Chronic lung conditions such as Asthma, Chronic Obstructive Pulmonary Disease (COPD), Bronchitis, Cystic Fibrosis (CF), Bronchiectasis, Chronic Sinusitis and Allergic Rhinitis (‘hay fever’), affect almost one third of Australians and add a $4 billion burden on the Australian health care system.
Despite the continual increase of sickness and monetary value (1), the current treatment and management of such conditions commonly only consider the lungs as an isolated organ, and in some cases may be contributing to illness exacerbations. This summary will outline holistic views that need to be considered in the treatment and management of chronic respiratory conditions including the gut-lung microbiome connection, viral exposure, antibiotic use, and the nutritional, lifestyle and emotional health of the patient.
Immune deficiency has been identified as a potential exacerbating factor and/or risk factor for chronic lung conditions (2). The gut microbiota is known for their role in maintaining immune homeostasis via immune cell expression and regulation (3). Evidence suggests that early life development of the microbiome is important for the lung immune response, as demonstrated in Asthma and CF (3). The microbiota influences conditions that affect bacterial proliferation including oxygen tension, local pH, blood flow, temperature, inflammation and epithelial cell architecture (3). For this reason, studies suggest there is a cross talk between the gut and lung microbiome (3). However, the lung microbiota is poorly understood.
Viral and post-viral exposure also plays a significant role in the exacerbation of chronic respiratory disease, which has the ability to increase opportunistic microbiome species such as Pseudomonas spp. (3). Similar observations have been made in Asthma patients with altered microbiome in the bronchial tree when compared with controls, however no studies have assessed the airway microbiome in Asthma exacerbations despite 80% of these being associated with viral infections (3).
A common treatment for lung conditions is the prescription of antibiotics. It is well known that antibiotics disrupt the gut microbiome and enhance fungal colonisation, enhancing allergic responses and altering immune cell functioning (3). Interestingly, studies have demonstrated that children with broad microbial exposures such as those seen in traditional farming were protected from Asthma in childhood (4). Other studies have demonstrated that Asthma is reduced in children with high fibre diets, and animal studies have proposed this is due to the influence of short chain fatty acids on immune cells to protect against inflammation (3). Traditional Chinese Medicine (TCM) Dietetics promote eating correctly to reduce chronic lung disease exacerbations, such as reducing mucous forming or drying foods, and to work with nutrition and the external environment to enhance immunity and lung health (5).
The emotional health of the patient also needs to be considered, as TCM states that emotions have affiliations for specific bodily organs, with the lungs associated with sadness and grief (6). The effect of long-term stress is also well known for its negative impact on the immune system (7). Despite this knowledge, emotions and stressors are rarely taken into account in the treatment of chronic respiratory conditions.
The treatment and management of chronic respiratory conditions need to be viewed from the perspective of a multi-layered systemic immune disorder, with consideration given to the patient’s nutritional, lifestyle and emotional health. This being said, further research studies incorporating a holistic picture of health are required.
(1) Australia Government Australia Institute of Health and Welfare. (2020).
Chronic Respiratory Conditions. Retrieved from https://www.aihw.gov.au/reports/australias-health/chronic-respiratory-conditions
(2) Berger, M., Geng, B., Cameron, D. W., Murphy, L. M., & Schulman, E. S. (2017). Primary immune deficiency diseases as unrecognized causes of chronic respiratory disease. Respir Med., 132, 181-188. https://doi.org/10.1016/j.rmed.2017.10.016
(3) O'Dwyer, D. N., Dickson, R. P., & Moore, B. B. (2016). The Lung Microbiome, Immunity, and the Pathogenesis of Chronic Lung Disease. Journal of immunology, 196(12), 4839–4847. https://doi.org/10.4049/jimmunol.1600279
(4) Ege, M.J., Mayer, M., Normand, A.C., Genuneit, J., Cookson, W. O., Braun-Fahrlander, C., Heederik, D., Piarroux, R., von Mutius, E. (2011). Exposure to environmental microorganisms and childhood asthma. N Engl J Med., 364. 701–709. https://doi.org/10.1056/NEJMoa1007302
(5) Deng Z. (2009). TCM diet therapy for bronchial asthma. J Tradit Chin Med. 29(3), 209-10. https://doi.org/10.1016/s0254-6272(09)60067-4
(6) Lee, Y. S., Ryu, Y., Jung, W. M., Kim, J., Lee, T., & Chae, Y. (2017). Understanding Mind-Body Interaction from the Perspective of East Asian Medicine. Evidence-based complementary and alternative medicine. https://doi.org/10.1155/2017/7618419
(7) Dhabhar, F. S. (2014). Effects of stress on immune function: the good, the bad, and the beautiful. Immunol Res., 58(2-3), 193-210. https://doi.org/10.1007/s12026-014-8517-0
After graduating from Endeavour College with a Bachelor of Health Science (Naturopathy), Bec Harwood is now a Naturopath who owns her own practice Mother Nature Heals, which operates out of Frisbee Health and Chiropractic in Fulham, Melbourne. At this clinic, Bec works alongside chiropractors, Chinese medicine doctors, acupuncturists, and more, which offers a holistic approach to treating clients.
Bec is passionate about whole healing, including emotional healing and nutrition. After battling serious respiratory and immune conditions for most of her life, Bec's conditions have been entirely healed by natural health practitioners. She hopes to bring this same healing to her clients.