Regulatory effects of stage-treatment with established Chinese herbal formulas on inflammatory mediators in pediatric asthma

The Antioxidant Rosmarinic Acid Ameliorates Oxidative Lung Damage in Experimental Allergic Asthma via Modulation of NADPH Oxidases and Antioxidant Enzymes

Oxidative stress can induce lung damage and aggravate airway inflammation in asthma. Previously, we reported that rosmarinic acid (RA) exerted strong anti-inflammatory effects in a mouse allergic asthma model. Therefore, we hypothesized that RA might also have antioxidative effects in a superimposed asthma mouse model with oxidative lung damage challenged with ovalbumin (Ova) and hydrogen peroxide (H2O2). We evaluated the antioxidative and anti-asthmatic activity of RA and explored its possible mechanisms of action. Mice sensitized to Ova and challenged with Ova and H2O2 were treated with RA 1 h after challenge. RA treatment greatly diminished the number of inflammatory cells; decreased IL-4, IL-5, and IL-13 production; increased IFN-γ secretion; significantly downregulated ROS production; and markedly upregulated the activities of SOD, GPx, and CAT. Furthermore, RA treatment resulted in a significant increase in the expression of Cu/Zn SOD and a notable reduction in NOX-2 and NOX-4 expression in lung tissues. These findings suggest that RA may effectively alleviate oxidative lung damage and airway inflammation in asthma.

Serum levels of vitamin A and 25-hydroxyvitamin D3 (25OHD3) as reflectors of pulmonary function and quality of life (QOL) in children with stable asthma: A case-control study

BACKGROUND

This study aims to explore the relationship between serum vitamin A and 25-hydroxyvitamin D3 (25OHD3) levels with pulmonary function and quality of life (QOL) in children with stable asthma.

METHODS

A total of 117 cases of children with stable asthma were assigned into the case group and 129 healthy children underwent physical examination during the same period into the control group. Electrochemiluminescence was employed to determine serum vitamin A and 25OHD3 levels. The children with stable asthma were further divided into the mild, moderate, and severe groups according to their degree of asthma. A pulmonary function meter was used to assess the pulmonary function indexes: percentage of forced expiratory volume in 1 sec/predictive value (FEV1%pred), forced vital capacity (FVC), forced expiratory volume in 1 sec/forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV). The children's quality (QOL) of life with asthma was evaluated by their activities of daily living (ADLs) and Medical Research Council (MRC) scores. Pearson correlation analysis was applied to analyze the correlations of serum vitamin A and 25OHD3 levels with FEV1%pred, FVC, FEV1/FVC, PEF, MVV, ADL, and MRC.

RESULTS

Serum vitamin A and 25OHD3 levels were lower in children with stable asthma than those who were in the control group (P < .05). The severe group showed the lowest FEV1%pred, FVC, FEV1/FVC, PEF, MVV, and ADL scores, and the highest MRC score compared to the mild and moderate groups (all P < .05). Serum vitamin A and 25OHD3 levels were positively correlated with pulmonary function and ADL score in children with stable asthma, while serum vitamin A and 25OHD3 levels were negatively correlated with MRC score (all P < .05). In the case group, serum vitamin A and 25OHD3 levels were positively correlated with serum calcium and phosphorus levels (all P < .05).

CONCLUSION

These findings indicate that increased serum vitamin A and 25OHD3 levels reflect good pulmonary function and good QOL in children with stable asthma.

Effect of Traditional Chinese Medicine on Inflammatory Mediators in Pediatric Asthma

Objective. To observe the effects of empirical prescriptions of traditional Chinese medicine (TCM) on inflammatory mediators in pediatric asthma and to explore the underlying molecular mechanism in the treatment of asthma. Methods. A total of 182 children with asthma were randomly placed into either the TCM group (n = 97) or the salbutamol and montelukast (SM) group (n = 85). Patients in the TCM group were treated with a series of empirical prescriptions of TCM, while those in the SM group received salbutamol and montelukast. Both groups received their respective treatment for 12 weeks. There were 35 patients in TCM group and 34 patients in SM group providing venous blood. Real-time PCR was used to determine the mRNA expression levels of interleukin- (IL-) 10, IL-17, matrix metalloproteinase-9 (MMP-9), and transforming growth factor β1 (TGF-β1) in peripheral blood mononuclear cells before and after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-10, IL-17, MMP-9, and TGF-β1 in peripheral blood before and after treatment. Results. The mRNA expression of TGF-β1 in the SM group was downregulated (P = 0.00) after treatment. No significant differences were found between the TCM group and the SM group after treatment (P > 0.05). In the TCM group, the levels of IL-10, IL-17, and MMP-9 significantly decreased after treatment (P = 0.01, 0.04, and 0.03, resp.). In the SM group, IL-17, MMP-9, and TGF-β1 levels significantly decreased after treatment (P = 0.00, 0.03, and 0.00, resp.). There was no significant difference between the two groups regarding the levels of IL-10, IL-17, TGF-β1, and MMP-9 (P > 0.05). The difference of the level of IL-17 was negatively correlated with the change of C-ACT score in TCM group and SM group. Conclusion. TCM has a regulatory effect on the balance of some inflammatory mediators in pediatric asthma.

The Immunoregulatory Effects of Traditional Chinese Medicine on Treatment of Asthma or Asthmatic Inflammation

Asthma is a chronic respiratory symptoms with variable airflow limitation and airway hyperresponsiveness (AHR), and causes high economic burden. Traditional Chinese medicine (TCM) has a long-lasting history of using herbal medicine in the treatment of various respiratory diseases including asthma. In the last several decades, an increasing number of herbs have been shown to be effective in the treatment of asthma in clinical trials or asthmatic inflammation in animal models. Literature about the effects of TCM on the immune system were searched in electronic databases such as PubMed, Google Scholar and Scopus from 2000 to 2014. 'TCM' and 'asthma' were used as keywords for the searches. Over 400 literatures were searched and the literatures about the immune system were selected and reviewed. We only reviewed literatures published in English. Accumulating evidence suggests that TCM can directly inhibit the activation and migration of inflammatory cells, regulate the balance of Th1/Th2 responses, and suppress allergic hyperreactivity through inducing regulatory T cells or attenuating the function of dendritic cells (DCs). These studies provided useful information to facilitate the use of TCM to treat asthma. This review was conducted to classify the findings based on their possible mechanisms of action reported.

Complementary and alternative medicine in pulmonology

PURPOSE OF REVIEW

To provide a comprehensive review of complementary and alternative medicine (CAM) therapies for the treatment of pulmonary disorders in children.

RECENT FINDINGS

The use of complementary medicine (CAM) is commonly used by both children and adults with breathing problems, and especially in chronic pulmonary disorders such as asthma and cystic fibrosis. Many clinics and hospitals now offer CAM, even though most of the conventionally trained health practitioners have little knowledge or education regarding CAM therapies. Research in CAM that demonstrates overall benefit is lacking, especially in children. Often parents do not report CAM use to their child's healthcare provider and this could compromise their overall quality of care. Although many research studies evaluating CAM therapies have methodological flaws, data exist to support CAM therapies in treating children with pulmonary disorders.

SUMMARY

This review examines the latest evidence of CAM use and effectiveness in children with pulmonary disorders. Physicians should be aware of the many CAM therapy options and the research surrounding them in order to provide their patients with the most current and accurate information available.

Antioxidant and anti-inflammatory effects of Schisandra and Paeonia extracts in the treatment of asthma

The aim of the present study was to investigate the antioxidant and anti-inflammatory effects of Paeonia and Schisandra extracts in asthmatic rats. An ethanol extraction method was used to prepare the Schisandra and Paeonia extracts, and the levels of hydroxyl radical, total antioxidant activity and total phenolic content were detected. The rats were divided into three groups: Treatment (group A), model (group B) and control (group C). The treatment group received traditional Chinese antiasthmatic medicine (mixed extract, 2 ml/day) for 10 days. Levels of malondialdehyde (MDA), Cu-Zn-superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were detected in the serum, while interleukin (IL)-4, IL-6, interferon (IFN)-γ, IL-13 and IL-22 levels were analyzed in the serum, bronchoalveolar lavage fluid and lung tissue homogenates of the three groups. In addition, pathological changes of the tracheal tissues were observed via biopsies and the NF-κB p65 level was measured in the lung tissue using immunohistochemistry. Total antioxidant activity, hydroxyl radical levels and total phenolic content in the mixed herbal extracts were higher than those in the single herbal extracts. At day 5 following the treatment, the number of eosinophils was significantly reduced in the tracheal tissues. At day 10 following the treatment, the mucosa was significantly repaired. In vivo antioxidant levels revealed that the serum and erythrocyte SOD activity and GSH-Px were higher in group A as compared with group B, while the level of MDA in group A was lower than that in group B (P<0.05). The levels of serum and erythrocyte SOD activity and GSH-Px in group B were lower than those in group C, while the level of MDA in group B was higher than that in group C (P<0.05). IL-4, IL-6 and IL-13 levels in the serum, bronchoalveolar lavage fluid and lung tissue in group A were not significantly different from those in group B (P>0.05). However, IFN-γ levels in group A significantly increased as compared with the level in group B, while IL-22 levels decreased significantly in group A as compared with group B (P<0.05). IL-4, IL-6, IL-13 and IL-22 levels in the lung tissue, bronchoalveolar lavage fluid and serum in group B were significantly higher than those in group C. In addition, the IFN-γ level decreased significantly in group B as compared with the level in group C (P<0.05). Immunohistochemical analysis revealed that the protein expression of NF-κB p65 in group A was significantly lower compared with group B (P<0.05). Therefore, Paeonia and Schisandra extracts may be used to treat asthma through their in vivo antioxidant and anti-inflammatory effects.