What do YOU use for atopy in humans / animals?

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Hi All,

 

What is YOUR preferred treatment for atopy in humans / animals?

 

What percentage of your atopic patients benefit well or markedly?

 

Do you prefer TOPICAL or ORAL medication (herbs / WM) if you medicate?

 

A quick (definitely incomplete) search of recent Medline titles on herbs and

atopy gave 9 hits.

 

The conclusions varied 6:2:1 for SIGNIFICANT POSITIVE effects (benefit;

Refs 1-6), NEUTRAL effects (evidence neither for nor against; Refs 7 & 8)

and NO SIGNIFICANT EFFECTS (no benefit over placebo; Ref 9). Much

more research is needed in the area.

 

1. Hon KL, Leung TF, Wong Y, Lam WK, Guan DQ, Ma KC, Sung YT, Fok

TF, Leung PC. | A PentaHerbs capsule as a treatment option for atopic

dermatitis in children: an open-labeled case series. | Am J Chin Med.

2004;32(6):941-50. | Dept of Paediatrics, The Chinese University of Hong

Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.

ehon | TCM has been used in patients with atopic dermatitis

(AD), but its therapeutic effects are debatable. We evaluated the clinical

and biochemical effects of a TCM capsule (PentaHerbs capsule) in children

with AD. After a run-in period of 4 weeks, children old enough to manage

oral medication were admitted and their disease severity was evaluated by

the SCORing Atopic Dermatitis (SCORAD) index. Blood was obtained for

complete blood count, total and allergen-specific immunoglobulin E (IgE),

biochemical studies and inflammatory markers of AD severity [serum

cutaneous T cell-attracting chemokine (CTACK), macrophage-derived

chemokine (MDC), thymus and activation-regulated chemokine (TARC) and

eosinophil cationic protein (ECP)] prior to, and after 3 months of, TCM use.

Three PentaHerbs capsules twice a day were prescribed for 4 months.

Patients were followed monthly to ensure compliance, and SCORAD scores

were obtained at each visit. Five boys and four girls participated in the

study. All patients had detectable food or inhalant-specific IgE in serum.

There was significant improvement in the overall and component SCORAD

scores. There were no significant differences between the pre- and post-

treatment values of the serum CTACK, MDC, TARC and ECP levels but

CTACK showed a decreasing trend (p = 0.069). No clinical or biochemical

evidence of any adverse drug reaction was observed during the study

period. | PentaHerbs capsules were well tolerated by the children and

apparent beneficial effects were noted clinically. A larger, randomized

placebo-controlled study is required to confirm the efficacy of this

formulation for AD. | PMID: 15673199 [PubMed - indexed for MEDLINE]

 

2. Kobayashi H, Mizuno N, Teramae H, Kutsuna H, Ueoku S, Onoyama J,

Yamanaka K, Fujita N, Ishii M. | The effects of Hochu-ekki-to in patients

with atopic dermatitis resistant to conventional treatment. | Int J Tissue

React. 2004;26(3-4):113-7. | Dept of Dermatology, Osaka City University

Graduate School of Medicine, Osaka, Japan. hiromik

| Hochu-ekki-to is one of Kampo formulas containing Astragalus root,

liquorice, jujube, ginseng, white Atractylodes rhizome, fresh ginger and

Chinese angelica root. This formula has been identified as an effective drug

to improve the function of digestive systems and to strengthen defensive

systems against many kinds of infections. We examined serum IgE levels

and eosinophils before and after the administration of Hochu-ekki-to in

patients with recalcitrant atopic dermatitis. | The increased numbers of

eosinophils was statistically decreased after 3 months' use of this formula.

Serum IgE levels showed a tendency to decrease after the administration of

this substance. | PMID: 15648444 [PubMed - indexed for MEDLINE]

 

3. Lee J, Jung E, Park B, Jung K, Park J, Kim K, Kim KH, Park D. |

Evaluation of the anti-inflammatory and atopic dermatitis-mitigating effects

of BSASM, a multicompound preparation. | J Ethnopharmacol. 2005 Jan

4;96(1-2):211-9. | Biospectrum Life Science Institute, Doosan Bldg., 39-3

Sungbok-dong, Yongin-city, 449-840 Kyunggi-do, Republic of Korea. | For

effective management of atopic dermatitis (AD), it is important to introduce

a therapeutic agent, which although having the fewest side effects, has the

greatest anti-inflammatory effect. In the course of screening anti-

inflammatory agents, we obtained BSASM, a mixture of several plant

extracts. This study was designed to investigate the AD-mitigating effect of

BSASM in patients, as well as its anti-inflammatory and immunomodulatory

effects in an in vitro experiment. The anti-inflammatory effects of BSASM

were evaluated by the level of production of proinflammatory cytokines.

Clinical evaluation was also done using eczema area severity index (EASI)

score in AD patients. BSASM inhibited LPS-induced activation of NF-

kappaB promoter. In addition, LPS-induced an increase of IL-8, and the

TNF-alpha production in THP-1 cells was also inhibited. These results

suggest that BSASM has an anti-inflammatory activity. A clinical study in

patients with AD showed that BSASM induced a reduction of EASI score,

degree of pruritus, and TEWL on both the antecubital fossa and abdomen.

Besides, BSASM had no irritative or allergic effects. | BSASM has anti-

inflammatory and AD-mitigating effects. | PMID: 15588673 [PubMed -

indexed for MEDLINE]

 

4. Na HJ, Moon PD, Hong SH, Shin JY, Kim HM. | Inhibitory effect of

Yunbutang on mast cell-dependent allergic reactions. | Immunopharmacol

Immunotoxicol. 2004 May;26(2):233-42. | Dept of Pharmacology, College of

Oriental Medicine, Kyung Hee University, Seoul, South Korea. | Yunbu Tang

(YB) is an Oriental herbal prescription, which has been successfully applied

for the treatment of allergic disorders, mainly atopic dermatitis in clinical

medicine. However, its effect in experimental models remains unknown.

Here, we report inhibitory effects of YB on mast cell-dependent immediate-

type allergic reactions. YB inhibited systemic allergic reaction induced by

compound 48/80. YB dose-dependently inhibited the histamine release from

the mast cells activated by compound 48/80. YB also showed an inhibitory

effect of anti-dinitrophenyl IgE antibody-induced passive cutaneous

anaphylaxis reaction by oral administration. Furthermore, YB inhibited tumor

necrosis factor-alpha secretion from stimulated mast cells. | Yunbu Tang

inhibits the mast cell-dependent allergic reactions. | PMID: 15209359

[PubMed - indexed for MEDLINE]

 

5. Ramsay HM, Goddard W, Gill S, Moss C. | Herbal creams used for atopic

eczema in Birmingham, UK illegally contain potent corticosteroids. | Arch

Dis Child. 2003 Dec;88(12):1056-7. Comment in: Arch Dis Child. 2003

Dec;88(12):1032-3. | Dept of Dermatology, Birmingham Children's Hospital,

Steelhouse Lane, Birmingham B4 6NH, UK. Helen.Ramsay |

AIMS: To determine whether " herbal creams " reported as being effective for

the treatment of childhood atopic eczema contained corticosteroids.

METHODS: Patients attending the paediatric dermatology clinic at

Birmingham Children's Hospital, April 2001 to March 2002, and who

reported using " herbal creams " with good effect for atopic eczema were

asked to submit the cream for analysis. Hydrocortisone, clobetasone

butyrate, betamethasone valerate, and clobetasol propionate were analysed

by HPLC. RESULTS: Twenty four creams from 19 patients, median

(interquartile range) age 3.82 (0.69-7.98) years were analysed. All five

creams labelled Wau Wa and the two labelled Muijiza cream contained

clobetasol propionate. Thirteen of 17 unnamed creams contained

corticosteroids: clobetasol proprionate (n = 4), clobetasol proprionate +

hydrocortisone (n = 1), betamethasone valerate (n = 2), clobetasone

butyrate (n = 3), and hydrocortisone (n = 2); there was an unidentified peak

in one. Further analysis suggested Wau Wa cream contained approximately

20% proprietary Dermovate Cream in a paraffin base. No parents were

aware that the creams contained steroid. | Most analysed herbal creams

illegally contained potent or very potent topical steroids. There is an urgent

need for tighter regulation of herbal creams and for increased public

education about the potential dangers of alternative therapies. 768 | PMID:

14670 [PubMed - indexed for MEDLINE]

 

6. Saeedi M, Morteza-Semnani K, Ghoreishi MR. | The treatment of atopic

dermatitis with licorice gel. | J Dermatolog Treat. 2003 Sep;14(3):153-7. |

Dept of Pharmaceutics, Mazandaran University of Medical Sciences, Sari,

Iran. saeedi_m_2001 | Glycyrrhiza glabra L. has been used

in herbal medicine for skin eruptions, including dermatitis, eczema, pruritus

and cysts. The effect of licorice extract as topical preparation was evaluated

on atopic dermatitis. The plant was collected and extracted by percolation

with suitable solvent. The extract was standardized, based on Glycyrrhizinic

acid by using a titrimetry method. Different topical gels were formulated by

using different co-solvents. After standardizing of topical preparations, the

best formulations (1% and 2%) were studied in a double-blind clinical trial in

comparison with base gel on atopic dermatitis over two weeks (30 patients

in each group). Propylene glycol was the best co-solvent for the extract and

Carbopol 940 as gelling agent showed the best results in final formulations.

The quantity of glycyrrhizinic acid was determined 20.3% in the extract and

19.6% in the topical preparation. | Two percent licorice topical gel was more

effective than 1% in reducing the scores for erythema, oedema and itching

over two weeks (p<0.05). The results showed that licorice extract could be

considered as an effective agent for treatment of atopic dermatitis. | PMID:

14522625 [PubMed - indexed for MEDLINE]

 

7. Olivry T, Mueller RS; International Task Force on Canine Atopic

Dermatitis. | Evidence-based veterinary dermatology: a systematic review of

the pharmacotherapy of canine atopic dermatitis. | Vet Dermatol. 2003

Jun;14(3):121-46. Comment in: Vet Dermatol. 2003 Jun;14(3):119-20. |

Dept of Clinical Sciences, North Carolina State University, College of

Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA.

Thierry_Olivry | The efficacy of pharmacological interventions

used to treat canine atopic dermatitis, excluding fatty acid supplementation

and allergen-specific immunotherapy, was evaluated based on the

systematic review of prospective clinical trials published between 1980 and

2002. Studies were compared with regard to design characteristics

(randomization generation and concealment, masking, intention-to-treat

analyses and quality of enrolment of study subjects), benefit (improvement

in skin lesions or pruritus scores) and harm (type, severity and frequency of

adverse drug events) of the various interventions. Meta-analysis of pooled

results was not possible because of heterogeneity of the drugs evaluated.

Forty trials enrolling 1607 dogs were identified. | There is good evidence for

recommending the use of oral glucocorticoids and cyclosporin for the

treatment of canine atopic dermatitis, and fair evidence for using topical

triamcinolone spray, topical tacrolimus lotion, oral pentoxifylline or oral

misoprostol. Insufficient evidence is available for or against recommending

the prescription of oral first- and second-generation type-1 histamine

receptor antagonists, tricyclic antidepressants, cyproheptadine, aspirin,

TCM herbal therapy, an homeopathic complex remedy, ascorbic acid, AHR-

13268, papaverine, immune-modulating antibiotics or tranilast and topical

pramoxine or capsaicin. Finally, there is fair evidence against

recommending the use of oral arofylline, leukotriene synthesis inhibitors and

cysteinyl leukotriene receptor antagonists. | PMID: 12791047 [PubMed -

indexed for MEDLINE]

 

8. Zhang W, Leonard T, Bath-Hextall F, Chambers CA, Lee C, Humphreys

R, Williams HC. | Chinese herbal medicine for atopic eczema. | Cochrane

Database Syst Rev. 2005 Apr 18;(2):CD002291. Update of: Cochrane

Database Syst Rev. 2004;(4):CD002291. | Academic Rheumatology,

University of Nottingham, Clinical Sciences Building, City Hospital,

Nottingham, England, UK, NG5 1PB. Weiya.Zhang |

BACKGROUND: TCHMs have been used to treat atopic eczema for many

years. Their efficacy has attracted public attention and recently some clinical

trials have been undertaken. OBJECTIVES: To assess the effects of

Chinese herbal mixtures in the treatment of atopic eczema. SEARCH

STRATEGY: We searched the Cochrane Central Register of Controlled

Trials (CENTRAL) ( January 2004), the Cochrane Skin Group Specialised

Register (January 2004), MEDLINE (1966 to January 2004), EMBASE

(1980 to January 2004), CINHL (1980 to January 2004) and a number of

complementary medicine databases. In addition, the cited references of all

trials identified and key review articles were searched. Pharmaceutical

companies involved in oral TCM herbs and experts in the field were

contacted. SELECTION CRITERIA: Randomised controlled trials of

Chinese herbal mixtures used in the treatment of atopic eczema. DATA

COLLECTION AND ANALYSIS: Two reviewers independently applied

eligibility criteria, assessed the quality of the trials and extracted data. Any

discrepancies were discussed to achieve consensus. MAIN RESULTS:

Four randomised controlled trials, with eight weeks for each phase, met the

inclusion criteria. The trials randomised 159 participants aged from 1 to 60

years. The withdrawal rates ranged from 7.5% to 22.5% and no trial used

intention to treat analysis. Three trials were randomised placebo controlled,

two-phase cross-over designs assessing the same Chinese herbal mixture,

Zemaphyte. In two of these three trials the reduction in erythema and

surface damage was greater on Zemaphyte than on placebo, and

participants slept better and expressed a preference for Zemaphyte. One

trial also reported that participants itched less. The fourth trial was an open-

label design comparing Zemaphyte in herbal form with Zemaphyte as a

freeze dried preparation. There was a reduction in erythema and surface

damage with both formulations, but no comparison between the two

formulations was reported. Some adverse effects were reported in all four

trials, but none were regarded as serious. AUTHORS' CONCLUSIONS: |

TCHMs may be effective in the treatment of atopic eczema. However, only

four small poorly reported RCTs of the same product, Zemaphyte, were

found and the results were heterogeneous. Further well-designed, larger

scale trials are required, but Zemaphyte is no longer being manufactured. |

PMID: 15846635 [PubMed - indexed for MEDLINE]

 

9. Kobayashi H, Mizuno N, Teramae H, Kutsuna H, Ueoku S, Onoyama J,

Yamanaka K, Fujita N, Ishii M. | Diet and Japanese herbal medicine for

recalcitrant atopic dermatitis: efficacy and safety. | Drugs Exp Clin Res.

2004;30(5-6):197-202. | Dept of Dermatology, Osaka City University

Graduate School of Medicine, Osaka, Japan. hiromik

| We have been utilizing Kampo, a Japanese herbal medicine, together with

lifestyle advice, for recalcitrant atopic dermatitis. To estimate the safety and

efficacy of the treatment, we administered Kampo formulas to patients in

whom conventional treatment failed to improve symptoms, along with

dietary advice recommending traditional Japanese food. The therapeutic

effects of Kampo formulas were assessed in 95 patients with recalcitrant

atopic dermatitis who consulted our clinic from January to June, 2000. The

overall result was 'markedly effective " in 19 patients (20%), " moderately

effective " in 33 (35%), " slightly effective " in 36 (38%) and " ineffective " in

four

(4%). Three patients dropped out of the study. No adverse reactions in

laboratory data were noted in examined patients. The most commonly used

formula was Hochu-ekki-to containing Astragalus root, liquorice, jujube,

ginseng, white Atractylodes rhizome, fresh ginger and Chinese Angelica

root. Diet and Japanese herbal medicine are thought to be useful as an

alternative therapy of intractable atopic dermatitis. PMID: 15700746

[PubMed - indexed for MEDLINE] J Am Acad Dermatol. 2005

Apr;52(4):691-3. Links Treatment of atopic dermatitis with herbal

combination of Eleutherococcus, Achillea millefolium, and Lamium album

has no advantage over placebo: a double blind, placebo-controlled,

randomized trial.Shapira MY, Raphaelovich Y, Gilad L, Or R, Dumb AJ,

Ingber A. Dept of Bone Marrow Transplantation, Hadassah University

Hospital, Jerusalem, Israel. shapiram OBJECTIVE: To

test the efficacy of tri-herbal combination on atopic dermatitis in a

randomized, placebo-controlled trial. METHODS: Forty-nine patients were

included for 2 weeks of treatment. Patients were followed until week 8.

RESULTS: The response to the real medication was significant in objective

and subjective parameters. Patients maintained partial remission until the

end of follow-up. The placebo-treated group had a similar response without

a significant difference. | Treatment with tri-herbal combination for atopic

dermatitis does not differ from treatment with placebo. | PMID: 15793525

[PubMed - indexed for MEDLINE]

 

Best regards,