title: The immune-modulatory effects of a mixed herbal formula on dendritic cells and CD4+ T lymphocytes in the treatment of dust mite allergy asthma and perennial allergic rhinitis.
abstract: OBJECTIVE
  Asthma and allergic rhinitis are chronic inflammatory diseases of the conducting nasal airway. Traditional Chinese medicine has long been used for supplemental therapy of allergic diseases, especially asthma and allergic rhinitis. We previously reported the effects of a mixed herbal formula in patients with allergic rhinitis. However, the immune-modulatory mechanism underlying the effects of herbal medicine for the treatment of allergic diseases remains unclear.
  
  
  METHODS
  We investigated the physiologic changes in dendritic cell (DC) and CD4(+) T cell activity in patients with asthma and allergic rhinitis who were treated with a mixed herbal formula composed of Xin-yi-san + Xiao-qing-long-tang + Xiang-sha-liu- jun-zi-tang. Specifically, we set up in vitro autologous or heterologous co-culture experiments between DCs and CD4(+) T cells, and used flow cytometry and ELISA to analyze the expression of surface molecules on DCs and the release of cytokines by CD4(+) T cells.
  
  
  RESULTS
  Expression of HLA-DR on DCs was suppressed following treatment with the mixed herbal formula. Surface expression of CD40, CD54 and CD86 on DCs was also attenuated after treatment. In autologous co-cultures, CD4(+) T cells increased their IL-10 production while decreasing TNF-α production. In heterologous co-cultures, IL-10 secretion by T cells was enhanced, while IL-12, IL-4, IL-5 and TNF-α secretion were reduced.
  
  
  CONCLUSIONS
  Our mixed herbal formula attenuated the allergic reaction by modifying the physiologic function of the DC-CD4(+) T cell interaction. Further investigations are necessary to understand the mechanism of immune modification mediated by the mixed herbal formula.
authors.affiliation: a School of Chinese Medicine, Chang Gung University , Taoyuan , Taiwan .|b Department of Traditional Chinese Medicine , Chang Gung Memorial Hospital , Taipei , Taiwan .
authors.forename: Sien-Hung
authors.initials: SH
authors.lastname: Yang
authors.affiliation: c Institute of Molecular Medicine, National Taiwan University College of Medicine , Taipei , Taiwan .|d Center for Complementary and Integrative Medicine, National Taiwan University Hospital , Taipei , Taiwan .
authors.forename: Chia-Li
authors.initials: CL
authors.lastname: Yu
authors.affiliation: e Manchester Medical School, University of Manchester , Manchester , UK , and.
authors.forename: Yi-Han
authors.initials: YH
authors.lastname: Yang
authors.affiliation: f School of Dentistry, Matsumoto Dental University , Shiojiri , Japan.
authors.forename: Yi-Hsun
authors.initials: YH
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects* / Q000276:immunology*; D002478:Cells, Cultured; D003713:Dendritic Cells / Q000187:drug effects* / Q000276:immunology*; D004365:Drugs, Chinese Herbal / Q000494:pharmacology* / Q000627:therapeutic use*; D004391:Dust / Q000276:immunology*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008925:Mites; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000276:immunology*; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal; D004391:Dust; D007155:Immunologic Factors
keywords: Asthma; CD4+ T cells; dendritic cells; herbal medicine; perennial allergic rhinitis