Asthma and COPD

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Sections

Information Resources and Links to Scientific Studies

The information below represents just a small portion of the sound research information now available to the public concerning asthmatic therapies and herbal medicine. The research oriented Licensed Acupuncturist accesses this information to better guide therapy.

  1. Current debate illustrated in a New York Times article of Dec. 5, 2008, Warnings Given on Four Popular Asthma Drugs, but Debate Remains http://www.nytimes.com/2008/12/06/health/policy/06allergy.html?em If you have trouble accessing this database by clicking on this address, try searching for the article on Google. The New York Times now restricts free access to information on the web.
  2. An expert panel of the U.S. National Institutes of Health provided a report on the pathophysiology and pathogenesis of asthma, noting that current anti-inflammatory therapy to treat asthma does not appear to prevent progression of the underlying disease severity: http://www.ncbi.nlm.nih.gov/books/NBK7223/
  3. The report by the manufacturer, Merck Pharmaceuticals, noting adverse effects and risks in short-term human clinical trials of albuterol sulfate inhaler, as well as the limited long-term study of adverse effects and risks in laboratory animals: http://allergies.about.com/gi/o.htm
  4. A 2014 study of the beneficial health effects seen from U.S. EPA regulations concerning air pollution shows that dramatic decreases in disease and mortality are apparent from decreasing the airborne pollution, with public costs just a fraction of the cost of treating these diseases. Today, the enormous amount of toxic air pollution still occurring, which causes enormous suffering, especially from lung and respiratory disease, can still be dramatically reduced, at a reasonable cost, thanks to advancing technology: http://www.epa.gov/air/caa/progress.html
  5. A 2011 study of the incidence of COPD in the U.S., by the Centers for Disease Control and Prevention, noted that this 2011 study was the first study of state-specific, or geographic, prevalence of COPD. The study also noted that COPD is very underdiagnosed in the U.S. with 63 percent of Americans with a spirometry test showing poor lung function never diagnosed with COPD, and about 20 percent of patients diagnosed with COPD not diagnosed with a spirometry test of lung function, a simple, inexpensive, and essential diagnostic tool. Current statistics on COPD prevalence in the United States are simply inadequate, and there is no stated reason for this lack of adequate study: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6146a2.htm
  6. A 2009 study at Chiba University, Chiba, Japan, found in a study of 1200 patients that COPD and ILD (interstitial lung diseases) were strong risk factors for lung cancer. These experts noted that lung cancer is frequently accompanied by both COPD and interstitial lung diseases, but the coincidence of these overlapping degenerative and inflammatory lung diseases with lung cancer has not been well studied: http://www.ncbi.nlm.nih.gov/pubmed/19192220
  7. A 2013 study at Bhopal Memorial Hospital and Research Center, Bhopal, India, in a continuing study of the large number of patients still affected by the Methyl isocyanates toxicity from the 1984 Bhopal Disaster, the worst industrial accident in history, where pesticide plant leaks from a Union Carbide plant exposed over 500,000 people to methyl isocyanate gas and other toxic chemicals, killed 2,259 and leaving tens of thousands with severe chronic lung diseases, showed that epigenetic changes, with specific variants of the gene expressing the immune complement protein CD-14, seen in 10-20 percent of patients with asthma and COPD, whereas healthy controls without exposure to the toxic gas showed only 1-2 percent of persons with these epigenetic variants. The CD-14 protein acts with the Toll-like receptors to detect bacterial endotoxins called liposaccharides in the innate immune system: http://www.ncbi.nlm.nih.gov/pubmed/24019621
  8. A 2015 study at Duke University Medical Center, in Durham, North Carolina, U.S.A. and the National Health and Environmental Effects Research Laboratory of the U.S. NIH, concluded that antioxidant supplementation and dietary antioxidants must play a role in the holistic treatment protocol of COPD, the most common chronic illness in the world. An array of genetic and epigenetic traits connected to predisposition to COPD have been linked to oxidant/antioxidant imbalance. Not only diet and supplements, but acupuncture stimulation itself has been shown to improve antioxidant metabolism: http://www.ncbi.nlm.nih.gov/pubmed/25673984
  9. A 2003 review of scientific study of COPD exacerbations by the Royal London School of Medicine, published in the European Respiratory Journal, found that more frequent exacerbations of COPD are attributed to a variety of factors, not just smoking, with chronic use of corticosteroids, excessive antibiotic therapy, flu vaccination, and chronic use of mucolytics all associated with more frequent exacerbations, and that the lack of effective pulmonary rehabilitation was also a significant factor. Genetic components that are proven apply to only about 1 percent of COPD patients. The need for increased lung and bronchiole therapy, with increased use of Complementary Medicine, rather than overuse of corticosteroid inhaler and mucolytics, as well as overuse of antibiotics due to frequency of viral infections in COPD patients, points to a basic failure in the protocol for patients developing a degenerating COPD: http://www.ersj.org.uk/content/21/41_suppl/46s.full
  10. A 2013 study at Longzihu University and the Henan University of Traditional Chinese Medicine, in Zhengzhou, China, found that the combination of standard medicine integrated with TCM treatments of short course of acupuncture, herbal and nutrient medicine has provided COPD patients with the best outcomes in treating this increasingly prevalent and difficult to treat disease. http://www.ncbi.nlm.nih.gov/pubmed/24280466 - A large multicenter randomized controlled human clinical trial was started in 2015 to provide firm evidence of this clinical protocol: http://www.ncbi.nlm.nih.gov/pubmed/24885672
  11. Report of the NIH expert panel on food allergy research 2006: http://www3.niaid.nih.gov/topics/foodAllergy/PDF/FoodAllergyExpertReport.pdf
  12. The relationship between food allergies and asthma is now widely accepted, as this Cleveland Clinic webpage demonstrates: http://my.clevelandclinic.org/disorders/asthma/hic_the_connection_between_food_allergies_and_asthma.aspx
  13. In 2011, the Mount Sinai School of Medicine in New York, New York, U.S.A found that numerous studies now show the link between food allergies and asthma, as well as the fact that concurrent food allergies and asthma increases the risk for serious asthmatic conditions and deaths related to asthma. The causal link is still not well established, but immune missense, superantigen effects, and the effects of environmental toxins on the immune regulation are now heavily researched: http://www.ncbi.nlm.nih.gov/pubmed/21467928
  14. A definitive study of the effect of air pollution on asthma in 2010, by the University of California Berkeley, U.S.A., found that chemicals in air pollution such as organic lead and mercury from coal-fired power plants and smelters could alter the expression of genes related to the regulatory T cells of the immune system (Treg), altering the ability of the body to control immune reactivity to non-pathogenic substances in the body, and this was highly associated with onset of severe asthma. Past studies failed to find the definitive link between such air pollution and the cause of the associated asthma, and this study finally and definitively shows direct pathological cause: http://www.universityofcalifornia.edu/news/article/24239
  15. Study in 1986, at the Mayo Medical School and Mayo Clinic, Rochester, Minnesota, U.S.A. noted that excessive shedding and damage to the bronchial epithelium, or membrane tissues, is a hallmark of both allergic and non-allergic asthma, and this is associated with excessive eosinophils, or white blood cells that attack parasitic helminths, and certain infections. When activated by immune stimulants these eosinophils released various proteins and enzymes that are toxic to bronchial epithelial cells, such as major basic protein. Normally, eosinophils do not circulate in the lung, bronchioles, or esophagus: http://www.sciencedirect.com/science/article/pii/0091674986903416.
  16. Study in 2007, at the University of Toronto, and the associated Hospital for Sick Children, noted that lung biopsies of children with asthma showed even at a young age that eosinophil infiltration, thickening of the bronchial epithelium basement membrane and smooth muscle, and mucus plugs with degenerated epithelial cells, macrophages and cell fragments are seen with light microscopy. The thickened epithelial basement membrane consisted of excess collagen fibrils. These pathological changes indicate that parasitic helminths, low-grade infections, allergens, and airborne pollutants may be degenerating the bronchiole epithelia even at a very young age in asthma: http://onlinelibrary.wiley.com/.
  17. A report from the U.S. NIH National Institute of Allergy and Infectious Diseases, in Bethesda, Maryland, U.S.A. shows that eosinophilia-related diseases were a rising concern in 2007 and that in areas where helminth and other fungal and parasitic diseases were rare, that overuse of antibiotics and NSAIDS were the predominant cause of infiltrating eosinophilia and related asthma, esophagitis and gastritis in children. The health of the host immune barriers, gut membranes, and adrenal steroid health were also important in these diseases, allowing infiltration of both eosinophils when they were stimulated, and the parasitic allergens and toxins that attract this eosinophil infiltration to problematic tissues: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099264/.
  18. A 2014 meta-review of all published scientific study of acupuncture in the treatment of allergic disease by the Technical University of Munich, in Germany, found that: "Specifically for allergic rhinitis and asthma, acupuncture may be cost-effective in terms of money spent per quality of life gained. Acupuncture plays and increasingly important role as an evidence-based therapy for allergy relief and can be recommended as adjunct therapy for allergic rhinitis". http://www.ncbi.nlm.nih.gov/pubmed/24881629
  19. A 2014 meta-review of all published studies concerning acupuncture in the treatment of COPD, found 16 high quality studies, and evidence that acupuncture therapy increased the Quality of Life outcomes and degree of severity and incidence of dyspnea. Such study demonstrates how acupuncture can be utilized as part of the adjunct health care to improve the health of the patients and functional quality of life. Prior meta-analysis shows that the reviewers stated that there was insufficient evidence that acupuncture could cure COPD, a very difficult disease to treat, with virtually no significant therapies in standard medicine. This review notes that short courses of needle stimulation could enhance the overall treatment outcomes with no adverse effects. Of course, clinical treatment in TCM for COPD includes a combination of individualized therapies, with herbal and nutrient medicine, diet and lifestyle advice, and even helpful physiotherapies, and this holistic array is not analyzed in any human randomized controlled trials to date. The failure to see TCM as such a holistic and integrative medicine, not an alternative to standard care, has been the greatest impediment to its utilization: http://www.ncbi.nlm.nih.gov/pubmed/25478799
  20. A 2013 study at the Korea Institute of Oriental Medicine, published in the medical journal Immunopharmacological Immunotoxicology, showed that a common Chinese herb, Pinellia ternata (Ban xia) attenuated induced influx of eosinophils, neutrophils, macrophages and other leukocytes and lymphocytes into lungs and bronchioles in response to stimulation. Such studies indicate that Chinese herbal formulas provide broad protective effects against the parasite-related disease mechanisms: http://www.ncbi.nlm.nih.gov/pubmed/23461466
  21. A 2011 study at Nanjing Medical University, Changzhou, China, showed that proanthocyanidins in grape seed extract remarkably suppressed airway resistance and eosinophil infiltration into lungs and bronchioles, decreased IL-4 like common pharmaceutical asthmatic medications, and decreased airway hyperresponsiveness and inflammation in allergic asthma: http://www.ncbi.nlm.nih.gov/pubmed/21452107
  22. A 2012 study at Nanjing Medical University, Changzhou, China, showed that chrysin, in Chrysanthemum herbs, such as the common Chinese herb Ju hua, or Chrysanthemum morifolium, significantly attenuated allergen-induced lung eosinophil infiltration, and switched the immune response from a Th-2 domination towards a Th-1 effect, modulating GATA-3, all drivers of parasite-induced eosinophil activation and infiltration: http://www.ncbi.nlm.nih.gov/pubmed/22552848
  23. A 2011 study at the Korea Institute of Oriental Medicine, Daejeon, Sourth Korea, found that the commonly used Chinese herb Angelica dahurica (Bai zhi) alcohol extract significantly lowered airway eosinophilia, IL-4, IL-5, and other cytokines related to allergic inflammation in asthma, as well as IgE and mucus production: http://www.ncbi.nlm.nih.gov/pubmed/21146576
  24. Study in 2012 at Yeungnam University, Gyeongsan, South Korea, found that an herbal lignan, Saucerneol F, found in the Chinese herb Saururus chinensis (Sambaekcho, or Chinese Lizard's tail), inhibits eicosanoid generation and degranulation, a hallmark of early asthma pathology. : http://www.ncbi.nlm.nih.gov/pubmed/24009845.
  25. Study in 2004 at Mount Sinai School of Medicine in New York found that a commonly used Chinese herbal formula, termed MSSM-02, was effective in treating allergic asthma and had beneficial immunoregulatory or modulatory actions that posed less chance of side effects than comparable pharmaceuticals. This formula is typical of most professional formulas used to treat asthma in TCM practice: http://www.ncbi.nlm.nih.gov/pubmed/15330010.
  26. A 2012 review of 12 Chinese herbal extracts found in common formulas to treat asthma and COPD, at the Chinese University of Hong Kong, in China, found that 4 of these herbs demonstrated significant anti-inflammatory and bronchorelaxant activities. These 4 herbs were Schizonepetae (Jing jie), Glycyrrhizae (Gan cao, or licorice root), Cynanchi stauntonii (Bai qian), and Scutellaria (Huang qin): http://www.ncbi.nlm.nih.gov/pubmed/22105892
  27. A 2014 multicenter randomized controlled human clinical trial, at the Fudan University School of Medicine, Nanjing University, Sichuan University, Henan University, and various Chinese hospitals, showed that 2 common Chinese herbal formulas used to treat COPD were safe and effective, decreasing inflammatory cytokines, relieving symptoms of COPD, improving levels of cortisol and IL-10, and having no adverse effects with 331 patients enrolled. Bu Shen Yiqi and Bu Shen Fangchuan are 2 names of typical Chinese formulas used to treat COPD, and have nearly the same ingredients as most typical herbal formulas with many names in the United States: http://www.ncbi.nlm.nih.gov/pubmed/25118962
  28. Study in 2007 at the National Taiwan University found that the Chinese herb Ganoderma tsugae (Ling zhi, or Reishi mushroom) exerted potent anti-inflammatory effects on asthmatic airway redponses and attenuated the immune reaction specifically without overall immune suppression seen in pharmaceuticals such as prednisone: http://www.ncbi.nlm.nih.gov/pubmed/17191006.
  29. A 2005 double-blinded placebo-controlled study conducted by Mount Sinai School of Medicine in New York jointly with Weifang Asthma Hospital and School of Medicine in China, found that a combination of Ling zhi (Reishi mushroom), Ku shen (Sophora bark) and Gan cao (licorice root) performed almost as well as prednisone in a large scale human study, and was found to be as effective as corticosteroid therapy to control asthma symptoms and cough after 2 weeks of therapy: http://www.nutricology.com/In-Focus-Newsletter-August-2006-Chinese-Herbs-sp-37.html.
  30. Safety and efficacy trials of the 3-herb formula, Lingzhi, Kushen and Gancao cited above were tested for safety and efficacy in 2009 in a randomized, placebo-controlled, dose escalation phase 1 trial and found to demonstrate safety and tolerability over a prolonged period of use: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830609/.
  31. Study in 2000, at Misasa Medical Branch, Tottori, Japan found that the commonly used Chinese medicinal herb, perilla seed (Su zi) contained essential fatty acids and other chemicals in its oil that acted as potent leukotriene inhibitors over time. Both these omega-3 fatty acids, such as alpha-linolenic acid (ALA) and other omega-3 essential fatty acids are proven to help regulate the inflammatory mechanisms in asthma. Perilla is a common food in Japan, and perilla seed could be easily included in the diet, as well as taken medicinally in herbal formula: http://www.ncbi.nlm.nih.gov/pubmed/10878492.
  32. Study in 2010, at the University of Beni Sueif, Beni Sueif, Egypt, found that the herbal combination of Boswellia serrata (Ru xiang), licorice root (Gan cao), and Turmeric root (Curcuma longa, or Jiang huang), exerted significant effects as natural leukotriene inhibitors to control bronchial asthma, and exerted significant antioxidant effects as well, reducing malondialdehyde toxicity and inducible nitric oxide: http://www.ncbi.nlm.nih.gov/pubmed/20430018.
  33. A 2013 report on the well-studied Tylophora asthmatica herb shows that there is signficant proof of benefits as an anti-inflammatory, smooth muscle anti-spastic, and anti-allergic herb with great reduction acutely for allergic asthma. Two studies noted some toxicity, but appeared to be manipulated in design, with one small study having the patient chew the actual leaves rather than take the alcohol extract that is most studied - animal studies show only mild toxicity at high doses, which would never be used in clinical practice in holistic medicine: http://www.med.nyu.edu/content?ChunkIID=21875.
  34. Study in 2009, at the National Chung Hsing University, Taichung, Taiwan, found that perilla seed oil (Su zi) may exert a moderately beneficial effect on asthmatic allergy by both lowering serum lipids (triglycerides and the HDL/LDL ratio) as well as lowering the important antibody excesses of IgG and IgA noted in airway allergic dysfunction. Although the research found that this herbal oil alone did not correct the T-helper cell imbalance and Th2 dominance, these effects, along with the previously studied anti-leukotriene effects, prove that perilla oil and perilla seed (Su zi) are important and effective additions to the overall herbal therapy and TCM protocol: http://www.ncbi.nlm.nih.gov/pubmed/19271319.
  35. Study in 2013 at Columbia University, New York, New York, U.S.A. found that an important herbal chemical in Chinese Herbal Medicine, quercetin, exerts significant tissue-specific effects inhibiting phosphodiesterases to control the inflammatory effects in asthma, a focus of early asthma therapies with methylxanthines, acutely relaxing smooth muscle in the airways, and presenting a possibility that quercetin might decrease reliance on beta-adrenergic agonists commonly used today. Quercetin is also well studied to exert beneficial effects in modulation of histamine metabolism, aiding this immune reaction and its healthy regulation in the body: http://www.ncbi.nlm.nih.gov/pubmed/23873842.
  36. Study in 2011, at Comenius University Department of Pharmacology, Martin, Slovakia, found that the Chinese herbal chemical quercetin proved in laboratory studies, both in vivo and in vitro, to exert significant effects as a bronchodilator, reducing hyperreactivity of airways that may have a lasting effect: http://www.ncbi.nlm.nih.gov/pubmed/21452772.
  37. Study in 2008 at the University of Moncton, NB, Canada, also found that dietary or herbal nutrient supplement gamma-linolenic acid (GLA) and eicosapentaenoic acid (EPA) could effectively inhibit leukotriene synthesis, improve quality of life in asthma, and decrease dependence on asthma medications, in randomize controlled human clinical trials: http://www.ncbi.nlm.nih.gov/pubmed/18194593.
  38. Study in 2000 at the Harvard School of Public Health, Harvard Medical School, Boston, Massachusetts, U.S.A. found that dietary essential fatty acids may play a big role in prevention of lung disease, and that consumption of omega-3 fatty acids were protective against asthma and COPD: http://www.ncbi.nlm.nih.gov/pubmed/10618003.
  39. Study in 2008 at the Fudan University, Shanghai, China, found that the Chinese herb Epimedium (Yin yang huo) was effective in alleviating the attack stages of asthmatic inflammation by decreasing the gene expression of the inflammatory chemokine RANTES and MCP-3 in lung tissue: http://www.ncbi.nlm.nih.gov/pubmed/18476425.
  40. Study in 2013 at Osaka University Graduate School of Medicine, in Japan, found that herbal and dietary flavonoids may play a key role in the prevention and treatment of allergic diseases, providing antioxidant, immune modulating, and anti-allergic activities, especially inhibition of excess Th2 cytokines: http://www.ncbi.nlm.nih.gov/pubmed/23701574.
  41. Study in 2010 at the Federal University of Sao Paulo, Brazil, found that electroacupuncture could be an important complementary treatment for asthma, balancing the Th1/Th2 T-cell responses, increasing IL-1 and IFN-gamma, while decreasing IL-4, IL-10, Nitric oxide, and Leukotriene B4. Previous study had shown that eosinophil infiltration into the lung tissue was decreased with use of electroacupuncture: http:/www.ncbi.nlm.nih.gov/pubmed/20231101.
  42. A 2012 meta-review of scientific research and clinical studies by the U.S. Agency for Healthcare Research and Quality found that evidence does support breathing retraining neuromuscular techniques to reduce asthma symptoms and dependence on pharmaceutical inhalers: http://www.ncbi.nlm.nih.gov/pubmed/23101047.
  43. A 2013 randomized double-blinded placebo-controlled study by researchers in Hong Kong, China, published the January 24, 2013 issue of the medical journal Chest online, showed that for the 120 patients assessed for one year, age 50-80, with chronic COPD, that a high-dose N-acetyl cysteine supplement significantly improved lung function, symptoms, and decreased flare-ups: http://www.ncbi.nlm.nih.gov/pubmed/23348146.
  44. A 2013 study at Maastricht University Medical Center, in the Netherlands, explores the relationship of the metabolic hormone leptin in both the cause and maintenance and regulation of COPD: http://www.ncbi.nlm.nih.gov/pubmed/23542720.
  45. A 2010 study in the Netherlands, at the NUTRIM School of Nutrition, found that leptin levels in the lung significantly modulate the innate and adaptive immune responses after inhalation of cigarette smoke. Such study demonstrated the important immunomodulating effects of this metabolic hormone in lung disease: http://www.ncbi.nlm.nih.gov/pubmed/20488786.
  46. A 2009 study at Maastricht University in the Netherlands found that the metabolic hormone leptin is more highly expressed in cells of the lungs with COPD, whether the patient was a smoker or not: http://www.ncbi.nlm.nih.gov/pubmed/18835960.
  47. A 2010 study at Chung Shan Medical University, in Taichung, Taiwan, found that antioxidant deficiency in plasma was highly associated with COPD, and deficiency of Vitamin C and beta-carotene were most correlated: http://www.ncbi.nlm.nih.gov/pubmed/20805084.
  48. A 2012 randomized, placebo-controlled study at the U.O.C. di Pneumolgia, Verona, Italy, found that 12 weeks of essential amino acid supplement signficantly improved both lung function and quality of life for COPD patients, benefitting oxygen saturation as well as muscle strength and cognitive function. Tryptophan, phenylalanine, methionine, lysine, leucine, isoleucine, histidine, threonine and valine are essential, meaning that they must be obtained from the diet, and a variety of symptoms accompany essential amino acid deficiencies, including exhaustion, fatigue, nervousness and dizziness. Besides supplement pills, whey powder, eggs, fermented soy products, sesame and sunflower seeds, beans, brazil nuts, butternut squash, cheese and whitefish are excellent sources: http://www.ncbi.nlm.nih.gov/pubmed/23193843.
  49. A 2013 randomized, placebo-controlled study in Denmark of the use of a simple acupuncture protocol for children with asthma, aged 6 months to 6 years old, found that just 3 treatment per month, utilizing a non-individualized and simple protocol, resulted in significant reduction in asthma symptoms and decreased use of inhaler medication for the group receiving acupuncture, although the effects were not sustained 8 months later. This implies that a simple repeated course of infrequent acupuncture, combined with pediatric herbal formulas and changes in the diet, could dramatically improve the quality of life with pediatric asthma patients: http://www.ncbi.nlm.nih.gov/pubmed/23981368.
  50. A 2013 randomized, placebo-controlled study at Ain Shams University, Cairo, Egypt, found that even use of a cold laser stimulator of acupuncture points by a competent Licensed Acupuncturist could safely and effectively treat pediatric asthma, improving lung function and decreasing use of asthma medications: http://www.ncbi.nlm.nih.gov/pubmed/23843569.
  51. A 2010 follow-up study of how electroacupuncture works to modulate the inflammatory problems driving asthma, by experts at the Federal University of Sao Paulo, in Brazil, showed that elecroacupuncture decreases eosinophil inflltration in lung tissues and reduces airway swelling by achieving better balance of the Th-1 and Th-2 pro-inflammatory and anti-inflammatory immune responses, both inhibiting Leukotriene B4 like asthma medications, but also stimulating anti-inflammatory modulators such as IL-1 and interferon gamma, using the organisms own system to achieve a cure to the unwanted responses that trigger asthma symptoms: http://www.ncbi.nlm.nih.gov/pubmed/20231101
  52. A 2009 study at National Chung Hsing University, in Taichung, Taiwan, found that high-dose Vitamin C also attenuates allergic inflammation in membranes by modulating the Th-1 and Th-2 immune responses, decreasing pro-inflammatory cytokines that drive the eosinophil infltration of membrane and lung tissues and airway swelling: http://www.ncbi.nlm.nih.gov/pubmed/19831405