Pomegranate Extract Improves Severity of Allergic Asthma Symptoms

by | Jan 17, 2024 | 2023, Allergies, Asthma, Fruits and Vegetables, Lung Health

Written by Taylor Woosley, Staff Writer. 8-week supplementation with 500 mg daily of pomegranate extract significantly improved symptom severity (p < 0.05) and significantly decreased neutrophil and eosinophil levels (p < 0.0001 and p = 0.002, respectively) compared to the control group. 

fruits and vegetablesAllergic asthma is the most common asthma phenotype and is defined as asthma associated with sensitization to aeroallergens, leading to asthma symptoms and airway inflammation1. It is present in up to approximately 60% of adult patients with moderate-to-severe asthma and its prevalence is increasing2. The etiology underlying asthma includes both genetic predisposition and environmental exposures3.

Pomegranate is a well-known source of nutritional substances and contains tannins, flavanols, anthocyanins, and phenolic and organic acids, which have been studied for numerous health benefits4. Punicalagin, a major polyphenol present in pomegranate, is reported to possess antioxidant and anti-proliferative effects and has been shown to reduce cellular infiltration5. Furthermore, research on ellagic acid found in pomegranate shows that it has significant anti-inflammatory activity in asthma6.

Hosseini et al. conducted a double-blind, randomized, controlled trial to assess the effects of pomegranate extract on complete blood count with differential (CBC-diff) and clinical symptoms in subjects with mild-to-moderate allergic asthma. Subject inclusion consisted of participants with diagnosed allergic asthma, aged 18 to 65 years old, with a BMI less than 30 kg/m2, serum IgE ≥30 IU, with insensitivity to pomegranate. Participants were divided into two intervention groups (mild and moderate allergic asthma) based on disease severity using the Global Initiative for Asthma (GINA) diagnostic criteria and its severity (FEV1 ≥ 60%) by spirometry test. Subjects with FEV1 ≥ 80% were placed in the mild group, while participants with FEV1 between 60% and 80% were included in the moderate group.

The intervention groups were informed to consume a pomegranate extract capsule containing 250 mg of pomegranate seed extract twice daily (500 mg total) for 8 weeks. Each pomegranate extract capsule contained 2.1 µg of ellagic acid, 118.4 µg of punicalagin alpha, and 53 µg of punicalagin beta. The control group received rusk powder containing capsules that was similar in appearance. Primary outcomes were the clinical symptoms of asthma consisting of daily breath shortness, nocturnal breath shortness, salbutamol spray usage, nocturnal waking up, and asthma-related activity limitation. Additionally, secondary outcomes included basophil, eosinophil, and neutrophil counts. All outcomes were assessed at the beginning and end of the study.

Fasted blood samples were obtained at baseline and at the end of the eight weeks. Total IgE concentration was measured using a Roche enzyme-linked immunosorbent assay (ELISA) kit. Subjects completed a 3-day 24-h dietary recall to evaluate their diet. Anthropometric measurements such as waist circumference (WC), weight, hip circumference, and waist-to-hip ratio (WHR) were completed at baseline and end of intervention. Furthermore, information on physical activity level, demographic data, medication use, duration of asthma disease, and blood pressure were evaluated at baseline and end of the study.

64 subjects (intervention, n = 32; control, n = 32) were included in the final analysis. No significant differences were noted between the control and intervention groups regarding demographic features, anthropometric data, diet, asthma severity, physical activity level, and clinical characteristics (p > 0.05). Significant findings of the study are as follows:

  • An improvement in day-and-night shortness of breath and activity limitation due to asthma symptoms was observed in the intervention group compared to the control (p < 0.05).
  • The change levels in neutrophils and eosinophils in the intervention group were statistically significant at the end of the study compared to the control group (p < 0.0001 and p = 0.002, respectively).

Results of the double-blind, randomized, controlled trial show that 8-week supplementation with 500 mg pomegranate extract daily significantly reduced the severity of allergic asthma symptoms. Furthermore, the pomegranate extract group experienced significant reductions in neutrophils and eosinophils levels. Study limitations include the self-reported nature of asthma symptoms and the short length of the study.

Source: Hosseini, Seyed Ahmad, Zainab Shateri, Farhad Abolnezhadian, Elham Maraghi, Maryam Haddadzadeh Shoushtari, and Marzie Zilaee. “Does pomegranate extract supplementation improve the clinical symptoms of patients with allergic asthma? A double-blind, randomized, placebo-controlled trial.” Frontiers in Pharmacology 14 (2023): 1109966.

© 2023 Hosseini, Shateri, Abolnezhadian, Maraghi, Haddadzadeh Shoushtari and Zilaee. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Posted January 17, 2024.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Akar-Ghibril N, Casale T, Custovic A, Phipatanakul W. Allergic Endotypes and Phenotypes of Asthma. The journal of allergy and clinical immunology In practice. Feb 2020;8(2):429-440. doi:10.1016/j.jaip.2019.11.008
  2. Bernstein JA, Llanos JP, Hunter G, Martin N, Ambrose CS. Efficacy of Biologics in Patients with Allergic Severe Asthma, Overall and by Blood Eosinophil Count: A Literature Review. Adv Ther. Nov 2023;40(11):4721-4740. doi:10.1007/s12325-023-02647-2
  3. Zhang J, Zou Y, Chen L, et al. Regulatory T Cells, a Viable Target Against Airway Allergic Inflammatory Responses in Asthma. Frontiers in immunology. 2022;13:902318. doi:10.3389/fimmu.2022.902318
  4. Kandylis P, Kokkinomagoulos E. Food Applications and Potential Health Benefits of Pomegranate and its Derivatives. Foods. Jan 23 2020;9(2)doi:10.3390/foods9020122
  5. Yu L, Li J. Punicalagin attenuated allergic airway inflammation via regulating IL4/IL-4Rα/STAT6 and Notch- GATA3 pathways. Acta Pharm. Dec 1 2022;72(4):561-573. doi:10.2478/acph-2022-0038
  6. Shateri Z, Hosseini SA, Abolnezhadian F, Maraghi E, Haddadzadeh Shoushtari M, Zilaee M. Pomegranate extract supplementation improves lung function parameters and IL-35 expression in participants with mild and moderate persistent allergic asthma: A randomized, double-blind, placebo-controlled trial. Front Nutr. 2022;9:1026343. doi:10.3389/fnut.2022.1026343