Bronchial Asthma research studies for holistic treatments

Tamaka Shwasa is one of the major disease explained in our Ayurvedic classics produced due to vitiation of kapha and vata dosha in pranavaha srotas, is analogous to Bronchial Asthma as explained in modern medical science. India has an estimated 15-20 million asthmatics and mortality due to Bronchial Asthma is not comparable in size to the day-to-day effects of the disease. It is a disease characterized by recurrent attacks of breathlessness and wheezing which vary in severity and frequency from person to person. The nidanas for Tamaka Shwasa are raja, dhuma, vata sevana, residing in sheeta stana, sheeta jala sevana, ati vyayama etc. Asthma is a chronic condition, it usually requires continuous medical care and medication is not the only way to control Asthma. The inhalation route has been developed to administer the drugs by delivering to site of action and to get immediate effects. The drugs used in Allopathic medicines causes side effects like dry or irritated throat, sneezing, stuffy or itchy nose, watery eyes, nose bleed, nausea, frequent urination, dizziness, drowsiness, headache, skin rash, bruising, severe tingling, numbness, pain, muscle weakness, joint pain and general illness but as it is a herbal preparation it minimizes the side effects. Most of our Acharyas explained different treatment modalities in the management of Tamaka Shwasa especially Dhumapana using different drugs but a unique concept ‘Arka’ for dhoomapan is explained by Ravana in Arka Prakasha. Hence efforts are put forth to conceptualize the effect of aqueous extract – Arka for inhalation in Tamaka Shwasa through Nebulization and parallel new perspective to rising trend in cases of treating Asthma.

Background:
There is concern that long-acting beta agonist (LABA) drugs may increase the risk of asthma mortality.
METHODS:
A meta-analysis was conducted of asthma deaths in randomised controlled clinical trials from the GlaxoSmithKline database that compared salmeterol with a non-LABA comparator treatment in asthma. The Peto one-step method was used to determine the risk overall (all studies) and in derived datasets based on inhaled corticosteroid (ICS) use.
Results:
There were 35 asthma deaths in 215 studies with 106,575 subjects. Two studies (SMART and SNS) contributed 30/35 (86%) asthma deaths, the overall findings largely reflecting the characteristics of these studies. The odds ratio for risk of asthma mortality with salmeterol was 2.7 (95% CI 1.4 to 5.3). In 54 placebo controlled studies the risk of death from asthma in patients not prescribed ICS was 7.3 (95% CI 1.8 to 29.4). In 127 studies in which patients were prescribed ICS, the risk of asthma death was 2.1 (95% CI 0.6 to 7.9). In 63 studies in which patients were randomised to receive the combination salmeterol/fluticasone propionate inhaler or ICS, there were no asthma deaths among 22,600 patients. CONCLUSIONS: Salmeterol monotherapy in asthma increases the risk of asthma mortality and this risk is reduced with concomitant ICS therapy. There is no evidence that combination salmeterol/fluticasone propionate therapy is associated with an increased risk of asthma mortality, although this interpretation is limited by the low statistical power of available studies.

Urinary xanthurenic and kynurenic acid levels were measured in five patients while they were receiving 50 mg and 100 mg of pyridoxine. The levels of tryptophane metabolite decreased progressively as the dose was increased but remained above basal levels. There was marked clinical improvement in these patients while receiving the higher dose only. The double-blind study with 76 asthmatic children followed for five months indicated significant improvement in asthma following pyridoxine therapy (200 mg daily) and reduction in dosage of bronchodilators and cortisone. The data suggest that these children with severe bronchial asthma had a metabolic block in tryptophane metabolism, which was benefitted by long-term treatment with large doses of pyridoxine.

Omega-3 polyunsaturated fatty acids have anti-inflammatory effects in vitro, and high dietary levels are associated with a lower incidence of inflammatory s. However, only limited effects have been demonstrated in asthma. The effects of dietary supplementation with fish oil for 10 months in 29 children with bronchial asthma was investigated in a randomized controlled fashion. In order to minimize the effects of environmental inhaled allergens and diet, this study was performed in a long-term treatment hospital. Subjects received fish oil capsules containing 84 mg eicosapentaenoic acid (EPA) and 36 mg docosahexaenoic acid (DHA) or control capsules containing 300 mg olive oil. The daily dosages of EPA and DHA were 17.0-26.8 and 7.3-11.5 mg x kg body weight(-1), respectively. Asthma symptom scores decreased and responsiveness to acetylcholine decreased in the fish oil group but not in the control group. In addition, plasma EPA levels increased significantly only in the fish oil group (p<0.0088). No significant side-effects were observed. The present results suggest that dietary supplementation with fish oil rich in the omega-3 polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid is beneficial for children with bronchial asthma in a strictly controlled environment in terms of inhalant allergens and diet.

Background:
The protective effect of breast-feeding on the development of childhood asthma remains a matter of controversy. We conducted a systematic review of prospective studies that evaluated the association between exclusive breast-feeding during the first 3 months after birth and asthma. STUDY DESIGN: We searched the 1966-1999 MEDLINE database and reviewed reference lists of relevant articles to identify 12 prospective studies that met pre-stated inclusion criteria. Methodological aspects of the studies, duration and exclusivity of breast-feeding, and outcomes were assessed. Effect estimates were abstracted by the investigators, using a standardized approach.
Results:
The summary odds ratio (OR) for the protective effect of breast-feeding was 0.70 (95% CI 0.60 to 0.81). The effect estimate was greater in studies of children with a family history of atopy (OR = 0.52) than in studies of a combined population (OR = 0.73). CONCLUSIONS: Exclusive breast-feeding during the first months after birth is associated with lower asthma rates during childhood. The effect, caused by immunomodulatory qualities of breast milk, avoidance of allergens, or a combination of these and other factors, strengthens the advantage of breast-feeding, especially if a family history of atopy is present.

RATIONALE: Acute asthma exacerbations, precipitated by viral infections, are a significant cause of morbidity, but not all asthmatics are equally susceptible. OBJECTIVES:
To explore susceptibility factors for asthma exacerbations, we considered a role for histoblood group antigens, because they are implicated in mechanisms of gastrointestinal viral infection, specifically the O-secretor mucin glycan phenotype. We investigated if this phenotype is associated with susceptibility to asthma exacerbation.
METHODS:
We performed two consecutive case-control studies in asthmatic subjects who were either prone or resistant to asthma exacerbations. Exacerbation-prone cases had frequent use of prednisone for an asthma exacerbation and frequent asthma-related healthcare utilization, whereas exacerbation-resistant controls had rarely reported asthma exacerbations. The frequency of different mucin glycan phenotypes, defined by the presence or absence of H (O), A, B, or AB antigens, was compared in cases and controls. Measurements&MAIN
Results:
In an initial study consisting of 49 asthmatic subjects (23 cases and 26 controls), we found that having the O-secretor phenotype was associated with a 5.8 fold increase in the odds of being a case (CI 1.7â 21.0, p=0.006). In a replication study consisting of 204 asthmatic subjects (101 cases and 103 controls), we found that having the O-secretor phenotype was associated with a 2.3 fold increased odds of being a case (CI 1.2 â 4.4; p=0.02). CONCLUSIONS: The O-secretor mucin glycan phenotype is associated with susceptibility to asthma exacerbation. www.clinicaltrials.gov NCT00201266.