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Questions About Specific Health Issues

Type A with Sarcoidosis


QUESTION

Dr. Dadamo, I just recently purchased your book "Eat Right 4 Your Blood Type". I must say that since I changed my eating habits, I feel great. I have not lost any weight, but I am breathing much better. I am an African American female who has Sarcoidosis, a condition that manifest itself in my lungs. Are you familiar with this desease and in addition to eating according to my blood type which is A+, are there some herbs that I can take to enhance my immune system? Please let me hear from you. Sarcoidosis is a rare desease and not many people know that much about it.


ANSWER

Sarcoidosis is a chronic, multisystem disorder of an unknown cause characterized by the accumulation of T-lymphocytes and mononuclear phagocytes, nonsecreting epithelial granulomas and derangements of the normal tissue architecture in affected organs. All parts of the body can be affected, but the organ most affected is the lung. Involvement of the skin, eye and lymph nodes is also common. A variety of infectious and noninfectious agents have been implicated, but there is no proof that any specific agent is responsible. However, available evidence is consistent with the concept that the disease results from an exaggerated cellular immune response (acquired, inherited or both) to a limited class of antigens or self antigens.

Cases of sarcoid have been described in both sexes, almost all ages, races and geographic locations. Females appear to be slightly more susceptible than males. There is remarkable diversity of the prevalence of sarcoidosis among certain ethnic and racial groups. In the United States, the majority of patients are black 10:1 to 17:1. Blacks are often younger than whites with the disease. I know of no specific association with ABO blood type, but have observed that following the correct diet for your type has almost always resulted in improvement in the cases I have seen in my clinic. Perhaps this is through the avoidance of blood type food lectins and the subsequent improvement in immune function. Whereas you are type A and obviously should follow the A plan, the rest of the information given below can be employed by any ABO type:

Chinese herbal treatment: A traditional Chinese remedy, Qing-Fei-Tang (Seihai-to, T90), has been used for treatment of chronic respiratory diseases, including sarcoid, with long-lasting cough and sputum, e.g. chronic bronchitis. We examined the effect of T90 and its main component flavonoid, baicalein, on the lucigenin-dependent chemiluminescence

(CL) and leukotriene B4 (LTB4) synthesis of human alveolar macrophages (AM). These results suggest that T90 exerts its effect on inflammatory lung diseases through the anti-inflammatory action, i.e. inhibiting the oxidative and arachidonate metabolism of local inflammatory lung cells. (1)

Boswellia serrata: Used largely as an arthritis remedy, Boswellia is a moderate to large branching tree found in India, Northern Africa, and the Middle East. Strips of bark are peeled away, yielding a gummy oleo-resin which contains oils, terpenoids, and gum. Up to 16 percent of the resin is essential oil, the majority being alpha thujene and p-cymene. Four pentacyclic triterpene acids are also present, with beta-Boswellic acid being the major constituent. Extracts of this gummy exudate have been traditionally used in the Ayurvedic system of medicine as an anti-arthritic. In vitro testing revealed Boswellia specifically, and in a dose-dependent manner, blocks the synthesis of pro-inflammatory 5-lipoxygenase products, including 5-hydroxyeicosatetraenoic acid (5-HETE) and leukotriene B4 (LTB4), which cause bronchoconstriction, chemotaxis, and increased vascular permeability. Other anti-inflammatory plant constituents, such as quercetin, also block this enzyme, but they do so in a more general fashion, as an antioxidant; whereas, Boswellia seems to be a specific inhibitor of 5-lipoxygenase. Human clinical studies are woefully lacking for this substance, and need to be conducted to better elucidate its effects in humans, as well as to determine optimal dosing. Animal and in vitro studies suggest it is useful for many inflammatory and bronchoconstrictive conditions. (2)

Melatonin: Matteo L. Cagnoni at the Dept of Dermatology University of Siena, Italy, writes: "We are presently studying the effects of Melatonin in the treatment of chronic refractary sarcoidosis. We have treated with Melatonin two cases of chronic refractary sarcoidosis unresponsive to long-term steroidal therapy. A more detailed report on this research has appeared in The Lancet November 4, Vol 346, pp 1229-1230, 1995."

CASE 1

A 34-year-old woman with sarcoidosis since 1990 had steroid treatment for 16 month from diagnosis with no improvement of her chest radiograph. Dyspnoea was present and FVC was reduced. High-resolution computed tomography (CT) of the lung showed swelling of hilar lymphonodes and a diffuse fibrosis characterised by interstitial reticular parenchymal infiltrates and thickening of bronchial walls. Serum angiotensin-converting-enzyme (ACE) values were increased (180 U/l). A 20 mg Melatonin daily therapy was started. 4 months later, dyspnoea had disappeared and the chest radiograph showed reduction of the reticular nodulation. Melatonin was continued and a year later a chest radiograph showed no interstitial involvement. In September 1993 Melatonin was tapered to 10 mg daily and discontinued in June, 1994. In January 1995, CT confirmed disappearence of the interstitial involvement and reduction of hilar lymphonodes.

CASE 2

In 1992 Sarcoidosis was diagnosed after a skin biopsy in a 45-year-old woman with reddish nodular papules on her right knee, which spread to her right cheekbone, left ear, and right elbow. Chest radiograph showed interstitial nodules; exertional dyspnoea was present; after a nine months steroidal therapy the patient did not improve: lung CT showed swelling of hilar lymponodes and micronodular and nodular interstitial images. ACE concentrations were increased. After treatment with 20 mg Melatonin daily for 5 months, the skin lesions were almost completely cleared, and dyspnoea reduced.CT scan showed disappearence of lymphonodes swelling and interstitial thickening. Resolutions of symptoms and radiological findings of these two cases of chronic sarcoidosis, previously unresponsive to steroid treatment, suggests that Melatonin might be a useful treatment. There were no side-effects. Further studies on acute sarcoidosis and on more patients with chronic sarcoidosis are needed to validate our observations.

1. Tanno Y, Kakuta Y, Aikawa T, Shindoh Y, Ohno I, Takishima T. Effects of qing-fei-tang (seihai-to) and baicalein, its main component flavonoid, on lucigenin-dependent chemiluminescence and leukotriene B4 synthesis of human alveolar macrophages. Am J Chin Med 1988;16(3-4):145-154

2. Monograph:Boswellia serrata. Altern Med Rev 1998 Aug;3(4):306-307




The Ask Dr. D'Adamo internet advice column ran from 1996 to 2009, at which time Dr. D'Adamo's teaching and programming responsibilities no longer allowed him to devote time and resources to directly answering visitor questions. However we've recently reorganized this treasure-trove of material and made it again available to his readership. He occasionally posts new entries. These are marked with a NEW tag.



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