Effect of Giving Polyphytopharmaca on Improvement in The Degree of Asthma Control through Reduction of Eosinophils and Interleukin-13 Uncontrolled Asthma Patients

Aditya Sri Listyoko, Iin Noor Chozin, Susanthy Djajalaksana

Abstract


Background: Bronchial asthma is a heterogeneous disease characterized with chronic airway inflammation.The level of asthma control is an indicator of asthma management outcomes. It is influenced by a complex immunological mechanism, included the role of IL-13 as a key biomarker of inflammation. We investigate the effect of Poly-Phytopharm (Kleinhovia hospita 100 mg, Curcuma xanthorriza 75 mg, Nigella sativa 100 mg and Ophiocephalus striatus 100 mg ) on the level of asthma control tests (ACT) score, blood eosinophils, and serum IL-13 on not fully controlled asthma stable patients.
Methods: This study used quasi-experimental pre-and post-test methods, in 15 stable asthma patients who were not fully controlled at the pulmonary outpatient clinic of Dr. Saiful Anwar General Hospital Malang. Assessment of ACT score, blood eosinophils, and serum IL-13 are carried out before and after supplementation of Poly-Phytopharm three times a day, two capsules respectively for 12 weeks. The ACT was scored by the investigator by direct questioning of patients, the blood eosinophil was measured with blood analysis, and the IL-13 in serum was detected with qPCR method.
Results: There is significant increase of ACT score (18.07±2.57 to 22.06±1.83, p=0.001). In subject with baseline eosinophils ≥ 300 pg/mL (n=9), there were significant reduction in blood eosinophils (653.15±276.77 /µL to 460.66±202.04 /µL, p=0.038), and a decrease of serum IL-13 (17.69±9.901 pg/ml to 16.17±12.438 pg/ml, p=0.609).
Conclusion: The administration of Poly-Phytopharm for 12 weeks improves ACT level, decreases blood eosinophils, and decrease serum IL-13 on not fully controlled asthma stable patients.

Keywords


Poly-Phytopharm; Asthma Control Test; Eosinophil; IL-13

References


Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. 2018; pp. 14-18

Nunes C, Pereira AM, Morais-Almeida M. Asthma costs and social impact. Asthma research and practice. 2017 Dec;3(1):1.

Amin M, Djajalaksana S, Wiyono WH, Yunus F, Suradi, Sutoyo DK, Tarigan AP, Dmayanti T, Ratnawati, Antariksa D. Asma Pedoman Diagnosis & Penatalaksanaan di Indonesia. 2018; pp 4-9

Badan Penelitian dan Pengembangan Kesehatan Kemenkes RI. 2013. Riset Kesehatan Dasar 2013. pp 85

Schatz M, Mosen D, Apter AJ, Zeiger RS, Vollmer WM, Stibolt TB, Leong A, Johnson MS, Mendoza G, Cook EF. Relationships among quality of life, severity, and control measures in asthma: an evaluation using factor analysis. Journal of Allergy and Clinical Immunology. 2005 May 1;115(5):1049-55.

Rabe KF, Vermeire PA, Soriano JB, Maier WC. Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study. European Respiratory Journal. 2000 Nov 1;16(5):802-7.

Balaha MF, Tanaka H, Yamashita H, Rahman MN, Inagaki N. Oral Nigella sativa oil ameliorates ovalbumin-induced bronchial asthma in mice. International immunopharmacology. 2012 Oct 1;14(2):224-31.

Salem AM, Bamosa AO, Qutub HO, Gupta RK, Badar A, Elnour A, Afzal MN. Effect of Nigella sativa supplementation on lung function and inflammatory mediators in partly controlled asthma: a randomized controlled trial. Annals of Saudi medicine. 2017 Jan;37(1):64-71.

Koshak A, Wei L, Koshak E, Wali S, Alamoudi O, Demerdash A, Qutub M, Pushparaj PN, Heinrich M. Nigella sativa supplementation improves asthma control and biomarkers: A randomized, double‐blind, placebo‐controlled trial. Phytotherapy Research. 2017 Mar;31(3):403-9.

Alzahrani YA, Becker EA. Asthma control assessment tools. Respiratory care. 2016 Jan 1;61(1):106-16.

Revicki D, Weiss KB. Clinical assessment of asthma symptom control: review of current assessment instruments. Journal of Asthma. 2006 Jan 1;43(7):481-7.

Schatz, M., Sorkness, C.A., Li, J.T., Marcus, P., Murray, J.J., Nathan, R.A., Kosinski, M., Pendergraft, T.B. and Jhingran, P., 2006. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. Journal of Allergy and Clinical Immunology, 117(3), pp.549-556.

Jia CE, Zhang HP, Lv Y, Liang R, Jiang YQ, Powell H, Fu JJ, Wang L, Gibson PG, Wang G. The Asthma Control Test and Asthma Control Questionnaire for assessing asthma control: systematic review and meta-analysis. Journal of Allergy and Clinical Immunology. 2013 Mar 1;131(3):695-703.

Chung KF. Personalised medicine in asthma: time for action: Number 1 in the Series “Personalised medicine in respiratory diseases” Edited by Renaud Louis and Nicolas Roche. European Respiratory Review. 2017 Sep 30;26(145):170064..

Eguiluz‐Gracia I, Tay TR, Hew M, Escribese MM, Barber D, O'hehir RE, Torres MJ. Recent developments and highlights in biomarkers in allergic diseases and asthma. Allergy. 2018 Dec;73(12):2290-305.

Corren J. Role of interleukin-13 in asthma. Current allergy and asthma reports. 2013 Oct 1;13(5):415-20.

Doran E, Cai F, Holweg CT, Wong K, Brumm J, Arron JR. Interleukin-13 in asthma and other eosinophilic disorders. Frontiers in medicine. 2017 Sep 19;4:139.

Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, Gibson P, Ohta K, O'byrne P, Pedersen SE, Pizzichini E. Global strategy for asthma management and prevention: GINA executive summary. European Respiratory Journal. 2008 Jan 1;31(1):143-78.

Voorend-van Bergen S, Vaessen-Verberne AA, Landstra AM, Brackel HJ, van den Berg NJ, Caudri D, de Jongste JC, Merkus PJ, Pijnenburg MW. Monitoring childhood asthma: web-based diaries and the asthma control test. Journal of Allergy and Clinical Immunology. 2014 Jun 1;133(6):1599-605.

Thomas M, Kay S, Pike J, Williams A, Rosenzweig JR, Hillyer EV, Price D. The Asthma Control TestTM (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey. Primary Care Respiratory Journal. 2009 Feb 24;18(1):41.

Schatz M, Mosen DM, Kosinski M, Vollmer WM, Magid DJ, O Connor E, Zeiger RS. Validity of the asthma control test™ completed at home. American Journal of Managed Care. 2007 Dec 1;13(12):661.

Ko FW, Hui DS, LEUNG TF, CHU HY, Wong GW, Tung AH, Ngai JC, Ng SS, Lai CK. Evaluation of the asthma control test: a reliable determinant of disease stability and a predictor of future exacerbations. Respirology. 2012 Feb;17(2):370-8.

Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, Murray JJ, Pendergraft TB. Development of the asthma control test: a survey for assessing asthma control. Journal of Allergy and Clinical Immunology. 2004 Jan 1;113(1):59-65.

Kalus U, Pruss A, Bystron J, Jurecka M, Smekalova A, Lichius JJ, Kiesewetter H. Effect of Nigella sativa (black seed) on subjective feeling in patients with allergic diseases. Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 2003 Dec;17(10):1209-14.

Boskabady, M.H., Javan, H., Sajady, M. and Rakhshandeh, H.The possible prophylactic effect of Nigella sativa seed extract in asthmatic patients. Fundamental & clinical pharmacology.2007 Oct;21(5):559-566.

Kardani AK, Fitri LE, Barlianto W, Olivianto E, Kusuma C. The effect of house dust mite immunotherapy, probiotic and Nigella sativa in the number of Th17 cell and asthma control test score. IOSR J Dent Med Sci. 2013;6:37-47.

Abidi A, Gupta S, Agarwal M, Bhalla HL, Saluja M. Evaluation of efficacy of curcumin as an add-on therapy in patients of bronchial asthma. Journal of clinical and diagnostic research: JCDR. 2014 Aug;8(8):HC19.

Jusufovic E, Kosnik M, Jusufovic A, Becarevic M, Al-Ahmad M, Nurkic J, Osmic M, Nadarevic A, Petrak F, Halilovic D, Sejdinovic R. Curcumin as an add-on therapy of moderate partially controlled asthma. Eur Respir J. 2017 Sep 1;50:442.

Edin, J., Mitja, K. and Nermina, A., 2019. Curcumin improves step 4 asthma treatment: placebo-controlled, single blind study. Pulm Resp Med Int J, 2(1), pp.5-9.

Chauhan PS, Dash D, Singh R. Intranasal curcumin inhibits pulmonary fibrosis by modulating matrix metalloproteinase-9 (MMP-9) in ovalbumin-induced chronic asthma. Inflammation. 2017 Feb 1;40(1):248-58.

Walford HH, Doherty TA. Diagnosis and management of eosinophilic asthma: a US perspective. Journal of asthma and allergy. 2014;7:53.

Bartemes KR, Kephart GM, Fox SJ, Kita H. Enhanced innate type 2 immune response in peripheral blood from patients with asthma. Journal of Allergy and Clinical Immunology. 2014 Sep 1;134(3):671-8.

Lambrecht BN, Hammad H. The immunology of asthma. Nature immunology. 2015 Jan;16(1):45.

Bartemes KR, Kephart GM, Fox SJ, Kita H. Enhanced innate type 2 immune response in peripheral blood from patients with asthma. Journal of Allergy and Clinical Immunology. 2014 Sep 1;134(3):671-8.

Saadat S, Mohammadi M, Fallahi M, Aslani MR. The protective effect of α-hederin, the active constituent of Nigella sativa, on tracheal responsiveness and lung inflammation in ovalbumin-sensitized guinea pigs. The Journal of Physiological Sciences. 2015 May 1;65(3):285-92.

Fallahi M, Keyhanmanesh R, Khamaneh AM, Saadatlou MA, Saadat S, Ebrahimi H. Effect of Alpha-Hederin, the active constituent of Nigella sativa, on miRNA-126, IL-13 mRNA levels and inflammation of lungs in ovalbumin-sensitized male rats. Avicenna journal of phytomedicine. 2016 Jan;6(1):77.

Boskabady MH, Vahedi N, Amery S, Khakzad MR. The effect of Nigella sativa alone, and in combination with dexamethasone, on tracheal muscle responsiveness and lung inflammation in sulfur mustard exposed guinea pigs. Journal of ethnopharmacology. 2011 Sep 2;137(2):1028-34.

Zhu T, Chen Z, Chen G, Wang D, Tang S, Deng H, Wang J, Li S, Lan J, Tong J, Li H. Curcumin Attenuates Asthmatic Airway Inflammation and Mucus Hypersecretion Involving a PPARγ-Dependent NF-κB Signaling Pathway In Vivo and In Vitro. Mediators of inflammation. 2019;2019.

Chauhan PS, Dash D, Singh R. Intranasal curcumin attenuates airway remodeling in murine model of chronic asthma. International immunopharmacology. 2014 Jul 1;21(1):63-75.




DOI: https://doi.org/10.36497/jri.v40i3.109

Refbacks

  • There are currently no refbacks.





Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org


An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License

Statcounter