ABSTRACT
Background: Cupping therapy is a well-known traditional treatment modality, and has been used in various diseases around the world since ancient times. This method is reported to have a better clinical as well as adverse events (AEs) profile as found in various studies conducted around the world. Aim: This study identifies, assesses, and classifies the adverse events profile of various types of cupping therapies in studies conducted in twenty one century. Methods: Using electronic and hand searches, three databases including Pub Med, Google Scholar and Cochrane library were searched from the year 2000 to 2016. Studies were included in this review provided they reported adverse effects related to cupping therapy. Observational studies were assessed using the WHO-UMC causality scale. Randomized controlled trials were assessed in accordance to the quality of reporting for harm data. Results: Nine hundred seventy nine (n=979) articles were identified. Based on exclusion and inclusion criteria and extensive review of all retrieved articles by two independent reviewers, only 25 studies that included six RCTs, sixteen single case reports and three case series were finally selected. The mostly observed adverse events of cupping therapy were scar formation reported in four studies that described fifty nine cases, and burns reported in two studies described sixteen cases, respectively. The adverse events of cupping therapy could be classified into local and systemic adverse events. Conclusion: Cupping therapy adverse events were infrequently reported, but they were not rare. Most of adverse effects were mild to moderate in severity. Some of the cupping therapy adverse events were preventable by following the general infection control guidelines, hygienic techniques, safety protocols and rigorous training of cupping therapists. Cupping adverse events should be reported in all studies on cupping, and this therapy should be practiced only by qualified medical professionals.
ABSTRACT
The role of T-Helper 2 [Th2] cells in the pathogenesis of allergy and asthma has been well described. However, the immunologic mechanisms that down modulate and protect against the development of these disorders are poorly characterized. A spectrum of CD4+ T cells, including, FOXP3-positive CD4+CD25+ T regulatory cells [Tregs] might play a critical role in regulating these diseases. To investigate the role of CD4+CD25high FoxP3 Tregs in the pathogenesis of pediatric asthma. The study included 24 asthmatic children, 12 had mild intermittent asthma and 12 were of severe persistent asthma . In addition, 12 healthy subjects were used as controls. All patients were subjected to clinical examination and laboratory investigations including complete blood count with differential leucocytic and absolute eosinophilic count, serum total IgE level by ELIZA and flow cytometry was used to study the frequency of Tregs in peripheral blood lymphocytes of all studied groups using specific markers: cell-surface CD25 and CD4 expression and cytoplasmic FoxP3 expression. It was noticed a significant decrease in CD4+CD25+ % and CD4+CD25 high % in both mild intermittent cases and severe persistent asthmatic patients when compared to healthy controls. FoxP3 expression in Tregs was significantly lower in CD4+CD25high T-cells of mild asthmatic patients when compared to control group. While the FoxP3 expression in Tregs was non- significantly lower in CD4+CD25high T-cells of severe asthmatic patients .Tregs cells % was correlated significantly with mild asthma .While it did not show correlation with severe asthma . An inverse correlation between FoxP3 protein expression was revealed within CD4+CD25high T-cells and total serum IgE when analyzed for all subjects. However, when correlation analysis was performed in each studied group separately, no significant correlation was found between FoxP3 expression and total serum IgE levels and there was no correlation between FoxP3 protein expressions within CD4+CD25high T-cells and eosinophilic count was noticed. The correlation of CD4+CD25high FoxP3 Tregs with asthma pathogenesis indicates that it is important to evaluate Tregs in allergic asthmatic children. Greater understanding of the molecular and immunological mechanisms underlying the CD4+CD25high FoxP3 Tregs might contribute the development of treatment modalities to influence disease processes of bronchial asthma in children as a future therapeutic target