TCM Asthma Treatment – Why is it Important?
Worldwide, we are seeing an increasing prevalence of Asthma. Kids are growing up with inhalers in their pockets to manage the symptoms of asthma. Adults may resort to using long-acting beta2 agonists (LABAs), especially when stress and fatigue exacerbate the severity of asthma.
Is this the way to proceed? Are there more natural ways to help someone suffering from Asthma? Read on to learn more about why you should consider TCM in treating Asthma!
Asthma is characterized by an inflammatory response in the lungs that leads to chest tightness, breathing difficulties, cough and wheezing. While Asthma has historically been seen as an allergic response, we now know that it is actually more complex than that. This complexity is best managed by treatment customized to the individual.
What is Allergic Asthma?
Asthma has mostly been regarded by medical professionals as an allergic response. People who suffer from Asthma tend to react negatively to substances that other people find harmless. Asthma is an atopic disease and is closely associated with other atopic conditions, namely allergic rhinitis, atopic dermatitis (eczema) and urticaria (hives).
The most classic explanation for asthma is as follows: (1) allergen exposure (2) IgE-mediated response (3) IL5-mediated airway inflammation.
Too technical? Let’s break it down.
(1) Allergen Exposure
There are allergens in every environment you can think of. Both your indoor and outdoor environments contain allergens. Indoors, you have dust mites, mold or fresh paint. Outdoors, it could be pollen, or dust in the wind.
In allergic Asthma, inhaling allergens like these might cause an allergic response. Allergic responses often include IgE.
(2) IgE-mediated Allergic Response
IgE refers to antibodies produced by the immune system. In small amounts, it is fine, but the immune system produces IgE on overdrive when you have an allergic response.
When IgE binds to mast cells and causes them to explode, loads of substance you don’t want e.g. histamines and leukotrienes are released into your system.
This is why you may have been prescribed anti-histamines like Zyrtec and Ceterizine. This is also why leukotriene antagonists like Montelukast (with known side effects) are still a common go-to in the treatment of Allergic Asthma.
(3) IL5-mediated Airway Inflammation
In Allergic Asthma, IL5 creates an insane amount of white blood cells called Eosinophils. These eosinophils flood the lungs and cause the airways to narrow and not allow air through. This is why you might begin to feel like you can’t breathe. This may also cause you to wheeze or constantly cough up sputum.
Common Triggers and Treatment Options
What are the Symptoms of Allergic Asthma?
During an asthma attack, you may experience the following:
The symptoms could include the following:
- You experience a lack of air in your lungs.
- You are coughing frequently, especially when lying down at night.
- You are wheezing (a whistling noise while breathing).
- There is a feeling of tightness in the chest (feels like something is pressing on or constricting your chest).
- You feel anxious and your heart beats faster than usual.
Note: These symptoms appear in Allergic Asthma, but are also present in other forms of Asthma.
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What else is there besides Allergic Asthma?
While Asthma is tightly associated with the allergic response, there are other types of asthma that are less tied to allergy. They include:
- Cough-variant asthma.
- Exercise-induced asthma.
- Night-time asthma.
- Non-eosinophilic asthma.
In all these other forms of asthma, we need to pay heed to how your symptoms show up and tailor the treatment accordingly. For example, in cough-variant asthma, we want to take sputum production and the coughing reflex into account. As an alternative to using common prescriptive medications like expectorants and anti-tussives, we will throw useful herbs into the mix.
In exercise-induced asthma and night-time asthma, there is often the component of exertion and fatigue. The TCM approach is to also take endurance and recovery into account by adding in relevant adaptogenic herbs.
What is Type 2 Asthma?
More than 50% of Asthma is due to an exaggerated IgE-mediated response and an overdrive in eosinophil production. This is called Type 2 Asthma.
Type 2 Asthma includes Allergic Asthma, exercise-induced asthma as well as Adult-onset Eosinophilic Asthma.
What is Neutrophilic Asthma?
Neutrophilic Asthma is often termed Non-eosinophilic Asthma (NEA). It means that neutrophils are found in your blood sample, and while this is common with a one-off infection, it is dangerous to have asthma associated with persistently high levels of neutrophils.
Neutrophilic Asthma is often longstanding and chronic. It is commonly associated with asthma that shows up in adulthood, people who smoke and a poor response to treatment. There is destruction of the airway smooth muscle and causes permanent irreversible change in lung function.
If you have Neutrophilic Asthma and is not responding well to existing treatment, you can consider support using Chinese herbs.
TCM for Allergic Asthma
According to research, Traditional Chinese Medicine (TCM) herbal formulations for Asthma have been shown to provide several therapeutic benefits. These benefits include reducing airway hyper-reactivity, reducing inflammation in the lungs and calming muscle contractions around the airways.
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Else, continue reading on to understand how Traditional Chinese medicine (TCM) can really help!
Before we continue, know this!
It is common knowledge that Th1/Th2 imbalance is the basis for the “allergic” part of allergic asthma. What happens is a Th2 dominance where Th2 cells are secreting more IL4, IL5 and IL13 cytokines, which aggravate the histamine as well as other inflammatory responses:
- IL4 and IL13 together create more IgE, which then trigger a histamine response which is an integral component of an allergic response.
- IL13 alone directly affects the lining of the airway, causing hyper-responsiveness and mucus secretion.
- IL5 activates eosinophils which congregate in the lungs to secrete numerous cytokines as well as chemokines.
- On top of that, GATA-3 is critical in aggravating a Th1/Th2 imbalance.
One: TCM Herbs target Th1/Th2 Imbalance
If you are already using an inhaler to support your breathing function, consider using TCM herbs. You will be surprised how helpful they can be. The herbs are prescribed so as to tweak immune function and reduce inflammation in the lungs.
Because we are using a variety of herbs that function differently, some active ingredients can open up the lungs, other active ingredients can reduce inflammation without the use of steroids, while yet others can gently tweak the immune system over time.
While all this is happening, we want the body’s immune system to gradually balance out, so that it needs less and less to rely on the inhaler.
We also know that the following herbs are able to reduce GATA-3 protein expression:
- Radix Astragali and Panax Ginseng are known adaptogens for treating Qi Deficiency Asthma
- Fructus Psoralea is a rising star in the treatment of allergic asthma. Psoralen and Bavachinin are key ingredients in Fructus Psoralea that inhibiting GATA-3.
Another herb, called Fructus Cnidii Monnieri, is often used in the treatment of eczema itch.
- Now we know that its active ingredient Osthol also reduces IL4 induced eotaxin, hence evening out Th1/Th2 imbalance.
Two: TCM Herbs target MAPK and NF-kB Signaling Pathways
If you suffer from Allergic Asthma, MAPK (mitogen-activated protein kinases) is not your friend, because it triggers activation of inflammatory cells.
Nor will you like NF-kB (nuclear factor kappa B), because it facilitates expression of pro-inflammatory genes. In asthmatic patients exposed to an allergen, there is an increased activation of NF-kB in the lungs and in the lining of the airways
Some studies (Zhang et al, 2013 and Yang et al, 2015) have shown that allergic asthma can be improved by regulating the activation of MAPK and NF-kB signaling pathways.
Chinese herbs that target MAPK include:
- Scutellaria Baicalensis
- Panax Ginseng
- Flos Magnolia
- Crocus Sativus
- Artemisia Annua
Chinese herbs that target NF-kB include:
- Scutellaria Baicalensis
- Radix Astragali
- Artemisia Annua
Three: TCM Herbs raise Treg/Th17 Ratios
Treg cells are the good guys we want to have alot of, because they maintain a certain level of immune tolerance to non-harmful triggers.
Th17 cells are critical participants in chronic lung conditions. When you suffer from Allergic Asthma and you enter the chronic phase, Th17 levels are likely to be elevated. If more severe conditions like Steroid-resistant Asthma or Neutrophilic Asthma, Th17 levels are possibly elevated.
In many chronic conditions, the Treg/Th17 ratio is depressed. For example, in Primary Immune Thrombocytopenia (ITP), characterized by reduce platelet count, Treg levels fall while Th17 level are elevated during the acute phase. The same is true for other inflammatory conditions like Rheumatoid Arthritis (RA) and Gouty Arthritis.
In general, we want to raise Treg levels, and this is usually done through the Foxp3 pathway. The following herbs raise Treg level, which (all else equal) results in increased Treg/Th17 levels:
- Radix Astragali
- Panax Ginseng
- Crocus Sativus
- Ligusticum Chuanxiong
Four: TCM Herbs inhibit Mast Cell Degranulation
When treating Allergic Asthma, Scutellaria is a herb that must be included. You can think of it as an anti-allergy herb!
Mast cells play an important role in asthma. When mast cells explode, they release a cascade of inflammatory mediators like histamine, prostaglandins, leukotrienes, etc.
Scutellaria contains Oroxylin A, which stabilizes the mast cell, preventing it from exploding and exacerbating inflammation in the lungs.
You will learn more in the following video
Five: TCM Herbs slows down Airway Remodeling in Lung Inflammation
Airway remodeling refers to the structural changes that occur in airways to a person suffering chronically from Allergic Asthma. These people often have airway structural changes that include include sub-epithelial fibrosis, increased smooth muscle mass, gland enlargement, neovascularization and epithelial alterations.
Airway remodeling exists in Allergic Asthma; it shows up even more strongly in Neutrophilic Asthma.
The following herbs are known to attenuate allergen-induced airway remodeling. How they do so is via the inhibition of TGP-β1.
2. Scutellaria Baicalensis
If we are able to slow down airway remodeling, there will be less lung damage over the longer term.
In Conclusion, TCM helps Asthma
It is worth your while to use TCM to treat your Asthma. Below are 5 lesser-known and untapped reasons why TCM is so effective.
- TCM herbs help by targeting Th1/Th2 imbalance to reduce the allergic response.
- TCM herbs reduce inflammation in the lungs by reducing MAPK and NF-kB levels.
- TCM herbs balance out further inflammation that may happen in chronic lung damage.
- TCM herbs reduce inflammatory damage by inhibiting mast cell degranulation.
- TCM herbs reduce lung damage by slowing down airway remodeling.
TCM medicine can be used in conjunction with prescriptive drugs. Read on find out more about 12 herbs that are critical in TCM Asthma treatment.
Asthma is not just an allergic condition, it is also an inflammatory condition that becomes chronic. If you need help in treating Asthma for yourself or your child, feel free to drop us a line!