practitioner experience of herb quality in respiratory phytotherapy - serene foster

8/14/2019 Practitioner Experience of Herb Quality in Respiratory Phytotherapy - Serene Foster

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Practitioner Experience of Herb

Quality in Phytotherapy for theRespiratory System

Serene Foster

Hydes Herbal Clinic


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y

Nasal Passages filter antigens

Mucus prevents access toUnderlying Respiratory epithelium

Cough and Gag reflex to displaceForeign particles

Ciliary movement


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Microbicidal mediators of the immune response to infection

Permeabilises microbial cellwallsTriggers Alternative C

pathway

Bacteria,mycobacterium, fungiviruses

Phagocytes, lymphocytesepithelial cells

Defensins

Direct oxidative damageApoptosis of virally infectedcells

Fungi bacteria virusesphagocytesROS / NO

Limits viral replicationactivates macrophage, NKcells, T and B cells

VirusesMacrophageEpithelial cells

Type I interferons

Opsonisation agglutination,neutralisation clear apoptotic cells

Carbohydrate pathogenassociated molecular patterns

Alveolar Type II cellsSurfactant

Degradation of cell wallGram positive bacteriaNeutrophilMacrophage

Epithelial cells

Lysozyme

Sequesters iron essentialfor microbes

BacteriaNeutrophilMacrophageEpithelial cells

Lactoferrin

Method of protectionTargetSourceAntimicrobialAgent


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Respiratory ConditionsColds and Flu

Sinusitis

Hayfever

Asthma

Bronchitis

Bronchiecstasis

COPD

Farmers lung

Pneumonia

Cystic Fibrosis

Tumours

Asthma is significant global burdenWorldwide estimates 300MIn US 20M have reported asthma symptoms each year and 5000 dieMajor underlying cause of death

Moore and Peters: 2006, Current Reviews in Allergy and Clinical Immunology; 117: 487 COPD Fourth most common cause of death and morbidity in the world

Polkey and Moxham: 2006; Clinical Medicine: 6; 190

Influenza seasonally affects 20% of the worlds populationSnelgrove et al; 2004: Expert Review Anti Infection and Therapy 2; 89


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Pathophysiological effects of Asthma

Cellular events cause great damage

IgE mediated mast cell activation

Immediate release of histamine and protaglandins

Increase vascular permeability and smooth muscle contraction

Immediate


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Late phase

Leukotriene chemokines cytokines from activated mast cells

Recruitment of eosinophils Nk cells Th2 cells Neutrophils

Smooth muscle contraction and sustained oedema


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WheezingShortness of breathTight chestcough

Cellular events: Leukotrienes, Th2, eosinophils, basophils,Hyperresponsive airways and mucus production

Oedema and swelling of the airway wallArchitectural remodelling of the airwayChronic airflow obstruction



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Pathophysiological effects of COPD


Chronic bronchitis, obstructive bronchiolitis and emphysema (COPD)

Small airway obstruction, fibrosis, loss of elastic recoil

Increase mucusInflammation of smooth muscleCellular infiltration : CD8, Macrophage, NeutrophilInflammation and damage : IL-8,Alteration in size, mass, and structure of lung

Destruction of the alveolar parenchyma


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Balance between pathogen clearance and tissue damage

Immune defenceBasophilsEosinophilsNeutrophilsMacrophagesEpithelial cells

Cell lysis CD8, NK, C, apoptosisAirway remodellingObstructive breathing


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BaptisiaPhytolaccaEchinaceaImmune boosting

CalendulaEchinaceaEphedraAnti allergic

GrindeliaUrtica AltheaAnti tussive

SambucusPlantagoEuphrasiaAnticatarrhal

Glycyrrhiza AltheaDemulcent

MarrubiumGlycyrrhizaEphedraSpasmolytic

PopulusFilipendulaMatricariaAntiinflammatory

GrindeliaSambucusGlycyrrhizaMucolytic

AlliumBaptisiaEchinaceaAnti infective

BaptisiaEchinaceaGlycyrrhizaAnti viral

Plantago,


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New research to aid our choice of

herbs in respiratory medicineEchinacea Blocks signalling in T cellsDong et al, 2006: J Med Chem 49; 1845-1854

Sambucus Inhibits proinflammatory cytokines byperidontal pathogensHarokopakis et al; 2005: J Periodontal 77; 271-279

Glycyrrhiza inhibition of Nitric oxide and TNF inactivated macrophagesPark et al; 2005: Am J Chin Med 33; 415-424


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Cynarin inhibits CD28

Macrophage CD4 T cell

B7 CD28

HLA TCR

Cynarin


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New research to aid our choice of

herbs in respiratory medicineEchinacea Blocks CD28 signalling in T cellsDong et al, 2006: J Med Chem 49; 1845-1854

Sambucus Inhibits proinflammatory cytokines byperidontal pathogensHarokopakis et al; 2005: J Periodontal 77; 271-279

Glycyrrhiza inhibition of Nitric oxide and TNF inactivated macrophagesPark et al; 2005: Am J Chin Med 33; 415-424


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COPD Case study male 69 years

Heart attack in 1993 ischemic heart disease

COPD developed 2-3 years ago

Perenial rhinitis

Left knee replacement in Feb 2006

Worked in building industry asbsestos and cement

Keeps pigeons

Used to enjoy going to the gym finding this difficult now

Has a healthy diet, eats lots of vegetables

Recurrent cold since Jan 2006 been on antibiotics since


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Phytotherapy

Baptisia 1:5 30Marrubium 1:5 30Urtica 1:5 30Gingko 1:5 10

100ml per week

4 weeks treatment given

Other advice given always wear a mask around pigeons and wear a long sleeved shirt to be changed each time after work with pigeons


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Follow-ups

In one monthBP 150/80No colds since last visitLess catarrh although coughing in the morningDid not look as greyDidnt struggle to get into the clinicLung Dull sound bronchially, looser in the apices,

some base congestionFEV 490, 470, 490

Phytotherapy

Same given


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3 rd month

BP - 145/80

Lung Dull sound bronchially on the right sideSome base congestionFEV 510, 490, 490Managing to exercise on bike in gymSome tirednessNo further colds, nasal discharge

Phytotherapy

Eleutherococcus1:5 30Marrubium 1:5 20Euphrasia 1:5 20Urtica 1:5 30

Infection mixBaptisia 1:5 25Thymus 1:5 30Glycyrrhiza FE 5Sambucus 1:5 25Echinacea 1:5 15


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Asthma Case Study male 59 years

First asthma at 45 years

Nasal polyp removed 1996

No smell, poor taste

Has reduced dairy products recently

Always tired works too hard runs own business

Exercises at the gym

Wants to stop or reduce asthma drugs

Drug history

Flixotide 50Serevent 50

Supplements

Vitamin CFish Oils

Lamberts Multivitamin


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Clinical Findings

Nasal polyps right sideBP 134/84 p72 reg recent heart check ECG andechocardiogram clear Apical and bronchial wheeze both sidesFEV 620, 590, 600Recently been on prednisolone and antibioticsSuffers recurrent chest infections and coldsAlways coughs up green viscous phlegm

PhytotherapyEphedra 1:5 30Echinacea 1:5 20Tussilago 1:5 25

Euphrasia 1:5 30


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Follow ups1 month

Breathing improvedFelt less tiredNot coughing as much although still in the morningPhlegm still green although looser

No coldsThroat inflammedSubmandibular glands raisedLungs wheeze less in the bases, apical minor,

bronchial wheeze PhytotherapyPhytolacca 1:8 5Echinacea 1:5 20Ephedra 1:5 30Thymus 1:5 15

Plantago 1:5 20


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Follow ups

Echinacea 1:5 20Ephedra 1:5 30Grindelia 1:5 25Thymus 1:5 20

Phytolacca 1:8 5

Phytotherapy

Did have cold although did not last as long (about 7-10

days)

no need for additional steroids or antibiotics

Lung apical wheeze, bronchus clear base clear

Phlegm very light and wateryReduced Flixotide to once a day, salbutamol only when

required


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Farmers Lung - extrinsic allergic alveolitisFarmer all life

Pain in throat and chest (Left side) last 12

months

Coughing mucus up

Whitish like tacky chewing gumEyes runny

Recent heart palpitations

Other Case Studies


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BP 135/78, heart sounds NAD

Lungs consolidation in left side low and baseWhistling on exhaleUsing - Becotide 4AM/PM and Ventolin as required

PhytotherapyBaptisia, 1:5 25Echinacea, 1:5 25Grindelia, 1:5 20Filipendula 1:5 30

Findings

Follow-up Less pain in lungs, less coughing, more activeAt 6 weeks Lung some changed left side, base some

crackles


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Summary

Respiratory problems a significant globalburden

Define specific problems

Boost immunity without exacerbating the

inflammatory problems

Heal and improve lung functionHelp patients to reduce or stop off orthodox

treatment

practitioner experience of herb quality in respiratory phytotherapy - serene foster

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