Written by Joyce Smith, Staff Writer. Supplementation with 500 mg of Nigella sativa significantly improved two measures of the ACT score (daily function and overall asthma control), eosinophilia (a marker of inflammation) and pulmonary function in the 40 participating asthmatic subjects compared to the control.
Poor medication compliance due to costly medications, difficulty with inhaler use, 1,2 and adverse events (Gapp 2005) has made controlling asthma symptoms a challenging endeavor in spite of the readily available conventional treatments.3
The existing limited knowledge regarding composition and quality of Nigella sativa for the treatment of asthma prompted researchers to conduct the following clinical trial that offers a higher standard and with an objective of investigating the benefits of Nigella sativa oil (NSO) on clinical and inflammatory parameters of asthma. This randomized, prospective, phase 2 double-blind placebo-controlled trial consists of 80 asthmatic patients who received a four- week intervention of either 500mg twice daily of NSO (n=40) or virgin olive oil (n=40).) The NSO used in this study was “pharmaceutical good manufacturing practice certified” (England) and had a chemical composition that was determined using high –performance liquid chromatography analyses ( Cartagena, Spain; brand name: CUMINAR; batch number: L885) and was licensed as an herbal medicinal product in Saudi Arabia)) .
The ACT score, consisting of 5 questions with each question scaled from 1-5 and representing a total score of 25 4, is one of the numerical asthma control tools used to evaluate treatment effectiveness. It scores the level of asthma control and tracks patients’ progress. 5 Blood samples were collected at baseline and at follow-up visits. Primary outcome was the ACT score; secondary outcomes were the pulmonary function test, absolute blood eosinophil counts and total serum IgE level.
At baseline, total treatment scores were similar between treatment and placebo groups; however, at the end of 4 weeks, the average total ACT score was significantly higher in the NSO group relative to the placebo group (P=0.04). Analyses of the five individual parameters of the ACT found significant improvements relative to placebo in Q1 (daily functioning) (P=0.01) and Q5 (Overall asthma control) (P=0.01). However, there were also improvements, although not significant, in Q2 (Shortness of breath), Q3 (night symptoms), and Q4 (Use of rescue medication).
With respect to pulmonary function, analyses of a treatment subgroup of 14 patients with low basal predicted FEV1% (<80%) revealed a significant improvement of 8% relative to a 1% improvement in the placebo subgroup of 15 patients (P=0.018)
The NSO group also had a significant reduction in absolute peripheral blood eosinophil count relative to the placebo group (P=0.013). No significant changes were observed for total IgE levels between the two groups. Eosinophils play a major role in asthma inflammation and serve as a vital biomarker in asthma trials 6 which is consistent with previous studies.7 The authors suggest NSO was effective in decreasing histamine and leukotrienes production and increasing PGE2c (prostaglandin E2) release, as seen in a guineapig model of allergic asthma. 8
Study limitations include a short 4-week duration, lack of geographic motility and socioeconomic status of some of the participants, and lack of patient compensation due to limited funding.
NSO intervention reduced eosinophilia and effectively enhanced asthma symptom control with a trend in pulmonary function improvement, lending credence to its potential role in the clinical management of asthma; however, future studies of longer duration are warranted
Source: Koshak, Abdulrahman, Li Wei, Emad Koshak, Siraj Wali, Omer Alamoudi, Abdulrahman Demerdash, Majdy Qutub, Peter Natesan Pushparaj, and Michael Heinrich. “Nigella sativa Supplementation Improves Asthma Control and Biomarkers: A Randomized, Double‐Blind, Placebo‐Controlled Trial.” Phytotherapy Research 31, no. 3 (2017): 403-409.
2017 John Wiley & Sons, Ltd.
Posted August 3, 2017.
References:
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- Bateman E, Hurd S, Barnes P, et al. Global strategy for asthma management and prevention: GINA executive summary. European Respiratory Journal. 2008;31(1):143-178.
- Price D, Fletcher M, Van Der Molen T. Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ primary care respiratory medicine. 2014;24:npjpcrm20149.
- Nathan RA, Sorkness CA, Kosinski M, et al. Development of the asthma control test: a survey for assessing asthma control. Journal of Allergy and Clinical Immunology. 2004;113(1):59-65.
- Bousquet J. Global initiative for asthma (GINA) and its objectives. Clinical and Experimental Allergy. 2000;30(6; SUPP/1):2-5.
- Szefler SJ, Wenzel S, Brown R, et al. Asthma outcomes: biomarkers. Journal of Allergy and Clinical Immunology. 2012;129(3):S9-S23.
- Kalus U, Pruss A, Bystron J, et al. Effect of Nigella sativa (black seed) on subjective feeling in patients with allergic diseases. Phytotherapy Research. 2003;17(10):1209-1214.
- Saleh S, ElDenshary E, Mahran N. Nigella sativa (black seed) oil: anti-inflammatory and antioxidant effects in experimental models of allergic asthma. Paper presented at: First USIM International Conference on Medicine and Health (ICMH2012) DOI2012.
