Using the same mouse model, Remick is now studying the effects of various asthma treatments, including the anti-inflammatory drugs called tumor necrosis factor inhibitors, like Remicade and Enbrel. The drugs, already used for treating rheumatoid arthritis and inflammatory bowel disease, appear to derail a crucial immunologic compound that attracts eosinophils.
“Blocking tumor necrosis factor in a mouse model improves asthma,” Remick said. “It’s pretty slick.”
And a more exotic strategy is also under investigation. A few years ago, when Remick’s colleague Jiyoun Kim presented results of the mouse model at a professional conference in Korea, an audience member asked whether he had heard about standard Chinese herbal treatment.
He took herb samples back to the US, and in mice they proved to block eotaxin, the compound that sets off asthmatic reactions.
Chinese herbs carry the whiff and romance of an easy solution without the rigors of federal drug trials. But Remick warns that caution is in order.
“The power and trouble with Chinese herbal medicines,” he said, “is that they have more than one active ingredient — they have dozens. We know they block eotaxin, but we don’t know everything they block, or what actually makes things better.”
Complicating the treatment is the disease; asthma has many mechanisms.
“There may be 50 different inflammatory processes going on,” Remick said. “We’re still in the process of precisely defining which part of the herbs block which part of the inflammatory response.”
Still, hopeful parents, attracted by herbal treatments, have caused the researchers some anxious moments. “Yesterday,” Remick said, “I was contacted by someone whose co-worker wanted to know whether she should use Chinese herbs to treat her daughter’s asthma. I immediately replied that she shouldn’t. It’s not a question of Eastern versus Western medicine. Other drugs that treat asthma are better defined at this point. Herbs shouldn’t be front-line.
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