
ASTHMA AND ITS TREATMENT
WITH SYNTHETIC DRUGS,
MEDICINAL PLANTS AND ESSENTIAL OILS
INTRODUCTION
Asthma is an “inflammatory” disorder of the airways (1) characterized by inflammation of the bronchi with increased mucus production and hypersensitivity of the airways. In many cases asthma is of allergic origin. The allergic reaction at the respiratory level merges and adds to the “inflammatory” reaction (2).
The result: wheezing, coughing, and difficulty breathing.
Asthma is a “chronic” disease, very progressive over time, which affects both infants and adults.
The “asthma attack” is characteristic of asthmatic disease; it is a sudden event which combines rapid onset bronchospasm (narrowing of the bronchial airways) with congestion of the bronchial mucosa and bronchial hypersecretion. Air passes with difficulty, the patient suffocates, breathing is wheezing and difficult.
Asthma is a disease with multiple causes: genetic, allergic, environmental, infectious, psychological, nutritional.
Asthma is a rapidly growing disease in “developed countries”; the annual increase is estimated at around 5% per year among young people under 18, i.e. approximately a doubling of the number of asthmatics in 15-20 years. Some figures: in 1998 17 million asthmatics in the USA (annual mortality around 5,000) and in 2019 asthma affects around 262 million people worldwide (461,000 deaths per year).
Why this rapid increase in the last 30 years: the increase in chemical pollution of the air we breathe in cities (particles due to diesel, ozone, nitrous oxide, sulfur dioxide) but undoubtedly not only that, specialists add the very important modification of our way of living:
- living in confined and very isolated places (apartments) where the materials are largely synthetic and release irritating chemical substances (formalin, paint or glue thinners, insecticides)
- modern food is full of colorings, allergenic synthetic flavorings, pesticide residues, it is poor in natural antioxidants and magnesium
- some specialists blame the increase in the number and frequency of vaccinations.
THE MAIN CAUSES OF ASTHMA
ALLERGY AND ASTHMA
“Atopy” or atopic terrain is the exaggerated capacity of certain people to develop allergies; atopy is largely “inherited” (genetic).
When one of the parents, and even more so both, have disorders of allergic origin (respiratory (asthma, allergic rhinitis), skin or digestive), the children have a very clearly higher than average risk of having this condition, and therefore develop “allergic diseases” including asthma.
Allergic rhinitis (hay fever) is accompanied by asthma in 3/4 of cases.
WHAT ARE THE ALLERGENS MOST OFTEN RESPONSIBLE
FOR THE APPEARANCE OF ASTHMA?
Mite droppings: small commensal insects (Dermatophagoides sp.), which live in house dust, bedding (pillows), rugs and carpets. Their excrement is particularly antigenic and causes a very rapid allergic reaction in sensitive people when inhaled.
Cockroaches and their excrement are also very antigenic, but these insects are more easily visible and therefore eliminated
Allergens from domestic animals (especially cats and dogs)
Fungi (including yeasts) especially by air (Cladosporium, Alternaria, Penicillium, Aspergillus ), and internally antibiotics of fungal origin (penicillin, cephalosporin)
Pollens from many plants
Food: food allergens are less often involved in adult asthma than in childhood asthma.
OTHER CAUSES CAUSING OR AGGRAVATING ASTHMA
The role of respiratory infections in the occurrence of asthma is very important.
It appears that infections caused by numerous respiratory viruses or chlamydia disrupt the metabolism of cells of the respiratory mucosa and thus trigger reactions (of the immune type) conducive to the onset of an asthma attack.
Respiratory tract infections in children (rhinitis and bronchitis) trigger and worsen bronchial asthma.
Air pollution: active and passive smoking, particles and gases present in the smoke of internal combustion engines (diesel, gasoline), wood smoke, industrial fumes, ozone, nitrogen oxides, irritating gases (chlorine, volatile acids, paint thinners, gases released by “plastic materials”)
Certain medications: aspirin and anti-inflammatories
An abnormality of gastric functioning: many asthmatics complain of gastric reflux, bloating of the stomach but it is not easy to determine if it is asthma which causes these disorders or the opposite.
A deficiency in zinc, magnesium, selenium, vitamins B12, B6, C.
Asthma can be triggered, increase or on the contrary disappear following changes in hormonal balance: puberty, menstruation, pregnancy, menopause
Exercise-induced asthma: during prolonged physical exercise, especially when the air is cold and dry. The attack is triggered by hypersensitivity of the bronchi; even an attack of “giggling” can trigger a bronchial spasm.
Asthma is also an occupational disease.
Asthma “psychosomatic” disease. This way of describing asthma is no longer fashionable although all asthma specialists and asthmatics know the importance of the psychological factor in triggering and increasing the asthma attack.
PRINCIPLE OF TREATMENT
Asthma is more or less serious. Many asthmatics live completely normally and play sports, even at a high level.
In fact, the typical nocturnal asthma attack (when blood corticosteroid levels are at their lowest) is most often reversible, spontaneously or with the help of specific medications.
All levels of asthma exist up to very disabling asthma with continuous dyspnea, often old, poorly treated asthma.
But be careful, asthma is dangerous because there is always the risk of an acute asthma attack, regardless of the type of asthma you have, which may require emergency hospitalization.
There are asthma equivalents: dry nighttime cough, with more or less bronchial secretion that is quite difficult to expectorate.
Asthma, a disease with multiple causes, requires very personalized long-term treatment, although the treatment of asthma attacks is quite stereotypical.
EXCLUSIONS OF FACTORS PROMOTING OR AGAGRAGING ASTHMA
- elimination of mite breeding grounds, destruction of these insects using acaricides
- keeping pets away in case of allergy
- specific desensitization when the allergy is well defined and the asthma lends itself to this treatment by immunotherapy
- change of place of residence or occupation if necessary
THE ASTHMA ATTACK
It is generally controlled by the inhalation of short but rapid-acting inhaled beta-2 agonists (salbutamol, Ventolin), to be taken on demand as soon as possible.
BASIC TREATMENT OF ASTHMA (SUMMARY)
Depending on the severity of the asthma and the reaction of the disease to treatment, we will use:
- inhaled corticosteroids in varying doses
- theophylline derivatives
- long-acting Beta 2 sympathomimetics
- oral corticosteroids
- a new class of drugs: antileukotrienes (3), they block part of the inflammatory reaction causing asthma but do not have a bronchodilator effect. They prevent the occurrence of exercise-induced asthma.
Asthma is a “long-term” disease that must be evaluated and monitored every 3 to 6 months to adapt basic treatment to the progression of the disease. Asthma can completely disappear (around 1/3 of asthmatic children regain normal breathing at puberty and in the years that follow), but the “former asthmatic” must remain cautious: no tobacco, avoid allergens if possible and causes of bronchial irritation.
USES OF MEDICINAL PLANTS AND ESSENTIAL OILS
IN THE TREATMENT OF ASTHMA
Asthma attacks are not within the scope of herbal medicine.
Beta-2 agonists (salbutamol) or the new antileukotrienes have no equivalent in herbal medicine.
Remember that a few decades ago we used datura powder, or cigarettes containing it, to treat asthma attacks.
On the other hand, medicinal plants and essential oils are very useful in controlling the progression of asthmatic disease (basic treatment):
- antibacterial, antiviral and anti-inflammatory pulmonary tropism essential oils to limit infection of the mucous membranes of the respiratory tract, reduce inflammation and promote expectoration: essential oils of thyme and savory, eucalyptus and niaouli, pine
- anti-allergic and anti-inflammatory plants: blackcurrant, Tylophora asthmatica, Boswellia serrata, Petasites hybridus, ginger, mangosteen, Rubus suavissimus
- antispasmodic plants: thyme, hawthorn, lavender, lemon balm, ginger
- soothing and sleep-promoting plants: hawthorn, lavender, eschscholtzia, lemon balm, hypericum, lime
ESSENTIAL OILS AND ASTHMA
As we have seen, respiratory infections are very often responsible for triggering asthma attacks when the situation is favorable. Air restriction and airway congestion will delay healing.
It is therefore fundamental to prevent these infections (viral and bacterial) and to help the body fight against them.
To do this, essential oils are very precious.
They are natural antiseptics
which are absorbed by the respiratory or digestive route,
which increase the activity of the cilia of the cells of the mucous membrane of the bronchi, thus facilitating the evacuation of bronchial mucus,
which have an anti-inflammatory power
which provide a feeling of respiratory “well-being”
which are without toxicity at prescribed doses: for a child up to 6 drops per day, for an adult up to 12 drops per day orally.
Essential oils of Eucalyptus globulus,
Eucalyptus radiata (preferred for children),
Melaleuca viridiflora or Niaouli
By mouth: 2 to 3 drops, 3 to 4 times a day, pleasant to the taste and not very toxic
Externally: be careful in rare cases asthma can be increased by the “smell” of essential oils.
Inhalation (a few drops of essential oil in a bowl of very hot water) 2 to 3 times a day. ·
Application to the thorax of a few drops of essential oil mixed in a fatty substance (massage oil, balm)
Essential oil of Pinus sylvestris or Scots pine (needle and buds)
Be careful with the labeling because many extracts labeled “pine oil” are industrial by-products (sawmills, paper pulp) which have nothing to do, except a little smell, with the essential oil of the leaves. (needles) or pine buds.
By mouth: 2 drops 3 to 4 times a day Externally by inhalation several times a day.
Thyme and savory essential oils
Thymus vulgaris, or thymol thyme or carvacrol and Satureja (or Satureia) montana, mountain savory.
These two essential oils contain powerful antibacterials which also facilitate expectoration, but which can cause digestive burns in some people.
Orally: 2 to 3 drops 3 times a day
Externally: inhaled but not applied to the skin because it is an essential oil that irritates the skin. Here too, be wary of the risk of bronchospasm in children.
ANTI-ALLERGIC AND ANTI-INFLAMMATORY PLANTS
Ribes nigrum
In France, and with the experience of phytotherapists from the School of Biotherapy since the 1960s, blackcurrant, Ribes nigrum, is recommended in gemmotherapy.
These blackcurrant bud extracts are anti-inflammatory and have a therapeutic effect reminiscent of corticosteroids, but without having the side effects.
They can be used long-term in a course of several weeks in both children and adults. Ribes nigrum buds glycerin maceration 1 D: 50 to 100 drops per day divided into 2 to 3 times
Zingiber officinale
Ginger, widely used in herbal medicine in India, is much less used in France.
It has, among other things, an anti-inflammatory power.
Clinical trials have shown that a standardized hydroalcoholic extract could improve the respiratory performance of people with moderate asthma.
Alcoholic ginger tincture: equivalent to 1 g of rhizome in 4 doses.
Ginger tea: 1 to 2 teaspoons of grated ginger in 1/2 liter of very hot water, leave to infuse for ten minutes, the container covered: a cup 3 to 4 times a day.
You can also use ginger juice directly in the drink or in the form of a syrup.
Not everyone can tolerate ginger which can cause gastric irritation.
Rubus suavissimus
Chinese sweet bramble has interesting pharmacological properties. It is anti-inflammatory due to its medicinal tannin content, and experience has proven that it is anti-allergic, therefore useful for treating asthma when the allergic component is important.
Rubus suavissimus is a bushy plant found among other places in the Chinese provinces of Guang Xi, Guizhou and northern Guang Dong.
The sweet taste of the leaves is mainly due to the presence of a glycoside, ruboside or rubusoside. Ruboside or rubusoside is 200 to 300 times sweeter than sucrose (ordinary sugar), but provides very few calories, like stevioside extracted from the sweet Paraguayan grass (Stevia rebaudiana).
The aqueous extract of Rubus suavissimus is not only sweetening, it is also anti-allergic (used as such in Japan), experience shows that it is an antihistamine but that it has no effect on the synthesis of prostaglandins E2.
The Chinese mainly use the leaves of Rubus suavissimus to make a sweet tea, everyone finds the right proportion of leaves and hot water. If we increase the quantity of leaves, or if we drink a lot of this tea, the tannin content can induce constipation.
Tylophora asthmatica
Tylophora asthmatica (or indica) (Asclepiadaceae) is a climbing plant native to southeastern India.
It is a toxic plant which contains alkaloids including tylophorine.
It has been part of the Indian pharmacopoeia for a long time and used by Ayurvedic doctors.
It is an emetic that has anti-inflammatory and anti-allergic properties. It is traditionally used in India to treat asthma, certain allergic manifestations as well as digestive and joint disorders.
A recent study showed that an alcoholic extract of Tylophora asthmatica increased cortico-adrenal activity (the excretion of natural corticosteroids into the blood), which would explain its anti-inflammatory power.
This plant is not marketed in Europe due to its potential toxicity and the absence of pharmacological studies. At least one worldwide license for use was filed in 2005 ((WO/2006/003676) a novel method to inhibit inflammation and tumor growth by tylophora alkaloids). The authors suggest, in the case of asthma, a dosage of 160 to 600 micrograms of alkaloids (in a ratio of 2 quantities of tylophorin to 1 quantity of tylophorinin, to 2 quantities of tylophorinidine).
The typical dosage of dry leaves to treat asthma in India: 200 to 400 mg in two doses (i.e. approximately 1/2 to 1 leaf per day).
Petasides Hybridus
This asteraceae, perennial with its voluminous rhizome, is native to Europe and Asia (now present in North America), it prefers humid areas, river banks, slightly marshy land. It has very long leaves (up to 1 m) which are somewhat reminiscent of those of rhubarb and a reddish inflorescence which appears before the leaves at the end of winter.
It is not part of the French pharmacopoeia although it has been used since antiquity as a medicinal plant. The whole plant (rhizome and leaves) contains sesquiterpenes (petasin and isopetasin) which are antispasmodic and anti-inflammatory in particular by blocking the synthesis of leukotrienes.
Unfortunately the plant also contains toxic alkaloids (for the liver parenchyma) and perhaps carcinogens.
At least one patent has been filed for the development of an extract of Petasides hybridus containing sesquiterpenes but free of alkaloids (rhizome extract). This extract has already been successfully tested for the treatment of migraine.
A clinical study showed that these Petasis extracts improved the respiratory capacity of asthmatics and significantly reduced the number of attacks without side effects. A German drug, also available in the USA (Petadolex) and Switzerland (Dolomed), is standardized in petasin and isopetasin. The suggested dosage is, for adults, 50 to 100 mg of extract, twice a day. This medication is recent; its contraindications and interactions with other medications are not yet well determined.
Plantago major
The mother tincture is appreciated by the majority of phytotherapists for its anti-inflammatory and anti-allergic power (weak but without toxicity): 30 to 60 drops per day
Resin of Boswellia sp.
Several species of trees of the Boswellia genus, native to northeast Africa and Arabia, produce a fragrant resin, frankincense or frankincense, which has medicinal properties: antiseptic, analgesic, anti-inflammatory.
A clinical study from 1998 showed the benefit of incense for treating asthma.
300 mg of resin extract, 3 times a day, for 6 weeks, significantly improved the condition of the asthmatics in the study. Frankincense would act as an antileukotriene.
Garcinia mangostana
The mangosteen tree (Clusiaceae) is native to the Indo-Malay region, it is a medium-sized tropical tree (around ten meters) with evergreen foliage. It is grown for its purplish-red fruits, 4 to 7 cm in diameter, which contain a pleasantly sweet and fragrant pulp. The peel of the fruit of a related species Garcinia cambogia contains a significant amount of hydroxycitric acid. Calcium salt (calcium hydroxycitrate) is offered as a food supplement in weight loss diets.
Mangosteen peel is used in traditional Southeast Asian medicines as an anti-inflammatory, antidiarrheal and antiseptic. A Japanese study from 2002 showed that a hydro-alcoholic extract (at 40°) inhibited the synthesis of prostaglandin E and the release of histamine in vitro.
Mangosteen peel may soon be considered as an anti-allergic and anti-inflammatory plant useful for treating asthma.
Euphorbia hirta = euphorbia pilulifera
Euphorbia hirta or pilulifera is probably native to Australia (or the Indian subcontinent).
This small, discreet plant with little demands on the quality of the soil, resistant to sun and drought, is now present in all tropical or equatorial regions.
It has many local names: malnommée or ti-lait in the West Indies, or jean robert herb in the islands of the Indian Ocean, asthma herb in many English-speaking countries, yerba de la golondrina in Spanish-speaking countries but tripa de pollo in Puerto Rico, and very numerous appellations in Africa depending on the country and ethnic groups, some examples: adododo or akololo in Ivory Coast, dabadablé or homgoelem in Senegal and Mali, laganzu or ikondo wola in Congo, akponyon or nyahounayira in Benin, aidinono in Madagascar, mwache in Swahili…In India, dudhi in Indi and chara in Sanskrit, tawatawa in the Philippines.
Euphorbia hirta has bronchodilator, soothing and cough-reducing properties (analogous to codeine).
This plant cannot be compared to modern anti-asthma products that are much more powerful and can alleviate an asthma attack in just a few minutes.
On the other hand, it can be used as a basic treatment to prevent the onset of asthma attacks, or in cases of chronic bronchitis with emphysema (COPD), to try to prevent exacerbations of the disease.
Dosage examples:
30g of dry plant per liter of water, decoction for 10 to 15 minutes, use this herbal tea as a drink during the day (1 to 2 liters per day),
a handful of fresh plant in 1.5 liters of water, decoction for 10 to 15 minutes, to consume during the day,
In Western medicine, other medicinal plants were often combined with euphorbia hirta to calm asthma and asthmatic bronchitis: lobelia, grindelia
ANTISPASMODIC AND SOOTHING PLANTS
Thyme, ginger, hawthorn, lemon balm, lavender, eschscholtzia, hypericum, lime.
The asthmatic is often a person who is a little anxious, anxious, and has difficulty falling asleep. Experience shows that a mild hypnotic often reduces the frequency of middle-of-the-night asthma attacks.
CONDUCT OF TREATMENT
As we said a little above, the treatment of bronchial asthma cannot be standardized. Each asthmatic is individual and the treatment of their asthma must be adapted to them.
A few tips :
Limit respiratory tract infections, especially in children, and essential oils are very useful for this.
Treat the child’s asthma very early to prevent the damage to the bronchi from lasting.
Allow the asthmatic child to participate in sporting activities, especially those which give them confidence in their breathing abilities (swimming, snorkeling)
Stop the asthma attack as soon as possible by inhaling beta-2 agonists ( e.g. salbutamol, ventolin).
Use anti-inflammatory plant extracts as much as possible to reduce or even eliminate the use of inhaled corticosteroids.
note 1
Basically, asthma seems to be due to an abnormal regulation and a poor response of certain classes of immune cells: T lymphocytes (more specifically Th2 (T helper 2)).
These cells responsible for the body’s defense are capable of producing chemical mediators or cytokines (interleukins) which organize the immune response. These chemical mediators (cytokines) stimulate, differentiate and group other cells with more specific capacities (mast cells, eosinophils, basophils, other lymphocytes, etc.), responsible for allergic, immune and inflammatory reactions.
In asthma these “natural” cascade reactions are very exaggerated, amplified in the bronchi.
note 2
The exaggerated allergic reaction, which will be the cause of many cases of bronchial asthma, begins with the activation of mast cells by the presence of an antigen – immunoglobulin complex; mast cells quickly release histamine and leukotrienes which will cause constriction of the bronchi, abnormal secretion of mucus, and moreover attract other cells (lymphocytes) which will perpetuate this “abnormal” reaction.
note 3
Leukotrienes are natural chemical mediators secreted mainly by the cells responsible for the body’s defense: the cells of the mucosal lining, monocytes, eosinophils, basophils, mast cells, lymphocytes and even blood platelets.
The release of leukotrienes at the bronchial level causes:
a powerful constriction of the bronchi,
a local inflammatory reaction with increased permeability of blood vessels (causing the beginning of edema) and promoting the recruitment of eosinophils to the airways,
an increase in the secretion of bronchial mucus,
an increase in the power of the smooth muscles of the bronchi
The action of leukotrienes, originally intended to protect the lungs against external aggression, considerably aggravates the asthma attack.
Copyright 2024: Dr Jean-Michel Hurtel
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PHYTOTHERAPY, MEDICINAL PLANTS, AROMATHERAPY, ESSENTIAL OILS