Asthma gets help from injection-acupuncture

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November 14, 2007  
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zusanli1.gifCM NEWS – Injection of a traditional Chinese medicine herbal extract into a widely used acupuncture point may have an anti-inflammatory and immune-regulatory effect on bronchial allergic asthma, according to a new South Korean study.

The herb used in the study was perilla seed (Perillae fructus; or ??, Zisu in Chinese; or Shiso in Japanese). Injection of the herbal extract into an acupuncture point (herbal acupuncture) is a therapeutic technique combining both acupuncture and herbal treatment.

The study was led by researchers at the Department of Acupuncture, College of Oriental Medicine, Daejeon University, South Korea.

In Chinese medicine, perilla has been shown to stimulate interferon activity and thus, the body’s immune system.

The Japanese often eat perilla with sashimi (sliced raw fish) or cut into thin strips in salads, spaghetti, and meat and fish dishes. It is also used as a flavourful herb in a variety of dishes, even as a pizza topping (initially it was used in place of basil).

Perilla seed has been used to treat respiratory diseases in Chinese medicine. According to TCM theory, perilla seeds enters the lung meridian, arrests coughing and wheezing with copious phlegm, and treats exhalation difficulties and stiffness in the chest. The leaves of perilla (Perilla frutescens) have shown a suppressive effect on type 1 allergies. However, perilla seed has not yet been investigated for use on allergic diseases.

perilla-seedsRecent studies have shown that perilla seed polyphenols regulate allergic diseases due to 5-lipoxygenase inhibitory activity and suppression of histamine release from mast cells.

The functional compounds of perilla seed extract are flavonoid aglycons such as luteolin, apigenin, chrysoeriol, and resemarinic acid. It is known that the antioxidative activity and lipoxygenase inhibitory activity of flavonoid aglycons are stronger than that of corresponding glycosides.

Studies have shown that perilla seed extract inhibits the growth of cariogenic and periodontopathogenic microorganisms which in turn reduces plaque formation and acid production, helping to prevent dental carries.

Acupuncture and herbs are widely used to treat bronchial asthma – and according to TCM theory – by clearing the pathogenic factors and reinforcing the body’s resistance.

An important acupoint, zusanli (???), was investigated by the researchers in the current study. Zusanli is one of the most widely used acupuncture points, particularly for immune system regulation.

Zusanli is on the foot Yangming stomach meridian. This acupoint is known to strengthen the vital energy (qi). The ‘vital energy’ here means not only stomach qi, even though this acupoint belongs to the stomach meridian, but also the general qi in the whole body.

For this reason, zusanli is used to treat various diseases in different parts of the body or general symptoms in the whole body, including deficiency and weakness.

According to the book Chinese Acupuncture and Moxibustion, zusanli is listed to treat: gastric pain, vomiting, hiccup, abdominal distention, borborygmus, diarrhea, dysentery, constipation, mastitis, enteritis, aching of the knee joint and leg, beriberi, edema, cough, asthma, emaciation due to general deficiency, indigestion, apoplexy, hemiplegia, dizziness, insomnia, mania. (for a detailed explanation of zusanli, check here.)

Asthmatic mice were divided into 6 groups – both experimental and control. The experimental group was treated with perilla seed extract plus the acupuncture while the controlled ones received saline injection or just acupuncture. The treatments went on for 8 weeks.

According to the researchers:

Asthma is generally regarded as a T-cell mediated disease. Allergens cause the differentiation of naive T- cells into Th2 cells, which then secrete cytokines such as IL-4, IL-5 and IL-13 (3).

IL-4, which is pivotal in the pathogenesis of allergic disorders, acts on B cells to facilitate IgE production. Increased IgE production in response to common environmental antigens is the hallmark of atopic diseases such as bronchial asthma.

IL-4 also induces the rolling and adhesion of circulating eosinophils to endothelial cells. Therefore, inhibitors of the IL-4 signaling pathway have been suggested as therapeutic targets.

The results showed that perilla seed extracts + acupuncture at zusanli significantly decreased cytokins IL-4. It is inferred that the treatment may have an anti-allergic effect on allergic bronchial asthma by suppressing IL-4 secretion; and thus reduce eosinophil inflitration into the lungs by reducing the adhesion of circulating esoinophils to endothelial cells, the researchers wrote.

The researchers also found that even by applying acupuncture at zusanli ONLY may suppress asthma, though not as effective as the injection-acupuncture treatment. This result suggests that the mechanical stimulation of zusanli has a beneficial effect on bronchial allergic asthma.

“In summary, we hypothesize that PF-HA may be applicable to bronchial allergic asthma to reduce airway obstruction by inhibiting cellular infiltration and collagen accumulation in the lung, and to relieve airway hyper-responsiveness by reducing IL-4, IL-5, IL-13 and IgE,” the researchers conclude.

“Our data further suggest that PF-HA has a therapeutic effect on bronchial allergic asthma by regulating the immune system (suppressing excess Th2 activity and rebalancing Th1/Th2 in the immune system) and controlling eosinophilic inflammation in the airway. The anti-inflammatory effect of PF-HA may result from its immuno-regulatory effect on Th1 and Th2 activity.”

[eCAM, doi:10.1093/ecam/nem118]