Traditional Chinese Medicine for Pediatric Allergic Diseases.

IF 4.6 2区 医学 Q1 ALLERGY
Michelle Carnazza, Robert Werner, Morgan Begley, Nan Yang, Raj Tiwari, Jan Geliebter, Xiu-Min Li
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引用次数: 0

Abstract

Purpose of review: There is a clinically important and unmet need for long-term safe and effective preventative and therapeutic options for pediatric allergic diseases. This communication reviewed the use of Traditional Chinese Medicine (TCM) in pediatric allergic disease, including eczema, urticaria, eosinophilic esophagitis (EoE), food allergy (FA), asthma, and allergic rhinitis.

Recent findings: Through evaluation of case studies, series, or clinical trials of pediatric allergy patients, or in vitro studies involving samples collected from pediatric allergy patients and in vivo model systems, naturally occurring small molecule compounds' mechanism of action by evidence-based scientific outcomes were elucidated. Notable clinical outcomes include reduction in severity score, reduction across various allergic diseases that demonstrated no toxicity, no severe adverse effects, and are well-tolerated. Immunological outcomes that attribute to this include a switch from Th2-mediated allergic response to a Th1/Treg response, characterized by reduced total and specific IgE, total eosinophil counts, and levels of exotoxin, TNF-a, IL-6, IL-8, IL-5, and IL-4, with elevated levels of IFN-γ and IL-10. For eczema, both multiple and single herbal formulations are common treatment modalities, including internal administration and external herbal baths and creams, whereby both provide substantial beneficial outcomes. For EoE, internally administrated formulations and use of acupuncture have been reported and shown mitigation of allergic responses. In FA, formulations have been studied in clinical trials showing consistent safety, with protection remaining to be established. More advanced development of single herbal compounds may provide an advantage for use in FA treatment. For allergic rhinitis, several multiple herbal formulations and acupuncture have demonstrated improved symptom scores. Similarly, in asthma herbal formulas and acupuncture were highly clinically effective. TCM has demonstrated high safety and efficacy in both preclinical and clinical models of various allergic diseases, including eczema, food allergy, eosinophilic esophagitis, allergic rhinitis, and asthma. Therefore, this scientific evidence suggests that naturally occurring small molecule compounds are promising preventives and therapeutics for pediatric allergic diseases.

Disclosure: All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and national/institutional guidelines).

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儿童过敏性疾病的中医。
综述的目的:对儿童过敏性疾病的长期安全有效的预防和治疗方案有重要的临床需求,但尚未得到满足。本文回顾了中医药在儿童过敏性疾病中的应用,包括湿疹、荨麻疹、嗜酸性粒细胞性食管炎(EoE)、食物过敏(FA)、哮喘和过敏性鼻炎。最新发现:通过对儿童过敏患者的病例研究、系列或临床试验的评估,或涉及儿童过敏患者和体内模型系统样本的体外研究,通过循证科学结果阐明了天然存在的小分子化合物的作用机制。值得注意的临床结果包括严重程度评分的降低,各种过敏性疾病的减少,无毒性,无严重不良反应,耐受性良好。与此相关的免疫学结果包括从th2介导的过敏反应转变为Th1/Treg反应,其特征是总IgE和特异性IgE、总嗜酸性粒细胞计数、外毒素、TNF-a、IL-6、IL-8、IL-5和IL-4水平降低,IFN-γ和IL-10水平升高。对于湿疹,多种和单一草药配方都是常见的治疗方式,包括内部管理和外部草药浴和药膏,从而提供实质性的有益结果。据报道,对于EoE,内服配方和使用针灸可以减轻过敏反应。在FA方面,已在临床试验中对配方进行了研究,显示出一致的安全性,保护作用有待建立。更先进的单一草药化合物的开发可能为FA治疗提供优势。对于变应性鼻炎,几种多种草药配方和针灸已证明改善症状评分。同样,在哮喘中,中药方剂和针灸在临床上也非常有效。中药在临床前和临床模型中均显示出较高的安全性和有效性,包括湿疹、食物过敏、嗜酸性食管炎、变应性鼻炎和哮喘等各种变应性疾病。因此,这一科学证据表明,天然存在的小分子化合物是儿科过敏性疾病的有希望的预防和治疗药物。披露:所有报告的作者进行的人类或动物研究/实验均已发表,并符合所有适用的伦理标准(包括赫尔辛基宣言及其修正案、机构/国家研究委员会标准和国家/机构指南)。
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来源期刊
CiteScore
11.20
自引率
1.80%
发文量
21
审稿时长
6-12 weeks
期刊介绍: The aim of Current Allergy and Asthma Reports is to systematically provide the views of highly selected experts on current advances in the fields of allergy and asthma and highlight the most important papers recently published. All reviews are intended to facilitate the understanding of new advances in science for better diagnosis, treatment, and prevention of allergy and asthma. We accomplish this aim by appointing international experts in major subject areas across the discipline to review select topics emphasizing recent developments and highlighting important new papers and emerging concepts. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. Over a one- to two-year period, readers are updated on all the major advances in allergy and asthma.
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