Asthma Begins and Is Perpetuated in the Gut

Majid Ali, M.D.

Asthma is a problem of the gut which is manifested in the lungs. I consider all treatments of asthma scientifically inadequate and clinically insufficient unless all relevant bowel issues in a given patient are duly addressed. Most importantly, complete asthma treatment must include the core issue of restoration of gut ecology, for which I described my Seed, Feed, and Weed Approach (do a web search for my articles and videos on the subject for details).

I start to think and write about the above gut-asthma connections after I published my monograph entitled “Altered States of Bowel ecology” in 1987. Initially this view was based on personal clinical and laboratory observations. Simply stated, all my patients with asthma had clear laboratory evidence of mold allergy which always begins in the gut and may express itself in sinuses, ears, skin, and asthma. Some years later, I recognized that all my patients with asthma had objective laboratory evidence of impaired mitochondrial function in terms of reduced ATP generation. I presented these subjects at length in Integrative Immunology and Allergy, the fourth of my twelve volume textbook entitled “The Principles and Practice of Integrative Medicine” (1998, 2nd edition 2005, Canary 21 Press, available at

Cutting-Edge Allergy and Asthma Care

On February 17, 2015, I was amused this title on the 2015 program of the American Academy of Allergy, Asthma & Immunology: Gut Microflora in Cutting-Edge Allergy and Asthma Care. Better late than ever. Does it mean pulmonologists will think ecologically and act integratively? Time will answer this crucial question.

Below, I reproduce the text of the article as it appeared on the website of Medscape Medical News.


American Academy of Allergy, Asthma & Immunology 2015

HOUSTON — Technological advances are transforming how many physicians think about allergy and asthma. Delegates attending this year’s American Academy of Allergy, Asthma & Immunology (AAAAI) conference will hear how the microbiome could change disease management.

“They’re now using DNA techniques, measuring certain types of RNA that only occur in bacterial or viral species,” meeting program chair Paul Williams, MD, from the Northwest Allergy & Asthma Center in Mount Vernon, Washington, told Medscape Medical News.

“There are millions of organisms inhabiting the gastrointestinal tract that we didn’t know about,” he explained. “It’s not only the species that is important; even the strain of bacteria and the collection are important because they interact with each other and they interact with diet. All of that plays a role in inflammation and immune response.”

During the meeting, delegates will be guided through the hygiene hypothesis to the more murky details of the link between gut microflora and asthma and allergies.

A plenary will look at how the microbial environment influences the development of allergic diseases, an oral abstract session will highlight some of the links between infant and maternal microbiome and allergen exposure, and a translational symposium will examine how microbiome discoveries could guide future probiotic regimens for the treatment and prevention of food allergy and atopic dermatitis.

There are millions of organisms inhabiting the gastrointestinal tract that we didn’t know about.

“The concept of the microbiome and the gut is getting another wave, if you will, because there’s more science now. It’s a very trendy topic,” said Mary Beth Fasano, MD, from the University of Iowa Carver College of Medicine in Iowa City, who is vice chair of the annual meeting program subcommittee.

Gideon Lack, MD, from Guy’s and St Thomas’ NHS Foundation Trust in London, United Kingdom, will present much-anticipated results from the Learning Early About Peanut (LEAP) study.

LEAP Results

“The LEAP study was based on the hypothesis that early feeding of foods reduces the development of allergy,” Dr Williams explained. “There have been smaller studies and epidemiologic studies that suggest this, but this is the first controlled study.”

Immunotherapy will also be the subject of an oral abstract session. Newer epicutaneous and intralymphatic forms of delivery will be presented and discussed along with the more recognized oral and sublingual forms of immunotherapy.

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