Treat Your Asthma Gingerly

If numbers can be trusted (99% of all statistics being made up on the spot), there are almost 25 million cases of asthma in the United States. Out of almost 314 million people in the country, that equates to almost 8% of the population. More than 3,000 Americans die from asthma each year. The annual cost for prescription drugs exceeds 6 billion dollars, and, as reported in 2012, asthma cases have increased 48% in the last ten years. (http://www.statisticbrain.com/asthma-statistics/, from the American Lung Association). Wow, that’s quite an indictment.

Asthma is a condition in which airways become narrowed, swell and produce extra mucus, making it difficult to breathe. It triggers coughing, wheezing and shortness of breath. For the lucky few, it’s only a minor nuisance; for others, it can be a major problem that interferes with daily life and might lead to a life-threatening asthma attack. Although asthma has no cure, it can be controlled. Once in a while symptoms flare up in certain situations, such as the exercise-induced asthma that worsens when the air is cool and dry, or the occupational asthma that assaults people in a workplace where exposure to fumes, chemicals or gases are the norm.

The odds of developing the condition increase among smokers, those whose mothers smoked during pregnancy, those assailed by second-hand smoke, people having other allergic conditions, or those having a blood relative with asthma. Symptoms that interfere with sleep, work or recreational activities need serious attention and a visit to a physician.

The inhaled corticosteroids commonly prescribed to treat asthma claim to have fewer adverse effects than the oral steroids used for other inflammatory conditions, such as arthritis and allergies. But that is purely subjective. These medications are used for the long haul, as are the oral leukotriene modifiers that include Singulair and its kin. Leukotrienes are endogenous chemicals that mediate responses in allergic reactions and inflammation, and their modification with drugs is linked, albeit weakly, to psychological reactions characterized by aggression, agitation, hallucinations, depression and suicidal thoughts. No completed suicides have been reported, however (Philip, 209). That’s reassuring. Yep. Other medications are used in combination with inhaled corticosteroids, but have the nasty habit of occasional exacerbation of symptoms. A drug seldom used nowadays is theophylline, a pill that relaxes the muscles around the airways to keep them open. Originally extracted from tea leaves and later found in cocoa, theophylline is one hundred percent bioavailable, but its side effects are equally disturbing, and are worsened in the presence of fatty meals.

But the future is bright. On the horizon are compounds extracted from ginger, the zingy spice that livens up our baked goods. Traditionally used to treat stomach upset, including that from motion sickness (Langner, 1998), ginger has found its way into the grab bag of integrative medicine, where its anti-inflammatory nature finds favor with sufferers of arthritis, hypercholesterolemia (Madkor, 2011), elevated glucose (Akhani, 2004), and even hypertension (Ghayur, 2005) and worms (Mostafa, 2011) (Lin, 2010).

Researchers at Columbia University have discovered that the bronchoconstriction of asthma can be attenuated with ginger compounds that work synergistically with  medications called beta-agonists, the best-known probably being Albuterol. The relaxation of airway smooth muscle is the goal. When the drug and the natural components were combined, relaxation response was remarkable (Townsend, 2013). Of the ginger isolates, one called 6-shogaol was most effective in its relaxing effects. This constituent of ginger is similar in structure to the better-known gingerol, the most active ingredient of the herb which is related to compounds appearing in chilies and black pepper, capsaicin and piperine respectively. Shogaol is produced when ginger is dried or cooked. As far as pungency, it falls between capsaicin and piperine on the heat scale.

In the lungs there is an enzyme called PDE4D which interferes with the relaxation of the airways. The elements of ginger stop this enzyme from flaunting its attributes. To further aggravate asthma, there also exists a protein structure that plays a role in the constriction of airways and the contraction of muscles, named F-actin filament. 6-shogaol dissolves these filaments rapidly. While there is support for the idea that asthma can be outgrown as musculature matures (Chitano, 2005), there is comfort in knowing that management of the disease is readily obtainable and that all-natural adjuvants are in the offing. Calcium signaling is part of the muscle contraction process. With some blood pressure medicines, calcium is inhibited and vessels relax to allow the smooth passage of blood. It was found that ginger has an activity like that of verapamil, a calcium-channel blocker, in that it can ease the contraction of the smooth muscle that controls airways (Ghayur, 2008).

In the decade preceding the 21st century, plants have been documented to be useful in the treatment of various respiratory disorders, including asthma. In fact, the use of natural products has increased dramatically all over the world. Not only have they affected bronchodilation, but also mast cell stabilization, anaphylaxis, and overall leukotriene modulation (Mali, 2011). (Mast cells, by the way, are those that release histamine in response to injury, allergy or inflammation.) To the delight of alternative-minded practitioners, many of these medicinal plants provide relief of symptoms equal to allopathic medicines (Bielory, 1999).

We might be reminded to enjoy our spices, especially those with anti-inflammatory characteristics, such as ginger and its close cousin, turmeric, but to be prudent if taking blood thinners. That the therapeutic value of ginger is enhanced by its mineral constituents (Latona, 2012) adds another dimension to the study of its universal appreciation.

Akhani SP, Vishwakarma SL, Goyal RK. Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats. J Pharm Pharmacol. 2004 Jan;56(1):101-5.

Bielory L, Lupoli K. Herbal interventions in asthma and allergy. J Asthma. 1999;36(1):1-65.

Chitano P, Wang L, Murphy TM. Mechanisms of airway smooth muscle relaxation during maturation. Can J Physiol Pharmacol. 2005 Oct;83(10):833-40.

Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol. 2005 Jan;45(1):74-80.

Ghayur MN, Gilani AH, Janssen LJ. Ginger attenuates acetylcholine-induced contraction and Ca2+ signalling in murine airway smooth muscle cells. Can J Physiol Pharmacol. 2008 May;86(5):264-71.

Hirst SJ. Airway smooth muscle as a target in asthma. Clin Exp Allergy. 2000 Jun;30 Suppl 1:54-9.

Langner E, Greifenberg S, Gruenwald J. Ginger: history and use. Adv Ther. 1998 Jan-Feb;15(1):25-44.

Latona DF, Oyekele GO, Olayiwola OA Chemical analysis of Ginger Root IOSR Journal of Applied Chemistry (IOSRJAC). Volume 1, Issue 1; May/June 2012: 47-49

Levy AS, Simon O, Shelly J, Gardener M. 6-Shogaol reduced chronic inflammatory response in the knees of rats treated with complete Freund's adjuvant. BMC Pharmacol. 2006 Oct 1;6:12.

Lin RJ, Chen CY, Lee JD, Lu CM, Chung LY, Yen CM. Larvicidal constituents of Zingiber officinale (ginger) against Anisakis simplex. Planta Med. 2010 Nov;76(16):1852-8.

H Ling, H Yang, S-H Tan, W-K Chui, E-H Chew 6-Shogaol, an active constituent of ginger, inhibits breast cancer cell invasion by reducing matrix metalloproteinase-9 expression via blockade of nuclear factor-κB activation British Journal of Pharmacology. Volume 161, Issue 8, pages 1763–1777, December 2010

Madkor HR, Mansour SW, Ramadan G. Modulatory effects of garlic, ginger, turmeric and their mixture on hyperglycaemia, dyslipidaemia and oxidative stress in streptozotocin-nicotinamide diabetic rats. Br J Nutr. 2011 Apr;105(8):1210-7.

Mali RG, Dhake AS. A review on herbal antiasthmatics. Orient Pharm Exp Med. 2011 Aug;11(2):77-90.

Mostafa OM, Eid RA, Adly MA. Antischistosomal activity of ginger (Zingiber officinale) against Schistosoma mansoni harbored in C57 mice. Parasitol Res. 2011 Aug;109(2):395-403.

Philip G, Hustad C, Noonan G, Malice MP, Ezekowitz A, Reiss TF, Knorr B. Reports of suicidality in clinical trials of montelukast. J Allergy Clin Immunol. 2009 Oct;124(4):691-6.e6.

Ramji, Divya; ho, chi; Huang, Qingron; Rafi, Mohamed; Huang, Mou Isolation of gingerols and shogaols from ginger and evaluation of their chemopreventive activity on prostate cancer cells and anti-inflammatory effect on 12-O-tetradecanoyl-phorbol-13-acetate (TPA)-induced mouse ear inflammation RUcore - Rutgers University Community Repository. 2007 http://mss3.libraries.rutgers.edu/dlr/showfed.php?pid=rutgers-lib:21328

Sehwan Shima, Sokho Kima, Dea-Seung Choia, Young-Bae Kwonb, Jungkee Kwona Anti-inflammatory effects of <6>-shogaol: Potential roles of HDAC inhibition and HSP70 induction Food and Chemical Toxicology. Volume 49, Issue 11, November 2011, Pages 2734–2740

Townsend EA, Yim PD, Gallos G, Emala CW. Can we find better bronchodilators to relieve asthma symptoms? J Allergy (Cairo). 2012 ;2012:321949. doi: 10.1155/2012/321949. Epub 2012 Oct 2.

Townsend EA, Siviski ME, Zhang Y, Xu C, Hoonjan B, Emala CW. Effects of ginger and its constituents on airway smooth muscle relaxation and calcium regulation. Am J Respir Cell Mol Biol. 2013 Feb;48(2):157-63.

Wang L, Pozzato V, Turato G, Madamanchi A, Murphy TM, Chitano P. Reduced spontaneous relaxation in immature guinea pig airway smooth muscle is associated with increased prostanoid release. Am J Physiol Lung Cell Mol Physiol. 2008 May;294(5):L964-73.

Wu H, Hsieh MC, Lo CY, Liu CB, Sang S, Ho CT, Pan MH. 6-Shogaol is more effective than 6-gingerol and curcumin in inhibiting 12-O-tetradecanoylphorbol 13-acetate-induced tumor promotion in mice. Mol Nutr Food Res. 2010 Sep;54(9):1296-306.

Zick SM, Djuric Z, Ruffin MT, Litzinger AJ, Normolle DP, Alrawi S, Feng MR, Brenner DE. Pharmacokinetics of 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol and conjugate metabolites in healthy human subjects. Cancer Epidemiol Biomarkers Prev. 2008 Aug;17(8):1930-6.