Wet Cupping Therapy Ameliorates the Inflammatory Responses in Mice Model of Allergic Asthma: An Experimental Histopathological Study
As an inflammatory disease of the lung, asthma is characterized by bronchoconstriction, mucus hypersecretion, inflammatory mediator release, and eosinophil recruitment. Cupping therapy is an ancient method of treatment for a vast range of ailments. This study aimed to evaluate the anti-asthmatic effects of wet cupping therapy (WCT) in a mouse model. A total number of 35 Balb/c mice were randomly divided into five groups (n = 7): Negative and positive control groups were administered Phosphate Buffered Saline (PBS) and ovalbumin (OVA), respectively. The remaining three OVA-challenged groups were treated with budesonide, one session, and two sessions of WCT. Finally, eosinophil counts, the gene expressions, and the protein levels of interleukins IL-5, -13, and -33 were measured in bronchoalveolar lavage fluid (BALF) of mice. Lung tissues were removed and kept for histopathological evaluations. Both eosinophil counts and interleukin levels in BALFs were significantly diminished following WCT. Moreover, WCT prevented hyperplastic growth of goblet cells, overproduction of mucus, and inflammation of peribronchial and perivascular areas of lung tissue of mice compared to positive control group. Interestingly, the anti-inflammatory effects of WCT against asthma were comparable to budesonide. Our data suggested that the anti-asthmatic effects of WCT were mediated by reducing eosinophil trafficking and modulating Th2 inflammatory cytokines, leading to the histological changes of the lung. This may propose WCT as an efficient therapeutic approach to mitigate inflammatory complications of asthma.
Sadr S, Kaveh S, Choopani R, Bayat H, Mosaddegh M. Efficacy and safety of Iranian poly herbal formulation (compound honey syrup) in pediatric patients with mild to moderate asthma: a randomized clinical trial. Galen Med J 2017;6:291-301.
Soriano JB, Abajobir AA, Abate KH, Abera SF, Agrawal A, et al. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Resp Med 2017;5:691-706.
Bonomo S, Ferrante G, Palazzi E, Pelosi N, Lirer F, et al. Evidence for a link between the atlantic multidecadal oscillation and annual asthma mortality rates in the US. Sci Rep 2019;9:11683.
Loureiro CC, Amaral L, Ferreira JA, Lima R, Pardal C, et al. Omalizumab for severe asthma: beyond allergic asthma. Biomed Res Int 2018;2018:3254094.
Pelaia G, Vatrella A, Busceti MT, Gallelli L, Calabrese C, et al. Cellular mechanisms underlying eosinophilic and neutrophilic airway inflammation in asthma. Mediators Inflamm 2015;2015:879783.
Mathur SK, Viswanathan RK. Relevance of allergy in adult asthma. Curr Allergy Asthma Rep 2014;14:437.
Possa SS, Leick EA, Prado CM, Martins MA, Tibério IF. Eosinophilic inflammation in allergic asthma. Front Pharmacol 2013;4:00046.
McBrien CN, Menzies-Gow A. The biology of eosinophils and their role in asthma. Front Med (Lausanne) 2017;4:93.
Lambrecht BN, Hammad H, Fahy JV. The cytokines of asthma. Immunity 2019;50:975-991.
Heffler E, Madeira LNG, Ferrando M, Puggioni F, Racca F, et al. Inhaled corticosteroids safety and adverse effects in patients with asthma. J Allergy Clin Immunol Pract 2018;6:776-781.
Atarzadeh F, Daneshfard B, Dastgheib L, Jaladat A, Amin G. Early description of diet-induced blistering skin diseases in medieval persia: Avicenna's point of view. Skinmed 2016; 14:367-370.
Nimrouzi M, Daneshfard B, Tafazoli V, Akrami R. Insomnia in traditional persian medicine. Acta medico-historica Adriatica 2019;17:45-54.
Nimrouzi M, Mahbodi A, Jaladat AM, Sadeghfard A, Zarshenas MM. Hijamat in traditional Persian medicine: risks and benefits. J Evid Based Complementary Altern Med 2014;19:128-136.
Shahamat M, Daneshfard B, Najib KS, Dehghani SM, Tafazoli V, et al. Dry cupping in children with functional constipation: a randomized OPEN label clinical trial. Afr J Tradit Complement Altern Med 2016;13:22-28.
Kordafshari G, Shams Ardakani MR, Keshavarz M, Esfahani MM, Nazem E, et al. The role of phlebotomy (fasd) and wet cupping (hijamat) to manage dizziness and vertigo from the viewpoint of persian medicine. J Evid Based Complementary Altern Med 2017;22:369-373.
Moura CdC, Chaves ÉdCL, Cardoso ACLR, Nogueira DA, Corrêa HP, et al. Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem 2018;26:e3094.
Kim S, Lee S-H, Kim M-R, Kim E-J, Hwang D-S, et al. Is cupping therapy effective in patients with neck pain? a systematic review and meta-analysis. BMJ open 2018;8:e021070.
Michalsen A, Bock S, Lüdtke R, Rampp T, Baecker M, et al. Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial. J Pain 2009; 10:601-608.
Li J-Q, Guo W, Sun Z-G, Huang Q-S, Lee EY, et al. Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract 2017;28:152-160.
Cao H, Zhu C, Liu J. Wet cupping therapy for treatment of herpes zoster: a systematic review of randomized controlled trials. Altern Ther Health Med 2010;16:48-54.
Tagil SM, Celik HT, Ciftci S, Kazanci FH, Arslan M, et al. Wet-cupping removes oxidants and decreases oxidative stress. Altern Ther Health Med 2014;22:1032-1036.
Guo Y, Chen B, Wang D-q, Li M-y, Lim CH-m, et al. Cupping regulates local immunomodulation to activate neural-endocrine-immune worknet. Complement Ther Clin Pract 2017;28:1-3.
Aeeni Z, Afsahi A, Rezvan H. An investigation of the effect of wet cupping on hematology parameters in mice (BALB/C). Res Med 2013;37:145-150.
Dargahi T, Ilkhani R, Ghiaee A, Arbabtafti R, Fahimi S, et al. Anti-inflammatory effect of pimpinella anisum extract in a mouse model of allergic asthma. Res J Pharmacogn 2021;8:41-49.
Samimi F, Baazm M, Eftekhar E, Rajabi S, Goodarzi MT, et al. Possible antioxidant mechanism of coenzyme Q10 in diabetes: impact on Sirt1/Nrf2 signaling pathways. Res Pharm Sci 2019;14:524-533.
Luchak A, Solomon LA, Kanagalingam T, Vijeyakumaran M, Rowe BH, et al. Comparative efficacy of glucocorticoid receptor agonists on Th2 cell function and attenuation by progesterone. BMC Immunol 2020;21:54.
Chakir J, Shannon J, Molet S, Fukakusa M, Elias J, et al. Airway remodeling-associated mediators in moderate to severe asthma: effect of steroids on TGF-beta, IL-11, IL-17, and type I and type III collagen expression. J Allergy Clin Immunol 2003;111:1293-1298.
Saffari H, Hoffman LH, Peterson KA, Fang JC, Leiferman KM, et al. Electron microscopy elucidates eosinophil degranulation patterns in patients with eosinophilic esophagitis. J Allergy Clin Immunol 2014;133:1728-1734.
Chung KF. Asthma phenotyping: a necessity for improved therapeutic precision and new targeted therapies. J Intern Med 2016;279:192-204.
Bakakos A, Loukides S, Bakakos P. Severe eosinophilic asthma. J Clin Med 2019;8:1375.
Pavlidis S, Takahashi K, Ng Kee Kwong F, Xie J, Hoda U, et al. "T2-high" in severe asthma related to blood eosinophil, exhaled nitric oxide and serum periostin. Eur Respir J 2019;53: 1800938.
Badar A, Salem AM, Bamosa AO, Qutub HO, Gupta RK, et al. Association between FeNO, total blood IgE, peripheral blood eosinophil and inflammatory cytokines in partly controlled asthma. J Asthma Allergy 2020;13:533-543.
Fahy JV. Type 2 inflammation in asthma-present in most, absent in many. Nat Rev Immunol 2015;15:57-65.
Lee HY, Lee HJ, Kim GC, Choi JH, Hong JW. Plasma cupping induces VEGF expression in skin cells through nitric oxide-mediated activation of hypoxia inducible factor 1. Sci Rep 2019;9:3821.
Zhang Q, Wang X, Yan G, Lei J, Zhou Y, et al. Anti- versus pro-inflammatory metabololipidome upon cupping treatment. Cell Physiol Biochem 2018;45:1377-1389.
Lowe DT. Cupping therapy: an analysis of the effects of suction on skin and the possible influence on human health. Complement Ther Clin Pract 2017;29:162-168.
Mesnil C, Raulier S, Paulissen G, Xiao X, Birrell MA, et al. Lung-resident eosinophils represent a distinct regulatory eosinophil subset. J Clin Invest 2016;126:3279-3295.
Bok SH, Seo JH, Bae CS, Kang B, Cho SS, et al. Allium hookeri root extract regulates asthmatic changes through immunological modulation of Th1/Th2‑related factors in an ovalbumin‑induced asthma mouse model. Mol Med Rep 2019;20:3215-3223.
Chan BCL, Lam CWK, Tam LS, Wong CK. IL33: roles in allergic inflammation and therapeutic perspectives. Front Immunol 2019;10:00364.
Xing M, Yan X, Yang S, Li L, Gong L, et al. Effects of moving cupping therapy for plaque psoriasis: study protocol for a randomized multicenter clinical trial. Trials 2020;21:229.
Soleimani R, Mohammadi M, Saghebi SA, Taghipour A, Khorsand Vakilzadeh A, et al. Comparison of Th1/Th2 and Treg/Th17 ratios between wet and dry cupping therapies in persian medicine. Avicenna J Phytomed 2020;10:24-34.
Baghdadi H, Abdel-Aziz N, Ahmed NS, Mahmoud HS, Barghash A, et al. Ameliorating role exerted by al-hijamah in autoimmune diseases: effect on serum autoantibodies and inflammatory mediators. Int J Health Sci (Qassim) 2015;9:207-232.
|Issue||Vol 7, No 1, 2022|
|Persian medicine Wet cupping therapy Asthma Inflammatory response Interleukins|
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