Int. J. LifeSc. Bt & Pharm. Res. 2012 Ladde Shivakumar and Shalam, 2012 ISSN 2250-3137 www.ijlbpr.com Vol.1, Issue. 1, January 2012 © 2012 IJLBPR. All Rights Reserved Review Article A SHORT REVIEW ON MANAGEMENT OF ASTHMA THROUGH ALTERNATIVE THERAPIES Ladde Shivakumar1* and Shalam2 *Corresponding Author: Ladde Shivakumar, [email protected] Asthma, a common, chronic lung disease in industrialized countries, is characterized by the production of large quantities of IgE antibody by B cells and a decrease of the IFN-g /IL-4 (Th1/ Th2) ratio. Based on various research articles on management of asthma, we reviewed some alternative techniques for management of asthma. Various herbal and Chinese medicine possess their antisthamic activity by reversing histamine induced anaphylactic response, decreased the levels of reactive oxygen species (ROS), T helper (Th)2 cytokines, the total IgE produced by B cells and OVA. Also asthma can prevent through nutritional, life style, Acupuncture technique and Bronchial thermoplasty. Keywords: Asthma, Herbal remedies, Acupuncture, Thermoplasty. INTRODUCTION exposure is the generation of free radicals which Asthma can be defined as a lung disorder in which are the culprits causing oxidative damage leading spasms of the bronchial passages restrict the to shortness in breathing. One of the other flow of air in and out of the lungs. In today’s common causes of asthma may be hereditary. stressful life there is an increased exposure to Commonly Leukotriene modifiers include number of immunological agents like allergens, montelukast (Singulair), zafirlukast (Accolate) and dust, pollens, viruses, chemicals that acts as zileuton (Zyflo, Zyflo CR) and Long-acting beta stimuli to liberate mediators these mediators agonists (LABAs) include salmeterol (Serevent which include leukotrienes, prostaglandins, Diskus) and formoterol (Foradil Aerolizer) used histamine, IgE etc. are the endogenous chemicals in management of asthma, but some severe produced in the body which in turn cause broncho- unwanted reaction are associated with them are constriction (www.sciencedaily.com, J P psychological reactions such as agitation, Kowalak et al 2001). Another consequence of this aggression, hallucinations, depression and 1 Department of Pharmacology, Shivlingeshwar College of Pharmacy, Amit Nagar, Hasegaon 413512, Dist-Latur (MH). 2 Department of Pharmacology, College of Pharmacy, Al Qassim University, Buraidah, KSA. 16 Int. J. LifeSc. Bt & Pharm. Res. 2012 Ladde Shivakumar and Shalam, 2012 suicidal thinking. However, they’ve been linked to no detectable effect on mobilization of intracellular severe asthma attacks. LABAs should be taken calcium. These results coupled with the in vivo only in combination with an inhaled corticosteroid effects of ethanol extract reveal that the Alstonia (Litonjua AA, et al. 2010). Based on various scholaris leaves possess broncho-vasodilatory research articles on management of asthma, we activity mediated presumably by prostaglandins, reviewed some alternative techniques for calcium antagonism and endothelium-derived management of asthma. relaxing factor(s) (Shabana Channa et al. 2005). HERBAL THERAPY Amomum compactum soland ex Maton: It is widely distributed in Korea, and has been Number of herbs are reported in Ayurveda that commonly used in Korean traditional medicine provides as a whole protection against asthmatic to resolve dampness, disperse stuffiness, move attacks naturally without any side effects and qi, warm the middle, increase appetite, and gradually helps you to recover from asthma. promote digestion. A. compactum treatment Aegle Marmelos Bael or Bengal quince is a markedly decreased the number of infiltering deciduous sacred tree, associated with Gods eosinophils and the hypersecretion of mucus having useful medicinal properties, especially as when compared with the effects on mice treated a cooling agent. with OVA alone. The A. compactum treatment Albizzia lebbeck The decoction of Shirish dose-dependently decreased the levels of (Albizzia lebbeck) stem bark was found to be Reactive Oxygen Species (ROS) and T helper effective against bronchospasm induced by (Th)2 cytokines, including interleukin (IL)-4 and histaminic acid phosphate and shown to exert IL-5, in the bronchoalveolar lavage fluid (BALF), disodium cromoglycate like action on mast cells. and a high dose of A. compactum effectively Aqueous extract of both stem bark and flowers reduced the level of total immunoglobulin (Ig)E in significantly reduced (P<0.01) bronchospasm the serum. A. compactum may have a therapeutic induced by micro-aerosols of histamine acid effect on allergic asthma or inflammatory disease phosphate (1% solution) and acetycholine (Jin-Ah LEE et al. 2010). chloride (1% solution in guinea pig bronchi) (Nisha Andrographolide: It is traditional Chinese herbal Ojha 2011) medicines has been shown to possess a strong Alstonia scholaris: The extract of Alstonia anti-inflammatory activity and has the potential to scholaris inhibited the spontaneous movements be used in allergic lung inflammation. of rabbit jejunum and contractile effects of Andrographolide could inhibit extensive infiltration acetylcholine and histamine on guinea-pig ileum. of inflammatory cells in lung and decrease airway Additionally, the extract caused marked reduction hyperreactivity. Andrographolide could inhibit NF- of barium chloride-, potassium chloride- and kB expression in lung and suppress NF-kB calcium chloride-induced contraction on guinea- translocation from the cytoplasm to the nucleus pig ileum and pulmonary artery, implying a direct of airway epithelial cells. Results implicate the interference of plant extract with the influx of anti-inflammatory mechanisms of Andrographolide calcium ions into cells. However, the extract has are associated with NF-kB expression in lung and 17 Int. J. LifeSc. Bt & Pharm. Res. 2012 Ladde Shivakumar and Shalam, 2012 suppress NF-kB translocation from the cytoplasm bronchodilator (Bauer K1993). Another Ayurvedic to the nucleus of airway epithelial cells (Jing Li herbal remedy, Tylophora indica, has proven et al. 2009). beneficial in controlled, double-blind cross-over Asystasia gangetica: The terpenoid compounds studies, but the most effective dosages and long- in the leaves of A. gangetica are likely responsible term effects on children are unknown (Gupta S for the usefulness of the plant’s leaves in the 1979). management of asthma in traditional medicine Euphorbia lunulata (Euphorbiaceae): It practice (Ezike AC et al. 2008). is found in the southeast of China. The Benincasa hispida (Thunb.) Cogn: Commonly whole plants of E. lanulata have yielded known as ash gourd belonging to Cucurbitaceae kaempferol, quercetin, kaempferol 3-O- family, is employed as a main ingredient in Lrhamnoside, quercetin 3-O-L-rhamnoside, 6,7- Kusmanda lehyam in Ayurvedic system of dihydroxycoumarinand maoyancaosu. It has long medicine. Methanol extract of Benincasa hispida been used as a traditional crude drug for the (MEBH) showed excellent protection in guinea treatment of bronchial asthma and chronic pigs against the histamine-induced bronchospasm bronchitis (Tadahiro Nishimura et al. 2005). (D. Anil kumar et al. 2002). Gingko biloba: This is one of the most widely Coffee and tea: In the 1800s coffee was the used herbal remedies in Europe. Standardized treatment of choice for asthma. Epidemiologic extract of Gingko biloba (EGb), is sold under data support a relationship between coffee intake several different brand names: Ginkgobil, Rokan, and reduced respiratory symptoms that may be Tanakan, Tebonin, and Kaveri. Ginkgo’s active mediated through coffee’s xanthine content. ingredient, ginkgolide, antagonizes Platelet Caffeine is chemically related to theophylline. Like Activating Factor (PAF), and may decrease theophylline, it increases intracellular cyclic airway inflammation. Ginkgo is also a powerful adenosine monophosphate (cAMP) and thereby antioxidant. Although Gingko biloba has a long relaxes bronchial smooth muscles. In a large history and a reasonable biochemical rationale, Italian study, adults who drank two to three only one small pilot study has evaluated its cups of coffee daily had about 25% less asthma effectiveness as an asthma remedy. That study than adults who abstained (Schwarz J 1992). found it protective against exercise-induced American data support a dose-effect association bronchospasm; it also decreased participants’ between coffee intake and a reduced risk of reactivity to house dust mite antigen (Guinot P et asthmatic symptoms. There are no recent, al. 1987). randomized controlled trials evaluating the effects Gyokuheifusan (GHS): Gyokuheifusan (GHS) of caffeine on childhood asthma symptoms, nor is a classical formulation of traditional Chinese on the interaction between coffee, tea, colas, and medicine (TCM) that is usually prescribed to modern asthma medications. prevent or treat respiratory tract diseases, such Coleus forskohlii: This herb is used in Ayurvedic as respiratory infection and bronchial asthma. medicine to treat asthma. Like theophylline, it GHS down-regulates the over-production of IgE increases intracellular cAMP and is an effective and IL-4 via a significant and persistent increase 18 Int. J. LifeSc. Bt & Pharm. Res. 2012 Ladde Shivakumar and Shalam, 2012 of IFN-g. Yang et al., found that Astragalus Root components from HCWE may be beneficial in (a main material of GHS) reduced the secretion the treatment of mast cell-mediated allergic of IL-4 by regulating the