Philip A.M. Rogers MRCVS

AP and Immunity


Aleksandrova_RA; Zhikharev SS; Mineev VN; Sinitsina TM; Shchemelinina TI; Karpov OI; Pozigun MA; Duvakina AL; Zhikhareva NB; Solodovnikova GM (1991) [AP therapy to treat patients with bronchial asthma]. Klin Med (Mosk) Mar 69(3):69-72. Erythron membrane impairment was investigated using membrane-active drugs (obsidan, delagil, morphium, ethanol) to specify indications to AP in bronchial asthma (BA). Patients were studied during treatment and followed up for 1 yr. Both immediate and long-term results of AP were related to patterns of the membrane impairment. BA patients with a sharp, >1.5 fold diminution of microcyte count upon delagil test should be assigned to repeated courses of AP for 1 yr. To monitor the treatment effect, it is recommended to define osmotic resistance of the red blood cells in obsidan test in addition to clinicofunctional indices.

Aleksandrova_RA; Nemtsov VI; Petrova MA; Lavrova OV; Trofimov VI; Sinitsina TM; Dotsenko EK (1995) Bronchial nonspecific reactivity in patients with bronchial asthma and in the preasthmatic state and its alteration under the influence of AP. Ter-Arkh 67(8):42-45. The development of nonspecific bronchial hypersensitivity and hyperreactivity in bronchial asthma and effectiveness of its correction with AP were studied in 152 patients with asthma and preasthma. 94 of them were subjected to AP. The authors employed a complex of diagnostic methods with determination of 241 parameters processed later with the use of systemic modelling. Bronchial hypersensitivity as indicated by the response to ACh was related to impaired coordination of bronchomotor tone regulating systems: parasympathetic part of the ANS, eosinophilic and monocytic bronchial inflammation, glucocorticoid homeostatic alterations. The corrective role of AP consists in reduction of nonspecific bronchial hyperreactivity, normalization of blood ACh, resensitization of cell beta-adrenergic receptors, elevation of mean levels of 11-OCS and T-lymphocytes.

Aleksandrova_RA; Nemtsov VI; Lan' PL; Sinitsina TM; Verkhovskaia VA; Goncharova VA; Bondarenko VL; Kozlov VG; Zagustina NA (1995) An analysis of the AP treatment results in bronchial asthma patients. Vopr Kurortol Fizioter Lech Fiz Kult May-Jun(3):10-12. Treatment effects reached in 94 patients with bronchial asthma show that neurogenic, humoral and bioenergetic responses to AP proceed according to adaptation laws and result in reduction of bronchial hyperreactivity. Eosinophilic inflammation in the bronchi diminishes AP efficacy.

Andersson_S (1992) [AP for the treatment of asthma]. Nord Med 107(4):115. Physiology Inst, Goteborgs Univ, Sweden.

Gottberg_L (1992) [AP in asthma? A long_term study should decide]. Lakartidningen 10 Jun 89(24):2177. Lung & Allergy Clinic, Huddinge sjukhus, Sweden.

Guan_Z; Zhang J (1995) Effects of AP on immunoglobulins in patients with asthma and rheumatoid arthritis. JTCM Jun 15(2):102-105. Kunming Municipal Hospital of TCM, Yunnan Province. The effects of AP on immunoglobulins in patients with asthma and rheumatoid arthritis were studied. After AP, in 20 patients with asthma, IgG increased (p <.01), IgM and IgE decreased (both p <.01), while IgA did not change markedly (p >.05); in 12 patients with rheumatoid arthritis, after AP IgG, IgA and IgM decreased (p <.05, 0.05, and 0.01, respectively), while IgE did not change evidently. AP modulated immunoglobulins of the human body, and patients with asthma and rheumatoid arthritis responded effectively to AP therapy. The latter may be related to the reinforcement of the immunological function by AP.

Hauswald_B (1995) Current status of diagnosis and therapy of allergic rhinitis. Ther Umsch Nov 52(11):738-743. Klinik und Poliklinik fur Hals-Nasen-Ohren-Heilkunde der Medizinischen Fakultat Carl-Gustav Carus, Technischen Universitat Dresden. A general rise in the occurrence of allergies has led to an increasing number of ENT consultations due to allergic rhinitis. The prevalence of allergic rhinitis amounts to 10-16% in Central Europe with a tendency to increase. Causal factors include an unhealthy lifestyle (stress), dietary habits, exposure to environmental pollutants, and genetic predisposition. The diagnostic work-up consists of a specific history of allergies, a general ENT examination, provocation tests of allergens such as skin reaction tests, and Lab tests. Treatment includes avoidance of allergens, induction of hyposensitivity, symptomatic drug treatment, and AP.

Joshi_YM (1992) AP in bronchial asthma. J Assoc Physicians India May 40(5):327-331. Bhatia General Hospital, Bombay. By now, there is ample clinical experience of treating bronchial asthma with AP. AP has a limited role in treating acute attacks since it is a weak bronchodilator, but it has an excellent prophylactic effect. AP causes modest improvement in objective parameters, with significant subjective improvement in controlled trials. However, all these trials had wide variation in the technique and methodology used. With standardization of the technique by the best guidelines, future trials may be able to quantify the efficacy of AP in bronchial asthma. Also, investigation of the mechanism by which AP works may lead to better understanding of the pathophysiology of asthma.

Kasahara_T; Amemiya M; Wu Y; Oguchi K (1993) Involvement of central opioidergic and nonopioidergic neuroendocrine systems in the suppressive effect of AP on delayed type hypersensitivity in mice. Int J Immunopharmacol May 15(4):501-508. Dept of Pharmacol, Sch of Med, Showa Univ, Tokyo, Japan. The effect of a single treatment of EAP (Acu) at early or late stages of the efferent phase on 2, 4, 6-trinitrochlorobenzene (TNCB)-induced delayed type hypersensitivity (DTH) was studied in intact and hypophysectomized (HPX) mice. Acu (2.5 Hz, 15 min) applied to the AP point equivalent to GV04 at 0, 3, 18 or 21 h after TNCB challenge induced significant suppression (45-73%) of the maximal extent of ear swelling at 24 h after TNCB challenge. An immunosuppressive and antiinflammatory drug, prednisolone 10 mg/kg ip, also suppressed the DTH to the same extent. Pretreatment with icv injection of naloxone hydrochloride (2 ug) significantly blocked the AP-evoked DTH suppression when Acu treatment was done at 0 or 3 h. On the contrary, naloxone did not block the effect of Acu treatment given at 21 h. In order to examine the potential involvement of the pituitary in the suppression of DTH by Acu, the DTH reaction was examined in HPX mice. Acu failed to produce suppressive response in the HPX mice unless given at 0 h. AP at GV04 during the efferent phase of induced DTH suppressed DTH through central opioidergic or nonopioidergic systems. The pituitary is apparently pivotal in this immunosuppression; DTH suppression by AP may be mediated via activation of the neuroendocrine system.

Kleijnen_J; ter Riet G; Knipschild P (1991) AP and asthma: a review of controlled trials. Thorax Nov 46(11):799-802. Dept of Epidemiol and Biostatistics, Univ of Limburg, Maastricht, The Netherlands. Published trials of AP in asthma often involved too few subjects and gave contradictory results. We reviewed 13 controlled trials on the efficacy of AP to treat patients with asthma to see if clearer conclusions could be drawn. These studies were reviewed on the basis of 18 predefined criteria of methodology. A maximum of 100 points for study design could be earned in 3 main categories: A=Adequate study population; B=Adequate intervention and; C=Adequate measurement of effects. Even the 8 better studies were of mediocre quality (>50% of the maximum score) and had highly contradictory results. No study earned >72% of the maximum score. ConclusionS: Claims that AP is effective to treat asthma are not based on the results of well performed clinical trials.

Lai_X (1993) Observation on the curative effect of AP on type I allergic diseases. Chung i tsa chih (JTCM) Dec 13(4):243-248. In a comparative study on treatment of type I allergic diseases, AP and desensitization therapies were performed in 143 cases. AP therapy had an extensive and remarkable action against type I allergic reaction. The curative effect was higher in the AP group than in the desensitization group in allergic asthma, allergic rhinitis and chronic urticaria.

Liao_SJ2; Liao TA (1992) AP treatment for psoriasis: a retrospective case report. AETRIJ Jul-Sep 17(3):195-208. New York Univ Dental Coll, NY. We treated 61 cases of psoriasis with AP, including 25 patients with complications of joint involvement and 2 cases with scleroderma additionally. All of the patients had failed to respond to their prior conventional western medical management. 25 patients were males and 36 were females. Mean age was circa 52 (range 22-84) yr. Mean ages between the sexes were not significantly different. Most of them (circa 61%) had extensive involvement of the body. Mean duration of illness was >16 (range 2-65) yr. They received a mean of circa 9 (range 1-15) sessions of AP. Almost 33% (19) of them had 11-13 sessions. With the AP treatment, circa 50% (30/61) of patients had complete or almost complete clearance of the skin lesions. Circa 25% (14 patients) of them had a clearance of circa 67% of the skin lesions. 8 had a clearance of one third of the skin lesions. 9 patients had minimal or no improvement. AP is an effective therapy for psoriasis, particularly when the western medical management is unsuccessful. Possible involvement of the cutaneous reticuloendothelial system in the clearance of the skin lesions is discussed.

Liu_X7; Sun L; Xiao J; Yin S; Liu C; Li Q; Li H; Jin B (1993) Effect of AP and point-injection treatment on immunologic function in rheumatoid arthritis. Chung i tsa chih (JTCM) Sep 13(3):174-178. General Hospital of PLA, Beijing, PRC. 54 cases of rheumatoid arthritis (RA) were treated by warm needling (WN) and point-injection (PI) with Zhuifengsu (drug). Good clinical results were observed with an effective rate of 100%. Changes in cellular and humoral immunity and other parameters in peripheral blood were noted before and after treatment. The NK activity and IL-2 value in RA patients were found to be lower than those of normal people; both increased after treatment (p <.01). WN and PI with Zhuifengsu exert a regulatory effect on the cellular immunological function.

Lou_B (1990) Personal experience on AP treatment of asthma. JTCM Mar 10(1):13-16. Inst of TCM, Zhejiang Province, PRC.

Lu_S (1993) AP and moxibustion in the treatment of dermatoses. JTCM Mar 13(1):69-75. AP and Moxibustion Dept, Beijing AP-Moxibustion and Traumatology College, PRC.

Medici_TC (1994) [AP and bronchial asthma]. Schweiz Med Wochenschr Suppl 62:39-48. Dept fur Innere Medizin, Universitõtsspital Zurich. Complementary or alternative medicine is gaining popularity. Patients demand such treatment, but practising physicians need to know more about it. Perception that conventional medicine has limited value is the common motive for the interest of both groups. This is obvious in the case of bronchial asthma, whose underlying cause is largely unknown despite decades of research, and whose treatment is symptomatic. Also, asthma mortality is not declining. In these circumstances it is legitimate to look for alternatives. One alternative therapy is AP. Although there are many published studies on AP and asthma, few meet the scientific tests necessary to prove the effectiveness of AP. From these studies it emerges that short term effects of AP are better documented than long term ones. Nor is it possible to predict what proportion of asthmatics will respond to AP. Allergic eosinophilic inflammation of the respiratory tract is foremost among present day hypotheses concerning the pathogenesis and pathophysiology of asthma. It is interesting that there are no known clinical or experimental investigations into the effect of AP on allergic inflammation of the asthmatic's bronchial mucosa. In view of these facts we are conducting a long term controlled study of the acute and chronic effects of AP on both allergic inflammation of the bronchial mucosa and asthmatics' clinical symptoms, bronchial hyperreactivity and consumption of medication. To establish responders and non-responders, lung function tests and measurement of microcirculation and skin temperature are carried out before and after AP treatment. If we can show that AP has an effect on the allergic inflammation, this is not only a new pathophysiologic aspect and a further explanation of how the AP effect on asthma comes about. If it helps the disease, limits the consumption of medication, prevents side effects and lowers drug costs, AP may have far-reaching implications for asthmatics.

Morton_AR; Fazio SM; Miller D (1993) Efficacy of laser-AP in the prevention of exercise-induced asthma. Ann Allergy Apr 70(4):295-298. Dept of Human Movement Studies, Univ of Western Australia, Nedlands, WA. Many asthmatic patients are reluctant to follow the medication schedule prescribed for them and turn to alternative treatment methods. In this trial, laser-AP, did not prevent exercise-induced asthma.

Schwartz_C (1992) Chronic respiratory conditions and AP therapy. Probl Vet Med Mar 4(1):136-143. East-West Animal Care Ctr, Oakland, California 94606. AP effectively enhances the treatment of chronic allergic bronchitis and asthma in the cat and dog. According to TCM, chronic respiratory conditions can arise from LU, SP, LV or KI Xu (Deficiency). Proper diagnosis is made from patient history, as well as examination of tongue and pulse. AP points are chosen according to involved energy pathways (Channels) and classical AP combinations. In most cases, medication can be reduced as the AP takes effect.

Tandon_MK; Soh PF; Wood AT (1991) AP for bronchial asthma? A double-blind crossover study [see comments]. Med J Aust Mar 154(6):409-412. Thoracic Div, Repatriation General Hospital, Hollywood, W Australia. The therapeutic effectiveness of classic Chinese AP was compared with "placebo" AP in 15 patients with stable bronchial asthma. The patients received treatments with real and placebo AP in a randomly ordered, subject and evaluator-blind crossover fashion twice/wk for 5 wk. Both real and placebo treatment periods were preceded by 3 wk periods when no AP was used. 5 patients felt better on real treatment, 5 patients preferred placebo and 5 did not feel any improvement on either of the 2 treatments. Treatment with real AP when compared with no treatment and placebo treatment failed to provide any improvement in daily peak flow rates, asthma symptom scores, number of puffs of beta 2-agonist aerosol use, and pulmonary function results.

Wang_T; Xie S (1990) [Effect of moxibustion on the inflammatory reactions of adjuvant arthritics rats]. Chen Tzu Yen Chiu 15(1):44-47. Dept of Physiol, First Military Med Coll, Guangzhou, PRC. Adjuvant arthritic (AA) rats were used as the experimental model and the thickness of pedal pad, the circumference and the pathological (light microscopic changes of the ankle joint as well as the plasma level of middle sized molecules (MSM) were studied before and at subsequent experimental days after moxibustion (once/d for 6 d, on Shenque). Moxibustion reduced the inflammatory reactions significantly in comparison with that of the control group.

Waters_KC (1992) AP for dermatologic disorders. Probl Vet Med Mar 4(1):194-199. Vet AP is a useful therapeutic modality for treating dermatologic disease. The principles of TCM diagnosis can be applied to the animal patient, and AP points chosen based on the cause and clinical manifestations of the disease.

Williamson_L; Yudkin P; Livingstone R; Prasad K; Fuller A; Lawrence M (1996) Hay Fever Treatment in General Practice: A Randomised Controlled Trial Comparing Standardised Western AP with Sham AP. Adapted from WWW. The effect of standardised, Western AP on hay fever symptoms was studied in a randomised, controlled, single-blind trial in comparison with "sham" AP. 3 general practices, in Oxfordshire (rural), Lincolnshire (semirural), and Peterborough (urban), recruited 102 patients aged 16 or over with long-standing, moderate or severe hay fever symptoms that had required continuous therapy for at least one mo/yr for >/=3 yr. Patients were asked to record in a diary: the amount of medication used daily; a daily symptom score (using a 10-point scale), from which was derived a weekly remission of symptoms score; and their assessment of the effect of AP on the hay fever symptoms. Symptom scores and use of medication were similar in the 2 groups. In the 4-wk period after each patient's first treatment, remission of symptoms was reported by 39% in the active treatment group and 45% in the sham group; mean weekly symptom scores were 18.4 and 17.6 respectively; and mean units of medication used were 4.1 and 5.0 respectively. 16/43 patients in the active treatment group and 14/43 in the sham group felt that the AP gave an excellent or very good effect on their hay fever. The treatments were simple, safe, reproducible and perceived as equally effective. Whether this represented an AP effect, a placebo effect, or natural variation in a fluctuating condition, is not clear.

Xi_D; Han J; Zhang Z; Sun Z (1992) AP treatment of rheumatoid arthritis and exploration of AP manipulations. JTCM Mar 12(1):35-40. Yueyang Hospital, College of TCM, Shanghai, PRC.

Xiao_J2; Liu X; Sun L; Ying S; Zhang Z; Li Q; Li H; Zhang Z; Jin B; Wang S (1992) Experimental study on the influence of AP and moxibustion on interleukin-2 in patients with rheumatoid arthritis. Chen Tzu Yen Chiu - AP Research 17(2):126-128, 132. General Hospital of PLA, Beijing, PRC. Rheumatoid arthritis (RA) is regarded as an autoimmune disease in WM, but the pathogenesis is unclear. TCM regards RA as one of the Bi Syndromes. To study the effects of AP and moxibustion in the treatment of RA and on IL-2, 41 RA patients were assigned at random to 3 groups: 1=Warming needle (n=20 RAs); 2=AP point injection (n=21 RAs) and; 3=Control (n=19 healthy people). IL-2 levels in groups 1 and 2 before treatment were significantly lower (p<.05) than that in the control group. Treatment did not alter the IL-2 level in the control group, but increased it significantly (p<.01) in the considerably in the 2 RA groups. IL-2 is a very important signal to regulate the immune response. The decrease of IL-2 in patients with RA is one of the main causes of disorder of the internal environment. AP and moxibustion act as a form of stress-stimulation which, through the neuroendocrine system, activates the immune system to increase IL-2 production.

Yang_YQ (1993) [Progress on anti-allergy treatment with AP]. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih Mar 13(3):190-192. In Chinese.

Yu_S; Cao J; Yu Z (1993) AP treatment of chronic rhinitis in 75 cases. JTCM Jun 13(2):103-105. Beijing Hospital of TCM, PRC.

Zamotaev_IP; Mamontova LI; Zavolovskaia LI; Rudakova OM (1991) [Effect of (infrared) laser-AP on the pulmonary vascular resistance in patients with obstructive chronic lung diseases]. Klin Med (Mosk) May 69(5):68-71. Clinical pattern of the disease, systolic pressure in the pulmonary artery, external respiration, central haemodynamics were assessed in 111 patients (50 with chronic obstructive bronchitis and 61 with bronchial asthma) to study the effect of laser-AP. The treatment course consisted of 10 sessions performed with application of Uzor apparatus in pulse regimen with 890 nm wave length, 1500 Hz frequency and 2 mW mean radiation rate. IR laser-AP gave a positive response, evident from improved bronchial patency, enhanced bronchial sensitivity to sympathomimetics and reduced systolic pressure in the pulmonary artery. The promise of laser-AP is attributed to its separate broncholytic effect and the ability to lower pulmonary vascular resistance.

Zang_J (1990) Immediate antiasthmatic effect of AP in 192 cases of bronchial asthma. JTCM Jun 10(2):89-93. Dept of AP, 2nd Municipal People's Hospital, Kaifeng City, Henan Province, PRC. AP at LU06 and LU10 was used to treat 192 cases of bronchial asthma. The immediate total effective rate was 99% and the rate of clinical remission plus marked improvement was 76%. The efficacy for patients of varying ages and varying duration of the disease was not significantly different. Effects were best for asthma of the Cold Syndrome according to TCM and of the allergic type according to WM. Cases that responded fastest to treatment had better long-term clinical results. The duration of needle retention also influenced the clinical result. The author deemed that 40 min of needle retention after the treatment took effect was desirable. AP at LU06 and LU10 was very satisfactory in the treaatment of bronchial asthma. It was particularly useful for cases with a history of drug allergy.

Zwolfer_W2; Keznickl Hillebrand W; Spacek A; Cartellieri M; Grubhofer G (1993) Beneficial effect of AP in adults with bronchial asthma. Dept of Anaesthesia and Intensive Care, Univ of Vienna, Austria. AJCM 21(2):113-117. In a retrospective study 17 patients with long-standing history of bronchial asthma were treated with AP at the outpatient unit of the Dept of Anaesthesia and Intensive Care in the Univ Hospital of Vienna. The subjective effectiveness of the treatment was determined using a standard questionnaire, sent to the patients' homes 6 mo after starting AP treatment. >70% of our patients reported significant improvement of their ailments after 10 wk of treatment as well as 6 mo after starting AP.