Alternative and complementary medicine: a source of improved therapies for asthma? A challenge for redefining the specialty?

Bambusae Caulis in Taeniam extract reduces ovalbumin-induced airway inflammation and T helper 2 responses in mice

ETHNOPHARMACOLOGICAL RELEVANCE

Bambusae Caulis in Taeniam (BC) was known as traditional herbal medicine with anti-inflammatory property in the Orient.

AIM OF THE STUDY

Allergic asthma is inflammatory disease of airways associated with enhanced T helper (Th) 2 lymphocytes responses to allergens, leading to eosinophilic infiltration and elevated serum IgE levels. Although there were some studies that BC extract had an anti-inflammatory property, there was no study on asthma. In present study, we investigated the suitability of BC extract as a therapeutic candidate in the treatment of allergic airway disease in ovalbumin-induced asthma model.

MATERIALS AND METHODS

Balb/C mice (female, 6 weeks old) were treated by ovalbumin sensitization and nebulization, and used as asthma model. The number of eosinophil in bronchoalveolar lavage (BAL) fluid and the degree of eosinophila were investigated by hematoxylin and eosin stain and the infiltration of inflammatory cells into lung tissues was examined by staining by hematoxylin and eosin solution. The levels of interleukin (IL)-4 in BAL fluid, immunoglobulin E (IgE) in serum, interferon (IFN)-gamma and IL-4 production in splenocyte culture from Balb/C mice (not treated, 6 weeks old) that incubated with or without BC extract for 48 h were determined by enzyme-linked immunosorbent assay.

RESULTS

The level of eosinophils was decreased by treatment of the animals with BC extract (40 mg/kg) and correspondingly, a significantly lowered degree of eosinophila was also reported (p<0.01). In lung tissue, BC extract reduced the increased immune cell infiltration induced by OVA (p<0.05). Furthermore, the levels of IL-4 and IgE in BAL fluid or serum up-regulated by OVA was decreased by BC extract. Finally, IFN-gamma production was significantly increased (p<0.01), while IL-4 production significantly decreased (p<0.01), after treatment of the culture supernatants of splenocytes with BC extract.

CONCLUSIONS

These results indicated that BC extract reduces OVA-induced airway inflammation and Th 2 response in mice, suggesting that BC extract can be a therapeutic candidate for allergic airway disease, including asthma.

Efficacy and mechanisms of action of traditional Chinese medicines for treating asthma and allergy

BACKGROUND

Although corticosteroids and beta(2)-agonists are effective in managing asthma symptoms, a curative therapy for asthma is lacking. Traditional Chinese medicine (TCM), used in Asia for centuries, is beginning to play a role in Western health care as a complementary and alternative medicine modality. There is increasing scientific evidence supporting the use of TCM for asthma treatment.

OBJECTIVE

This review article discusses promising TCM interventions for asthma and explores their possible mechanisms of action.

METHODS

We first reviewed 5 clinical studies of antiasthma TCM herbal remedies published between 2005 and 2007. We then summarized possible mechanisms underlying their effects on the basis of data in the original articles, published abstracts, and available databases. Possible mechanisms include anti-inflammation, inhibition of airway smooth muscle contraction, and immunomodulation. Research on TCM herbal therapy for food allergy is rare, and we therefore focused on the effect and mechanism of action of food allergy herbal formula-2 on a murine model of peanut allergy and preliminary clinical study results.

CONCLUSION

Evidence from clinical studies supports beneficial effects of TCM herbal therapy on asthma. A number of mechanisms may be responsible for efficacy of these agents. Strong preclinical study data suggest the potential efficacy of food allergy herbal formula-2 for food allergy.

Traditional Chinese herbal remedies for asthma and food allergy

The increasing prevalence of allergic diseases in Westernized countries is a significant health problem. Curative therapies for these diseases are not available. There are also significant concerns regarding the potential side effects from the chronic use of conventional drugs such as corticosteroids, especially in children. Many patients with chronic allergic conditions seek complementary and alternative medicine therapies including traditional Chinese medicines. This trend has begun to attract interest from mainstream health care providers and scientific investigators and has stimulated government agencies in the United States to provide support and guidance for the scientific investigation of complementary and alternative medicine. This effort may lead to improved therapies and better health care/patient outcomes. This review presents an update on the most promising Chinese herbal remedies for asthma and food allergy.

Regulatory T Cells, a Potent Immunoregulatory Target for CAM Researchers: Modulating Allergic and Infectious Disease Pathology (II)

Regulatory T (T_reg) cells maintain dominant control of immune responses to foreign materials and microbes. Appropriate T_reg cell suppression of immune responses is essential for the maintenance of efficacious defensive responses and the limitation of collateral tissue damage due to excess inflammation. Allergy and infection are well studied and frequent afflictions in which T_reg cells play an essential role. As such, they provide excellent models to communicate the significance and relevance of T_reg cells to complementary and alternative medicine (CAM).

Defining complementary and alternative medicine in allergies and asthma: benefits and risks

In this review, the current literature discussing complementary/alternative medicine (CAM) interventions, the prevalence and pattern of use, examples of specific modalities and the risks of CAM for asthma and atopic disease are discussed. The specific risks of CAM interventions associated with the use of these modalities, omission of traditional therapeutic modalities, and the liability risk for physicians who either provide or counsel their patients regarding CAM interventions are also discussed.

Herbal and nonherbal supplements in medical-psychiatric patient populations

Nutritional supplements remain a popular choice for patients seeking relief or prevention from a wide range of physical and mental disorders. Review of available literature finds support for some therapeutic uses, but flaws in study design (e.g., small sample sizes) and methodology (e.g., inadequate blinding and a lack of placebo control) limit the possibility of making strong recommendations. Quality-control issues also raise concerns about the safety of supplement use (see previous list). In addition, potential interactions with prescription drugs are another consideration (Table 1). By becoming more knowledgeable about the risks and benefits of nutritional supplements, psychiatrists can assist patients in making informed choices and avoiding unnecessary harm.