Steroids vs herbal medicine

Name of the Student
Professor’s Name
Chemistry
2nd November, 2015
A Comparison between Steroid Based Medicines and Herbal Based Medicines for the Treatment of Inflammation
Inflammation is a condition that occurs as a manifestation of an immune reaction which is marked by pain, swelling and redness. The symptoms are a complete triad and occur together. This condition severely decreases the quality of life in a patient. Inflammation can occur under various circumstances. It is caused by an increased activation and reaction of immune cells to the damaged tissues of the body or foreign antigens (may or may not be in the form of an infection) which affects the body. Inflammation is associated with various chronic diseases like asthma or rheumatoid arthritis. In both these conditions, the patients are crippled by the pain and respiratory distress which hampers their quality of life.
Inflammation may be controlled with both steroidal and non-steroidal anti-inflammatory drugs. Under chronic inflammatory conditions, the drugs of choice are steroids. Steroids belong to natural or synthetic steroids and act by reducing the number of immune cells within the body. A reduction of immune cells decreases the interaction of such cells with the infective pathogens or body’s damaged tissues and leads to an alleviation of inflammation. Non-steroidal anti-inflammatory drugs like acetaminophen act by inhibiting the cyclo-oxygenase pathway and reduces the formation of prostaglandins. Prostaglandins are inflammatory mediators and attract immune cells to the site of injury or infection, which leads to inflammation.

Therefore, inhibiting the cyclo-oxygenase pathway provides alleviation of inflammation.
Herbal medicines are used all across the world due to its increased toleration profile, either as an adjunct to steroid therapy or independently for the reduction of pain and inflammation. These medicines are natural extracts of plants and are supposed to provide minimum side effects on the patients. Various types of herbal medications are documented for providing relief to the inflammatory conditions. The present article would evaluate two articles based on the efficacy of steroids and efficacy of herbal medicines in the management of inflammation.
Methylprednisolone is a synthetic steroid and is used for the prevention of various anti-inflammatory disorders. One such disorder where methylprednisolone has been shown to act is to reduce the inflammation associated with asthma. Asthma is a serious life-threatening respiratory disease that occurs due to airway obstruction and inflammation n the bronchioles. It is one of the commonest inflammatory conditions all across the world and affects around 300million people worldwide. The increased prevalence of asthma is a concern for the medical fraternity and to the patients also.
In this present study, methylprednisolone was shown to exhibit long lasting effect in other immunomodulatory diseases without the systemic side effects of log term treatment effects of glucocorticosteroids. The authors implemented an intervention protocol that could ameliorate the need for long-term oral supplementation of steroids for the management of asthma. The study was a double-blind, double-dummy study that compared evaluation of 1g of methylprednisolone as pulse therapy in 8 patients. The MPP dose was administered intravenously and the control arm consisted of 10 patients, who received short-term oral steroids. The patients were asthmatic and presented with symptoms of acute asthma. The study indicated that both the modalities of treatment were equally effective in the management of acute asthma. It was reflected that the MPP treated individuals did not show a quicker resolution pattern in the relief of asthmatic symptoms in comparison to the orally treated group. The patients from either groups did not need not be intervened with mechanical ventilation for the worsening of asthmatic conditions, which indeed portrayed the efficacy of both treatment modalities. Following one week after the treatment with methylprednisolone pulse therapy, the FEV1 decreased compared to the control group. However, such differences were not statistically significant and it may be concluded that the pulse therapy regime was as effective as the oral treatment regime (p=0.06). The patients who were on the pulse therapy needed oral prednisolone much earlier and in higher doses compared to the patients whose treatment regime was maintained with oral prednisolone. However, after 12 weeks it was reflected that FEV1 values were identical in both the groups. The authors concluded that there was no significant benefit of methylprednisolone pulse therapy over oral prednisolone, either over the short term or long term care. However, since the pulse therapy required methylprednisolone to be administered over shorter periods of time, it may lead to increased toleration profile, given the side effect profile of systemic corticosteroids.
A study done by Kim et al (2011), reflected that So-Cheong-Ryong-Tang (SCRT) which is one of the popular Chinese herbal medicines for the inflammatory condition has the ability to reduce the inflammation associated with acute asthmatic episodes. The authors tried to elucidate the mechanism of this herbal plant in the treatment of inflammatory conditions, related to allergic response. The authors studied the immunomodulatory effects of SCRT extracts in a murine model of asthma which was induced by a house dust extract that contained cockroach allergens and endotoxins. The study evaluated various aspects of pulmonary inflammation and various inflammatory mediators were also examined. The study reflected that SCRT significantly reduced the airway hyperactivity, which was measured by whole body plethysmography. The analysis was also reconfirmed through direct measurements of airway resistance. Since, airway resistance is increased in acute asthma; the authors appropriately selected the end point of assessing this variable as an indicator of acute asthma. The study further reflected that the immune response related to inflammation in the pulmonary tissue was significantly inhibited by SCRT. This was demonstrated by a decrease in IgE antibody levels. This antibody is associated with allergic manifestations within the body. Hence, a reduction in the titer of IgE, definitely indicates the reduction of allergic episodes which is the hallmark of acute asthma. SCRT was further associated with improvement in the histological features in the lungs. SCRT was further associated with a reduction of neutrophils in the bronchoalveolar lavage fluid. The BAL levels of various chemokines were also reduced. The study indicated that SCRT treatment provides a holistic approach in reduction of inflammation. SCRT treatment not only reduces inflammatory modulators but also helps to alleviate the IgE levels. Reduction of IgE levels will decrease the mast cell sensitization process and may be of potential implication I reduction of frequent episodes of acute asthma.
In both the articles, the authors have selected the endpoint measurements like relief of asthma and probable relief of asthma by considering the inflammatory mediators. However, the herbal extract was studied in a murine model and methylprednisolone pulse therapy was studied in human models. The efficacy of steroids in the treatment of asthma is a proven fact, but the potential of SCRT may provide an effective treatment alternative with an increased benefit of reduced side –effect profile, which is common with steroid treatment.Works Cited
Engel T, Dirksen A, Frølund L, Heinig JH, Svendsen UG, Pedersen BK, & Weeke B.
Methylprednisolone pulse therapy in acute severe asthma. A randomized, double-blind
study. Allergy., 45.3(1990) : pp.224-30.
Jiyoun Kim, Sudha Natarajan, Hyunsu Bae, Sung-Ki Jung, William Cruikshank, & Daniel G.
Remick. Herbal medicine treatment reduces inflammation in a murine model of
cockroach allergen–induced asthma. Annals of Allergy, Asthma & Immunology, 2011;
DOI:10.1016/j.anai.2011.05.001