Dosha phenotype specific Ayurveda intervention ameliorates asthma symptoms through cytokine modulations: Results of whole system clinical trial

Contention and collaboration: the tenuous encounter of modern Ayurveda and Western medicine in the twentieth and twenty-first centuries

Complementary medicine systems are ascending to rapid popularity as the twenty-first century progresses. Often adapted from ancient systems of healing such as Ayurveda, these modern alternative medical movements reappraise millennia-old health traditions that found their inception at the confluence of religious philosophy and herbal healing. Naturally, contemporary global economic forces and a desire to market traditional medicine products in an enticing fashion have characterised how historic traditional medicine systems are presented in the modern context. By establishing a vision of complementary medicine born from ancient traditions, it becomes clear how traditional methods of healing can contend with Western biomedicine-the prevailing standard of care around the globe. The claims made by both sides parry along a line of scientific validity, efficacy and regulatory purview. India, the birthplace of Ayurveda and an epicentre of contemporary medical education, is a prime arena to study the friction between biomedicine and traditional medicine. In this piece, I focus on the modernisation of Ayurveda and how it has found conflict with allopathic medicine. I posit that Ayurveda has re-emerged since the early twentieth century as a key tenet of Indian modernity: and in doing so has found contention with Western medicine. I furthermore argue that despite existing discord, the two medical traditions are not inherently antithetical. They can be synergistic, so long as healthcare delivery and education recognise the limits of each and focus on coaction rather than contradiction.

Ayurveda management of a patient having bronchial asthma and hemorrhoids- A case report

Ayurveda is a holistic science that treats root cause of diseases. One disease can become a causative factor for another disease. This concept is fundamentally described as Nidanarthakar Vyadhi in Ayurveda. In the same way, treating causative diseases is helpful in managing another diseases. However, many published clinical trials on Ayurveda management of Bronchial asthma and Hemorrhoids exist. There is a dearth of published case reports or clinical trials showing an association between Arsha (hemorrhoids) and Shwasa (bronchial asthma). This case report gives important viewpoints about the role of hemorrhoids and its treatment in pathogenesis and treatment of bronchial asthma. This case report of a 38-year-old female patient known case of bronchial asthma who came to the OPD of Kayachikitsa Government Ayurved College and Hospital, Nagpur with complaints of cough with sputum, breathlessness, chest pain (on/off) for three years. The severity of these symptoms increased for three months. The patient was treated with conventional Shwasghna Chikitsa (treatment of bronchial asthma) for five days, but the response was unsatisfactory. After five days of Shwasghna treatment, the patient gave a history of hemorrhoids. Considering Nidanarthakar Roga (one disease can cause of another disease), treatment was planned. The treatment principle is the treatment of causative disease (Arsha). Hence, Arshoghna treatment was added. Significant increases in peak expiratory flow rate (PEFR), Sustained minimal inspiration (SMI), and Modified Medical Research Council Dyspnoea scale (mMRC) were observed. The respiratory rate was also reduced from 28/min to 18/min. Improvement in the subjective and objective parameters of the patient was observed. The inclusion of Arsha treatment can be helpful in the management of Tamakshwas (Bronchial Asthma). The need for further research in this direction is warranted.

Genome-wide DNA methylation profiling after Ayurveda intervention to bronchial asthmatics identifies differential methylation in several transcription factors with immune process related function

BACKGROUND

The Indian traditional medicinal system, Ayurveda, describes several lifestyle practices, processes and medicines as an intervention to treat asthma. Rasayana therapy is one of them and although these treatment modules show improvement in bronchial asthma, their mechanism of action, particularly the effect on DNA methylation, is largely understudied.

OBJECTIVES

Our study aimed at identifying the contribution of DNA methylation changes in modulating bronchial asthma phenotype upon Ayurveda intervention.

MATERIALS AND METHODS

In this study, genome-wide methylation profiling in peripheral blood DNA of healthy controls and bronchial asthmatics before (BT) and after (AT) Ayurveda treatment was performed using array-based profiling of reference-independent methylation status (aPRIMES) coupled to microarray technique.

RESULTS

We identified 4820 treatment-associated DNA methylation signatures (TADS) and 11,643 asthma-associated DNA methylation signatures (AADS), differentially methylated [FDR (≤0.1) adjusted p-values] in AT and HC groups respectively, compared to BT group. Neurotrophin TRK receptor signaling pathway was significantly enriched for differentially methylated genes in bronchial asthmatics, compared to AT and HC subjects. Additionally, we identified over 100 differentially methylated immune-related genes located in the promoter/5'-UTR regions of TADS and AADS. Various immediate-early response and immune regulatory genes with functions such as transcription factor activity (FOXD1, FOXD2, GATA6, HOXA3, HOXA5, MZF1, NFATC1, NKX2-2, NKX2-3, RUNX1, KLF11), G-protein coupled receptor activity (CXCR4, PTGER4), G-protein coupled receptor binding (UCN), DNA binding (JARID2, EBF2, SOX9), SNARE binding (CAPN10), transmembrane signaling receptor activity (GP1BB), integrin binding (ITGA6), calcium ion binding (PCDHGA12), actin binding (TRPM7, PANX1, TPM1), receptor tyrosine kinase binding (PIK3R2), receptor activity (GDNF), histone methyltransferase activity (MLL5), and catalytic activity (TSTA3) were found to show consistent methylation status between AT and HC group in microarray data.

CONCLUSIONS

Our study reports the DNA methylation-regulated genes in bronchial asthmatics showing improvement in symptoms after Ayurveda intervention. DNA methylation regulation in the identified genes and pathways represents the Ayurveda intervention responsive genes and may be further explored as diagnostic, prognostic, and therapeutic biomarkers for bronchial asthma in peripheral blood.

Asthma History, Current Situation, an Overview of Its Control History, Challenges, and Ongoing Management Programs: An Updated Review

Asthma is a disease of the airways that is characterized by chronic inflammation and disordered airway function. The purpose of writing the current review paper is to review the history, current situation, control history, challenges, and ongoing management programs of asthma. Some official websites of known respiratory professional bodies were consulted for asthma guidelines, and information from Google Scholar® and PubMed® was also consulted. We reviewed around two hundred eight papers, and then, inclusion and exclusion criteria were applied to prepare this manuscript. Out of these papers, thirty papers, factsheets, and some official websites were used to prepare this manuscript. Physicians should follow already existing asthma guidelines in order to manage asthma. All prescribed medications should be continued. The government should make and adopt more strategies to promote the rational use of anti-asthmatic drugs and healthcare facilities and also make plans to disseminate more awareness among people about the schemes and programs made for safeguarding people against this life-threatening disease. We have done so much advancement to fight against this deadly disease, and we still need time to make the globe asthma-free. The number of people suffering from asthma is more than the number of people suffering from HIV infection and tuberculosis. Understanding the recommendations of professional bodies will assist in medical decision-making in asthma management. The individual needs of patients should be considered by healthcare professionals.

Graphical Abstract

An Artemisia ordosica extract: Effects on growth performance, immune, and inflammatory response in lipopolysaccharide-challenged broilers

Artemisia ordosica has been applied as a traditional Chinese/Mongolian medicine for treating csertain inflammatory ailments. This study was conducted to investigate the effect of Artemisia ordosica alcohol extract (AOAE) supplemented in diets on growth performance, immune, and inflammatory response in lipopolysaccharide (LPS)-challenged broilers. A total of 240 one-day-old Arbor Acre male broilers were randomly allotted into 5 groups with 6 replicates (n = 8), which were basal diet group (CON), LPS-challenge and basal diet group (LPS), LPS-challenge and the basal diet added with low (500 mg/kg), middle (750 mg/kg), and high (1,000 mg/kg) dose of AOAE groups (AOAE-L, AOAE-M, and AOAE-H), respectively. On d 16, 18, 20, 22, 24, 26, and 28, all broilers were injected intra-abdominally either with LPS or an equivalent amount of saline. Results showed that dietary AOAE alleviated the LPS-induced decrease in average daily gain and average daily feed intake in the broilers (P < 0.05). Dietary AOAE supplementation reversed the increased spleen index and the decreased bursa index in LPS-challenged broilers (P < 0.05). Moreover, feeding AOAE could mitigate the elevation of IL-1β in serum, liver, and spleen, IL-2 in serum and liver, IL-6 in serum and spleen, and the decrease of IgG in spleen, IgM in serum, liver, and spleen, and IL-4 in serum of the LPS-challenged broilers (P < 0.05). This study also showed that AOAE supplementation alleviated the increase of mRNA expression of TLR4, MyD88, TRAF6, NF-κB p65, NF-κB p50, IL-1β, and IL-6, and the decrease of gene expression of IκBα and PPARγ in liver and/or spleen of broilers challenged by LPS (P < 0.05). We speculated that AOAE administration could effectively alleviate LPS-induced inflammation via decreasing over-production of proinflammatory cytokines, ultimately relieving the growth inhibition of broilers caused by LPS. In conclusion, 1,000 mg/kg AOAE has a strong capacity to enhance immunity and inhibit inflammation, and can be used as a potential novel feed additive with applications in treating inflammation-related diseases and bacterial infection in broilers.

Design and implementation of a highly efficacious new yoga breathing and relaxation protocol for asthma: A discussion and summary

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.

Whole Systems Research Methods in Health Care: A Scoping Review

Objectives: This scoping review evaluates two decades of methodological advances made by “whole systems research” (WSR) pioneers in the fields of traditional, complementary, and integrative medicine (TCIM). Rooted in critiques of the classical randomized controlled trial (RCT)'s suitability for evaluating holistic, complex TCIM interventions, WSR centralizes the principle of “model validity,” representing a “fit” between research design and therapeutic paradigm.

Design: In consultation with field experts, 41 clinical research exemplars were selected for review from across 13 TCIM disciplines, with the aim of mapping the range and methodological characteristics of WSR studies. Using an analytic charting approach, these studies' primary and secondary features are characterized with reference to three focal areas: research method, intervention design, and outcome assessment.

Results: The reviewed WSR exemplars investigate a wide range of multimodal and multicomponent TCIM interventions, typified by wellness-geared, multitarget, and multimorbid therapeutic aims. Most studies include a behavioral focus, at times in multidisciplinary or team-based contexts. Treatments are variously individualized, often with reference to “dual” (biomedical and paradigm-specific) diagnoses. Prospective and retrospective study designs substantially reflect established biomedical research methods. Pragmatic, randomized, open label comparative effectiveness designs with “usual care” comparators are most widely used, at times with factorial treatment arms. Only two studies adopt a double-blind, placebo-controlled RCT format. Some cohort-based controlled trials engage nonrandomized allocation strategies (e.g., matched controls, preference-based assignment, and minimization); other key designs include single-cohort pre–post studies, modified n-of-1 series, case series, case report, and ethnography. Mixed methods designs (i.e., qualitative research and economic evaluations) are evident in about one-third of exemplars. Primary and secondary outcomes are predominantly assessed, at multiple intervals, through patient-reported measures for symptom severity, quality of life/wellness, and/or treatment satisfaction; some studies concurrently evaluate objective outcomes.

Conclusions: Aligned with trends emphasizing “fit-for-purpose” research designs to study the “real-world” effectiveness of complex, personalized clinical interventions, WSR has emerged as a maturing scholarly discipline. The field is distinguished by its patient-centered salutogenic focus and engagement with nonbiomedical diagnostic and treatment frameworks. The rigorous pursuit of model validity may be further advanced by emphasizing complex analytic models, paradigm-specific outcome assessment, inter-rater reliability, and ethnographically informed designs. Policy makers and funders seeking to support best practices in TCIM research may refer to this review as a key resource.

Beneficial role of Terminalia arjuna hydro-alcoholic extract in colitis and its possible mechanism

ETHNOPHARMACOLOGICAL RELEVANCE

Terminalia arjuna Roxb. (Combretaceae) is traditionally used in Ayurveda medicine and holds ethnomedicinal importance for treatment of gastrointestinal disorders. In view of its anti-inflammatory, antidiarrheal and antioxidant potential, it could be beneficial for the treatment of inflammatory bowel disease (IBD), which is associated with interaction between genetic, environmental factors and intestinal microbiome leading to dysregulated immune responses. This study evaluates the effect of hydroalcoholic extract of Terminalia arjuna bark (TAHA) in trinitrobenzenesulfonic acid (TNBS) model of rat colitis which resembles human IBD.

MATERIALS AND METHODS

TAHA (500, 250, 125 mg/kg) was administered orally for 28 days in TNBS induced rats. Response to treatment was assessed by comparing observations in diseased and treated groups using disease activity index (DAI); macroscopic/histological damage; determining oxidative stress indicators: myeloperoxidase, malondialdehyde, nitric oxide, catalase, superoxide dismutase, and reduced glutathione; gene expression of pro-inflammatory cytokines such as IL-6, IL-1β, TNF-α and chemokine: MCP-1. Furthermore, the role of TAHA in altering the gut microbiota profile in rat feces and plasma zinc was also studied.

RESULTS

TAHA treatment in colitic rats directed decreased DAI scores, macroscopic and histologic damage. It also reduced myeloperoxidase, malondialdehyde and nitric oxide level. Whereas, prevented depletion of plasma catalase, superoxide dismutase and glutathione level. In addition, TAHA treatment down-regulated the gene expression of pro-inflammatory mediators and displayed altered beneficial effect on fecal microbiota. Furthermore, enhanced plasma zinc level supported the beneficial effect of TAHA in colitic rats. The dose of TAHA that produced most significant beneficial effect was 500 mg/kg.

CONCLUSION

TAHA administration relieved the disease activity in TNBS induced colitis by reducing expression of pro-inflammatory cytokines and chemokine, decreasing oxidative stress, and improving plasma zinc level and structure of gut microbiota.