Treatment of allergic rhinitis with acupoint herbal plaster: an oligonucleotide chip analysis

Abstract

BackgroundAllergic rhinitis is regarded as an imbalanced Th1/Th2 cell-mediated response. The present study used microarray analysis to compare gene expression levels between allergic rhinitis patients before and after a series of acupoint herbal plaster applications.MethodsIn this experimental pilot study, volunteers experiencing sneezing, runny nose, and congestion for more than 9 months in the year following initial diagnoses were included after diagnostic confirmation by otolaryngologists to exclude patients with sinusitis and nasal polyps. Patients with persistent allergic rhinitis each received four acupoint herbal plaster treatments applied using the moxibustion technique. Clinical outcomes were evaluated using the Rhinitis Quality of Life Questionnaire (RQLQ). Peripheral blood samples were analyzed using an ImmunoCAP Phadiatop test, and patients were classified as phadiatop (Ph)-positive or -negative. Microarray results were analyzed for genes that were differentially expressed between (1) Ph-positive and -negative patients treated with herbal plaster; and (2) before and after herbal plaster treatment in the Ph-positive patient group. Unsupervised and supervised methods were used for gene-expression data analysis.ResultsNineteen Ph-positive and four Ph-negative participants with persistent allergic rhinitis were included in the study. RQLQ results indicated that the 19 Ph-positive volunteers experienced improvement in six of seven categories following acupoint herbal plaster treatments, whereas the four Ph-negative participants reported improvement in only two categories. Hierarchical clustering and principle component analysis of the gene expression profiles of Ph-positive and –negative participants indicated the groups exhibited distinct physiological responses to acupoint herbal treatment. Evaluation of gene networks using MetaCore identified that the “Immune response_IL-13 signaling via JAK-STAT” and the “Inflammation_Interferon signaling” were down- and up-regulated, respectively, among Ph-positive subjects.ConclusionsIn this preliminary study, we find that the IL-13 immune response via JAK-STAT signaling and interferon inflammation signaling were down- and upregulated, respectively, in the Ph-positive group. Further studies are required to verify these pathways in Ph-positive patients, and to determine the mechanism of such pathway dysregulation.Trial registrationClinicalTrials.gov: NCT02486159. Registered 30 Jun 2015.

The immediate effect of facial candling on inflammatory mediators, substance P, symptoms severity, and quality of life in allergic rhinitis patients

“…Furthermore, IL-13 immune response was downregulated in that particular group of patients. [ 22 ] Similarly, another study demonstrated the effectiveness of subcutaneous injectable immunotherapy in treating the sinus inflammation and pain in 281 allergic rhinitis patients. The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the QoL of patients.…”

“…In other Asian countries such as China and Japan, facial candling is practised in the form of moxibustion where burning cigar-shaped dried mugwort stick is used to warm regions and meridian points. [ 22 ] Facial candling treatments are believed to give various impacts to the patients, including reducing stress as it promotes relaxation, and reduces headache, ear, or throat infection. [ 23 ] Furthermore, the facial candling technique is said to improve the blood circulation throughout the whole body and reduce symptoms of allergic rhinitis.…”

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“…Investigating the action mechanisms of the plants used at acupoints indicated that acupoint herbal plaster improved allergic inflammation via maintaining an appropriate balance between Th1 and Th2 cells and therefore inhibited the secretion of cytokines GM-CSF, IL-3, IFN-γ, and IL-2 by Th1 cells and that of IL-3, GM-CSF, IL-13, IL-10, IL-5, and IL-4 by Th2 cells 57,58 . These cytokines contribute to activation of JAK-STAT (regulator of activity of histamine mediators).…”

“…For example, IL-13, which is one of the lymphocytes of Th2 and produces ILC2, plays a key role in exacerbating inflammatory response such that humanized monoclonal antibody against the fixed part of IL-13 was found to be greatly effective in improving allergy. A study demonstrated that plant-based compounds induced anti-inflammatory and antiallergy effects through down regulating IL-13 via JAK-STAT pathway 57 . Actually medicinal plants through several mechanisms can prevent the allergic rhinitis (Fig.…”

Efficacy of acupuncture at three nasal acupoints plus acupoint application for perennial allergic rhinitis: A multicenter, randomized controlled trial protocol

“…In TCM, disease is understood to originate from an imbalance or poor flow of qi. Acupuncture has long been used in TCM to treat AR, and studies of this treatment have shown mixed results, with the most rigorous studies showing only modest clinical benefits [21][22][23][24]. The 2015 revision of the American Academy of Otolaryngology-Head and Neck Surgery clinical practice guidelines for AR cites a low level of confidence in the evidence to support acupuncture as a treatment option.…”