key role.

Homeopathic Oscillococcinum(®) for preventing and treating influenza and influenza-like illness

BACKGROUND

Influenza is a highly infectious viral disease that is particularly common in the winter months. Oscillococcinum(®) is a patented homeopathic medicine that is made from a 1% solution of wild duck heart and liver extract, which is then serially diluted 200 times with water and alcohol.

OBJECTIVES

To determine whether homeopathic Oscillococcinum(®) is more effective than placebo in the prevention and/or treatment of influenza and influenza-like illness in adults or children.

SEARCH METHODS

We searched CENTRAL (2012, Issue 7), MEDLINE (1966 to July week 4, 2012), MEDLINE In-Process & Other Non-Indexed Citations (6 August 2012), AMED (2006 to August 2012), Web of Science (1985 to August 2012), LILACS (1985 to August 2012) and EMBASE (1980 to August 2012). We contacted the manufacturers of Oscillococcinum(®) for information of more trials.

SELECTION CRITERIA

Randomised, placebo-controlled trials of Oscillococcinum(®) in the prevention and/or treatment of influenza and influenza-like illness in adults or children.

DATA COLLECTION AND ANALYSIS

Three review authors independently extracted data and assessed risk of bias in the eligible trials.

MAIN RESULTS

We included six studies: two prophylaxis trials (327 young to middle-aged adults in Russia) and four treatment trials (1196 teenagers and adults in France and Germany). The overall standard of trial reporting was poor and hence many important methodological aspects of the trials had unclear risk of bias. There was no statistically significant difference between the effects of Oscillococcinum(®) and placebo in the prevention of influenza-like illness: risk ratio (RR) 0.48, 95% confidence interval (CI) 0.17 to 1.34, P = 0.16. Two treatment trials (judged as 'low quality') reported sufficient information to allow full data extraction: 48 hours after commencing treatment, there was an absolute risk reduction of 7.7% in the frequency of symptom relief with Oscillococcinum(®) compared with that of placebo (risk difference (RD) 0.077; 95% CI 0.03 to 0.12); the RR was 1.86 (95% CI 1.27 to 2.73; P = 0.001). A significant but lesser effect was observed at three days (RR 1.27, 95% CI 1.03 to 1.56; P = 0.03), and no significant difference between the groups was noted at four days (RR 1.11, 95% CI 0.98 to 1.27; P = 0.10) or at five days (RR 1.06; 95% CI 0.96 to 1.16; P = 0.25). One of the six studies reported one patient who suffered an adverse effect (headache) from taking Oscillococcinum(®).

AUTHORS' CONCLUSIONS

There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum(®) in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum(®) could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum(®).

Toxicodendron pubescens retains its anti-arthritic efficacy at 1M, 10M and CM homeopathic dilutions

BACKGROUND

Our previous studies of Toxicodendron pubescens (Rhus tox) in homeopathic dilutions have shown anti-inflammatory activity in line with the principle of similia. The present study aimed to evaluate its anti-inflammatory activity in 1M, 10M and CM dilutions in rats.

METHOD

Arthritis was induced by subplantar injection of 0.1 ml of Complete Freund's Adjuvant (CFA) in the right hind paws of rats. The severity of inflammatory lesions was measured plethysmometrically on 21st day post CFA injection. The intensity of pain was measured using digital Von Frey apparatus. Other estimations included serum C-reactive protein (CRP), hematological parameters, body weight changes, arthritic pain score and radiological analysis of the arthritic paws.

RESULT

The 1M, 10M and CM homeopathic dilutions of Rhus tox reduced primary and secondary arthritic lesions, improved body weight gain and protected rats against CFA-induced hematological and radiological perturbations. A significant reduction in the serum levels of CRP and an improvement in pain threshold of injected paws was observed in the groups treated with the Rhus tox dilutions.

CONCLUSION

The anti-arthritic potential of Rhus tox is retained at 1M, 10M and CM dilutions.