Asthma Alternatives

May 9, 2011 Written by JP    [Font too small?]

Last week, the U.S. Centers for Disease Control and Prevention reported that asthma rates are on the rise although pollution and second hand smoke exposure is declining. According to data collected in 2009, approximately 25 million Americans are now living with this inflammatory lung condition which causes coughing fits, shortness of breath, tightness in the chest and wheezing. What’s more, no age or ethnic group is immune to this trend. However, those without medical insurance are more at risk because the typical price tag associated with conventional asthma treatment rings in at over $3,200 per person/year. This explains why roughly 40% of uninsured asthma patients report that they’re unable to buy the prescription medications needed to address their symptoms. (1)

Identifying the precise cause of an illness is always preferable to simply chasing after symptoms. The trouble with asthma is that there are many suspected triggers that make it nearly impossible to pinpoint one as the primary culprit. Researchers have noted that threats ranging from environmental toxins to mitochondrial (cellular energy) dysfunction likely influence the development and progression of this disease. Then there’s the inescapable fact that certain people possess genes that interact with a variety of airborne insults and irritants in such a way as to allow for asthma to take hold. This is not to say that one shouldn’t try to avoid as many known risk factors (dust, mold, pet dander, secondhand smoke, etc.) as is feasible. That is the common sense, first line approach. But sometimes that’s not enough. (2,3,4,5,6)

The April 2011 issue of the Journal of Asthma provides some hopeful information about the future of holistic/integrative asthma management. A survey conducted at the University of Cincinnati College of Medicine, reveals that up to 80% of “urban adolescents” employ one form or another of alternative and complementary medicine (CAM) to help address asthma symptoms. The most commonly used modalities included prayer and relaxation. Dietary modification, guided imagery and yoga rounded out the list of non-pharmacological therapies used in this progressive group of youngsters. I’m optimistic about this trend because recent studies in prestigious medical journals report that various mind-body approaches may improve lung function, mood scores, perceived stress and quality of life in young asthmatics. Unconventional treatment options such as art therapy, guided imagery, “psychoeducation about asthma, stress and emotions” and “relaxation training paired with physiological feedback” have produced positive results.(7,8,9,10,11)

Conjugated linonleic acid (CLA), a fatty acid found in abundance in grass fed dairy and meat, is currently being investigated as a nutritional aid in asthmatics. A current review compiled by researchers at the University of British Columbia found that CLA may help to manage asthma naturally by way of: 1) an energy regulating effect; 2) anti-inflammatory properties and; 3) modulation of the immune system and lipid metabolism. Only a few human trials have thus far been concluded. One of the two determined that a daily dosage of 4.5 grams of CLA/day outperformed a placebo in a group of 28 overweight adults with mild asthma. Improvements in airway hyper-responsiveness and body mass index were documented. Preliminary animal research supports this finding and go on to explain that CLA lowers the levels of arachidonic acid, an eicosanoid-precursor, thereby reducing allergic airway inflammation. As a bonus, grass fed products are also a good source of omega-3 fatty acids which are known to be of value in asthmatics. (12,13,14,15,16,17,18)

Some, but not all research, draws a connection between the consumption of salty foods and asthma incidence. A paper appearing in the February 2011 issue of the Journal of the American Dietetic Association found a “4.8-times higher likelihood of having asthma” in children who ate salty snacks 3 or more times a week in comparison to those who never or rarely consumed them. How is this possible? A recent review notes that low-sodium diets may decrease bronchoconstriction during exercise and reduce airway hyper-responsiveness during inactivity. However, it should be noted that not all of the data supports this notion. In fact, a 6 week randomized trial using a low sodium diet failed to find statistically relevant improvements in a group of 220 adult asthmatics. Even so, I still think it’s worth experimenting with a reduced sodium diet as part of a holistic approach to asthma. Some evidence suggests that shifting the focus away from sodium in isolation and onto other frequently neglected minerals such as magnesium and potassium could provide yet an additional piece to the asthma puzzle. (19,20,21,22,23,24,25)

Select herbal extracts are currently being investigated in the relation to asthma. An Egyptian study from July 2010 reports a favorable outcome in asthmatics using an anti-inflammatory, immunomodulating herbal blend containing Boswellia serrata, licorice root and turmeric. A total of 63 participants with bronchial asthma were given either a placebo or the herbal intervention three times a day for 4 weeks. Statistically meaningful declines in plasma leukotriene C(4), malondialdehyde (MDA) and nitric oxide were documented in the herbal treatment group only. These notable changes resulted in improvements in pulmonary function. This finding is supported by previous inquiries in both animal and human studies dating back as far as 1998. (26,27,28,29,30)

Asthma is a chronic condition that is challenging to treat conventionally from both a cost and side-effect standpoint. Fortunately, specialists in the field are continuing to examine cheaper, natural and safer alternatives. A few promising candidates that may one day become mainstays in the integrative management of asthma include choline, a B-vitamin, and “synbiotics”, which are synergistic combinations of pre and probiotics. But ultimately, a truly holistic approach is usually the best way to go. This includes addressing any modifiable environmental factors and then incorporating dietary, mind-body and supplemental alternatives as needed. Adopting such an approach may lead to a dramatic decline in health care spending and an upswing in the long term prognosis for asthmatics worldwide. (31,32,33,34,35)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Alternative Therapies, Children's Health, Nutritional Supplements

23 Comments & Updates to “Asthma Alternatives”

  1. Paul F. Says:

    Hi JP,

    Great article!

    Thanks in behalf of my nephew Leila, who suffered of asthma since her youth. Leila lives in Rome (Italy) and she may benefit by considering and trying some of the highlighted alternatives.
    Healthy Fellow can help across the ocean!

    Keep up the great work!


  2. JP Says:

    Thank you, Paul! 🙂

    Be well!


  3. Dr Shreya Deshpande Says:

    One more great post must say! People must be made aware that alternative therapies like homeopathy too work wonderfully putting an end to the woes of asthma patients. Most importantly, such therapies do not just suppress the symptoms but cure asthma or other allergic disorders completely, never to bother again.

  4. JP Says:

    Thank you for your comments and praise, Dr. Deshpande!

    Be well!


  5. JP Says:

    Update: Avoiding food allergens improves asthma symptoms …

    Glob Adv Health Med. 2015 Jan;4(1):62-6.

    Food-specific IgG Antibody-guided Elimination Diets Followed by Resolution of Asthma Symptoms and Reduction in Pharmacological Interventions in Two Patients: A Case Report.

    Asthma is one of the most common causes of office visits in the primary care and emergency care settings. Individuals are often able to maintain symptomatic control with long-term pharmacological therapy. Exacerbations of asthma commonly occur due to exposure to triggers such as viruses, pollutants, and allergens. While it is widely accepted that exposure to immunoglobulin E food allergens can exacerbate asthma symptoms, there is little evidence examining delayed immunoglobulin G-mediated reactions to food. Here we present two clinical cases of individuals who experienced a reduction in asthma symptoms, decreased dependence on pharmacological therapies, and increased quality of life by eliminating foods that demonstrated reactivity to immunoglobulin G levels identified through serum testing.

    Be well!


  6. JP Says:

    Update 05/06/15:

    Psychosom Med. 2015 May 2.

    The Effects of Expressive Writing on Lung Function, Quality of Life, Medication Use, and Symptoms in Adults With Asthma: A Randomized Controlled Trial.

    OBJECTIVES: Asthma is a chronic condition affecting 300 million people worldwide. Management involves adherence to pharmacological treatments such as corticosteroids and β-agonists, but residual symptoms persist. As asthma symptoms are exacerbated by stress, one possible adjunct to pharmacological treatment is expressive writing (EW). EW involves the disclosure of traumatic experiences which is thought to facilitate cognitive and emotional processing, helping to reduce physiological stress associated with inhibiting emotions. A previous trial reported short-term improvements in lung function. This study aimed to assess whether EW can improve lung function, quality of life, symptoms, and medication use in patients with asthma.

    METHODS: Adults (18-45 years) diagnosed as having asthma requiring regular inhaled corticosteroids were recruited from 28 general practices in South East England (n = 146). In this double-blind randomized controlled trial, participants were allocated either EW or nonemotional writing instructions and asked to write for 20 minutes for 3 consecutive days. Lung function (forced expired volume in 1 second [FEV1]% predicted), quality of life (Mark’s Asthma Quality of Life Questionnaire), asthma symptoms (Wasserfallen Symptom Score Questionnaire), and medication use (inhaled corticosteroids and β-agonist) were recorded at baseline, 1, 3, 6, and 12 months.

    RESULTS: Hierarchical linear modeling indicated no significant main effects between time and condition on any outcomes. Post hoc analyses revealed that EW improved lung function by 14% for 12 months for participants with less than 80% FEV1% predicted at baseline (β = 0.93, p = .002) whereas no improvement was observed in the control condition (β = 0.10, p = .667).

    CONCLUSIONS: EW seems to be beneficial for patients with moderate asthma (<80% FEV1% predicted). Future studies of EW require stratification of patients by asthma severity.

    Be well!


  7. JP Says:

    Updated 04/04/16:

    Brain Behav Immun. 2016 Mar 30.

    Mind-body interactions in the regulation of airway inflammation in asthma: A PET study of acute and chronic stress.
    Rosenkranz MA1, Esnault S2, Christian BT3, Crisafi G2, Gresham LK4,

    BACKGROUND: Psychological stress has long been recognized as a contributing factor to asthma symptom expression and disease progression. Yet, the neural mechanisms that underlie this relationship have been largely unexplored in research addressing the pathophysiology and management of asthma. Studies that have examined the mechanisms of this relationship in the periphery suggest that it is the superimposition of acute stress on top of chronic stress that is of greatest concern for airway inflammation.

    METHODS: We compared asthmatic individuals with high and low levels of chronic life stress in their neural and peripheral physiological responses to the Trier Social Stress Test and a matched control task. We used FDG-PET to measure neural activity during performance of the two tasks. We used both circulating and airway-specific markers of asthma-related inflammation to assess the impact of acute stress in these two groups.

    RESULTS: Asthmatics under chronic stress had a larger HPA-axis response to an acute stressor, which failed to show the suppressive effects on inflammatory markers observed in those with low chronic stress. Moreover, our PET data suggest that greater activity in the anterior insula during acute stress may reflect regulation of the effect of stress on inflammation. In contrast, greater activity in the mid-insula and perigenual anterior cingulate seems to reflect greater reactivity and was associated with greater airway inflammation, a more robust alpha amylase response, and a greater stress-induced increase in proinflammatory cytokine mRNA expression in airway cells.

    CONCLUSIONS: Acute stress is associated with increases in markers of airway inflammation in asthmatics under chronic stress. This relationship may be mediated by interactions between the insula and anterior cingulate cortex, that determine the salience of environmental cues, as well as descending regulatory influence of inflammatory pathways in the periphery.

    Be well!


  8. JP Says:

    Updated 04/14/16:

    Am J Emerg Med. 2016 Jan 21.

    The effect of nebulized magnesium sulfate in the treatment of moderate to severe asthma attacks: a randomized clinical trial.

    OBJECTIVE: Thirty percent of people with asthma do not respond to standard treatment, and complementary therapies are needed. The objective of this study was to investigate the impact of inhaled magnesium sulfate on the treatment response in emergency department (ED) patients with moderate to severe attacks of asthma.

    METHODS: This study is a randomized controlled trial, enrolling patients with moderate to severe asthma in the ED. Subjects allocated to the study group were treated with the standard, plus 3ml of 260mmol/L solution of magnesium sulfate every 20 to 60minutes. The control group was treated with nebulized saline as a placebo in addition to standard protocol. The study results included admission rate and changes in peak expiratory flow rate (PEFR) (primary outcomes) as well as dyspnea severity score, respiratory rate and peripheral oxygen saturation.

    RESULTS: A total of 50 patients were enrolled (25 allocated to the study group and 25 to the control group). The study group as compared to the control group had significantly more improvement in the intensity of dyspnea, PEFR and Spo2 20, 40 and 60minutes after intervention. In the control group, 11 patients (44%) required admission as compared to 18 (72%) in the control group (P=.02).

    CONCLUSION: Adding nebulized magnesium sulfate to standard therapy in patients with moderate to severe asthma attacks leads to greater and faster improvement in PEFR, respiratory rate, oxygen saturation and respiratory rate. It also reduces hospitalization rates in this patient population.

    Be well!


  9. JP Says:

    Updated 06/11/16:

    J Asthma. 2016 Jun 10:0.

    A modified breathing exercise program for asthma is easy to perform and effective.

    OBJECTIVES: Breathing exercises are used by some asthmatic patients, yet are often difficult to perform and time-consuming. This study evaluated a simple, modified breathing exercise program regarding ease to perform and effectiveness as an adjunctive therapy.

    METHODS: Subjects age 18 to 65 with a current diagnosis of persistent asthma were enrolled. A program that incorporated three different breathing exercises (yoga pranayama techniques, diaphragmatic breathing and pursed lip breathing) was taught to subjects. The program was designed to be completed in less than 10 minutes per day. Subjects completed the Asthma Control Test (ACT) and mini-Asthma Quality of Life Questionnaire (AQLQ) at baseline and at 1-month follow-up. They also completed a survey which asked them to rate the effectiveness and difficulty of the exercises, and whether they would recommend them in the future.

    RESULTS: A total of 74 subjects were enrolled in this study. The intervention improved breathing for 52.9% of the subjects, while 67.6% felt that their daily activity was improved and 66.1% noted that the exercises allowed decreased use of a rescue inhaler. Most subjects (80.9%) recommended breathing exercises as a complementary therapy for asthma and 79.4% of the subjects stated the exercises took less than 10 minutes per day total. Overall, ACT scores improved significantly (p = 0.002) with a statistically non-significant improvement in AQLQ scores.

    CONCLUSION: A simple program of breathing exercises was found to be effective and could be completed in less than 10 minutes per day. Furthermore, there was a statistically significant improvement in ACT scores post-exercise.

    Be well!


  10. JP Says:

    Updated 06/15/16:

    Cytokine. 2016 Jun 8;85:61-66.

    Effects of omega-3 fatty acids on serum levels of T-helper cytokines in children with asthma.

    BACKGROUND: There has been a considerable interest in the potential therapeutic value of dietary supplementation with ω-3 fatty acids in patients with asthma.

    OBJECTIVES: This cross-sectional study was designed to identify the effect of ω-3 fatty acids on symptom score, pulmonary function and serum T-helper cytokine concentrations in children with mild to moderate persistent asthma.

    METHODS: A total of 39 patients among 50 volunteers completed this 3-month study. They took a soft gel capsule containing 180mg EPA and 120mg DHA daily. Pulmonary function was evaluated in 28 eligible patients by spirometry, and serum levels of Th1, Th2, Th9, Th17 and Th22 cytokines were measured by multiplex cytometric bead assay before and after treatment.

    RESULTS: After treatment with ω-3, symptom score improved in 28 (72%) patients. The results of spirometry showed remarkable improvement in FEV1/FVC (P=0.044) and PEF (P<0.0001) after treatment, but considering a cut-off of 80%, real improvement was observed in 32% of patients with PEF<80% which raised above the cut-off after ω-3 treatment (P=0.004) whereas, FEV1/FVC changes were above the cut-off value in 89% of the patients. After treatment, IL-17A and TNF-α levels decreased significantly (both P=0.049).

    CONCLUSION: Oral administration of natural anti-inflammatory products such as ω-3 is a promising complementary approach to managing asthma.

    Be well!


  11. JP Says:

    Updated 06/16/16:

    J Allergy Clin Immunol Pract. 2016 Apr 27.

    A Randomized Controlled Trial of the Effect of Broccoli Sprouts on Antioxidant Gene Expression and Airway Inflammation in Asthmatics.

    BACKGROUND: Broccoli sprouts (BS) are the richest source of sulforaphane (SFN), which is a potent inducer of phase II enzymes, which play a critical role in preventing oxidative stress (OS) and inflammation.

    OBJECTIVES: The objective of this study was to determine if ingestion of whole BS improves airway inflammatory and physiologic outcomes, and OS in adults with asthma and allergic sensitization to an indoor allergen.

    METHODS: The study is a double-blind, placebo-controlled, randomized trial to compare the effects of BS with placebo (alfalfa sprouts [AS]) on airway inflammation and markers of OS. Forty adults (aged 18-50 years) were randomized to eat either (a) 100 g of BS daily or (b) 100 g of AS daily for 3 days. Fractional exhaled nitric oxide (FENO), forced expiratory volume 1, nasal epithelial and PBMC gene expression, inflammatory and OS biomarkers, and symptoms were assessed both before and after ingestion of the sprouts. The primary outcome variable was the change in FENO. Secondary outcome measures included rhinitis and asthma symptoms, lung function, and OS and inflammatory biomarkers.

    RESULTS: BS ingestion for 3 consecutive days did not reduce FENO, despite resulting in a marked increase in serum SFN concentrations (21 vs 22 parts per billion, P = .76). Furthermore, BS consumption did not induce cytoprotective antioxidant genes in either PBMCs or nasal epithelial cells, reduce OS and inflammatory markers, or improve lung function.

    CONCLUSIONS: Ingestion of whole BS for 3 days does not appear to improve eosinophilic pulmonary inflammation, inflammatory and OS biomarkers, or clinical features of asthma among atopic adults with asthma despite resulting in a marked increase in serum SFN levels.

    Be well!


  12. JP Says:

    Updated 10/20/16:

    Am J Respir Crit Care Med. 2016 Jul 19.

    The Role of Exercise in a Weight-loss Program on Clinical Control in Obese Adults with Asthma: a RCT.

    RATIONALE: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight-loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated.

    OBJECTIVE: To examine the effect of exercise training in a weight-loss program on asthma control, quality of life, inflammatory biomarkers and lung function.

    METHODS: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program + exercise (WL+E group, n=28) or a weight-loss program + sham (WL+S group, n=27) group, where the weight-loss program included nutrition (caloric restriction) and psychological therapies. The WL+E group incorporated aerobic and resistance muscle training, whereas the WL+S group incorporated breathing and stretching exercises.

    MEASUREMENTS: The primary outcome was clinical improvement in asthma control over 3 months. Secondary outcomes included quality of life, lung function, body composition, aerobic capacity, muscle strength and inflammatory/anti-inflammatory biomarkers.

    MAIN RESULTS: After 3 months, 51 patients were analyzed. Compared with the WL+S group, the WL+E group demonstrated improved clinical control scores (-0.7 [-1.3, -0.3] vs. -0.3 [-0.9, 0.4]; P=0.01) and greater weight-loss (-6.8%±3.5 vs. -3.1%±2.6; P<0.001) and aerobic capacities (3.0 [2.4, 4.0] vs. 0.9 [-0.3, 1.3] mL; P<0.001). These improvements in the WL+E group were also accompanied by improvements in lung function, anti-inflammatory biomarkers and vitamin D levels, as well as reductions in airway and systemic inflammation.

    CONCLUSIONS: Adding exercise to a short-term weight-loss program should be considered as a useful strategy to achieving clinical control of asthma in obese patients.

    Be well!


  13. JP Says:

    Updated 12/06/16:

    Can Respir J. 2016;2016:6982010.

    Adequate Vitamin D Intake but Low Serum Levels in Pediatric Asthma Patients: A Pilot Study, Alberta Children’s Hospital.

    Background. We assessed vitamin D intakes and serum 25(OH) vitamin D levels in pediatric asthma patients on moderate-to-high dose inhaled steroids and compared them to published findings of healthy children in our city. Methods. Parents and/or patients were interviewed to estimate the children’s vitamin D intakes from foods and supplements (using an adapted validated food frequency questionnaire) and asthma duration and management. Vitamin D status: serum 25-hyroxy vitamin D (25(OH)D) was obtained from the medical records. Results. Vitamin D intakes from food and supplements of the asthma patients (n = 20, 742 ± 185 IU/day) were significantly higher compared to healthy Canadian children (n = 1442, 229 ± 121 IU/day). Despite higher vitamin D intakes, the children had nonsignificantly lower serum 25(OH) vitamin D levels compared to the comparison group. Serum 25(OH)D levels increased by 3.6 nmol/L with each 100 IU of vitamin D intake (95% Confidence interval = 2.0-4.0, R2 = 0.931, and p = 0.001). Conclusion. Since adequate vitamin D status in asthma patients is necessary to support bone mineral accretion, it is important to achieve adequate vitamin D status by checking serum 25(OH)D status and supplement accordingly.

    Be well!


  14. JP Says:

    Updated 01/05/17:

    Evid Based Complement Alternat Med. 2016;2016:6134593.

    Herbal Medicine Cordyceps sinensis Improves Health-Related Quality of Life in Moderate-to-Severe Asthma.

    Moderate-to-severe asthma has a substantial impact on the health-related quality of life (HR-QOL) of the patients. Cordyceps sinensis is a traditional Chinese medicine that is evaluated clinically for the treatment of many diseases, such as chronic allograft nephropathy, diabetic kidney disease, and lung fibrosis. In order to investigate the effects of Cordyceps sinensis on patients with moderate-to-severe persistent asthma, 120 subjects were randomized to receive Corbin capsule containing Cordyceps sinensis for 3 months (treatment group, n = 60), whereas the control group (n = 60) did not receive treatment with Corbin capsule. Inhaled corticosteroid and as-needed β-agonists were used in the treatment of both groups. HR-QOL was measured with the Juniper’s Asthma Quality of Life Questionnaire (AQLQ). The incidence of asthma exacerbation, pulmonary function testing, and serum measurements of inflammatory mediators were also evaluated. The results showed that the treatment group indicated a significant increase in AQLQ scores and lung function compared with the control group. The expression levels of the inflammation markers IgE, ICAM-1, IL-4, and MMP-9 in the serum were decreased and IgG increased in the treatment group compared with the control group. Therefore, the conclusion was reached that a formulation of Cordyceps sinensis improved the HR-QOL, asthma symptoms, lung function, and inflammatory profile of the patients with moderate-to-severe asthma.

    Be well!


  15. JP Says:

    Updated 01/12/17:

    Nutrients. 2017 Jan 10;9(1).

    Soluble Fibre Meal Challenge Reduces Airway Inflammation and Expression of GPR43 and GPR41 in Asthma.

    Short chain fatty acids (SCFAs) are produced following the fermentation of soluble fibre by gut bacteria. In animal models, both dietary fibre and SCFAs have demonstrated anti-inflammatory effects via the activation of free fatty acid receptors, such as G protein-coupled receptor 41 and 43 (GPR41 and GPR43). This pilot study examined the acute effect of a single dose of soluble fibre on airway inflammation-including changes in gene expression of free fatty acid receptors-in asthma. Adults with stable asthma consumed a soluble fibre meal (n = 17) containing 3.5 g inulin and probiotics, or a control meal (n = 12) of simple carbohydrates. Exhaled nitric oxide (eNO) was measured and induced sputum was collected at 0 and 4 h for differential cell counts, measurement of interleukin-8 (IL-8) protein concentration, and GPR41 and GPR43 gene expression. At 4 h after meal consumption, airway inflammation biomarkers, including sputum total cell count, neutrophils, macrophages, lymphocytes, sputum IL-8, and eNO significantly decreased compared to baseline in the soluble fibre group only. This corresponded with upregulated GPR41 and GPR43 sputum gene expression and improved lung function in the soluble fibre group alone. Soluble fibre has acute anti-inflammatory effects in asthmatic airways. Long-term effects of soluble fibre as an anti-inflammatory therapy in asthma warrants further investigation.

    Be well!


  16. JP Says:

    Updated 03/13/17:

    Ital J Pediatr. 2017 Mar 7;43(1):25.

    Bifidobacterium mixture (B longum BB536, B infantis M-63, B breve M-16V) treatment in children with seasonal allergic rhinitis and intermittent asthma.

    BACKGROUND: Allergic rhinitis (AR) and allergic asthma are caused by an IgE-mediated inflammatory reaction. Probiotics may exert anti-inflammatory and immune-modulatory activity. Thus, this study aimed at investigating whether a Bifidobacteria mixture could be able to relieve nasal symptoms, and affect quality of life (QoL) in children with AR and intermittent asthma due to Parietaria allergy.

    MATERIALS AND METHODS: The present study was conducted as placebo-controlled, double-blinded, and randomized. Globally, 40 children (18 males; mean age 9 ± 2.2 years) were enrolled. They were treated with probiotics or placebo: 1 sachet/day for 4 weeks. AR symptoms, and QoL were assessed at baseline and after treatment. Use of rescue medications, such as cetirizine syrup and salbutamol spray, was also permitted and recorded.

    RESULTS: Children treated with probiotic mixture achieved a significant improvement of symptoms (p < 0.005), and QoL ((p < 0.001). Placebo group had worsening of symptoms (p < 0.005) and QoL (p < 0.001). The use of rescue medications was overlapping in the two groups. The intergroup analysis showed that probiotic mixture was significantly superior than placebo for all parameters. CONCLUSIONS: The current study demonstrated that a Bifidobacteria mixture was able of significantly improving AR symptoms and QoL in children with pollen-induced AR and intermittent asthma. Be well! JP

  17. JP Says:

    Updated 04/24/17:

    Tanaffos. 2016;15(3):168-174.

    Effect of Borago Officinalis Extract on Moderate Persistent Asthma: A Phase two Randomized, Double Blind, Placebo-Controlled Clinical Trial.

    BACKGROUND: Borago officinalis and its derivatives are used in folk medicine to treat asthma because of its special effect on allergic disorders. It suppresses the tumor necrosis factor-alpha (TNF-alpha) and delivers gamma-linolenic acid. The objective of this clinical trial was to determine the effect of Borago officinalis on clinical and physiological findings in moderate persistent asthma.

    MATERIALS AND METHODS: This prospective, randomized, double blind, placebo-controlled, clinical trial was conducted on patients aged 15-90 years with moderate asthma and forced expiratory volume in one second (FEV1) of 60-79% of predicted who presented to a sub-specialty clinic of pulmonary medicine. We randomly allocated subjects to receive either Borago extract (5 mL three times a day) or a matched placebo for one month. The primary outcome was the asthma control test (ACT) score and fractional exhaled nitric oxide (FENO) test. Secondary outcomes included clinical findings, spirometry, and sputum cytology including inflammatory cells.

    RESULTS: Thirty-eight subjects with a mean age of 46.8±15.3 years and mean duration of asthma of 71±103 months were enrolled in our study. Cough, dyspnea, wheezing, nocturnal symptoms, and airway hyper-responsiveness reduced significantly in the Borago group after the treatment and ACT scores improved significantly (10.8±5.26 before and 15.4±5.12 after the trial). Flare up of asthma and emergency department visits in the Borago group also decreased significantly (3.6±2.33 to 2±1.86 flare ups per month and 0.62±0.9 to 0.05±0.23 for emergency department visits per month). Physiological parameters including spirometry, FENO, and sputum cytology including eosinophil and neutrophil did not change significantly.

    CONCLUSION: Borago improved the clinical findings of asthma, but it was not able to suppress the inflammation involved in asthma.

    Be well!


  18. JP Says:

    Updated 06/01/17:

    Evid Based Complement Alternat Med. 2017;2017:6287642.

    Tai-Chi-Chuan Exercise Improves Pulmonary Function and Decreases Exhaled Nitric Oxide Level in Both Asthmatic and Nonasthmatic Children and Improves Quality of Life in Children with Asthma.

    Tai-Chi-Chuan (TCC) is an exercise of low-to-moderate intensity which is suitable for asthmatic patients. The aim of our study is to investigate improvements of the lung function, airway inflammation, and quality of life of asthmatic children after TCC. Participants included sixty-one elementary school students and they were divided into asthmatic (n = 29) and nonasthmatic (n = 32) groups by the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Among them, 20 asthmatic and 18 nonasthmatic children volunteered to participate in a 60-minute TCC exercise weekly for 12 weeks. Baseline and postintervention assessments included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), fractional exhaled nitric oxide (FeNO) level, and Standardised Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)). After intervention, the level of FeNO decreased significantly; PEFR and the FEV1/FVC also improved significantly in both asthmatic group and nonasthmatic group after TCC. The asthmatic children also had improved quality of life after TCC. The results indicated that TCC could improve the pulmonary function and decrease airway inflammation in both children with mild asthma and those without asthma. It also improves quality of life in mild asthmatic children. Nevertheless, further studies are required to determine the effect of TCC on children with moderate-to-severe asthma.

    Be well!


  19. JP Says:

    Updated 06/14/17:

    Br J Nutr. 2017 Jun 13:1-11.

    Comparable reductions in hyperpnoea-induced bronchoconstriction and markers of airway inflammation after supplementation with 6·2 and 3·1 g/d of long-chain n-3 PUFA in adults with asthma.

    Although high dose n-3 PUFA supplementation reduces exercise- and hyperpnoea-induced bronchoconstriction (EIB/HIB), there are concurrent issues with cost, compliance and gastrointestinal discomfort. It is thus pertinent to establish the efficacy of lower n-3 PUFA doses. Eight male adults with asthma and HIB and eight controls without asthma were randomly supplemented with two n-3 PUFA doses (6·2 g/d (3·7 g EPA and 2·5 g DHA) and 3·1 g/d (1·8 g EPA and 1·3 g DHA)) and a placebo, each for 21 d followed by 14 d washout. A eucapnic voluntary hyperpnoea (EVH) challenge was performed before and after treatments. Outcome measures remained unchanged in the control group. In the HIB group, the peak fall in forced expiratory volume in 1 s (FEV1) after EVH at day 0 (-1005 (sd 520) ml, -30 (sd 18) %) was unchanged after placebo. The peak fall in FEV1 was similarly reduced from day 0 to day 21 of 6·2 g/d n-3 PUFA (-1000 (sd 460) ml, -29 (sd 17) % v. -690 (sd 460) ml, -20 (sd 15) %) and 3·1 g/d n-3 PUFA (-970 (sd 480) ml, -28 (sd 18) % v. -700 (sd 420) ml, -21 (sd 15) %) (P<0·001). Baseline fraction of exhaled nitric oxide was reduced by 24 % (P=0·020) and 31 % (P=0·018) after 6·2 and 3·1 g/d n-3 PUFA, respectively. Peak increases in 9α, 11β PGF2 after EVH were reduced by 65 % (P=0·009) and 56 % (P=0·041) after 6·2 and 3·1 g/d n-3 PUFA, respectively. In conclusion, 3·1 g/d n-3 PUFA supplementation attenuated HIB and markers of airway inflammation to a similar extent as a higher dose. Lower doses of n-3 PUFA thus represent a potentially beneficial adjunct treatment for adults with asthma and EIB.

    Be well!


  20. JP Says:

    Updated 12/05/17:;jsessionid=B3F79209BD50B6E992BF137AD7C2225D.f02t03

    Phytother Res. 2017 Nov 28.

    Possible therapeutic effect of carvacrol on asthmatic patients: A randomized, double blind, placebo-controlled, Phase II clinical trial.

    The relaxant effects of carvacrol, a phenolic monoterpene, on tracheal smooth muscle and its preventive effect on asthmatic animals were reported. The effect of carvacrol in asthmatic patients was examined in the placebo group (Group P, n = 11) receiving placebo and treatment group (Group C, n = 12), which received carvacrol capsule (1.2 mg/kg/day) for 2 months in a double-blind manner. Pulmonary function tests, respiratory symptoms, hematological indices, and high-sensitivity C-reactive protein (hs-CRP) were measured before, 1 and 2 months after starting treatment. At the end of treatment period, Pulmonary function tests values in Group C were significantly increased (p < .05 to p < .001). Most respiratory symptoms were also significantly reduced in Group C at the end of 2-month treatment (p < .05 to p < .001). Total and differential white blood cell (p < .05 to p < .001), as well as serum levels of hs-CRP in Group C were also significantly reduced after 2-month treatment with carvacrol (p < .001). Mean corpuscular hemoglobin concentration and hematocrit were changed in Group C (p < .05 and p < .01, respectively). However, in Group P, there was no significant changes in the evaluated parameters. Pulmonary function tests were increased but respiratory symptoms, inflammatory cells, and hs-CRP were reduced in asthmatic patients who received carvacrol that indicates its therapeutic effect on asthma. Be well! JP

  21. JP Says:

    Updated 10/24/18:

    Avicenna J Phytomed. 2018 Sep-Oct;8(5):399-407.

    Effects of Rosmarinus officinalis and Platanus orientalis extracts on asthmatic subjects resistant to routine treatments.

    Objective: The present study aimed to determine the effects of Rosmarinus officinalis (R. officinalis) and Platanus orientalis (P. orientalis) extracts on asthma.

    Materials and Methods: We conducted a randomized, double-blind, active-comparator study to evaluate the effect of P. orientalis and R. officinalis extracts on asthmatic patients resistant to routine treatment. The subjects were randomly divided into three groups receiving P. orientalis and R. officinalis extracts alone or in combination. The primary endpoints were clinical findings, spirometry, exhaled nitric oxide (FENO) and Asthma Control Test (ACT) assessed over the one-month treatment period.

    Results: ACT score showed significant improvement after treatment with R. officinalis (p<0.05) but not with P. orientalis. Clinical evaluations showed that cough, sputum production and wheezing were significantly improved in R. officinalis group (p<0.05 to p<0.001) while in P. orientalis group only improvement of cough and chest tightness were shown. Spirometry results showed significant improving in FEV1/VC values for subjects treated with P. orientalis and those who received the combination of extracts as well as significant decrease in FEF25-75 value only for P. orientalis group (p<0.05 for all cases). FENO was decreased in both groups but the results were statistically significant only for R. officinalis group (p<0.05). Abdominal pain and skin rash were the most frequent side effects of the treatments which led to discontinuation of the intervention.

    Conclusion: R. officinalis extract showed promising results in treatment of resistant asthma. Further studies to find the most effective components of these herbal medicines are recommended.

    Be well!


  22. JP Says:

    Updated 02/24/19:

    Respir Res. 2019 Feb 22;20(1):39.

    An evaluation of the effects of saffron supplementation on the asthma clinical symptoms and asthma severity in patients with mild and moderate persistent allergic asthma: a double-blind, randomized placebo-controlled trial.

    BACKGROUND: Asthma is a heterogeneous disease which is usually associated with chronic airway inflammation. Saffron has anti-inflammatory effects and may has beneficial effects on asthma.

    HYPOTHESIS: The present study was intended to survey the effects of saffron supplementation on blood pressure, lipid profiles, basophils, eosinophils and clinical symptoms in patients with allergic asthma.

    STUDY DESIGN: Our study was a clinical trial.

    METHODS: Subjects (N = 80, 32 women and 48 men, 41.25 ± 9.87 years old) with mild and moderate allergic asthma were randomized into two groups: the intervention group who received two capsules of saffron (100 mg/d), and the control group who received two capsules of placebo for 8 weeks. SPSS software (version 16.0) was used for the data analysis.

    RESULTS: Saffron improved the frequency of clinical symptoms of the patients (i.e., frequency of the shortness of breath during the day and night time, use of salbutamol spray, waking up due to asthma symptoms and activity limitation) in comparison to the placebo (p < 0.001). Besides, asthma severity decreased almost significantly in the saffron group (p = 0.07). It was also found that saffron, in comparison with the placebo, significantly reduced the systolic and diastolic blood pressure, triglycerides and low density lipoprotein cholesterol. Moreover, eosinophils and basophils concentration reduced in the saffron group (p = 0.06 and 0.05 respectively). CONCLUSION: Saffron seems to be an effective and safe option (in 8 weeks supplementation) to improve clinical symptoms of patients with allergic asthma but the toxicity and/or long-term effects of saffron intake are not known. Be well! JP

  23. JP Says:

    Updated 03/28/19:

    Glob Pediatr Health. 2019 Mar 19;6:2333794X19837455.

    Yoga Education Program for Reducing Drug Dependency and Promoting Better Asthma Control for Chronic Asthmatic Children: A Multicity Experiment.

    This article reports a 1-year long yoga education program (YEP) experiment aimed at reducing drug dependency and promoting better asthma control for chronic asthmatic children. Participants were 450 chronic asthmatic children across 4 cities. Two measures were used: Pediatric Asthma Diary (PAD) and Childhood Asthma Control Test (C-ACT). Results indicated that intervention group children had better asthma control in terms of lower average PAD scores and higher C-ACT scores and reduced drug intake vis-à-vis the control group. Within the intervention cohort, asthma symptoms persistence was lower and control was higher for children from Asian cities, boys, Hindus, middle-class children, those whose mothers were their primary caregivers, who lived in standard family setups, who also attended the optional YEP rounds, and regularly self-practiced. The strongest predictor of lower posttest PAD scores and higher C-ACT scores was self-practice. The YEP can be used as an effective complementary treatment for chronic asthmatic children.

    Be well!


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