by Dr. Xiu-Min Li
Allergic diseases are a significant health problem in “Westernized” countries. They represent a tremendous burden on quality of life for both patients and their families, and health care expenditures for the society as a whole. Food allergy in particular has no definitive treatment. The rise of allergic disease is prominently attributed to the “hygiene hypothesis” which contends that modern hygiene and other byproducts of modern behavior have deprived our immune systems of their natural enemies—mostly parasites–and our immune mechanisms have turned on normally harmless proteins in food, pollen, and so forth, instead. The accustomed medical approach is to control the response through medication and curtailing exposure. Certainly these are valid and important. But in the long run, my colleagues and I believe that the answer to this “Western” problem may be found in the “East.” That is the point of our “integrative” approach.
To be sure, allergic diseases are not only found in modern societies. They have been observed in some form throughout recorded history, including China, where I come from. And that is why I am working to bring what Chinese doctors have learned over the centuries into American medical practice. By combining these components of Traditional Chinese Medicine (TCM) into what we call integrative medicine, we hope to take advantage of the fact that the most powerful medical tool we have is the body itself. TCM is a unique system of theory, diagnosis and treatments including herbal medicines, acupuncture, mind-body therapy and dietary therapy. These are part of mainstream medicine not only in China and other Asian countries such as Korea and Japan, and are beginning to play a role in health care in the US and Europe.
At the Mount Sinai School of Medicine, we have taken a classical herbal formula called Wu-Mei-Wan that has been used in TCM for treating parasite infection and symptoms of food allergy-like conditions, and turned it into an herbal formula named food allergy herbal formula-2 (FAHF-2). We have shown that FAHF-2 can prevent and reverse established peanut allergy in animal-model peanut anaphylaxis, and that the effect is long lasting. There is nothing mysterious about this work, which is often the case with other so-called alternative treatments; our work is conducted according to NIH protocols and has been published in premier peer-reviewed journals. We measure and control and analyze, like any other Western researchers; everything must be repeatable. These data suggest that FAHF-2, and perhaps other Chinese herbal medicines may have a potential for treating food allergy. FAHF-2 is the first botanical drug that has entered clinical trials as an FDA Investigational New Drug (IND). Our phase I studies showed that FAHF-2 is safe and well tolerated. Phase II studies are in preparation at two centers–Mount Sinai, and Arkansas Children’s Hospital Research Institute in Little Rock.
We also developed anti-asthma herbal medicine international (ASHMI), which was shown in preclinical study to affect asthma mechanisms including inhibition of airway hyper-reactivity, inflammation and mucus hyperplasia, and overactive T-cell activity that can result in an allergic response. ASHMI is also effective in aged mice with asthma. Most exciting is that in addition to being safe and effective, ASHMI remained effective long after therapy. Unlike steroids, ASHMI does not induce overall suppression of immune system or adrenal function. This benefit is more than anything representative of the goal I mentioned earlier—to use the body’s own capabilities to fight disease. (I might add that this approach also has implications for the treatment of cancer and autoimmune diseases.)
Our studies provide scientific evidence supporting the use of TCM as a potential treatment for allergy and asthma. The goal of our clinical study is to develop botanical drugs that doctors can prescribe to complement or replace other therapies.
Food allergic children also suffer from other allergic conditions such as eczema, and environmental allergies. Families and physicians are interested in alternative approaches for these multiple allergic conditions. In addition to our research, and because acupuncture and herbal medicines are lawfully used by licensed practitioners in the US, we initiated an off-site TCM clinical program to help children with stubborn eczema associated with food allergies. The clinical outcomes have been well received. Given the growing interest in alternative and complementary medicine (CAM) therapies, and to make the clinical program accessible to more children, Mount Sinai Medical Center has established a new TCM clinical program named “Center for Integrative Medicine for Allergy and Immunology”. This center is supported by Winston-Wolkoff Children’s Holistic Medicine for Allergy Foundation and FARE.
This program will provide an additional health care option for children with multiple allergic conditions. This program will also provide allergists and pediatricians and dermatologists within or outside the Mt. Sinai with a reliable resource of CAM therapy. The combined effort will enhance the patient compliance and clinical outcomes.
Furthermore, we recently organized the first East-West Scientific Conference on Allergy and Traditional Medicine (EWAT) in China. This landmark conference—the first ever to focus on integrative medicine and allergy gathered some of the world leaders in allergy and traditional medicine research to share the most up-to date and comprehensive views on allergic diseases and traditional medicine as well as other new interventions for allergy. It not only provided an opportunity for experts to share knowledge of conventional allergy treatments, but also resulted in new insight into the growing use of traditional medicine and resulted in new collaborative research programs into traditional medicine as a potential solution to the allergy epidemic. Using this conference as a starting point, we continue to build up national and international collaborations to accelerate efforts to develop safe, effective natural products and novel therapies.
Dr. Xiu Min Li is Professor of Pediatrics in the Division of Pediatric Allergy and Immunology at Mount Sinai Hospital in New York. She has published her research in Journal of Allergy and Clinical Immunology and other top journals. She did her medical training at Stanford and Johns Hopkins, as well as Henen Medical University in China.