Effects of the forest bathing on older COPD patients

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Bezug Jia BB, Yang ZX, Mao GX, et al. Gesundheitlicher Effekt von Waldbaden bei älteren Patienten mit chronisch obstruktiver Lungenerkrankung. Biomed Environ Sci. 2016;29(3):212-218. Design und Teilnehmer Achtzehn Patienten (im Alter von 61–79) mit chronisch obstruktiver Lungenerkrankung (COPD), die in Hangzhou, China, lebten, wurden entweder in einen Wald oder in eine städtische Umgebung gebracht und dort drei Stunden lang (1,5 h morgens und nachmittags, am selben Tag) herumlaufen gelassen. Alle Teilnehmer waren vor dem Studiendatum mindestens 6 Wochen ohne ein signifikantes respiratorisches Ereignis geblieben, und es gab keine statistisch signifikanten Unterschiede bei den wichtigsten medizinischen Parametern (Body-Mass-Index [BMI]Ruheblutdruck oder Herzfrequenz, …
Reference Jia BB, Yang ZX, Mao GX, et al. Health effect of forest bathing in older patients with chronic obstructive lung disease. Biomed Environ Sci. 2016; 29 (3): 212-218. Design and participants eighteen patients (at the age of 61–79) with chronic obstructive pulmonary disease (COPD) who lived in Hangzhou, China, were either brought to a forest or in an urban environment and left around for three hours (1.5 h in the morning and in the afternoon, on the same day). All participants had remained without a significant respiratory event at least 6 weeks before the study date, and there were no statistically significant differences in the most important medical parameters (body mass index [BMI] resting flood pressure or heart rate, ... (Symbolbild/natur.wiki)

reference

Jia BB, Yang ZX, Mao GX, et al. Health effect of forest bathing in older patients with chronic obstructive lung disease. Biomed Environ Sci . 2016; 29 (3): 212-218.

design and participant

eighteen patients (at the age of 61–79) with chronic obstructive lung disease (COPD) who lived in Hangzhou, China, were either brought to a forest or in an urban environment and left around for three hours (1.5 h in the morning and in the afternoon, on the same day). All participants had remained without a significant respiratory event at least 6 weeks before the study date, and there were no statistically significant differences in the most important medical parameters (body mass index [BMI] resting flood pressure or heart rate, forced expiration volume [FEV] 1, FEV1/forced vital capacity [FVC] Dyspnoe scale of the modified Medical Research Council (MMRC) and COPD assessment test result) between the groups at the beginning of the study.

target parameter

In order to measure the physiological effects of the forest compared to the urban environment, the blood levels of the following biomarkers were measured before and after exposure:

  • Immunological T cell response: CD8+, natural killer cells (NK) and NKT-like cells, in particular cells that express the cytolytic enzymes perforin and granzyms, the main components of the pathogenesis of COPD;
  • inflammatory cytokines: interferon (ifn)- γ interleukin (il) -6, il-8, il-1β, tumor necrosis factor (tnf)- a and C reactive (CRP), all as part of the pathomechanism of COPD are; 2 measured by enzyme-left immunosorbent assay (elisa).
  • COPD biomarker: lung and activated chemokine (Parc)/chemokine (CC motif) Ligand 18 (CCL-18); Surfactant-pulmonary-associated protein D (SP-D); Metalloproteinase fabric inhibitor (TIMP) -1; Measured by Elisa.
  • neuroendocrine marker: serumcortisol and epinephrin

In addition, a psychometric pre-post measurement was carried out with the Profile of Mood States (POMS).

important knowledge

The flow cytometry showed a significant reduction in the proportion of perforated CD8+, NK and NKT-like cells. This decline was found in both the forest and the city group, but was much larger in the forest group (and statistically significant). The values ​​of the total and granzym-expressing T cells did not change significantly in the forest or in the city group.

Is it possible that forest therapy regulates the immune function to combat cancer while it is regulated to prevent further damage to COPD?

The enzyme-bound immunosorbent assay only showed a significant decrease in all inflammatory cytokines and COPD biomarkers among the participants of the forest group. A statistical significance was achieved for reducing the IFN cytokines. γ , IL-6, IL-8, IL-1β and CRP as well as the Biomarker Parc/CCL-18 and TIMP-1. The urban group had inflammatory cytokin and biomarker results that either did not change or increased pre-post exposure (IL-8, TIMP-1). The serum levels of Cortisol and Epinephrin also decreased ( p <0.05) for the forest group while increasing for the urban group.

Psychometric tests showed statistically significant decreases of the POMS measurements of tension fear, depression-lowness and anger aggression for the forest group. No significant changes were measured for the urban group.

practice implications

This study expands the empirical work on the forest air bathing ( Shinrin-Yoku in Japanese) by recruiting a clinically relevant population-patients with COPD. So far, research on forest therapy has mainly used healthy subjects in an exploratory attempt to understand relevant psychophysiological mechanisms. 3.4 The number of studies that investigate clinical results in sick population groups is low and currently mainly limited to cancer treatment. Diversity of immunological, inflammatory, neuroendocrine and COPD biomarkers After only 3 hours of exposure in an forested environment, a strong first support for the positive effect of forest therapy for patients with respiratory diseases.

Earlier studies on forest therapy tend to be based on cardiovascular biomarkers (e.g. heart rate variability). [HRV] Blood pressure) or the psycho-neuro-immuno-endocrinology tetra. B. lung diseases, helps to extend the benefits of forest therapy beyond a model based on "stress relief" to a broad and really holistic intervention.

It is interesting to determine the acceptance of the perforin-expressing T cells in this study. The majority of the papers on Shinrin-Yoku , including the study, which has made this aspect of forest therapy famous, show an increase in NK-Zell- und Perforin/Granzym activity according to forest exposure. 8.9 There are too many unknowns to say why such divergent results similar exposure occur. Despite the statistical significance of the results, this was only a pilot study, so that any interpretation of the data is premature.

Against this background, one of the purposes of pilot studies is to generate more hypotheses. Possibly different types of forest flora produce different phytonic terps, which was more of a decrease in the NK cells than the typically measured increase Shinrin-Yoku studies. A vegetation and/or air concentration analysis of aromatherapy connections would help to answer this question. 10 or maybe forest therapy has any kind of modulating or "tangible amphoter" property that helps to recognize the physiology of a person to restore health. Is it possible that forest therapy regulates the immune function to combat cancer as it is regulated to prevent further damage to COPD? Could the same ability be used for immune -regulatory diseases such as autoimmune diseases? These questions are purely speculative, but it is worth examining them with further studies.

restrictions

As mentioned above, this pilot study cannot be interpreted as clinically relevant due to its low sample size. However, the essential biomarker decreases (many of the p <0.05 level) from the forest vs. city exposure indicate that clinically significant physiological changes occur. Larger study populations with larger demographic variation would be necessary to make more meaningful claims.

The study authors have not included any of the numerical data in their publication and instead decided to present their results exclusively through bar diagrams. While this gives an indication of the relative change in pre-post measures and between forest and city groups, it limits a useful discussion of the numerical percentage change with academic and clinical listeners. It would be helpful to include the raw data in a table.

Finally, no functional measurements of the COPD severity degree were carried out after forest/city exposure to assess changes in the lung function status. Further research with pre-post-fev1 and/or FEV1/FVC measures is necessary to understand how forest therapy could benefit patients with lung diseases.

FAZIT

This study promotes understanding and therapeutic potential for forest therapy by examining its effects in connection with a new clinical disease (COPD) and providing convincing provisional results. It also raises more questions than it answers; Above all, how can the tested mechanism of action (cytotoxic T cells) react in contrast to other studies that have used the same intervention? The fact that the ultimate result can be the same (ie patients move away from the illness and closer to a state of health), regardless of the clinical condition treated by the time in the forest, speaks for the miracles and secrets of the human body and the healing power of the to Medicatrix Naturae .

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