Light Therapy An Effective Alternative Asthma Treatment

Asthma symptoms are typically managed with inhaler-based bronchodilators and corticosteroids, access to such medication has been credited with the drop in asthma related mortality in recent decades. But for those looking for additional ways to reduce and manage symptoms, light therapy may be the answer. Studies have shown an undeniable link between light exposure and asthma with some light therapies capable of reducing symptoms dramatically.

Asthma is common, affecting over 300 million people worldwide and unlike any other chronic diseases, incidence has spread dramatically over recent decades. The World Health Organisation estimates there will be 400 million sufferers by 2025.1)..World Health Organization. Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach, 2007. Its prevalence is highest in developed nations but the steepest increases in asthma are among middle income and poorer countries, suggesting lifestyle and environmental changes that accompany industrialisation and urbanisation are responsible.

Asthma occurrence is higher among those living in wealthier countries, living in urban areas, living in areas with higher air pollution, those exposed to cigarette smoke, people that have trouble sleeping, the overweight and those from low income families. Children from East Germany were less likely to suffer from asthma than children growing up in West Germany, despite it being dirtier and poorer. It’s also been found that asthma is 15% less likely to occur in children who grew up with dogs and is much rarer still in people who grew up on farms. Correlations such as these led to the once popular ‘hygiene hypothesis’, that exposing infants to dirt helped prepare their immune system for potential allergen exposure in later life.


To what extent does sunlight affect asthma?

While it’s difficult to pinpoint the exact mechanism by which modern living is causing the rise, light exposure appears to be linked to most correlating factors, and studies are further confirming it to be a crucial component.

A 2010 study2)   Arnedo-Pena A et al. Sunny hours and variations in the prevalence of asthma in schoolchildren according to the International Study of Asthma and Allergies (ISAAC) Phase III in Spain. Int J Biometeorol. 2011 May;55(3):423-34. involving over 45,000 children in Spain found that above all solar radiation explained why prevalence was much higher in some areas of Spain than others, the children living in the colder, wetter areas of northern Spain were more likely to have asthma and their symptoms were more severe than children living in areas with more sunshine hours. Researcher Dr Alberto Arnedo-Pena who led the study said vitamin D synthesized from sun exposure was key.

“Prolonged exposure to the sun can cause cancer, but it’s also dangerous to avoid it. There has to be a balance between the pros and cons,” – Dr Arnedo-Pena.

 

Another similar 2016 study3)..Zhang J et al. Air Pollutants, Climate, and the Prevalence of Pediatric Asthma in Urban Areas of China. Biomed Res Int. 2016;2016:2935163. on Chinese cities concluded that hours of sunshine was a ‘protective factor’, based on a survey of nearly half a million children over 43 cities.

The following graph shows hospital admissions throughout the year in the US: Source: Clalit Research Institute

asthma hospital by month

Hospital admissions due to asthma are widely shown to be seasonal, there tends to be a lull across summer followed by a spike come September as the climate changes. A 2006 study on hospital admissions, air pollution and climate4)..Chen CH et al. Seasonality in adult asthma admissions, air pollutant levels, and climate: a population-based study. J Asthma. 2006 May;43(4):287-92. found a negative correlation between admissions and average monthly sunshine hours.

As 80-90% of vitamin D is obtained from sunlight, an individual’s vitamin D levels can be a fairly accurate measure of their recent sun exposure. People with higher vitamin D levels have been found to be less likely to have asthma, those who do have the disease experience it less severely, are less likely to be admitted to hospital, respond better to treatment and are less likely to have respiratory tract infections, which cause symptoms to worsen.5)..KA Morgan et al. ASTHMA – comparing the impact of vitamin D versus UVR on clinical and immune parameters. Photochem Photobiol Sci. 2017 Jan 16.

A 2011 study6)..S Alyasin et al. The Relationship Between Serum 25 Hydroxy Vitamin D Levels and Asthma in Children Allergy Asthma Immunol Res. 2011 Oct; 3(4): 251–255.conducted on 100 children aged 6 to 18, half with asthma, half without, found a strong link between vitamin D deficiency and asthma symptoms. Once BMI, age and sex had been factored into the results, the correlation only grew. The same results were found in a cross sectional US study.7)..Freishtat et al. High prevalence of vitamin D deficiency among inner-city African American youth with asthma in Washington, DC. J Pediatr. 2010 Jun;156(6):948-52.

In recent years, our exposure to sunlight has decreased due to more sedentary lifestyles that involve more time indoors, not only this, when outdoors, people may be more inclined to avoid sunlight and seek shade due to fears of carcinogenic UV radiation causing cancer or premature aging of the skin.


Can taking vitamin D supplements reduce asthma symptoms?

With the combination of evidence that vitamin D is essential in regulating the immune system8)..Nancy E Lange et al. Vitamin D, the immune system and asthma Expert Rev Clin Immunol. 2009 Nov; 5(6): 693–702. and correlations found between vitamin D deficiency and prevalence, naturally the next step was to test whether oral vitamin D supplements affected symptoms.

In September 2016 a Cochrane Collaboration systematic review9)..Martineau AR et al. Vitamin D for the management of asthma. Cochrane Database Syst Rev. 2016 Sep 5;9:CD011511. was published with the aim of evaluating clinical trials on the efficacy of vitamin D at improving asthma symptoms and reducing hospital admissions. Nine studies met the criteria for the review with a combined total of 1093 patients, the studies found that patients taking supplements were half as likely to be hospitalised with life-threatening asthma (3 in 100 rather than the 6 in 100 in the control group). The nine studies also found that those taking vitamin d supplements were 40% less likely to have an exacerbation (asthma attack), though it’s worth noting that each study had a different definition of what constituted an exacerbation.  


UV light versus vitamin D supplements

We know sunlight and vitamin D help. But vitamin D supplements and UVB radiation do not have the same effects.10)…Hart, P.H et al. Modulation of the immune system by UV radiation: more than just the effects of vitamin D? Nat Rev Immunol, 2011. 11(9): p. 584-96. Can UV light reduce symptoms itself, or is UV even necessary if we can just take a supplement?

Image source: Royal Society of Chemistry.  There’s evidence to suggest UV radiation reduces symptoms via other mechanisms apart from vitamin D synthesis, by producing cells that suppress certain immune responses. Studies have been done11)…McGlade JP Suppression of the asthmatic phenotype by ultraviolet B-induced, antigen-specific regulatory cells. Clin Exp Allergy. 2007 Sep;37(9):1267-76.12)…Shelley Gorman et al. Acute Erythemal Ultraviolet Radiation Causes Systemic Immunosuppression in the Absence of Increased 25-Hydroxyvitamin D3 Levels in Male Mice PLoS One. 2012; 7(9): e46006. on mice – they were exposed to UV radiation, then exposed to an allergen and were found to have reduced constriction of the airways due to suppression of the immune system, and the effects were the same regardless of vitamin D levels. UV from sunlight has immunosuppressive effects, causes the synthesis of vitamin D and other wavelengths have health benefits too, such as infrared and near infrared.


Infrared therapy for asthma

Studies have show low level laser therapy to be anti-inflammatory, to reduce the production of histamines and stimulate the production of nitric oxide (NO).13)…Practical applications of low level laser therapy

Infrared light targeted at acupuncture points can cause dramatic reduction of symptoms in patients, in a study on 50 Egyptian children14)…MY Elseify et al. Laser Acupuncture in Treatment of Childhood Bronchial Asthma J Complement Integr Med 10. 2013 Jul 09. treated three times a day with 808nm (infrared) light over a ten days, all of the children either reported an improvement or disappearance of symptoms. At the start of the study, all of the children’s activities were limited by asthma, 72% had daytime and nighttime symptoms, and 80% used their rescue inhaler excessively (defined as more than 2 times in a day). By the end of the 10 day study, none of the children were using their rescue inhalers excessively, none reported daytime symptoms, 4% reported night time symptoms  and 4% reported feeling limited in activity by their asthma.

At the end of the study, 48 patients were totally symptom free with normal PFTs (pulmonary function tests) and had good asthma control. – Laser Acupuncture in Treatment of Childhood Bronchial Asthma

 

A Serbian study15)..,Milojević M Low power laser biostimulation in the treatment of bronchial asthma Med Pregl. 2003 Sep-Oct;56(9-10):413-8. carried out using the same method on adults reported similar, dramatic results. The effects of infrared on acupuncture points could be detected within 30 minutes, they saw the same drop in symptoms over the ten days and the effects were felt for up to months after the treatment. The therapy was most effective for young people, for those that haven’t had asthma as long as others and females responded better than males.

 


Summary: What can asthma patients do for themselves?

  • Make sure you’re getting enough sunlight, ideally midday sun for optimal vitamin D synthesis.
  • Vitamin D supplements help and have been proven to protect against severe attacks.
  • UV light therapy will likely be effective, but no studies have been done specifically on humans and asthma.
  • Infrared light therapy has been shown to have the most dramatic effects, but the methods studies employed involved lasers shone on specific acupuncture points, which is impractical for most. Infrared lamps are available to buy and could have similar effects.

References (click to view)   [ + ]

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