Asthma is a chronic inflammatory disorder of the airways characterised by variable airflow obstruction and airway hyper-responsiveness, and the presence of symptoms (more than one of wheeze, breathlessness, chest tightness and cough) (British Thoracic Society 2012). Around 5.4 million people in the UK are currently treated for asthma 4.3 million adults and 1.1 million children (Asthma UK). Up to 5% of adults with the condition have severe disease that responds poorly to treatment (Dennis 2008), while childhood asthma can be difficult to distinguish from viral wheeze (Keeley 2005).
Many people with asthma are atopic and, when they are exposed to certain stimuli, have inflammatory and structural changes in their airways (Duff 1992, Chan Yueng 1995). There are many such stimuli, for example, environmental allergens, occupational sensitising agents and respiratory viral infections (Duff 1992, Chan Yueng 1995)
There are many published studies investigating the mechanisms by which acupuncture may have an effect in asthma, showing that it may help relieve asthma by:
having regulatory effects on mucosal and cellular immunity in patients with allergic asthma, as shown, for example, by changes in levels of immunoglobulins, eosinophils, T-lymphocytes and cytokines (Yang 2013, Carneiro 2010, Joos 2000);
reducing bronchial immune-mediated inflammation, particularly through the balance between T helper 1 and 2 cells and their associated cytokines (Carneiro 2010; Carneiro 2005, Jeong 2002). Reducing inflammation in general by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003);
regulating expression of surfactant proteins, that help to reduce airways resistance biophysically and also modulate the immune response (Yan 2010);
inhibiting structural changes in the airways, and hence reducing airways resistance, possibly by inhibiting T-type calcium channel protein in airway smooth muscle cells (Wang 2012);
regulating the expression of genes and proteins that control the airways inflammatory response (Mo 2012, Xu 2012, Yin 2009);
acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the analytical brain, which is responsible for anxiety and worry (Hui 2010).
