Complementary therapeutic approaches in asthma

Abstract

Asthma is defined by The Initiative for Asthma (GINA 2018) as a heterogeneous disease, which include chronic airway inflammation and a history of respiratory symptoms. In the last decades asthma had a rise in prevalence, becoming one of the most frequent diagnosed diseases in the world. The main goals of asthma management are to achieve good symptom control, minimize the risks of exacerbations, decrease rescue medication intake, improve the quality of life by decreasing respiratory system inflammation and ameliorating the patient’s lung function. Beside effective medications, asthma continues to impair quality of life for most patients. Due to the difficulty of controlling symptoms and exacerbations, the need of developing complementary options of treatment is increasing in order to achieve an optimum control and a lower risk of acute episodes or fatal events. Pulmonary rehabilitation is suggested for asthma patients when adequate medical therapy poorly control the symptoms and mental, physical or social consequences of illness persist during the daily life. The following non-drug therapy components are included in the rehabilitation program: physical training, comprehensive smoking cessation program, comprehensive patient education, respiratory physiotherapy, psychosocial support and comprehensive nutritional counseling. These complementary therapies have been proven to improve muscle strength, exercise capacity and symptomatology. Also, it has been associated to fewer exacerbations and a lower use of rescue medication, leading to a better quality of life. Key words: asthma, quality of life, symptomatology, rehabilitation, physiotherapy,

Oxygen Toxicity to the Immature Lung—Part II: The Unmet Clinical Need for Causal Therapy

“…Most of the studies dealing with ROS toxicity relied on associations; however, as in the Canadian oxygen trial, no causal link can be provided [ 40 ]. Due to the lack of data on preterm infants, we cannot provide data on complementary approaches that are available, e.g., for asthma patients [ 104 ]. Lastly, for most ROS therapies, no dose-escalation studies are available that might have concealed their efficacy.…”

The efficacy of pulmonary rehabilitation in improving the clinical status in idiopathic pulmonary fibrosis

“…Asthma is a heterogeneous condition that is associated with IPF, influencing the prognosis of these patients and remaining poorly controlled despite optimum management. The additional interventions in asthma and IPF management, such as physical training, smoking cessation, environmental control practices, inspiratory muscle training, breathing techniques, speleotherapy and halotherapy have been proven to improve muscle strength, symptomatology, exercise capacity and quality of life (15,51).…”

Composition and modification of the lung microbiome in patients with idiopathic pulmonary fibrosis

“…Modification of the intestinal microbiome favors respiratory infections [40], with all the implications described above, practically proving that in patients with IPF, they are very difficult to control. In this context, an ideal therapeutic agent should combine the antimicrobial, antiviral, and antifibrotic effects [41,42], although it remains to be discussed whether alternative therapies would have antiviral, antimicrobial, anti-inflammatory and antifibrotic effects [43,44] Herbal remedies such as Black Elder (Sambucus nigra L.) have been identified so far which associates antiviral (herpes simplex virus type 1, influenza virus) and antimicrobial (Streptococcus pneumoniae, Haemophilus influenza, Streptococcus pyogenes, group C and G Streptococci, Branhamella caterrhalis, and Haemophilus influenza) [45] effects, with demonstrated myocardial antifibrotic effects [46] and renal tissue [47].…”