Cupping (Hijama) in Skin diseases with positive Koebner’s Phenomenon: What is New?
Khalifa E. Sharquie, Fatema A. Al-Jaralla
J Clin Exp Invest 2019;10(3):em00726.
https://doi.org/10.5799/jcei/5856
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Background: Cupping therapy is an ancient traditional and complementary medicine used in the treatment of a broad range of medical conditions. It is very popular in many countries, especially in China, Korea, and Japan. It is used in the Muslim world, as well as in North Africa, Eastern Europe and Latin America. Cupping involves applying a heated cup to generate a partial vacuum that mobilizes the blood flow and promotes effective healing. Till now, there is no certain scientific base for using cupping in treating any medical problem especially skin diseases. Many skin diseases have tendency to appear at the site of injury or damage to the skin, the so called koebners phenomena. Our observation is that hijama induces skin diseases at the site of cupping in patients with skin dis-eases with koebner phenomenon. Objective: to present cases with koebner phenomenon after cupping with primary lesions seen at the site of cupping. Patients and method: a total of 24 male patients previously diagnosed with skin diseases; 16 with psoriasis, 6 with lichen planus, one patient with dermatitis herpetiformis, and one with seborrheic dermatitis. Results: All patients had stable skin diseases prior to cupping but new lesions appeared at the site of cupping around two weeks after the procedure. Conclusion: cupping should not be encouraged for skin diseases with positive koebner phenomenon commonly psoriasis and lichen planus and possibly contraindicated as till now there is no scientific basis for using this procedure.
Keywords: hijama, skin diseases, psoriasis, lichen planus, koebner phenomenon
REFERENCES
- Hasan I, Ahmad T, Ahmad S. Management of hypertension by wet cupping therapy (Al-Hijamah): a case study. Int J Pharmacol Toxicol. 2014;4(1):24–27
- Sheikho MA. Cupping: a prophetical medicine appears in its new scientific perspective. North Charleston: Create Space Independent Publishing Platform. 2011:12–15.
- Albinali, Hajar (June 2004). “Traditional Medicine among Gulf Arabs Part II - Blood Letting”. Heart Views. 5(2): 74–85.
- Hanan SA, Eman SE. Cupping therapy (Al-Hijama): it’s impact on persistent non-specific lower back pain and client disability. Life Sci J. 2013;10(4s):631–642.
- Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner T, Zwart JA. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27(3): 193–210.
- Cui S, Cui J. Progress of researches on the mechanism of cupping therapy. Zhen Ci Yan Jiu. 2012;37:506–510.
- Chen C, Yu H. Acupuncture, electrostimulation, and reflex therapy in dermatology. Dermatologic Therapy. 2003;16(2):87–92.
- Bamfarahnak H, Azizi A, Noorafshan A, Mohagheghzadeh A. A tale of Persian cupping therapy: 1001 potential applications and avenues for research, Forsch Komplementmed. 2014;21:42-47.
- Kim TH, Kim KH, Choi JY, Lee MS. Adverse events related to cupping therapy in studies conducted in Korea: a systematic review, Eur J Integr Med, 2013;6:434-40.
- Lee SJ, Chung WS, Lee JD, Kim HS. A patient with cupping-related post-inflammatory hyperpigmentation successfully treated with a 1,927 nm thulium fiber fractional laser, J Cosmet Laser Ther, 2014;16:66-8.
- Park TH. Keloid on scapular area secondary to therapeutic dry cupping, Int Wound J, 2013. (doi: 10.1111/iwj.12184).
- Hon KLE, Luk DCK, Leong K, Alexander KCF. Cupping therapy may be harmful for eczema: a PubMed search, Case Rep Pediatr, 2013;2013. (doi: 10.1155/2013/605829).
- R Abdul, B Noor Ul-Ain, A Muhammad. Practice of cupping (Hijama) and the risk of bloodborne infections, Am J Inf Cont, 2014;42:1139.
- Blunt SB, Lee HP. Can traditional “cupping” treatment cause a stroke? Med Hypotheses, 2010;74:945-9.
- Hameed A, Khan AA. Koebner phenomenon in pemphigus vulgaris. Br J Dermatol 1996;135:152-3.
- Hebra F. Disease of the skin. New Sydenham Society 1874:180.
- Preissmann M. The provocative action of light in Darier’s disease. Ann Dermatol Syphilol 1946:188.
- Rosenberg EW, Noah PW. The Koebner phenomenon and the microbial basis of psoriasis. J Am Acad Dermatol 1988;18:151-8
- Liu W, Piao S, Meng X, Wei LH. Effects of cupping on blood flow under skin of back in healthy human, World J Acupuncture Moxibustion, 2013;23:50-2.
- Norouzali T, Roostayi MM, Dehghan MF, Abbasi M, Akbarzadeh BA, Khaleghi MR. The effects of cupping therapy on biomechanical properties in wistarrat skin, J Res Rehab Sci, 2014;9:841-51.
- Emerich M, Braeunig M, Clement HW, Lüdtked R, Hubera R. Mode of action of cupping—local metabolism and pain thresholds in neck pain patients and healthy subjects, Complement Ther Med, 2014;22:148-58.
- Tian H, Tian YJ, Wang B, Yang L, Wang YY, Yang JS. Impacts of bleeding and cupping therapy on serum P substance in patients of postherpetic neuralgia, Zhongguo Zhen Jiu, 2013;33:678-81.
- Khalil AM, Al-Qaoud KM, Shaqqour HM. Investigation of selected immunocytogenetic effects of wet cupping in healthy men, J Complement Med Drug Discov, 2013;3:51-7.
- Köbner H. Zur Aetiologie der Psoriasis. Vjschr Dermatol 1876:559.
- Camargo CM, Brotas AM, Ramos-e-Silva M, Carneiro S. Isomorphic phenomenon of Koebner: facts and controversies. Clin Dermatol 2013;31:741–9. (doi: 10.1016/j.clindermatol.2013.05.012).
- Sagi L, Trau H. The Koebner phenomenon. Clin Dermatol 2011;29:231–6. (doi: 10.1016/j.clindermatol.2010.09.014).
- El-Domyati M, Saleh F, Barakat M, Mohamed N. Evaluation of cupping therapy in some dermatoses. Egypt Dermatol Online J 2013;9:2.
- Yu RX, Hui Y, Li CR. Köebner phenomenon induced by cupping therapy in a psoriasis patient. Dermatol Online J 2013;19:18575.
Tumor Immunized Autologous Natural Killer Cell (NK) Therapy/Compassionate Use
Serdar Baki Albayrak, Ayhan Bilir, Türker Karancı, Emine Tural
J Clin Exp Invest 2019;10(3):em00727.
https://doi.org/10.5799/jcei/5858
Letter to Editor
[Abstract]
[PDF]
[References]
ABSTRACT
As well known, diffuse infiltrative pontine glioma (DIPG)-despite all available treatment modalities- carries a dismal prognosis with a mean survival of around one year [1]. A four year old boy was referred to me with a radiological diagnosis of DIPG. He was irradiated and a ventriculoperitoneal shunt (VPs) was inserted in a health facility in Europe. On admission (seven months after the diagnosis), patient was tracheostomized, conscious, quariparetic and with bilateral abducens and lower cranial nerve paresis. I decided to operate on the patient in order to debulk the necrotic pontine mass and to verify the radiological diagnosis histopathologically. Additionally, I planned to co-culture the tumoral cells with the natural killer (NK) cells isolated from the peripheral venous blood to investigate the immunization and potentiation of autologous NK cells against glioma cells in vitro after the ethical committee approval was obtained from the Istanbul Aydin University. In January 2019, pontine mass was partially removed via telo-velar approach under neurophysiological monitorization with no additional post op deficits and the unilateral abducens nerve recovery. Tumor specimens were sent to the tissue culture labs and the cell culture procedures were carried out meticulously. Meanwhile, routine histopathological evaluation reported the pontine lesion as DIPG (Grade 4 astrocytoma) officially.
Keywords:
REFERENCES
- Pollack IF, Agnihotri S, Broniscer A. Childhood brain tumors: current management, biological insights, and future directions. J. Neurosurg Pediatr. 2019;23:261-273.
Age-dependent Role of Cilostazol on Cold Restraint Stress-induced Gastric Ulceration in Female Rats
Abeer Mohamed Rashad, Gehan Hussein Heeba, Somya Hassan Hamad
J Clin Exp Invest 2019;10(3):em00728.
https://doi.org/10.5799/jcei/5902
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Introduction: Cilostazol (CIL), a phosphodiesterase III inhibitor, is a potent antiplatelet drug which possesses vasodilator and anti-inflammatory activity that making it an effective drug in gastric ulcer protection.
Objectives: This study investigated the influence of age on the effects of CIL against cold restraint stress (CRS) - induced gastric ulcer in rats.
Methods: CIL (10 mg/kg/day) was administered orally for 2 weeks to adult and aged female rats before CRS-induced gastric ulcer.
Results: This syudy showed that CIL exhibited gastroprotective effects in both adult and aged rats as evidenced by significant decrease in ulcer index, gastric mucosal malondialdehyde level, myeloperoxidase activity and tumor necrosis factor-α protein expression with concomitant increase in gastric mucosal reduced glutathione level and glutathione peroxidase activity, nitric oxide, prostaglandin E2 level, cyclooxygenase-1 and 2 protein expression and gastric juice mucin concentration compared to adult and aged CRS rats, respectively. Additionally, the histopathological examination results came to confirm the protection afforded by CIL in CRS - induced gastric ulcer.
Conclusion: The possible protective effect of CIL against CRS-induced gastric ulceration in both adult and aged rat’s may be explained via its antioxidant and antiinflammatory properties and by enhancement of gastric mucus secretion. It could be recommended that CIL is considered as a more proper antiplatelet drug for adult and elderly patients who are at risk of gastric ulceration.
Keywords: cilostazol, gastric ulcer, nitric oxide, prostaglandin E2, cyclooxygenase
REFERENCES
- Chang XR, Peng L, Yi SX, Peng Y, Yan J. Association of high expression in rat gastric mucosal heat shock protein 70 induced by moxibustion pretreatment with protection against stress injury. World J. Gastroenterol. 2007;13:4355-9.
- Dekanski D, Janićijević-Hudomal S, Ristić S, Radonjić NV, Petronijević ND, Piperski V, et al. Attenuation of cold restraint stress-induced gastric lesions by an olive leaf extract. Gen. Physiol. Biophys. 2009;28:135-42.
- Chung HY, Lee EK, Choi YJ, Kim JM, Kim DH, Zou Y, et al. Molecular inflammation as an underlying mechanism of the aging process and age-related diseases. J. Dent. Res. 2011;90:830-840.
- Seo PJ, Kim N, Kim JH, Lee BH, Nam RH, Lee HS, et al. Comparison of Indomethacin, Diclofenac and Aspirin-Induced Gastric Damage according to Age in Rats. Gut and Liver 2012;6:210-217.
- Choi YJ, Kim N, Lee JY, Nam RH, Suh JH, Lee SM, et al. PMK-S005 Alleviates Age-Related Gastric Acid Secretion, Inflammation, and Oxidative Status in the Rat Stomach. Gut and Liver 2016;15:10:749-756.
- Eikelboom JW, Hirsh J, Spencer FA, Baglin TP, Weitz JI. Antiplatelet Drugs: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141:89–119.
- Sostres C, Lanas A. Gastrointestinal effects of aspirin. Nat. Rev. Gastroenterol. Hepatol. 2011;8:385-394.
- Patrono C, García Rodríguez LA, Landolfi R, Baigent C. Low-dose aspirin for the prevention of atherothrombosis. N. Engl. J. Med. 2005;353:2373-2383.
- Rogers KC, Oliphant CS, Finks SW. Clinical efficacy and safety of cilostazol: a critical review of the literature. Drugs 2015;75(4):377-395.
- Hattori Y, Suzuki K, Tomizawa A, Hirama N, Okayasu T, Hattori S, et al. Cilostazol inhibits cytokine-induced nuclear factor-kappaB activation via AMP-activated protein kinase activation in vascular endothelial cells. Cardiovasc. Res. 2009;81:133–139.
- Lee WC, Chen HC, Wang CY, Lin PY, Ou TT, Chen CC, et al. Cilostazol ameliorates nephropathy in type 1 diabetic rats involving improvement in oxidative stress and regulation of TGF-Beta and NF-kappaB. Biosci. Biotechnol. Biochem. 2010;74:1355–1361.
- Odashima M, Otaka M, Ohba R, Jin M, Wada I, Horikawa Y, et al. Attenuation of gastric mucosal inflammation induced by aspirin through inhibition of selective type III phospshodiesterase in rats. Dig. Dis. Sci. 2007;52:1355-1359.
- Winzler RJ. Determination of serum glycoproteins. In: Glick DP, eds., Methods of Biochemical Analysis. New York: Interscience Publishers Inc., 1955:279–311.
- Biswas K, Bandyopadhyay U, Chattopadhyay I, Varadaraj A, Ali E, Banerjee RK. A novel antioxidant and antiapoptotic role of omeprazole to block gastric ulcer through scavenging of hydroxyl radical. J. Biol. Chem. 2003;278:10993-1001.
- Ohkawa H, Ohishi N, Yagi K. Assay of lipid peroxidation in animal tissues by thiobarbituric acid. Anal. Biochem. 1979;95:351-358.
- Bradley PP, Priebat DA, Christensen RD, Rothstein G. Measurement of cutaneous inflammation: estimation of neutrophil content with an enzyme marker. J. Invest. Dermatol. 1982;78:206–209.
- Griffith OW. Determination of glutathione and glutathione disulfide using glutathione reductase and 2-vinylpyridine. Anal. Biochem. 1980;15:106:207-212.
- Paglia DE, Valentine WN. Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase. J. Lab. Clin. Med. 1967;70:158-169.
- Green LC, Wagner DA, Glogowski J, Skipper PL, Wishnok JS,Tannenbaum SR. Analysis of nitrate, nitrite, and [‘5N] nitrate in biological fluids. Anal. Biochem., 1982;126:131–138.
- Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal. Biochem. 1976;72:248–254.
- Tarnawski AS, Ahluwalia A, Jones MK. Increased susceptibility of aging gastric mucosa to injury: The mechanisms and clinical implications. World J. Gastroenterol. 2014;20:4467–4482.
- Kang JM, Kim N, Kim JH, Oh E, Lee BY, Lee BH, et al. Effect of aging on gastric mucosal defense mechanisms: ROS, apoptosis, angiogenesis, and sensory neurons. Am. J. Physiol. Gastrointest. Liver Physiol. 2010;299:1147-1153.
- Ohba R, Otaka M, Odashima M, Jin M, Komatsu K, Konishi N, et al. Effect of cilostazol, a selective type-III phosphodiesterase inhibitor, on water-immersion stress-induced gastric mucosal injury in rats. J. Gastroenterol. 2006;41:34-40.
- Peng YC, Hsu CL, Tung CF, Chou WK, Huang LR, Hung DZ, et al. Chemiluminescence assay of mucosal reactive oxygen species in gastric cancer, ulcer and antral mucosa. Hepatogastroenterol. 2008;55(82-83):770-773.
- Laine L, Takeuchi K, Tarnawski A. Gastric mucosal defense and cytoprotection: bench to bedside. Gastroenterol. 2008;135:41-60.
- Ahangarpour A, Heidari H, Mard SA, Hashemitabar M, Khodadadi A. Progesterone and cilostazol protect mice pancreatic islets from oxidative stress induced by hydrogen peroxide. Iran J. Pharm. Res. 2014;13:937-944.
- Da Motta NA, De Brito FC. Cilostazol exerts antiplatelet and anti-inflammatory effects through AMPK activation and NF-kB inhibition on hypercholesterolemic rats. Fundam. Clin. Pharmacol. 2016;30:327-337.
- Tanaka A, Hatazawa R, Takahira Y, Izumi N, Filaretova L, Takeuchi K. Preconditioning stress prevents cold restraint stress-induced gastric lesions in rats: roles of COX-1, COX-2, and PLA2. Dig. Dis. Sci. 2007;52:478–487.
- Amagase K, Izumi N, Takahira Y, Wada T, Takeuchi K. Importance of cyclooxygenase-1/prostacyclin in modulating gastric mucosal integrity under stress conditions. J. Gastroenterol. Hepatol. 2014;4:3-10.
- Wallace JL. Prostaglandins, NSAIDs, and gastric mucosal protection: why doesn`t the stomach digest itself? Physiol. Rev. 2008;88:1547-1565.
- Schmassmann A, Zoidl G, Peskar BM, Waser B, Schmassmann-Suhijar D, Gebbers JO, et al. Role of the different isoforms of cyclooxygenase and nitric oxide synthase during gastric ulcer healing in cyclooxygenase-1 and -2 knockout mice. Am. J. Physiol. Gastrointest. Liver Physiol. 2006;290:747–756.
- Groneberg D, Voussen B, Friebe A. Integrative control of gastrointestinal motility by nitric oxide. Curr. Med. Chem. 2016;23:2715-2735.
- Takeuchi K, Kita K, Hayashi S, Aihara E. Regulatory mechanism of duodenal bicarbonate secretion: Roles of endogenous prostaglandins and nitric oxide. Pharmacol. Ther. 2011;130:59-70.
- Saber A, Bayumi K. Age - Related Gastric Changes. J. Surgery 2016;4:20-26.
- El-Demerdash E, El-Mesallamy HO, Abu-Zaid NM, Gad MZ. The potential therapeutic effect of nitric oxide modulators in experimentally-induced gastric ulcers. Drug Discov. Ther. 2010;4:276-284.
- Mendes JB, Campos PP, Rocha MA, Andrade SP. Cilostazol and pentoxifylline decrease angiogenesis, inflammation, and fibrosis in sponge-induced intraperitoneal adhesion in mice. Life Sci. 2009; 10:84(15-16):537-543.