Traditional Chinese Medicine for Pediatric Allergic Diseases

There is a clinically important and unmet need for long-term safe and effective preventative and therapeutic options for pediatric allergic diseases. This communication reviewed the use of Traditional Chinese Medicine (TCM) in pediatric allergic disease, including eczema, urticaria, eosinophilic esophagitis (EoE), food allergy (FA), asthma, and allergic rhinitis.

Through evaluation of case studies, series, or clinical trials of pediatric allergy patients, or in vitro studies involving samples collected from pediatric allergy patients and in vivo model systems, naturally occurring small molecule compounds' mechanism of action by evidence-based scientific outcomes were elucidated. Notable clinical outcomes include reduction in severity score, reduction across various allergic diseases that demonstrated no toxicity, no severe adverse effects, and are well-tolerated. Immunological outcomes that attribute to this include a switch from Th2-mediated allergic response to a Th1/Treg response, characterized by reduced total and specific IgE, total eosinophil counts, and levels of exotoxin, TNF-a, IL-6, IL-8, IL-5, and IL-4, with elevated levels of IFN-γ and IL-10. For eczema, both multiple and single herbal formulations are common treatment modalities, including internal administration and external herbal baths and creams, whereby both provide substantial beneficial outcomes. For EoE, internally administrated formulations and use of acupuncture have been reported and shown mitigation of allergic responses. In FA, formulations have been studied in clinical trials showing consistent safety, with protection remaining to be established. More advanced development of single herbal compounds may provide an advantage for use in FA treatment. For allergic rhinitis, several multiple herbal formulations and acupuncture have demonstrated improved symptom scores. Similarly, in asthma herbal formulas and acupuncture were highly clinically effective. TCM has demonstrated high safety and efficacy in both preclinical and clinical models of various allergic diseases, including eczema, food allergy, eosinophilic esophagitis, allergic rhinitis, and asthma. Therefore, this scientific evidence suggests that naturally occurring small molecule compounds are promising preventives and therapeutics for pediatric allergic diseases.

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and national/institutional guidelines).