Inhibitory effect of Zingiber cassumunar Roxb. (Phlai)on nasal cytokine productions and eosinophilic recruitment in patients with allergic rhinitis
Nichanan Achararit,1,2,† Phuntila Tharabenjasin,3,† Prapasri Kulalert,1,2 Paskorn Sritipsukho,1,2 Sira Nanthapisal,1,2 Noel Pabalan,3 Nateetip Krishnamra,4,5 Panan Suntornsaratoon,4,5 Orapan Poachanukoon1,2,6
Affiliations:
1 Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University Hospital, Pathumthani, Thailand
2 Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
3 Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
4 Center of Calcium and Bone Research (COCAB), Faculty of Science, Mahidol University, Bangkok, Thailand
5 Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand
6 Thammasat Universiy Research Unit in Allergy and Respiratory Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
†The first and second authors contributed equally to the manuscript
Abstract
Background: Zingiber cassumunar Roxb. (Phlai) has been used for the treatment of allergies including allergic rhinitis (AR). Although the anti-histamine effects have been reported, assessment of nasal cytokine and eosinophil production had not been investigated.
Objective: This study aimed to examine the effect of Phlai on alterations in nasal pro-inflammatory cytokine levels and eosinophil counts in nasal mucosa.
Methods: This was a randomized, double-blinded, three-way crossover study. Nasal concentrations of cytokines, namely interleukin (IL)-4, IL-5, IL-13 and interferon-gamma (IFN-γ), nasal smear eosinophilia as well as total nasal symptom score (TNSS) were evaluated before and after a 4weeks treatment with 200 mg Phlai capsules or placebo in 30 AR patients.
Results: We observed significant (p < 0.05) reduction in IL-5, IL-13 as well as the number of eosinophils in subjects given Phlai. The degree of improvement of TNSS after Phlai treatment was initially manifested in week 2 with the greatest effect in week 4. In contrast, there were no significant differences in all nasal cytokines, eosinophil counts or TNSS between before and after receiving placebo.
Conclusions: These findings provided the first evidence for the anti-allergic effect of Phlai which possibly involved inhibition of nasal pro-inflammatory cytokines production and eosinophilic recruitment. Phlai thus represents a promising herbal medicine for alleviating inflammation and AR symptoms.
Key words: Zingiber cassumunar, Phlai, allergic rhinitis, eosinophils, Th2 cytokine