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Among the atopic
disorders increasing in
prevalence of U.S.
children are asthma,
food allergies,
eosinophilic esophagitis
in newborns, and
dermatitis,
gastroesophageal reflux,
chronic rhinorrhea, and
recurrent wheezing in
infants. The so-called
"atopic march"
represents the natural
tendency of
children with early
signs of allergic
reaction to
environmental stimuli to
progress to more severe
manifestations of
allergic disease. Many
families turn to
complementary and
alternative (CAM)
therapies to prevent and
treat atopic disorders
in children.
The author refers to the
functional medicine
"iceberg" model as a way
to understand a new
method of
care for children with
atopic disorders. The
tip of the iceberg
represents the visible
phenomena in
atopic children (skin
rashes, vomiting, runny
noses, and coughing).
Beneath the tip is a
genomic
predisposition -- a
familial and individual
tendency to develop
immune dysregulation
under certain
environmental
circumstances.
Individuals with a
genomic predisposition,
under certain
environmental
circumstances, will
suffer metabolomic
consequences manifested
by an increase in
oxidative stress.1
Certain immune cells are
overstimulated relative
to others, resulting in
an imbalance between
Th1-
dominant and
Th2-dominant immune
responses.2 Evidence
suggests that certain
infectious,
nutritional, or toxic
events may affect
Th1/Th2 balance.3
Perhaps, says the
author, practitioners
can
intervene prenatally, or
even preconceptually, to
prevent the inevitable
sequence of events.
The "hygiene hypothesis"
is a popular theory to
explain the increase in
atopic disease
prevalence.
According to this
theory, many
environments are too
"clean," (because of the
eradications of
infectious agents by
vaccines, anti-infectives,
and "super-clean" living
conditions), and
individuals
are not exposed to as
many antigens
(bacterial, fungal, or
viral) as were those of
previous generations.
Another explanation is
that another
environmental factor,
increased societal
stress, is shifting the
human immune response
toward Th2-dominance.4
For at-risk individuals,
exposure to certain
foods may contribute to
severe, lifelong asthma
or food
allergies. Focusing on
the following areas is
important: maternal pre-
and postnatal antigen
introduction; and fatty
acid intake (both in
breastfeeding mothers
and in infants).
Many CAM therapies are
reportedly effective for
preventing and treating
allergy diseases.
Several
studies have
demonstrated that
probiotics, given
prenatally to women and
then postnatally to
either
breastfeeding mothers or
directly to formula-fed
infants, can reduce the
incidence of atopic
dermatitis
by half in infants at
high risk. Prebiotics
(special
oligosaccharides that
act as nutrients for
probiotic
growth) have also been
shown to prevent eczema
in vulnerable infants.
The author cites other
studies,
including several
randomized controlled
trials that suggest a
positive effect of
probiotics and
prebiotics on the course
of atopic dermatitis.
Many botanically derived
products have been used
to treat eczema,
allergic rhinitis, and
asthma. One
of the most promising
herbs for allergy
treatment is butterbur (Petasites
hybridus). In one cited
study,
a specific butterbur
leaf extract Ze 339 (Max
Zeller Söhne AG;
Switzerland) was shown
to relieve
allergic rhinitis
effectively and safely.
In other cited studies,
boswellia (Boswellia
serrata) gum resin
and French maritime pine
bark (Pinus pinaster
syn. P. maritimus) were
shown to reduce asthma
symptoms.
In traditional Chinese
medicine, says the
author, acupuncture has
been singled out as a
promising
therapy for conditions
such as asthma, and
acustimulation is
considered a potential
part of the care of
children with atopic
conditions.
Among the most widely
studied, safe, and
effective treatments for
the stress component of
atopic
disorders are mind-body
therapies, including
self-hypnosis, guided
imagery, biofeedback,
mindfulness-based stress
reduction, and
meditation. Manual
treatments include
chiropractic,
osteopathic
manipulation, and
therapeutic massage.
The author concludes
that holistic
integration of CAM and
conventional strategies
coupled with
dedication to evaluating
and alleviating
environmental triggers
can help families avoid
the "allergic
march to lifelong atopic
disorder." He further
writes: "It is often the
practical combination of
several
approaches (e.g.,
nutritional
modification,
environmental trigger
avoidance, or
stress-coping skill
training) that make the
most sense and the
biggest difference."
―Shari Henson
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