The array of information concerning the immune system and herbal approaches to treatments can be truly daunting! The therapeutic suggestions that follow are based upon my training and clinical experience in England and Wales. This point must be re-iterated as the approach might seem too simplistic in light of the impressive research on specific plants. Remember that the approach throughout this course is people based, rather than focusing on specific plants. All to often this can lead to the patient being viewed in terms of how well they fit a plants indications, instead of identifying their needs and what herbs might address them.
Types of pathologies
The phytotherapist has a number of therapeutics options when approaching the immune system. Most exciting is the ability to generally support without an overt pathology being present. Using immuno-modulators within the context of the approach described above, preventive healing and the nurturing of `wellness’ becomes a readily achievable goal. Additionally there are a range of immune system pathologies that may be addressed herbally. Immunological problems are grouped into these categories:
- Immunodeficiency Disease : associated with a deficiency or mal-function of one or more of the major aspects of the immune response. Immuno-deficiency diseases are usually divided into two groups:
1. Primary immune deficiency disease, hereditary or acquired, in which the immune deficiency is the cause of a disease. These are relatively conditions.
2. Secondary immune deficiency disease, in which the immune deficiency is a result of other diseases. An extreme example would be AIDS.
- Hypersensitivity Reactions : these are normal immunity processes that become damaging rather than protective. The pathological processes result from specific interactions between an antigen and components of the immune system. Four types are known:
1. Type I. Anaphylactic reactions, resulting from release of pharmacologically active substance, such as histamine, from IgE-sensitized mast cells and basophils after contact with specific antigens. Examples are hayfever, allergic asthma, food allergies etc.
2. Type II. Cytotoxic reactions, here binding of antibody to an antigen on the surface of a cell produces damage to that cell through a variety of mechanisms. Examples are blood transfusion and Rh incompatibility reactions.
3. Type III. Immune complex reactions, resulting from deposition of soluble circulating antigen-antibody complexes in vessels or tissue. This process seems to be involved in autoimmune conditions such as rheumatoid arthritis.
4. Type IV. Cell mediated immunity, problems mediated by T-cells rather than antibodies. Examples are contact sensitivity to Poison Oak and Poison Ivy. Graft rejections may be of this type.
- Auto-Immune Disease : conditions where lymphocytes produce anti-bodies that attack the body’s own cells and tissues as if they were the foreign substances, thus causing pathological damage. Any organ or tissue may be involved. Conditions thought to have an autoimmune basis include rheumatoid arthritis, polyarthritis, chronic active hepatitis, multiple sclerosis and psoriasis.
– Etiology of Autoimmune disease : The immune system in the embryos thought to contain lymphocytes that can produce antibodies that are self-reacting, but that are somehow inactivated as the system develops. This has lead to the suggestion that autoimmune diseases arise when this inactivation is disrupted in some way. A process has been postulated called immuno-regulationwhich theorizes that complex homeostatic mechanisms hold the `auto-reactive ‘cells in check. This has interesting implications for the holistic practitioner. The invoking of homeostasis in this way leads directly to the broader issues discussed at the beginning of this section. The fascinating complexities of biochemical and cytological immunology can become all too mesmerizing to both theorist and therapist. Phytotherapists often become infatuated with the research findings about plant/immune system interactions at the expense of retaining a holistic perspective that perceives the person as whole, much more than their blood chemistry. These ideas about homeostatic immuno-regulation point to a possible bridge between concepts of wholeness(whether whole plant actions or holistic medicines whole body perspectives)and the reductionist science of immunology.
- Tumors, `Cancer’ : there is a direct immunological relationship between the body and tumors. This highlights the possibilities of prevention and treatment through working with immunity. See below.
- Transplantation problems : transplantation rejection is immunologically based.
So where does all of this leave the phytotherapist? What actions or specific herbs are indicated for these conditions? Just because effects can be produced does not mean they are appropriate in every case. That is obvious, or is it……….
Western herbalism has got itself tied in knots around the word `immune’, with non-professional and professional alike showing the symptoms of conceptual overload. People are wanting `immune system boosts’ and herbalist’s are trying to supply them (whatever they are), but two misconceptions do not make a strong immune system. Appropriate remedies for immune system problems must be selected based upon individual need, which can only be identified by careful diagnosis, in turn necessitating the practitioner being knowledgeable in the complexities of the process in play. The word immune does not equate with herb Echinacea!
The real question is when to use the immuno-stimulant herbs and, more critically, when not to. Stimulating immunological activity may be inappropriate in some conditions and vital in others. The classic eclectic, physio-medical, and European texts on herbal therapy do not address these issues. In an attempt to clarify this for myself I have provisional established guidelines for identifying those therapeutic situations calling for immuno-stimulation, and those where it might be contra-indicated.
As a generalization it seems safe to say that in conditions involving inappropriate activity of some aspect of the whole immunological complex, immuno-stimulant plants should be avoided. In auto-immune conditions any stimulation might increase the production or pathological impact of antibodies. Similarly with hypersensitivity, even though an external antigen may be present. Transplantation issues would also fit in here, but are rarely encountered by the phytotherapist.
Immuno-stimulants probably contra-indicated :
In conditions involving inadequate or compromised activity of immunity, immuno-stimulant plants are fundamentally important in herbal treatment. This can be immuno-compromise in the face of pathogenic or parasitic organisms, or inadequate response to the bodies own cells becoming cancerous.
Immuno-stimulants probably indicated :
Immuno-deficiency Disease (AIDS)
Why have I chosen to express this in terms of probably? The phyto-therapists completely at home with the multi-factorial effects of plants, let alone the diversity and mutability of people. It is a mistake to see a plant as simply an `immuno-stimulant’. It is quite feasible that a remedy having specific value in the treatment of rheumatoid arthritis might also be shown in the laboratory to have immuno-stimulating activity. The long standing usage, based on many generations of practitioners and patients has more value in practice than the theoretical concerns brought up by in vitroor animal studies.