Article

Does the Burning of Moxa ( Artemisia vulgaris ) in traditional Chinese medicine constitute a health hazard?

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Abstract

Concerns have been expressed about potential toxicity of the smoke produced by the burning of moxa in traditional Chinese medicine. With the advent of strict anti-smoking legislation in the UK, it was decided to test the volatiles produced by moxibustion and compare them with current agreed safe exposure levels. Moxa, in the form of cigar shaped moxa "sticks" or "rolls", was tested under International Organization for Standardization conditions in a tobacco testing laboratory, and the quantities of a number of pre-determined volatiles measured. The smoke tested was "sidestream smoke", the smoke which arises from the burning tip of the moxa. The test results were then scaled up to reflect normal use and to provide direct comparisons with agreed national safety standards for both short- and long-term exposure levels. Levels of only two volatiles produced were equivalent or greater than the safe exposure levels, as was the carbon monoxide level reported, both as a consequence of using worst case assumptions for comparison. Under normal operating conditions neither volatile nor carbon monoxide would present a safety hazard. One group of chemicals tested, the aromatic amines, with known carcinogenic properties have no agreed safety levels. Results for these in the study compared favourably with background levels reported in urban environments. There are no immediate concerns arising from the continued use of moxa as a therapeutic modality in traditional Chinese medicine. Further testing may be required to establish whether current recommendations for ventilation and cleansing of treatment room surfaces may need to be revised. Stronger recommendations may also be necessary on the inadvisability of using moxa on broken skin.

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... None of included trials assessed adverse events. Currently 3 studies evaluated the adverse events or possible risks of moxibution [30][31][32]. Mild or no adverse effects of were noted in previous reports [30,32], while one study [31] concerned possible hazardous in health by smoke from mouldering moxibustion. Relative to those of other conventional treatments, these are mild, infrequent and perhaps even negligible. ...
... Currently 3 studies evaluated the adverse events or possible risks of moxibution [30][31][32]. Mild or no adverse effects of were noted in previous reports [30,32], while one study [31] concerned possible hazardous in health by smoke from mouldering moxibustion. Relative to those of other conventional treatments, these are mild, infrequent and perhaps even negligible. ...
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Moxibustion is a traditional Chinese method that uses the heat generated by burning herbal preparations containing Artemisia vulgaris to stimulate acupuncture points. Considering moxibustion is closely related to acupuncture, it seems pertinent to evaluate the effectiveness of moxibustion as a treatment of symptoms of cancer. The objective of this review was to systematically assess the effectiveness of moxibustion for supportive cancer care. We searched the literature using 11 databases from their inceptions to February 2010, without language restrictions. We included randomised clinical trials (RCTs) in which moxibustion was employed as an adjuvant treatment for conventional medicine in patients with any type of cancer. The selection of studies, data extraction, and validations were performed independently by two reviewers. Five RCTs compared the effects of moxibustion with conventional therapy. Four RCTs failed to show favourable effects of moxibustion for response rate compared with chemotherapy (n = 229, RR, 1.04, 95% CI 0.94 to 1.15, P = 0.43). Two RCTs assessed the occurrence of side effects of chemotherapy and showed favourable effects of moxibustion. A meta-analysis showed significant less frequency of nausea and vomiting from chemotherapy for moxibustion group (n = 80, RR, 0.38, 95% CIs 0.22 to 0.65, P = 0.0005, heterogeneity: chi2 = 0.18, P = 0.67, I2 = 0%). The evidence is limited to suggest moxibustion is an effective supportive cancer care in nausea and vomiting. However, all studies have a high risk of bias so effectively there is not enough evidence to draw any conclusion. Further research is required to investigate whether there are specific benefits of moxibustion for supportive cancer care.
... The indoor air pollutants in prescribed Chinese medicine clinics (CMCs) were reported by Mo et al 2 and Hsu et al 3 The results have shown that moxa smoke had severely polluted indoor air in CMCs, and an investigation in southern Taiwan concluded that both cancer and non-cancer risks exceed acceptable criteria. While, Wheeler et al 4 and Matsumoto et al 5 tested several predetermined volatiles from moxa smoke under international standardized conditions. The results have identified that the quantities of harmful substance in moxa smoke during normal clinical therapy were below maximum levels of the agreed national safety standards for both short-and long-term exposure, and no immediate concerns from the continued use of moxa. ...
... Britain study showed no immediate concerns regarding the continued use of moxa as a therapeutic modality under normal operating conditions. 4 Lan et al 14 also indicated that moxa smoke was not overtly toxic to rats. However, study at two clinics in Zhejiang 2,3 have concluded that moxa smoke may cause serious indoor pollution, and an investigation in southern Taiwan 3 concluded that both cancer and non-cancer risks exceed acceptable criteria. ...
Article
Objective: To assess the toxicity of moxa smoke in rats. Methods: Forty-eight female Wister rats were randomly divided into 4 groups (n = 12/group) to simulate moxa smoke exposure in Chinese medicine clinics (CMCs): the control group, and three moxa-smoke exposed groups of PM10 mass concentrations 3-5, 7-9 and 27-30 mg/m3 , respectively. These concentrations were 1 × , 2-3 × , and 7-9 × fold the concentrations found in CMCs. Exposures continued for 12 weeks (200 min/d, 5 d/week). Results: No deaths were noted. After the exposure, the body weights, ratios of organ weight to body weight, urinary parameters, hematological parameters, clinical chemistry parameters and microscopic examinations revealed no obvious toxicity. Conclusion: Moxa smoke did not induce toxic effects in female rats in the study. These findings provide new evidence to the toxicity of moxa smoke.
... There have already been studies of the constituent ingredients of the base ingredient mugwort and the processed substance moxa [7]. However, there has been no such analysis of the constituent products of smoke released upon burning moxa [8,9]. In particular, there have been no reports on the safety of smoke from moxa produced in Japan. ...
... In Chinese practice [9], extremely large quantities of mediumrefined moxa sticks are regularly used for therapy, resulting in different levels of harmful combustion products compared to Japan. A report cites five doctors using 24,000 moxa sticks over the course of a single year. ...
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Moxibustion is an ancient method of traditional medicine (along with acupuncture) using moxa, or processed mugwort leaves. Both the smoke and heat generated by burning moxa are considered to have therapeutic effects. However, recently there have been reports of harmful substances released in smoke from everyday objects such as scented candles or incense. Therefore, we decided to study combustion products in moxa smoke using three types of commonly used moxa, each with a differing level of refinement.
... 17 (Jakupovic et al, 1987), 18 (Lin et al., 2014), 19 (Tu et al., 1985), 20 (Nakamura & Hattori, 2001), 21 (Saadali et al., 2001), 22 (Yamada et al., 2011), 23 (Wheeler et al., 2009), 24 (Rashid et al., 2015), 25 (Umano et al., 2000), 26 (Bak et al., 2015), 27 (Kavvadias et al., 2000), 28 (Megdiche-Ksouri et al., 2015), 29 (Kim et al., 1992), 30 (Choi et al., 2014), 31 (Geng et al., 2015), and 32 (Mizushina et al., 1999). ...
... Likewise, 1-(1-oxo-9,12,15-octadecatrienyl)-pyrrolidine (41), oleamide (42), and palmitamide (43) Hara through a combination of SFSI and GC/MS analysis (Mamun et al., 2015). 3-Methyl-butyramide (44) was identified in the moxa of A. vulgaris (Wheeler, Coppock, & Chen, 2009). The oleamide (42) (Cravatt, Lerner, & Boger, 1996). ...
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Several reviews have been published on Artemisia's derived natural products, but it is the first attempt to review the chemistry and pharmacology of more than 80 alkaloids and allied nitrogen compounds obtained from various Artemisia species (covering the literature up to June 2018). The pharmacological potential and unique skeleton types of certain Artemisia's alkaloids provoke the importance of analyzing Artemisia species for bioactive alkaloids and allied nitrogen compounds. Among the various types of bioactive Artemisia's alkaloids, the main classes were the derivatives of rupestine (pyridine-sesquiterpene), lycoctonine (diterpene), pyrrolizidine, purines, polyamine, peptides, indole, piperidine, pyrrolidine, alkamides, and flavoalkaloids. The rupestine derivatives are Artemisia's characteristic alkaloids, whereas the rest are common alkaloids found in the family Asteraceae and chemotaxonomically links the genus Artemisia with the tribes Anthemideae. The most important biological activities of Artemisia's alkaloids are including hepatoprotective, local anesthetic, β-galactosidase, and antiparasitic activities; treatment of angina pectoris, opening blocked arteries, as a sleep-inducing agents and inhibition of HIV viral protease, CYP450, melanin biosynthesis, human carbonic anhydrase, [3H]-AEA metabolism, kinases, and DNA polymerase β1 . Some of the important nitrogen metabolites of Artemisia include pellitorine, zeatin, tryptophan, rupestine, and aconitine analogs, which need to be optimized and commercialized further.
... As a considerable amount of particulate matter is present [11][12][13] in MBP, safety concerns about the potential health risks of MBP are spawning. Recent studies of MBP have reported its constituents, 14 therapeutic efficiency [15][16][17] and indoor air quality assessment. Wheeler et al 14 tested several predetermined volatiles from MBP under international standardized conditions and found no immediate concerns from the continued use of moxa. ...
... Recent studies of MBP have reported its constituents, 14 therapeutic efficiency [15][16][17] and indoor air quality assessment. Wheeler et al 14 tested several predetermined volatiles from MBP under international standardized conditions and found no immediate concerns from the continued use of moxa. Animal studies showed that MBP might work mutually with moxibustion to bring about immunomodulatory, 15 antiaging, 16 and reproduction-improving 17 effects. ...
Article
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Objective To assess toxicities of the air in Chinese medicine clinics polluted by moxa-burning smoke due to moxibustion-derived burning products (MBP). Methods Both acute and chronic toxicity studies were conducted. For the acute toxicity study, five groups of Wistar rats (n = 16/group, male: female = 1∶1) were exposed to five different concentrations (95%, 90%, 85%, 80% and 75%, respectively) of MBP for 2 h. For the chronic toxicity study, other three groups of male rats (n = 21/group) were exposed to MBP in three concentrations (10%, 40% and 70%, respectively) and one control group exposed to clean air 20 min/d for 144 d. Routine examinations were performed and analyzed by analysis of variance and dose-response relationship. Results In the acute toxicity study, the number of dead rats in the 95%, 90%, 85%, 80% and 75% groups were 16, 13, 7, 6 and 3, respectively, with LD50 of 86.274% after or during the 2 h exposure. In the chronic toxicity study, MBP exposure induced a decline in activity of the rats. Rats in the 10% group showed no signs of toxicity, while those in the 40% MBP group showed toxicity effects on the body weights (P < 0.05) and lung. Rats in the 70% MBP group also presented with reversible damage in the blood coagulation system (P < 0.05). Conclusions Exposure to 10% MBP, which is equivalent to 27.45 mg/m³, was under the critical threshold for male rats' safety. Exposure to MBP above that limit induced lung damage. MBP in clinics need to be reduced to a safe level with enhanced ventilation.
... Indications for this treatment include tumors, although its effectiveness has not been confirmed so far [92]. In 2009, Reference [93] investigated the harmfulness of compounds formed during the combustion of this plant species. The authors tested the smoke emitted by moxa for the presence of compounds commonly found in cigarettes, such as tar, nicotine, carbon monoxide, polycyclic aromatic hydrocarbons, ammonia, hydrogen cyanide, polyaromatic amines, volatile organic compounds, semi-volatile compounds, phenols, and carbonyls (e.g., formaldehyde and acetone), all of which are associated with the highest risk of cancer. ...
... Therefore, the authors concluded that burning moxa should not pose a health risk. Evidence of exceeded limits appeared only after the extrapolation of results for long-term use, which probably did not reflect the actual concentration of the tested compounds [93]. In TCM, A. vulgaris is most often used in thermopuncture in the form of cotton buds impregnated with the plant extract, or as cigarettes filled with dried leaves and used to cauterize the skin. ...
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Artemisia absinthium—wormwood (Asteraceae)—is a very important species in the history of medicine, formerly described in medieval Europe as “the most important master against all exhaustions”. It is a species known as a medicinal plant in Europe and also in West Asia and North America. The raw material obtained from this species is Absinthii herba and Artemisiae absinthii aetheroleum. The main substances responsible for the biological activity of the herb are: the essential oil, bitter sesquiterpenoid lactones, flavonoids, other bitterness-imparting compounds, azulenes, phenolic acids, tannins and lignans. In the official European medicine, the species is used in both allopathy and homeopathy. In the traditional Asian and European medicine, it has been used as an effective agent in gastrointestinal ailments and also in the treatment of helminthiasis, anaemia, insomnia, bladder diseases, difficult-to-heal wounds, and fever. Today, numerous other directions of biological activity of the components of this species have been demonstrated and confirmed by scientific research, such as antiprotozoal, antibacterial, antifungal, anti-ulcer, hepatoprotective, anti-inflammatory, immunomodulatory, cytotoxic, analgesic, neuroprotective, anti-depressant, procognitive, neurotrophic, and cell membrane stabilizing and antioxidant activities. A. absinthium is also making a successful career as a cosmetic plant. In addition, the importance of this species as a spice plant and valuable additive in the alcohol industry (famous absinthe and vermouth-type wines) has not decreased. The species has also become an object of biotechnological research.
... Indications for this treatment include tumors, although its effectiveness has not been confirmed so far [92]. In 2009, Reference [93] investigated the harmfulness of compounds formed during the combustion of this plant species. The authors tested the smoke emitted by moxa for the presence of compounds commonly found in cigarettes, such as tar, nicotine, carbon monoxide, polycyclic aromatic hydrocarbons, ammonia, hydrogen cyanide, polyaromatic amines, volatile organic compounds, semi-volatile compounds, phenols, and carbonyls (e.g., formaldehyde and acetone), all of which are associated with the highest risk of cancer. ...
... Therefore, the authors concluded that burning moxa should not pose a health risk. Evidence of exceeded limits appeared only after the extrapolation of results for long-term use, which probably did not reflect the actual concentration of the tested compounds [93]. In TCM, A. vulgaris is most often used in thermopuncture in the form of cotton buds impregnated with the plant extract, or as cigarettes filled with dried leaves and used to cauterize the skin. ...
Article
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Artemisia vulgaris L. (common mugwort) is a species with great importance in the history of medicine and was called the “mother of herbs” in the Middle Ages. It is a common herbaceous plant that exhibits high morphological and phytochemical variability depending on the location where it occurs. This species is well known almost all over the world. Its herb—Artemisiae vulgaris herba—is used as a raw material due to the presence of essential oil, flavonoids, and sesquiterpenoids lactones and their associated biological activities. The European Pharmacopoeia has listed this species as a potential homeopathic raw material. Moreover, this species has been used in traditional Chinese, Hindu, and European medicine to regulate the functioning of the gastrointestinal system and treat various gynecological diseases. The general aim of this review was to analyze the progress of phytochemical and pharmacological as well as professional scientific studies focusing on A. vulgaris. Thus far, numerous authors have confirmed the beneficial properties of A. vulgaris herb extracts, including their antioxidant, hepatoprotective, antispasmolytic, antinociceptive, estrogenic, cytotoxic, antibacterial, and antifungal effects. In addition, several works have reviewed the use of this species in the production of cosmetics and its role as a valuable spice in the food industry. Furthermore, biotechnological micropropagation of A. vulgaris has been analyzed.
... Moxibustion carries health hazards, including the possibility of burns. [24][25][26] Animal studies of the thermal properties of indirect moxibustion show that the maximum temperature induced by indirect moxibustion was about 65°C on the skin surface and 45°C in the subcutaneous layer. 27 Excessive heating can cause protein denaturation and cell damage. ...
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Objective This study evaluates the thermographic changes associated with moxa burner moxibustion at the SP6 acupuncture point to establish an appropriate, safe distance of efficacy for moxibustion. Methods Baseline temperature changes using a moxa burner were obtained for a paper substrate at various distances and times, and the tested with volunteers in a pilot study. A single-group trial was then conducted with 36 healthy women to monitor temperature changes on the body surface at the acupuncture point (SP6). Results Based on the temperature changes seen for the paper substrate and in the pilot study, a distance of 3 cm was chosen as the intervention distance. Moxibustion significantly increased the SP6 point skin surface temperature, with a peak increase of 11°C at 4 min (p <0.001). This study also found that during moxibustion the temperature of the moxa burner's rubber layer and moxa cautery were 56.9±0.9°C and 65.8±1.2°C, as compared to baseline values of 35.1°C and 43.8°C (p<0.001). Conclusions We determined 3 cm was a safe distance between the moxa burner and acupuncture point. Moxibustion can increase the skin surface temperature at the SP6 point. This data will aid traditional Chinese medicine (TCM) practitioners in gauging safer treatment distances when using moxibustion treatments.
... Since many people are exposed to moxa smoke during acupuncture-moxibustion treatment, some studies have been done recently to investigate if burning moxa in TCM constitutes a health hazard recently. There are no immediate concerns found arising from the continued use of moxa as therapeutic modality in TCM [2] However, to our knowledge the influence of moxa smoke on biological signals has not been investigated sufficiently in Asia and also in Europe [3,4]. ...
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Objective: To evaluate the changes of human heart rate (HR) and heart rate variability (HRV) during and after moxa smoke inhalation and to investigate the effects of moxa smoke on human autonomic nervous system. Methods: 24 healthy volunteers were exposed to moxa smoke with their HRV parameters measured before, during and after the moxa smoke inhalation. Results: The healthy volunteers exposed to moxa smoke had significant reductions in HR and also significant changes in HRV parameters. Conclusions: Moxa smoke can improve the autonomic nervous system activity. The inhalation of moxa smoke will induce a depressant effect on human body.
... However, one study gave consideration to short-term and long-term exposure. It showed that the volatile matter and carbon monoxide generated by moxa smoke under normal operating conditions did not exceed safety levels [45]. ...
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Moxibustion is a traditional medical treatment originating in China. It involves using the heat of burning moxa to stimulate acupoints. It is considered safe and effective and is widely used throughout the world. The increasing use of moxibustion has drawn attention to the procedure's adverse events (AEs). This review covers a total of 64 cases of AEs associated with moxibustion in 24 articles, reported in six countries. Some evidence of the risks of moxibustion has been found in these cases. AEs include allergies, burns, infection, coughing, nausea, vomiting, fetal distress, premature birth, basal cell carcinoma (BCC), ectropion, hyperpigmentation, and even death. The position, duration, distance between moxa and skin, proficiency of the practitioners, conditions of the patients, presence of smoke, and even the environment of treatment can affect the safety of moxibustion. Improving practitioner skill and regulating operations may reduce the incidence of adverse reactions and improve the security of moxibustion.
... Animal studies found that electroacupuncture and acupoint injection showed benefit on bone marrow suppression after chemotherapy, through protection of hematopoietic function, improvement of WBC counts in the peripheral blood, and enhancement of immune function [6,7]. However, needling acupuncture might result in some degrees of discomfort, such as pain, while moxibustion produces smog, which could be irritant and harmful to the health of both the practitioners and patients [8][9][10]. These factors limited the application of traditional acupuncture in the clinical use. ...
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Objective. To assess the effect of different lasers on cyclophosphamide- (CTX-) induced leucopenia in rats. Methods. 11 rats were normal control and 55 rats were injected with a dose of 80 mg/kg CTX for the first time and 40 mg/kg on the 6th and the 11th days to establish a leucopenia model. Rats of the irradiation groups received a 5-minute laser irradiation with either single 10.6 μ m or 650 nm laser or alternatively 10.6 μ m-650 nm laser irradiation, besides a sham treatment on acupoint Dazhui (DU 14) and acupoint Zusanli (ST 36) of both sides, 8 times for 16 days. Normal and model control group received no treatment. Results. On day 16 after the first CTX injection, the WBC counts from all the laser irradiation groups were significantly higher than those from the model control and the sham group (P < 0.05), while there were no significant differences compared with the normal control (P > 0.05). The TI of 10.6 μ m-650 nm laser irradiation group was significantly higher than that of the model control group (P < 0.05). Conclusions. The single and combined 10.6 μ m and 650 nm laser irradiation on ST36 and DU14 accelerated the recovery of the WBC count in the rats with leucopenia.
... Despite the long appreciated clinical benefits of moxibustion, its use appears to be undervalued in the US. As reasons for not utilizing moxibustion therapy, practitioners cite time commitment, exposure to smoke and the lack of US malpractice insurance coverage for some forms of moxibustion (direct) [2]. In contrast to the US, the use of moxibustion for a myriad of diseases and conditions is still widespread in East Asia. ...
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Limited research suggests that indirect moxibustion may be beneficial for treating fatigue, but no studies to evaluate direct moxibustion have been conducted in the United States. Thus, we explored the usefulness of four outcome measures for evaluating the effectiveness of direct moxibustion for patients with spleen qi and yang deficiency fatigue (SQYDF). Eleven female volunteers, ages 25-60 years, were enrolled. Three to five rice grains in thread-sized moxa cones were burned on 11 acupuncture points once per week for 8 weeks. Eight participants completed the study. The most common adverse events (AEs) were temporary worsening of fatigue, lightheadedness, and headache. Symptomatic improvement was seen on the SF-36 energy/fatigue scale (p = 0.003), SF-36 social function scale (p = 0.008) and Flinders fatigue scale (p = 0.014). The skin conductance at acupoints showed no consistent diagnostic baseline meridian patterns. Heart rate variability data showed an improved low frequency/high frequency (LF/HF) ratio in three of four participants. Direct moxibustion is safe in patients with SQYDF. The Flinders Fatigue Scale (FFS) and the SF-36 are useful outcome measures for evaluating the effects of direct moxibustion, and the heart rate variability (HRV) may be, but the skin conductance did not correlate with SQYDF diagnosis or with symptomatic improvement.
... They would do damage to the patients and staffs [51]. But a research giving consideration to short-term and long-term exposure showed that the volatile matter and carbon monoxide generated by the smoke of moxa under normal operating conditions did not exceed the safety level [52]. ...
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THE MOXIBUSTION HAS A DUAL EFFECT OF TONIFICATION AND PURGATION IN TCM THEORIES, WHICH ARE BASED ON TWO ASPECTS: the actions of the meridian system and the roles of moxa and fire. Modern research works of the moxibustion mechanism mainly relate to the thermal effects, radiation effects, and pharmacological actions of moxa and its combustion products. Experimental results showed that moxibustion thermal stimulation affects both shallow and deep tissues of the skin, and the warm-heat effects of moxibustion have a close relation to the warm receptors or/and the polymodal receptor. The burning moxa radiation spectrum ranges from 0.8 to 5.6 μ m; peak is nearby 1.5 μ m, lying within the near infrared portion. There is an amazing consistency in the infrared spectrums of three types of indirect moxibustion and the unified spectrum of acupoints; all have their peaks of radiation near 10 μ m. Lots of ingredients had been identified from mugwort leaves and moxa smoke, which have a variety of biological activities; they were considered to participate in the comprehensive effects of moxibustion. Although lots of research works have been carried out and made some progress, there is still a great distance from fully understanding the mechanism of moxibustion.
... Other investigations focused on targeting the papain-like protease of SARS-CoV-2 [25][26][27]. Among these medicinal plants, Artemisia shrubs (Asteraceae family), which were assigned as safe in several clinical trials [28][29][30][31], were considered with great interest for fighting COVID-19 [32]. These herbs have been used by several populations to cure influenza, cough, and respiratory distress [33]. ...
Article
Citation: Badraoui, R.; Saoudi, M.; Hamadou, W.S.; Elkahoui, S.; Siddiqui, A.J.; Alam, J.M.; Jamal, A.; Adnan, M.; Suliemen, A.M.E.; Alreshidi, M.M.; et al. Antiviral Effects of Artemisinin and Its Derivatives against SARS-CoV-2 Main Protease: Computational Evidences and Interactions with ACE2 Allelic Variants. Pharmaceuticals 2022, 15, 129.
... Moxa floss (burning material of moxibustion) is made from the mugwort leaf (Folium Artemisiae argyi), and its smoke contains multiple essential oils, suspended particulate matters, and products of chemical oxidation [31]. Wheeler et al. [32] tested the chemical products of moxibustion in clinically common dosages and found that neither carbon monoxide nor volatile compounds that present safety hazards are produced under clinical conditions. Air pollution studies show that the suspended particles in polluted air can reduce HRV by affecting the neurological system and consequently affecting the cardiovascular system by increasing HR and blood coagulation and decreasing hemoglobin to cause oxidative stress [33][34][35]. ...
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Objective. To determine the effects of the moxa smoke on human heart rate (HR) and heart rate variability (HRV). Methods. Fifty-five healthy young adults were randomly divided into experimental (n = 28) and control (n = 27) groups. Experimental subjects were exposed to moxa smoke (2.5 ± 0.5 mg/m(3)) twice for 25 minutes in one week. ECG monitoring was performed before, during, and after exposure. Control subjects were exposed to normal indoor air in a similar environment and similarly monitored. Followup was performed the following week. Short-term (5 min) HRV parameters were analyzed with HRV analysis software. SPSS software was used for statistical analysis. Results. During and after the first exposure, comparison of percentage changes or changes in all parameters between groups showed no significant differences. During the second exposure, percentage decrease in HR, percentage increases in lnTP, lnHF, lnLF, and RMSSD, and increase in PNN50 were significantly greater in the experimental group than in control. Conclusion. No significant adverse HRV effects were associated with this clinically routine 25-minute exposure to moxa smoke, and the data suggests that short-term exposure to moxa smoke might have positive regulating effects on human autonomic function. Further studies are warranted to confirm these findings.
... Other investigations focused on targeting the papain-like protease of SARS-CoV-2 [25][26][27]. Among these medicinal plants, Artemisia shrubs (Asteraceae family), which were assigned as safe in several clinical trials [28][29][30][31], were considered with great interest for fighting COVID-19 [32]. These herbs have been used by several populations to cure influenza, cough, and respiratory distress [33]. ...
Article
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Fighting against the emergent coronavirus disease (COVID-19) remains a big challenge at the front of the world communities. Recent research has outlined the potential of various medicinal herbs to counteract the infection. This study aimed to evaluate the interaction of artemisinin, a sesquiterpene lactone extracted from the Artemisia genus, and its derivatives with the SARS-CoV-2 main protease. To assess their potential use against COVID-19, the interactions of the main active principle of Artemisia with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro) was investigated through in silico probing. Our results showed that artemesinin and its derivatives manifested good oral absorption and bioavailability scores (0.55). They potently bound to the Mpro site of action—specifically, to its Cys145 residue. The selected compounds established two to three conventional hydrogen bonds with binding affinities ranging between −5.2 and −8.1 kcal/mol. Furthermore, artemisinin interactions with angiotensin converting enzyme 2 (ACE2) were dependent on the ACE2 allelic variants. The best score was recorded with rs961360700. A molecular dynamic simulation showed sufficient stability of the artemisinin–Mpro complex on the trajectory of 100 ns simulation frame. These binding interactions, together with drug-likeness and pharmacokinetic findings, confirmed that artemisinin might inhibit Mpro activity and explain the ethnopharmacological use of the herb and its possible antiviral activity against SARS-CoV-2 infection inducing COVID-19. Nevertheless, it interacted differently with the various ACE2 allelic variants reported to bind with the SARS-CoV-2 spike protein.
... It should be noted that there has been the advent of strict antismoking legislation in many countries, and as a result there are concerns about the potential effectiveness and toxicity of the volatiles produced by moxibustion. Up to now, no immediate concerns have been raised about the continued use of moxibustion as a therapeutic modality in traditional Chinese medicine [69]. ...
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"Acupmoxa" is a hybrid word of "acupuncture" and "moxibustion" that more closely resembles the Chinese ideograph for this treatment. People in Western countries are more familiar with acupuncture, while moxibustion is less popular, partially due to the paucity of scientific studies. Although the evidence-based efficacy of moxibustion needs to be further clarified, the mechanisms by which moxibustion may work include temperature-related and nontemperature-related ones. Local somatothermal stimulation (LSTS), one type of moxibustion, is achieved by application of a heat source to and above the acupoint. Such mild heat stimulation of the acupoint induces little skin damage, in contrast to the burning effect of moxibustion, but does provoke mild oxidative stress in the viscera. Thus, preconditioned LSTS at the peripheral acupoints LR 14 and PC 6 of animals is able to induce visceral HSP70 expression and to protect the liver and the heart against ischemia-reperfusion injury. Nontemperature-related mechanisms include smoke, herbs, and biophysical (far infrared) stimulation. We conclude that LSTS, a remote preconditioning method, has potential clinical usefulness. However, evidence-based efficacy and safety studies involving large-scaled clinical trials are needed in order that this approach will pass muster with Western scientists.
... Moxibustion may be a safe treatment for RA in this study. However, the probable adverse events of moxibustion including allergic reactions, burns and infections have been reported in previous research [43,44]. Therefore, future trials should provide more details about any adverse events associated with moxibustion or safety assessment. ...
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Introduction Moxibustion is widely used in China and other East Asian countries to manage the symptom of rheumatoid arthritis (RA) and to lessen the adverse effects of western medicine.The purpose of this systematic review was to evaluate the available evidencefrom randomized controlled trials (RCTs) of moxibustion for treating patients with rheumatoid arthritis (RA). Methods Seven Chinese and English databases were searched to November 2013 from their inception. Eligible RCTs were included if moxibustion was used either alone or in combination with Western medicine for treating rheumatoid arthritis. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk of bias was used to assess the methodological quality of the trials. Results Eight RCTs met the inclusion criteria, and most were of low methodological quality. Meta-analysis showed favorable effects of moxibustion on the response rate, either alone [RR = 1.18, 95%CI (1.03,1.35), p = 0.02; heterogeneity: Chi2 = 1.11, p = 0.77, I2 = 0%] or the combination with Western medicine therapy [RR = 1.28, 95%CI (1.12,1.47), p = 0.0004; heterogeneity: Chi2 = 1.96, p = 0.58, I2 = 0%]. When compared with Western medicine therapy, Western medicine plus moxibustion therapy showed a favorable statistically significant effect on a reduction on American College of Rheumatology (ACR) 50 [RR = 1.57, 95%CI (1.25,1.99), p = 0.0001; heterogeneity: Chi2 = 2.87, p = 0.58, I2 = 0%], whereas it failed to do so on American College of Rheumatology (ACR) 20. Additionally, when compared with western medicine therapy alone, meta-analysis of three RCTs suggested favorable but no statistically significant effects of moxibustion plus western medicine on the control of disease activities of rheumatoid arthritis. Conclusions It is difficult to draw firm conclusions on whether moxibustion is an effective intervention for treating RA due to the small sample size of eligible RCTs and the high risk of bias among the available RCTs. Further rigorous RCTs are warranted but need to overcome methodological shortcomings of the existing evidence
... Therefore, tumor treatments should tonify qi and blood to promote blood circulation to encourage formation of collaterals. Moxibustion is a type of TCM treatment that is becoming widespread, with 67% of Korean Oriental Medicine doctors prescribing moxibustion [6]; additionally, over 15,000 general practitioners in the UK are likely use moxibustion on a regular basis [7]. Moxibustion can reduce inflammation, repair the gastrointestinal mucosa, and increase the gastrointestinal hypomotility. ...
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Background The present prospective, observational study evaluated the safety and efficacy of moxibustion in preventing acute and chronic radiation enteritis post-radiation in patients with cervical cancer.Methods Between March 2015 and October 2018, 90 patients with stage I-IV cervical cancer were treated with radiation at the Guangzhou University of Chinese Medicine Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine). The patients were randomly divided into a moxibustion group and a control group. The moxibustion group received moxibustion on Guānyuán (RN4), Qìhǎi (RN6), Shénquē (RN8) and Tiānshū (ST25) during radiation. The control group received radiotherapy only. We observed and compared the occurrence of acute radiation enteritis (ARE) between the two groups of patients during radiotherapy. Then, the patients were followed-up 1-1.5-year after radiation, and we observed and compared the occurrence of chronic radiation enteritis (CRE) between the two groups.ResultsThe incidence of ARE was significantly lower in the moxibustion group (10.9%) than the control group (36.4%; P < 0.05). At follow-up post-radiotherapy, the incidence of CRE was significantly reduced (15.2%) in the moxibustion group compared with the control group (35.7%; P < 0.05).Conclusions Moxibustion significantly improved physical function and reduce the gastrointestinal response caused by radiotherapy, thus the occurrence of acute and chronic radiation enteritis was reduced. These results can improve the therapeutic effect of radiation and improve the patient’s quality of life.Trial registrationProspective clinical trial for the effects of moxibustion on acute and chronic radiation enteritis in cervical patients. ChiCTR2000029650. Registered: February 9, 2020-Retrospectively registered.
... However, there are concerns regarding the safety of moxa smoke. Some reports have shown that moxa smoke may be harmful to the human body, such as causing allergic reactions [22][23][24]. Moreover, moxibustion requires extreme care due to the risk of burns. ...
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Background Korean medicine (KM) has been widely used in Korea. This study aimed to assess the general perceptions of KM, to investigate the patterns of its usage in 2014, and to compare the results with those of an earlier survey from 2011. Methods A cross-sectional study was conducted with 1000 Korean people. The questionnaire included items regarding trust in KM, reasons for distrust of KM, and visit frequency to KM clinics. This study used methods consistent with those of a 2011 survey to examine changes in attitudes over 3 years. Results Despite high rates of trust in KM, the visit frequency decreased from 69.3% in 2011 to 63.2% in 2014. Usage among young adults (in their 20s and 30s) was significantly reduced compared to all other age groups. The KM modality most commonly used by participants was acupuncture, whereas the use of moxibustion and cupping therapies has decreased since 2011. Men and women were most likely to distrust KM due to a “lack of scientific evidence” (59.3%) and “suspicion of KM safety” (47.4%), respectively. Conclusions The findings suggested that KM use and trust in KM were slightly lower in 2014 than in 2011. The decreases were most notable among individuals in their 30s and in the use of moxibustion in KM therapy. This study aimed to produce practical insights by reviewing patterns of KM use and perceptions over time. Additional surveys must be considered to produce a more in-depth analysis. Electronic supplementary material The online version of this article (10.1186/s12906-017-1969-8) contains supplementary material, which is available to authorized users.
... Their results have shown that neither volatile organic compounds nor carbon dioxide present a safety hazard under normal operating conditions. 20 Another study tested the gaseous pollutants in environmental moxa smoke. 21 The results demonstrated that the levels of carbon dioxide, carbon monoxide, sulphur dioxide, and nitrogen dioxide produced from combustion of 4 g of moxa floss did not exceed present international air quality standards and occupational exposure limits. ...
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Objective To investigate the effects of long-term exposure to moxa smoke on acupuncturists and to consider the association between physical symptoms and gender, age, secondhand smoke (SHS) exposure, and the duration of exposure. Methods A self-report, web-based questionnairewas used to evaluate the effects of moxa smoke on acupuncturists. Logistic regression was used to analyze the relationship between physical symptoms and possible correlative factors. Results A total of 858 questionnaires were analyzed. The data showed that 42.42% of acupuncturists had been exposed to moxa smoke for 5-10 years. The most frequent symptom was tearing (32.98%) and theleast frequent symptom was asthma (5.24%). Logistic regression analysis showed that female acupuncturists were slightly more susceptible to cough and tearing than males (cough: OR: 1.583, 95% CI: 1.079, 2.321, P = 0.019; tearing: OR: 1.519, 95% CI: 1.094, 2.108, P = 0.013). Acupuncturists aged over 25 years reported a slightly lower incidence of eye itchiness than those aged under 25 years (26–40 years: OR: 0.604, 95% CI: 0.379, 0.965, P = 0.035; over 40 years: OR: 0.330, 95% CI: 0.114, 0.958, P = 0.042). Ophthalmodynia occurred less in acupuncturists aged 26-40 years (OR: 0.591, 95% CI: 0.359, 0.970, P = 0.038) than in those younger than 25 years. The only association between prevalence of symptoms and tobacco use and SHS exposurewas that smokers had a lower occurrence of phlegm in the throat (OR: 0.579, 95% CI: 0.392, 0.856, P = 0.006). Shortness of breath was less frequent in participants exposed to moxa smoke for more than 5 years (5-10 years: OR: 0.400, 95% CI: 0.204, 0.785, P = 0.008; 11–20 years: OR: 0.392, 95% CI: 0.178, 0.864, P = 0.02), but a slightly higher incidence of eye itchiness was found in those with over 20 years of moxa exposure (OR: 4.200, 95% CI: 1.344, 3.128, P = 0.014). Conclusions The most frequent symptom of moxa smoke exposure in acupuncturists was tearing. The association of symptoms with age and duration of exposure to moxa smoke were rather complicated; hence, care should be taken in drawing conclusions about the safety of moxa smoke based solely on its potentially harmful ingredients.
... Since many people are exposed to moxa smoke during acupuncture-moxibustion treatment, some studies have been done recently to investigate if burning moxa in TCM constitutes a health hazard recently. There are no immediate concerns found arising from the continued use of moxa as therapeutic modality in TCM [2] However, to our knowledge the influence of moxa smoke on biological signals has not been investigated sufficiently in Asia and also in Europe [3,4]. ...
Article
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Objective: To evaluate the changes of human heart rate (HR) and heart rate variability (HRV) during and after moxa smoke inhalation and to investigate the effects of moxa smoke on human autonomic nervous sys-tem. Methods: 24 healthy volunteers were exposed to moxa smoke with their HRV parameters measured before, during and after the moxa smoke inhalation. Results: The healthy volunteers exposed to moxa smoke had significant reductions in HR and also significant changes in HRV parameters. Conclusions: Moxa smoke can improve the autonomic nervous system activity. The inhalation of moxa smoke will induce a de-pressant effect on human body.
... (2,3) The literature on smoke toxicity and particulate matter is still emerging with some studies showing high levels of volatile compounds like formaldehyde (3) as well as particulate matter (4) and other studies demonstrating lower, more acceptable levels. (5,6) Furthermore, the use of a lit moxa roll or burning moxa cone has potential to set off fire alarms especially if the alarms are smoke sensitive. ...
Article
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Background: Moxibustion is a widely used adjunct therapy within Chinese medicine in many Asian countries, as well as Australia. A variety of diseases are treated with moxibustion as well as a range of application methods used, ranging from moxa roll to warm needle. Few studies have looked at the types of diseases and methods used when administering moxibustion. Method: The clinic database at the University of Technology Sydney (UTS) Chinese medicine clinic was mined for the type of disease using the International Classification of Primary Care (ICPC) as well as the most commonly used application methods when moxibustion was applied within a treatment. The period assessed was from January 1998 to December 2014. Results: The six most common disease areas where moxibustion had been administered were in the categories of neurological, digestive, respiratory, musculoskeletal, psychological and general diseases. In total 104,676 treatments had been recorded in the database across these six disease areas with moxibustion being used in 9.3% (n=9,733) of all the recorded treatments in these six disease areas. In addition, the moxa roll was most commonly used (6%) followed by direct moxa (1.3%), moxa box (1.2%) and warm needle (0.8%). Conclusion: More research is needed into the efficacy, safety and underlying mechanism of moxibustion therapy. This will lead to a better understanding of moxibustion and familiarisation by the public of its role in treating a variety of diseases
... Earlier research of our group proved that a fixed concentration of moxa smoke was safe [11]. Moreover, John Wheeler compared moxa smoke with cigarette smoke and found levels of only two volatiles produced were equivalent or greater than the safe exposure levels [30]. A study in Japan showed that quantities of harmful substances released upon combustion of moxa during normal clinical therapy in Japan fell below national safety standards [31]. ...
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Objective. Moxibustion is a complementary therapy that has been used for thousands of years. Burning moxa produces smoke and inhalable particulates. Recent research has indicated that smoke inhalation is associated with negative lung effects. This study aimed to evaluate the lung function of rats after moxa smoke exposure at different concentrations. Methods. Using a randomised block experiment design, 28 male Wistar rats were randomly divided into three moxa smoke groups (opacity) (n=7): low concentration (27.45 mg/m3), medium concentration (168.76 mg/m3), and high concentration (384.67 mg/m3) with a control group. Rats in the moxa smoke groups were exposed in an automatic dynamic exposure device separately with different concentrations for 20 min/d, 6d/week, for 24 weeks. Rats in the control group were exposed in the same space without moxa smoke. Lung function was evaluated by the AniRes 2005 animal pulmonary function analysing system. Statistical Product and Service Solutions 18.0 software was used for data analysis. Results. In the study, no deaths were found in any group. There was no difference of forced expiratory volume in one second/forced vital capacity percentage (FEV1/FVC%), inspiratory resistance (Ri), and expiratory resistance (Re) among each group after 24 weeks of moxa smoke exposure (P>0.05). Compared with the control group (0.33 ml/cmH20), dynamic compliance (Cdyn) was reduced in the medium (0.29 ml/cmH20) and high (0.25 ml/cmH20) concentration groups (P
... 18 Studies are expanding to assess the effectiveness of TCM as a treatment option. 19,20 The unique characteristics of the clinical practice of TCM, such as pattern differentiation and individualization of treatment, make it difficult to translate its models. 21 Facets 1 on sensorial functioning, 2 on autonomy, 4 on social participation, and TS, showing a significant tendency to be superior in the experimental group, confirm that TCM can have a positive effect on the autonomy of the elderly. ...
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The shift in age structure is having a profound impact, suggesting that the aged should be consulted as reporters on the quality of their own lives. The aim of this research was to establish the possible impact of traditional Chinese medicine (TCM) techniques on the quality of life (QOL) of the elderly. Two non-selected, volunteer groups of Rio de Janeiro municipality inhabitants: a control group (36 individuals), not using TCM, and an experimental group (28 individuals), using TCM at ABACO/Sohaku-in Institute, Brazil. A questionnaire on elderly QOL devised by the World Health Organization, the WHOQOL-Old, was adopted and descriptive statistical techniques were used: mean and standard deviation. The Shapiro-Wilk test checked the normality of the distribution. Furthermore, based on its normality distribution for the intergroup comparison, the Student t test was applied to facets 2, 4, 5, 6, and total score, and the Mann-Whitney U rank test to facets 1 and 3, both tests aiming to analyze the P value between experimental and control groups. The significance level utilized was 95% (P < 0.05). The experimental group reported the highest QOL for every facet and the total score. The results suggest that TCM raises the level of QOL.
... 12 Over 15,000 general practitioners in the UK may use moxibustion on a regular basis. 13 As the usage of moxibustion increases, the question of its risks become more relevant because heating of the skin during moxibustion increases the risk of adverse events such as burning, coughing and allergies due to the ingredients included in moxa pillar. ...
Article
The aim of this review was to identify adverse events of moxibustion as reported in the medical literature. Computerised literature searches were carried out in 14 databases. All articles reporting adverse effects of any type from moxibustion in humans were included, regardless of study design and publication language. The related journals and references in all located articles were manually searched for further relevant articles. Data were extracted and evaluated according to predefined criteria by three independent reviewers. Adverse events related to moxibustion treatment were reported in 4 randomised clinical trials, 1 controlled clinical trial, 2 uncontrolled observational studies, 13 case reports, and 1 prospective study. The most common effects identified in this review were allergic reactions, burns, and infections such as cellulitis and hepatitis C. Allergic reactions were reported in six case reports (four case reports related to infections and two related to burns). The other articles were case reports of xerophthalmia, xeroderma, hyperpigmented macules, ptosis and eversion of the eyelids. In clinical trials, various adverse events such as rubefaction, blistering, itching sensations, discomfort due to smoke, general fatigue, stomach upsets, flare-ups, headaches, and burns were reported. Tenderness and pressure in the epigastric region or in one of the hypochondriac regions, unpleasant odour with or without nausea and throat problems, abdominal pain, premature birth, premature rupture of the membrane and bleeding due to excess pressure on the anterior placenta were reported in pregnant women. Moxibustion is not entirely risk free, as it has several kinds of potential adverse events such as allergy, burn and infection. Currently, the incidence of such events is not known. In the interest of patient safety, sufficiently large prospective studies should be considered to clarify this issue.
... The most important key to gaining the expected results is that an experienced TCM practitioner or acupuncturist must rely on four skills with meridian identification to make accurate diagnosis and identify precisely the patterns to write up the prescriptions. [13,14]. ...
... By keeping ventilation well, the contents of CO, NO 2 , PM 10, and PM 2.5 in the air can be controlled within safe ranges [20]. And under normal operating conditions, neither volatile nor carbon monoxide would do harm to health and safety [21]. Based on these studies, the potential effect of moxa smoke on health is controversial. ...
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Objectives: To evaluate the safety of moxa smoke, especially to provide quantitative information and details for the occupational prevention of acupuncturists. Methods: We combined the questionnaire-based cross-sectional survey and lung function testing-based historical retrospective cohort research to investigate the safety of moxa smoke exposure (MSE) among acupuncturists. A mathematical regression model was established to quantitatively evaluate the relationship between moxa smoke exposure and the respiratory health of the acupuncturist. The smoke exposure time of the acupuncturist and the prevalence of abnormal respiratory symptoms or diseases were also evaluated. Results: (1) The cross-sectional research showed that the incidence of expectoration (18.7%) and rhinitis (22.7%) was the most common respiratory symptom and disease after MSE. No statistical difference was found between smoke exposure time of the acupuncturist and the prevalence of abnormal respiratory symptoms or diseases, except the prevalence of rhinitis and shortness of breath (P < 0.01). Regression model for the incidence of first three symptoms (expectoration, shortness of breath, and wheezing) from the cross-sectional survey indicated that the weight coefficients of factors associated with moxa smoke were lower than those of factors unrelated to moxa smoke, such as gender and personal history of respiratory diseases. (2) Historical retrospective cohort research showed that there was no significant difference in the % predicted PEF. No statistic difference was found between the exposed and nonexposed group in large airway function indexes (% predicted FEV1, % predicted FVC, and % predicted FEV1/FVC) and small airway function indexes (% predicted FEF25, % predicted FEF50, % predicted FEF75, and % predicted MMEF), either. Especially, the % predicted MVV among males (106.23 ± 2.92 vs. 95.56 ± 1.92, P < 0.01 and % predicted VC among females (100.70 ± 1.59 vs. 95.91 ± 1.61, P < 0.05) between the two groups had statistical significance, but did not cause pulmonary ventilation dysfunction. Conclusions: MSE has no significant effect on the respiratory health of acupuncturists.
... Burning has been reported in moxibustion therapy [31], and any minor burning must be monitored. In addition, adverse effects due to smoke can occur during moxibustion and should be monitored with caution [32]. ...
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Moxibustion is a traditional East Asian medical therapy that uses the heat generated by burning herbal preparations containing Artemisia vulgaris to stimulate acupuncture points. The aim of this review was to evaluate previously published clinical evidence for the use of moxibustion as a treatment for hypertension. We searched 15 databases without language restrictions from their respective dates of inception until March 2010. We included randomized controlled trials (RCTs) comparing moxibustion to either antihypertensive drugs or no treatment. The risk of bias was assessed for each RCT. During the course of our search, we identified 519 relevant articles. A total of 4 RCTs met all the inclusion criteria, two of which failed to report favorable effects of moxibustion on blood pressure (BP) compared to the control (antihypertensive drug treatment alone). However, a third RCT showed significant effects of moxibustion as an adjunct treatment to antihypertensive drug therapy for lowering BP compared to antihypertensive drug therapy alone. The fourth RCT included in this review addressed the immediate BP-lowering effects of moxibustion compared to no treatment. None of the included RCTs reported the sequence generation, allocation concealment and evaluator blinding. There is insufficient evidence to suggest that moxibustion is an effective treatment for hypertension. Rigorously designed trials are warranted to answer the many remaining questions.
Article
Concentrations and risk of monoaromatic hydrocarbons (MAHC), formaldehyde (HCHO), and polycyclic aromatic hydrocarbons (PAHs) in two moxibustion rooms were determined. The mean concentrations of MAHC, HCHO and PAHs were 535.2 μg/m3, 157.9 μg/m3 and 12.86 μg/m3, respectively, with notable health risks, indicating relatively serious pollution in indoor air due to the use of burning moxa. The indoor emissions of target pollutants from burning moxa in test chamber were also investigated. Toluene, benzene and xylene appeared to be dominant MAHCs, and naphthalene (NA) the dominant PAH, which were consistent with the pollution levels of the detected moxibustion rooms. The emission characteristics of smoky moxa and mild moxa were much in common and relatively close to that of tobacco; while that of smoke-free moxa showed a distinction. Though pollutants emission patterns varied within the three types of moxa, all of them had apparently higher emission intensities than other typical indoor sources, including tobacco. The results of this study can offer some references during the selection of moxa sticks and application of moxibustion.
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Midwives at West Middlesex NHS Trust (WMUH) have been trained in the use of moxibustion to turn a breech presentation. This paper informs the reader of this service, how it was implemented, the audit and importance of maintaining accurate data as well as the resulting changes to the service. Moxibustion appears to be a safe, easy and cost effective way to promote cephalic presentation and is offered prior to external cephalic version (ECV).
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Asthenozoospermia is a leading cause of male infertility, characterized by reduced sperm motility. In this study, we determined sperm motility and the activities of antioxidant enzymes and oxidation products in the testis of rats with ornidazole (ORN)‐induced asthenozoospermia and further examined and compared the differential effects of moxa smoke (MS) and cigarette smoke (CS) on sperm motility and oxidative stress (OS) of asthenozoospermic rats. The smoke intervention was initiated 11 days after intragastric administration of ORN, followed by the examination of testis index, sperm parameters, OS‐related gene levels, and testicular histopathology. Sperm motility and antioxidant enzyme activities, as well as oxidation products significantly decreased in ORN‐induced rats compared with MS‐treated rats (p < .05–.001). MS treatment restored the reduced sperm motility and activities of glutathione peroxidase, superoxide dismutase, and catalase, but increased the malondialdehyde and nitric oxide synthetase levels in ORN‐induced rats (p < .05–.001). Also, the histopathological changes in the testis of ORN‐induced rats were improved by MS treatment. The study highlighted that MS was an effective factor in moxibustion therapy, which notably improved the sperm motility of asthenozoospermic rats by inhibiting OS in the reproductive system. 弱精子症是以精子活力下降为主要表现的病症,是引起男性不育症的常见病因之一。本实验我们探讨了不同浓度的艾烟对弱精子症大鼠精子参数的影响和对生殖系统氧化应激损伤产生的作用,比较了艾烟与香烟对机体产生的效应差异。实验从奥硝唑溶液灌胃的第11天开始进行烟雾干预。干预结束后,检测每组大鼠的体重增量、睾丸质量、睾丸指数、精子参数、氧化应激指标以及睾丸组织形态病理学变化。结果表明,弱精子症模型大鼠的精子活力和抗氧化酶活性显著下降,氧化产物含量显著升高。不同浓度的艾烟干预后,能够显著改善弱精子症大鼠的精子活力和抗氧化酶活性,降低氧化产物含量,睾丸组织形态结构损伤也得到恢复。因此,艾烟作为艾灸疗法的起效因素之一,可能通过改善生殖系统氧化应激反应的方式,提高弱精子症大鼠的精子活力。
Article
International organisations such as WHO and the International Organization for Standardization are increasingly committed to the development of traditional Chinese medicine (TCM). Moxibustion is an integral modality of acupuncture that has been in use for thousands of years. It stands out as a health choice due to its potential effects in disease prevention, health promotion and maintenance, as well as affordability and accessibility. As the use of moxibustion increases, concerns are being raised regarding its safety and quality. The need to establish standards to protect patient safety is paramount in all medical fields. As a form of medical practice, it is essential to develop moxibustion standards in the areas of terminology, moxibustion products, treatment rooms and practice to ensure its harmonisation and safe usage. The evidence base guiding policy and decision making has to be based on evidence from basic and clinical research. Promoting strategic basic and clinical research on the safety and effectiveness of moxibustion will answer some of the fundamental questions surrounding moxibustion, create a climate of awareness and acceptance and, in turn, drive its standardisation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Many air toxicants, and especially aldehydes, are generated by moxibustion, which means burning Artemisia argyi. Our goal was to investigate indoor-air aldehyde emissions in Chinese medicine clinics (CMCs) during moxibustion to further evaluate the potential health risks, including cancer risk and non-cancer risk, to the medical staff and adult patients. First, the indoor-air-quality in 60 public sites, including 15 CMCs, was investigated. Four CMCs with frequent use of moxibustion were selected from the 15 CMCs to gather the indoor airborne aldehydes in the waiting and therapy rooms. The mean values of formaldehyde and acetaldehyde in the CMCs' indoor air were 654 and 4230 μg m(-3), respectively, in the therapy rooms, and 155 and 850 μg m(-3), respectively, in the waiting rooms. The average lifetime cancer risks (Rs) and non-cancer risks (hazard quotients: HQs) of airborne formaldehyde and acetaldehyde among the CMC medical staff exceeded the acceptable criteria (R < 1.00 × 10(-3) and HQ < 1.00) for occupational workers. The patients' Rs and HQs were also slightly higher than the critical values (R = 1.00 × 10(-6) and HQ = 1.00). Our results indicate that airborne aldehydes pose a significant threat to the health of medical staff, and slightly affected the patients' health, during moxibustion in the CMCs.
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The burning of moxa floss in moxibustion releases moxa smoke containing a substantial amount of particulate matter (PM10) into the environment, which has generated safety concerns about its potential health impact. Plasmid scission assay was performed using PM10 collected from moxibustion clinics. PM10 was collected in winter 2012 by burning three types of moxa floss samples in moxibustion simulation clinics and the resulting PM10 mass concentration was calculated. Oxidative capacity of the PM10 samples was measured by plasmid scission assay and the percentage of DNA damage at dosage 500 μg mL(-1) (D500) was calculated by linear regression analysis. The average PM10 mass concentration of samples A (3 year and 3:1 ratio), B (3 year and 8:1 ratio) and C (10 year and 3:1 ratio) was 273.33, 172.22 and 168.89 μg/m(3), respectively. The D500 oxidative capacity of PM10 was on average 24.25%, 27.83% and 28.07% for samples A, B and C, respectively. No significant difference was found in the PM10-induced oxidative damage by moxa smoke produced from the three types of moxa floss. PM10 mass concentrations from the three types of moxa floss combustion exceeded internationally recommended levels. Despite so, PM10 mass concentration of moxa smoke was much lower than biomass and coal combustion, and similar to that of gas combustion. The oxidative DNA damage induced by individual PM10 in moxibustion environment was lower than that reported in other environments, indicating that moxibustion-derived PM10 might not be as injurious to human health as generally assumed. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Article
Moxibustion is a traditional Chinese medicine therapy that burns moxa floss which produces a substantial amount of PM10 into the environment, thus spawning safety concerns about health impacts of the smoke. We compared the oxidative capacity and elemental composition of moxibustion-derived and ambient PM10 in summer and winter to provide a source-, spatial- and temporal-comparison of PM10 biological responses. The PM10 oxidative capacity was 2.04 and 1.45 fold lower, and dose-dependent slope gradient was 2.36 and 1.76 fold lower in moxibustion environment than indoor or outdoor. Oxidative damage was highly correlated with iron, cesium, aluminum and cobalt in indoor, but moxibustion environment displayed low associations. The total elemental concentration was also lower in moxibustion environment than indoor (2.28 fold) or outdoor (2.79 fold). The source-to-dose modeling and slope gradient analysis in this study can be used as a model for future source-, spatial- and temporal-related moxibustion safety evaluation studies. Copyright © 2015 Elsevier Ltd. All rights reserved.
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To design a combined dynamic inhalation device for testing the toxicity induced by moxa smoking. The new apparatus (Patent No. 201120101911.5) includes air renewal and recycling systems, a gas generating device, a gas control unit, and a device to measure and control temperature and humidity. Sprague-Dawley rats were tested for acute and sub-chronic toxicity after exposure to moxa-burning smoke. We found an LC50 of 1.2 x 10(4) mg/m3 in the acute toxicity assays. In sub-chronic toxicity tests the organ coefficients studied showed no significant differences within rats groups of the same gender after treatment with moxa smoke or a month of recovery. However, mean gray degree of lung 70 heat shock protein (HSP70) was significantly elevated in the high dose group in comparison with the low dose group (P < 0.05); mean gray degree, mean optical density, gross area of HSP70 in other organs and caspase-9 parameters showed no significant differences between groups. These results suggest that moxa smoke had no overt toxicity in rats. This work provides evidence and reference for the design of dynamic inhalation exposure systems.
Chapter
The use of acupuncture and moxibustion can date back to primitive Chinese societies. Today, they are sometimes used in Western medicine, mainly in cancer patients, as a complementary treatment. Scientific evidence has shown their effects on various diseases and cancer treatment. This chapter discusses different acupuncture and moxibustion techniques and their applications in oncology. Acupuncture points can be stimulated through needles, pressure, electric stimulus, laser and local heat applications using herbs. Moxibustion techniques involve stimulating the points by burning herbs directly or indirectly. Scientific evidence demonstrates the action mechanisms of acupuncture and moxibustion that benefit cancer patients, relieving various collateral treatment effects and disease symptoms. Quality of life (QoL) assessments are meant to improve care for cancer patients and expand the parameters of the benefits provided by conventional and unconventional treatments, apart from assessing the disease-free survival and overall survival. There are several measures to evaluate QoL. The European Organization for Research and Treatment of Cancer—Quality of Life Questionnaire-Core30 (EORTC—QLQ-C30) and Functional Assessment Cancer Therapy-General (FACT-G) are the most commonly used tools. As QoL measure provides important information about treatment impact on patients, specific tools for measuring health-related QoL (HRQoL) should be used to assess the impact of acupuncture and moxibustion. Acupuncture and moxibustion may be used as complementary treatments for cancer patients because they can help with symptom control and enhance patients’ physical and emotional aspects.
Article
Acupuncture and moxibustion, although not potent enough to act as first line cancer treatments, are powerful tools to support conventional cancer therapy, including surgery, chemotherapy and radiotherapy. In the experience of the author, they can render these interventions better tolerated by patients and lead to more successful treatment outcomes. In particular, they play a significant role in alleviating, and in some cases preventing, the side effects of chemotherapy. This paper focuses on a treatment protocol developed by the author, in which patients and their helpers are taught how to use daily moxibustion at home during chemotherapy. Moxa is used at the acupuncture points Geshu BL-17, Ganshu BL-18 and Pishu BL-20 in order to prevent leukopenia, the dropping of the white blood cell and neutrophil counts (also known as neutropenia). This treatment also helps to prevent anaemia and thrombocytopenia (a drop in the platelet count). The four terms in italics above are also known as pancytopenia, or bone marrow depression. This paper discusses the rationale for using this regimen, and whether it is contraindicated to apply moxibustion during chemotherapy. It also explores some of the technical issues to consider when teaching patients and their helpers how to use moxibustion at home. The article ends with a few selected case histories.
Article
Objective To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment (SAAT) on chronic pulmonary disease (CPD). Methods A total of 2,038 patients with CPD were enrolled at 3 independent hospitals (defined as Groups A, B and C, respectively) in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen (BL 12) and Feishu (BL 13) on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data (no reaction, itching, stinging, blistering, and infection) were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients' symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. Results A large number of patients (85.3%) displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B (99.3%) and Group C (76.5%) displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SAAT was as high as 90.4% for patients of Group B, which was followed by Group A (70.9%) and Group C (42.2%). Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching: odds ratio (OR)=2.17, 95% confidence interval (CI): 1.49 to 3.14; blistering: OR=0.43, 95% CI: 0.25 to 0.73; and no reaction: OR=0.56, 95% CI: 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. Conclusions SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by the crude Semen Sinapis Albae.
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Background Moxibustion therapy has been used historically for thousands of years and there are many clinical trials supporting its efficacy and effectiveness for various conditions. Moxa smoke has been a major reason for avoiding moxibustion due to its smell and potential risks to the human body. Methods 10 units of commercial indirect moxa (CIM) from six manufacturers (A–F) were burnt in a 2.5×2.5×2.5 m chamber without ventilation, and concentrations of carbon oxides (CO and CO2), nitrogen oxides (NOx), and volatile organic compounds (VOCs) from the indoor air samples were measured. Results For brands A, B, C, D, E, and F, respectively, relative to baseline values, we observed an increase in CO (from 0.002 to 0.007, 0.006, 0.005, 0.006, 0.005, and 0.006 parts per billion (ppb)), NOx (from 0.009 to 0.051, 0.025, 0.015, 0.050, 0.019, and 0.020 ppb), and total VOCs (TVOC; from 48.06 to 288.83, 227.93, 140.82, 223.22, 260.15, and 161.35 μg/m3), while the concentration of CO2 was not elevated. Each CIM brand demonstrated different VOC emission characteristics, which could be divided into three groups. On average, we estimated that 20 units of CIM or 2.41 g moxa floss would need to be combusted in order to exceed the safe levels set by Korean environmental law. This limit is likely to be greater in the case of a larger room or use of ventilation. Conclusions Despite increased CO/NOx/VOC concentrations, overall levels remained within safe limits. These findings may help clinicians to maintain safe moxibustion treatment conditions to help keep both patients and clinicians safe from the pollutants generated by moxa combustion.
Article
Objective: Moxibustion therapy achieves satisfactory therapeutic effects largely depending on the heat stimulation of burning moxa. Understanding the thermal characteristics of heating process is an effective way to reveal the underlying mechanisms of moxibustion therapy. Methods: This paper performs experimental study on temperature distributions of burning moxa sticks and fresh in-vitro porcine abdominal tissue using an infrared camera and thermocouples. Meanwhile, a moxibustion model incorporating moxa stick burning model and tissue heat transfer model was established with consideration of radiation propagation and water evaporation. Results: The burning features of moxa sticks were acquired and the radiation energy generated by the burning moxa stick was absorbed and scattered in biological tissue, resulting in a large temperature gradient in the skin layer. And the water evaporation led to a mass loss and reduced skin surface temperature. The numerical model was verified by experimental results and the effects of moxibustion treatment distance and duration can be quantified based on model calculation. Conclusion: The detailed heat transfer process of moxibustion was obtained experimentally and numerically. During moxibustion, the radiation attenuation and water evaporation have a significant influence on the energy transport in biological tissue which cannot be ignored. The treatment distance of 3 cm is the recommended value to achieve the treatment efficacy without thermal damage and pain. Significance: This research would reveal the underlying mechanisms of moxibustion therapy. Besides, the developed models are expected to establish a guideline for moxibustion clinical treatment.
Article
Introduction Moxibustion is described as a technique that applies heat which is generated by burning herbal preparations containing Artemisia vulgaris to stimulate acupuncture points. The aim of this study is to assess the efficacy and safety of moxibustion treatment for AS. In the future, a larger RCT will be conducted based on preliminary data from this study. Methods This research is a protocol for an open, assessor- and analyst-blinded, randomized clinical trial with two parallel groups. Participants who meet the modified New York criteria for AS will be randomly allocated to the intervention group or the control group with a 1:1 allocation ratio. The intervention group will receive moxibustion intervention for 3 weeks and follow-up for 6 weeks. The control group will not receive moxibustion intervention and will be followed for 6 weeks. Conventional interventions will be allowed for both groups. Primary outcome measures are BASFI, BASDAI, and BASMI. Secondary outcome measures are SF-36, EQ-5D, ASQoL and serum levels of ESR and CRP. Ethics and dissemination This protocol has been approved by the Institutional Review Board (IRB) of the Clinical Research Centre (Affiliated Hospital of Nanjing University of Chinese Medicine, IRB No. [2018] YK006-01). In addition, results of this preliminary study will be disseminated through peer-reviewed publications.
Article
An understanding of the thermal performance of biological tissue under moxibustion with ash cleaning and distance adjustment (ACDA) is helpful for the optimization and standardization of moxibustion clinical treatment. This study compared surface temperature distribution of burning moxa stick with and without ash cleaning. The experimental of moxibustion treatment on in-vitro tissue and human abdomen were conducted and corresponding numerical models were developed. The effect of ACDA on thermal performance of biological tissue under moxibustion therapy were analyzed. The results show that the surface temperature of burning moxa stick with ash cleaning maintained at a higher range compared to that without ash cleaning. During moxibustion with ACDA process in in-vitro tissue experiment, the temperature increase (ΔT) at skin surface almost fluctuated in the same temperature range, and the ΔT in subcutaneous tissue (>11 mm) kept increasing. Relatively, these ΔT under moxibustion treatment without ACDA showed different trends and these values were all much smaller than those with ACDA. In addition, the position of maximum temperature of tissue under moxibustion with and without ACDA was fixed on treatment acupoint and moved away from treatment acupoint, respectively. Besides, the surface temperature of human abdomen tissue under moxibustion treatment with ACDA can be maintained at 46 °C-50 °C for a longer time compared to that under moxbustion without ACDA. In conclusion, moxibustion with ACDA can create a larger and more durable thermal effect on biological tissue. The results also suggest that ACDA may be helpful to improve moxibustion therapy efficacy in clinic treatments.
Article
Background: Moxibustion, a Traditional Chinese Medicine technique, involves burning moxa floss to apply heat to certain points or areas of the body surface to treat disease. Moxibustion releases a considerable amount of smoke into the environment. There remains controversy over the safety of moxa smoke and its potential effects on human health. Methods: We measured the PM2.5 (particulate matter with aerodynamic diameter <2.5 μm) mass concentration in moxa smoke and the oxidative capacity of PM2.5 and moxa ash (using a plasmid scission assay in whole and water-soluble fractions) in the by-products of moxibustion produced from burning moxa floss of different ratios (3:1 or 15:1) and duration of storage (3 or 10 years) in three simulated moxibustion clinics. Results: PM2.5 mass concentration was 224.28, 226.39 and 210.56 μg/m(3) for samples A (3 years and 3:1 ratio), B (3 years and 15:1 ratio), and C (10 years and 3:1 ratio), respectively. Average D500 oxidative damage of PM2.5 was 29.42%, 29.16% and 27.01% and that of moxa ash was 22.78%, 20.60% and 21.42% for samples A, B and C, respectively. PM2.5 demonstrated a significantly greater oxidative capacity than moxa ash (p<0.05). Conclusions: The oxidative DNA damage induced by individual PM2.5 following moxibustion was lower than that reported in other environments. However, PM2.5 mass concentration after moxibustion is still relatively high. We would recommend ensuring adequate ventilation during moxibustion to reduce any possible risks. Further studies are needed to better define the potential impact of particles in moxibustion by-products on human health.
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There are only few studies about the relationship of skin lesions and the percutaneous uptake of hazardous substances in exposed workers. Several aromatic amines are well known carcinogens for humans and/or animals. This case report emphasizes the relevance of dermal absorption of the aromatic amine ortho-toluidine considering four workers with different skin status (healthy, erythematous and burned skin as well as dishydrotic eczema) during the vulcanisation process of rubber products in a components supplier plant for automobile industry. The results of our case report show that dermal absorption of o-toluidine through damaged epidermal barrier is significantly higher than through healthy skin.
Chapter
Cigarette smoking is the major cause of lung cancer, the largest cancer killer in the world. This chapter discusses the role of cigarette smoke carcinogens as causes of lung cancer. A general mechanistic framework is presented, in which cigarette smoke carcinogens and their metabolically activated forms cause mutations in critical growth control genes, along with other effects. Evidence and unresolved issues for the role of various groups of carcinogens, such as polycyclic aromatic hydrocarbons, nitrosamines, volatile organic compounds, and metals as causes of lung cancer are discussed. An overview of inhalation studies of cigarette smoke in laboratory animals is also presented. Collectively, the massive studies on carcinogenesis by cigarette smoke and its constituents provide a firm base for understanding the mechanisms of human lung carcinogenesis.
Article
A very sensitive mass-spectrometry method has been developed for the analysis of aromatic amines in tobacco smoke and in indoor air. Cigarettes were smoked with a smoking machine; the anwies from the smoke were trapped in a 5% HCl water solution containing internal standards and detected by gas chromatography/mass spectrometry in the selected-ion-monitoring (SIM) mode. The amines measured were the following: aniline. 2-toluidine, 3-toluidine, 4-toluidine, 2-ethylaniline, 3-ethylaniline, 4-ethylaniline, 2,3-dimethylaniline, 2,4-dimethylaniline, 2,5-dimethylaniline, 2,6-dimethylaniline, 1-naphthylamine, 2-naphthylamine, 2-methyl-1-naphthylamine, 2-aminobiphenyl,3-aminobiphenyl and 4-aminobiphenyl. We analyzed nine brands of cigarettes sold commercially in Italy (Gauloise, Nazionali, Marlboro, Camel, MS, MS mild and MS lights), with and without filter. Main-stream smoke contained a lower amount of aromatic amines than side-stream smoke: the total level of these amines in main-stream smoke ranged from 200 to 1300 nglcigarette, whereas the level of aromatic amines in side-stream smoke varied from 20,000 to 30,000 nglcigarette. The smoke of black-tobacco cigarettes had higher levels of aromatic amines compared to light-tobacco cigarettes and the filters significantly reduced aromatic amines in main-stream smoke. We also determined the levels of aromatic amines in ambient air, offices and houses. Some aromatic amines (aniline and toluidine) were detected in ambient air, as well as in rooms of non-smokers. Most measurements showed a considerable contamination of aromatic amines derived from side-stream smoke, which was detected also in parts of the buildings in which smoking was not allowed.
Article
The complexity of tobacco smoke leads to some confusion about the mechanisms by which it causes lung cancer. Among the multiple components of tobacco smoke, 20 carcinogens convincingly cause lung tumors in laboratory animals or humans and are, therefore, likely to be involved in lung cancer induction. Of these, polycyclic aromatic hydrocarbons and the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone are likely to play major roles. This review focuses on carcinogens in tobacco smoke as a means of simplifying and clarifying the relevant information that provides a mechanistic framework linking nicotine addiction with lung cancer through exposure to such compounds. Included is a discussion of the mechanisms by which tobacco smoke carcinogens interact with DNA and cause genetic changes--mechanisms that are reasonably well understood--and the less well defined relationship between exposure to specific tobacco smoke carcinogens and mutations in oncogenes and tumor suppressor genes. Molecular epidemiologic studies of gene-carcinogen interactions and lung cancer--an approach that has not yet reached its full potential--are also discussed, as are inhalation studies of tobacco smoke in laboratory animals and the potential role of free radicals and oxidative damage in tobacco-associated carcinogenesis. By focusing in this review on several important carcinogens in tobacco smoke, the complexities in understanding tobacco-induced cancer can be reduced, and new approaches for lung cancer prevention can be envisioned.
Article
We studied the concentration of 10 primary aromatic amines (AA), which are classified as suspected carcinogens, in indoor and outdoor air in Italy. The measured AA included: aniline, o-toluidine, m-toluidine, p-toluidine, 2,3-dimethylaniline, 2,4-dimethylaniline, 2,5-dimethylaniline, 2,6-dimethylaniline, 2-naphtylamine and 4-aminobiphenyl. In the indoor environment (homes, offices and public buildings) the level of contamination (expressed as sum of 9 AA, excluding aniline) varied from 3 ng/m3 (hospital ward) to 207 ng/m3 (discotheque). In most indoor environments with no contamination from cigarette smoke the AA levels were below 20 ng/m3, whereas in the presence of smokers higher values were observed. Aniline levels were more erratic (varying from 53 ng/m3 (office of non-smokers) to 1929 ng/m3 (discotheque) and were not related to cigarette smoke. The concentration range of AA (excluding aniline) in the outside air varied from 3 ng/m3 (Siena) to 104 ng/m3 (Brindisi); aniline concentration was extremely variable. Most samples of outdoor air had AA levels lower than 40 ng/m3. In conclusion, AA are widespread air contaminants and attain a high concentration in heavily contaminated indoor environments, due to smoking and poor ventilation. AA occasionally attain a high level in outdoor air as well. Therefore, a strategy of reduction of the exposure to AA should consider the abatement of multiple sources of contamination.
Article
Diverse biological activities of moxa extracts and smoke (gas phase) were investigated. Moxa was extracted with hot water (Fr. I), or ethanol (Fr. II), or extracted with hot water after ethanol wash (Fr. III) and then lyophilized to obtain the dried powders. Moxa smoke (containing a lot of gaseous components obtained by burning Moxa) (Fr. IV) was collected into phosphate-buffered saline and quantified spectrophotometrically. These extracts and Moxa smoke showed comparable cytotoxic activity against human oral tumor cell lines (HSC-2, HSG). Human gingival fibroblasts (HGF) were more resistant to any Moxa fractions. Neither of the extracts showed anti-HIV activity. Pretreatment of mice with Fr. I significantly reduced the lethal effect of E. coli infection. All extracts produced radicals under alkaline condition, with a maximum intensity at pH 10.5, and enhanced the radical intensity of sodium ascorbate. It was unexpected that these extracts show significant O2- scavenging activities. These data suggest the medicinal efficacy of Moxa extracts and smoke.
Article
Moxa smoke induced internucleosomal DNA fragmentation in human promyelocytic leukemic HL-60 cells, but not in other cell lines. The cytotoxic activity of Moxa smoke was significantly reduced by a popular antioxidant, N-acetyl-L-cysteine (NAC). Moxa smoke showed oxidation potential (measured by NO monitor) and produced carbon radical (measured by ESR spectroscopy). The addition of NAC significantly reduced both the oxidation potential and carbon radical intensity of Moxa smoke. Activity staining of polyacryamide gel electrophoresis of MnSOD revealed the possible modification of the conformation and/or activity of this enzyme at an early stage of HL-60 cell death. These data suggest that Moxa smoke induces cytotoxicity by its pro-oxidant action.
Article
A method for the analysis of o-toluidine, o-anisidine, 2-naphthylamine, and 4-aminobiphenyl in cigarette mainstream smoke has been developed, which combines the sensitivity of their pentafluoropropionyl (PFP) derivatives in negative ion chemical ionization (NICI) mode with the selectivity of the gas chromatography/tandem mass spectrometry (GC/MS/MS) technique. The use of four deuterated analogues as internal standards along with the application of the standard addition method results in accurate and precise results; the interday precision for the aromatic amines was 3-10% and the accuracy ranged from 97-100%. This method was applied to two American-blend University of Kentucky reference cigarettes, eight American-blend market cigarettes, a bright (flue-cured) tobacco cigarette, and an electrically heated cigarette smoking system (EHCSS). For the American-blend cigarettes there was a linear correlation between aromatic amine yields and mainstream smoke 'tar' ('tar' = total particulate matter - (nicotine + water)), whereas the bright tobacco cigarette and the EHCSS demonstrated significantly lower aromatic amine yields on an equal 'tar' basis. The results support the hypothesis that the nitrogen content of the tobacco, and above all the cigarette combustion temperature, are determining factors for the yields of aromatic amines in smoke.
Article
Occupational exposure is definitely a major cause of cancer. In the field of urology, the urinary bladder is the most important target. A classical cause of bladder cancer is exposure to carcinogenic aromatic amines, especially benzidine and beta-naphthylamine. Such exposures were related to work places in the chemical industry, implying production and processing of classical aromatic amines, and in the rubber industry. Occupational bladder cancer has also been observed in dyers, painters and hairdressers. Even some occupations with much lower exposures to carcinogenic aromatic amines, like coke oven workers or workers in the rubber industry after the ban on beta-naphthylamine, are at risk. In these occupations, exposure to complex mixtures of substances containing combustion products (e.g. polycyclic aromatic hydrocarbons) or nitrosamines is common. Renal cell cancer has been observed as an occupational disease in cases of very high exposure to trichloroethylene having led to narcotic or prenarcotic symptoms. Occupationally related cancers of the prostate or the testes appear currently not relevant.
Article
The biological activities of Moxa, used as moxibustion, have not been well documented. We investigated here Moxa smoke for its tumor-specific cytotoxicity, anti-HIV activity, radical intensity and radical scavenging activity, in comparison with previously published data of Moxa extract. Moxa smoke showed slightly higher cytotoxicity against human tumor cell lines (oral squamous cell carcinoma HSC-2, HSC-3, promyelocytic leukemia HL-60) than against normal oral cells (gingival fibroblast HGF, pulp cell HPC, periodontal ligament fibroblast HPLF), yielding a tumor specificity index of 1.29. Moxa smoke dose-dependently induced internucleosomal DNA fragmentation, activation of caspases 3, 8 and 9, and slightly modified the expression of apoptosis-related proteins (Bcl-2, Bad, Bax) in HL-60 cells, but to much lesser extents than attained by positive controls (UV irradiation, actinomycin D treatment). ESR spectroscopy showed that Moxa smoke generated semiquinone-type radicals under alkaline conditions, and scavenged O2(-), hydroxyl radical, singlet oxygen and NO. All Moxa smoke preparations showed no apparent anti-HIV activity. These data demonstrate the antitumor potential of Moxa smoke.
Article
The major cytotoxic activity of Moxa was extracted with CH2Cl2 and partially purified by three cycles of silica gel column chromatography. The active fractions showed higher cytotoxicity against six human tumor cell lines (two oral squamous cell carcinoma, one salivary gland tumor, one melanoma, two leukemia) than three normal oral human cells (gingival fibroblast, periodontal ligament fibroblast, pulp cell). All fractions failed to protect the cells from the cytopathic effect induced by HIV infection. ESR spectroscopy showed that all fractions produced little or no radical under alkaline conditions, while showing much lower O2- scavenging activity, generated by hypoxanthine-xanthine oxidase reaction, than antioxidants and polyphenols. Active fractions induced DNA fragmentation in HL-60 cells, but failed to modify the mobility and activity of mitochondrial Mn-containing superoxide dismutase (MnSOD), in contrast to Moxa smoke. These data suggest that the active principles in the Moxa extract might be different from that in Moxa smoke, which produced carbon radical and modified MnSOD mobility and activity.
The changing cigarette: chemical studies and bioassays. In: Risks associated with smoking cigarettes with low machine-measured yields of tar and nicotine. Bethseda, MD: US Department of Health and Human Services
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Hoffmann D, Hoffmann I. The changing cigarette: chemical studies and bioassays. In: Risks associated with smoking cigarettes with low machine-measured yields of tar and nicotine. Bethseda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 2001:159-91.
Ventilation as a means of controlling exposure of workers to environmental tobacco smoke (ETS)Commission of the European Union, Joint Research Centre, Institute for Health and Consumer Protection, Ispra (Va), Italy
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Kotzias D, Geiss O, Leva P, et al. (2003) Ventilation as a means of controlling exposure of workers to environmental tobacco smoke (ETS).Commission of the European Union, Joint Research Centre, Institute for Health and Consumer Protection, Ispra (Va), Italy. http://www.publications.parliament.uk/pa/ld200506/ldlwa/60504wa1.pdf (accessed 4 Feb 2009).
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Golka K, Wiese A, Assenato G, et al. Occupational exposure and urological cancer World J Urol 2004;21:382-91.
Commission of the European Union, Joint Research Centre, Institute for Health and Consumer Protection
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Kotzias D, Geiss O, Leva P, et al. (2003) Ventilation as a means of controlling exposure of workers to environmental tobacco smoke (ETS).Commission of the European Union, Joint Research Centre, Institute for Health and Consumer Protection, Ispra (Va), Italy. http://www.publications.parliament.uk/pa/ld200506/ldlwa/60504wa1.pdf (accessed 4 Feb 2009).