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The same Japanese cedar pollinosis RCTs that examined AGIQ in seasonal allergy involved respiratory allergy subjects, though significant improvement was observed for ocular but not nasal symptom endpoints. Mechanistically, AGIQ's mast cell-stabilizing and antihistamine properties via its quercetin metabolite provide biological plausibility for respiratory allergy effects. Evidence specific to nasal/respiratory improvement is currently limited.

Astragalus membranaceus extract was evaluated in a randomized controlled trial for seasonal allergic rhinitis (Matkovic et al., Phytother Res, 2010) and showed efficacy and safety as an adjunctive treatment for SAR symptoms. Astragalus polysaccharides and astragalosides modulate Th1/Th2 immune balance, relevant to IgE-mediated respiratory allergies. It has a long traditional use in Traditional Chinese Medicine as an immunomodulator for respiratory conditions.

Clinical pilot studies demonstrate that B. clausii modulates the nasal immune environment in children and adults with allergic rhinitis, reducing Th2 cytokines and increasing Th1/Treg markers. Reduced eosinophil infiltration and improved nasal symptoms have been documented alongside immunological changes. The evidence base is preliminary and requires larger confirmatory trials.

Beta-glucan modulates the Th1/Th2 immune balance, shifting it away from the pro-allergic Th2 response. Clinical studies in patients with allergic rhinitis have shown reductions in pro-inflammatory cytokines (IL-4, IL-5) and eosinophil counts in nasal lavage fluid. Both oral and topical formulations have shown measurable symptom improvements in human trials.

B. breve strains have been shown to modulate IgE-mediated allergic respiratory responses in both animal and human studies. B. breve M-16V reduced allergen-specific IL-5 release and beneficially affected peak expiratory flow in adult patients with house dust mite IgE-mediated allergic asthma. The immunomodulatory mechanism appears to involve shifting Th2-dominant immune responses toward a more balanced Th1/Treg profile.

Clinical trials and narrative reviews support that Bifidobacterium lactis strains can reduce allergic rhinitis symptoms by modulating the Th1/Th2 immune balance and lowering serum IgE and IL-13. A randomized double-blind trial of B. lactis A6 in adults with perennial allergic rhinitis demonstrated significant symptom reduction. The gut-lung axis provides the mechanistic basis for systemic effects on airway allergy.

Multiple clinical studies show N. sativa reduces symptoms of allergic rhinitis and related respiratory allergy. Reviews summarising clinical and experimental data confirm antihistaminic, immunomodulatory, and anti-inflammatory effects. Seed oil at 25–250 mg/kg for 15–30 days has alleviated allergic rhinitis symptoms in patients.

Boswellia inhibits the 5-lipoxygenase (5-LOX) enzyme, reducing leukotriene biosynthesis—a key driver of respiratory inflammation. A double-blind, placebo-controlled trial in 40 asthma patients showed 70% improvement in pulmonary function with Boswellia gum resin vs. 27% with placebo. A second trial using a Boswellia/Aegle marmelos combination reduced asthma symptom scores and serum IL-4.

Boswellic acids from Boswellia serrata inhibit 5-lipoxygenase and thromboxane synthetase, directly suppressing leukotriene production—a key driver of respiratory inflammation in allergies. A randomized controlled trial of a Boswellia serrata and bromelain compound in 150 patients with seasonal allergic rhinitis complicated by upper respiratory infections demonstrated significant clinical benefit. Boswellia has traditional use in Ayurvedic medicine for respiratory inflammatory conditions.

Bromelain, a cysteine protease mixture from pineapple (Ananas comosus), has demonstrated inhibition of allergic airway disease in murine asthma models and clinical benefit in human allergic rhinitis. A controlled trial of a Boswellia serrata and bromelain compound showed significant benefit in seasonal allergic rhinitis complicated by upper respiratory infections. Mechanistically, bromelain reduces eosinophilic airway inflammation and modulates dendritic cell function.

Butterbur (Petasites hybridus) extract Ze 339 has been evaluated in multiple RCTs for seasonal allergic rhinitis and found comparable in efficacy to second-generation antihistamines such as cetirizine and fexofenadine. A landmark BMJ 2002 double-blind RCT showed butterbur was similarly effective to cetirizine on SF-36 quality-of-life scores and clinical global impression without sedative side effects. A systematic review of herbal medicines for allergic rhinitis (Annals of Allergy, Asthma & Immunology) confirmed encouraging evidence for butterbur as an effective seasonal AR treatment.

Curcumin from turmeric (Curcuma longa) inhibits NF-κB and MAPK signaling pathways, reducing Th2 cytokine production, eosinophil infiltration, and airway inflammation relevant to respiratory allergies. Clinical studies demonstrate antioxidant activity in allergic rhinitis patients. A comprehensive 2025 systematic review (MDPI Nutrients) confirmed curcumin improves allergic rhinitis and dermatitis despite limited bioavailability. Turmeric has a long traditional use in Ayurvedic and traditional Chinese medicine for respiratory conditions.

DAO deficiency is associated with reduced capacity to degrade histamine, which is the principal mediator of allergic rhinitis and related respiratory allergy symptoms. Clinical studies show that lower DAO activity correlates with reduced nasal airflow in persistent allergic rhinitis patients. DAO supplementation has been reported to reduce respiratory symptom scores in histamine intolerance (HIT) clinical trials.

EGCG (epigallocatechin gallate), the major catechin of green tea, stabilizes mast cells, attenuates FcεRI signaling, and reduces airway inflammation and IgE levels in preclinical allergic asthma models. A 2025 comprehensive systematic review (MDPI Nutrients) summarized EGCG's mechanistic anti-allergic activity, noting preclinical models show decreased specific IgE and increased IL-10 in bronchoalveolar lavage. Clinical data for EGCG alone in respiratory allergy remain scarce.

Forskolin raises intracellular cAMP, which inhibits mast cell degranulation and the release of histamine and allergic mediators such as leukotrienes. Preclinical (animal) studies show dose-dependent prevention of allergen-induced bronchospasm. This mechanism underlies long-standing traditional Ayurvedic use for allergic respiratory complaints and is supported by limited human asthma trials.

Ginger (Zingiber officinale) constituents 6-gingerol and 6-shogaol modulate Th1/Th2 balance, inhibit mast cell activity, and reduce oxidative stress. A randomized controlled trial compared ginger extract to loratadine in allergic rhinitis patients, with early clinical evidence of comparable symptom reduction. Preclinical data show suppression of mast cell infiltration in nasal mucosa and reduced OVA-specific IgE.

Preclinical studies show H. spicatum rhizome extracts exert dose-dependent antihistaminic activity, blocking histamine-induced bronchospasm in guinea pigs. Both aqueous and ethanolic extracts at 100–400 mg/kg demonstrated this effect. The anti-allergic action is supported by identification of diterpene compounds such as hedychenone with documented anti-allergic properties.

Hesperidin suppresses allergic airway inflammation through inhibition of NF-κB, reduction of Th2 cytokines (IL-4, IL-5, IL-13), mast cell stabilization, and eosinophil suppression—all mechanisms relevant to respiratory allergies including allergic rhinitis and allergic asthma. Evidence is primarily preclinical; no standalone human RCTs for respiratory allergies have been identified.

A 2025 animal study demonstrated that Lonicera japonica extract reduces nerve growth factor and inflammatory pathways in an allergic rhinitis mouse model. Chlorogenic acid and iridoid derivatives from honeysuckle flower buds showed allergy-preventive effects in published pharmacological studies. Honeysuckle polysaccharides also display anti-allergic activity documented in preclinical research.

A randomized double-blind placebo-controlled trial (n=75, 8 weeks) found Tinospora cordifolia extract produced significant relief from sneezing, nasal discharge, nasal obstruction, and nasal pruritus in allergic rhinitis patients compared to placebo. A specific extract (Tinofend) has been identified as the studied formulation. Evidence is promising but limited to a single small trial whose dramatic effect sizes have drawn some methodological scrutiny.

An animal study (Indian J Physiol Pharmacol, 1999; 43(2):235-41) specifically evaluated antiallergic activity (type I hypersensitivity) of I. racemosa, confirming mast cell-stabilizing, antihistamine, and capillary permeability-reducing effects. These preclinical findings support the Ayurvedic classification as anti-allergic.

L. casei has been evaluated in an RCT in preschool children with allergic asthma and/or rhinitis; while asthma outcomes were not significantly improved, the study provided clinical evidence of investigation in respiratory allergic conditions. L. casei Shirota inhibits IgE production in animal models and shifts Th1/Th2 immune balance, providing a mechanistic basis for potential benefit in respiratory allergy.

Multiple strains of L. paracasei, notably LP-33 and GM-080, have been evaluated in randomized controlled trials for respiratory allergy. The LP-33 strain administered for 30 days improved quality of life in allergic rhinitis patients. Mechanistically, L. paracasei shifts the Th1/Th2 cytokine balance, reducing Th2-driven IgE and IL-5. Results across trials are mixed, with some studies showing no significant benefit, indicating strain- and study-design dependency.

L. rhamnosus GG has been studied for immunomodulation of respiratory allergies via the gut-lung axis. Multiple clinical trials using LGG as adjunct to allergy immunotherapy or corticosteroids showed improved immune responses and quality of life. Murine asthma models demonstrate that early oral LGG reduces airway inflammation and hyperreactivity. Results in humans are mixed across different formulations and populations.

Licorice root has documented traditional and emerging clinical use for respiratory allergic conditions including asthma and allergic rhinitis. Glycyrrhizin exerts corticosteroid-like and antihistaminic effects that may reduce airway inflammation. A clinical trial of nasal irrigation with licorice extract showed significantly better improvement in allergic rhinitis symptom scores than saline alone. Evidence from human trials is still preliminary and largely involves multi-herb TCM formulations.

Luteolin is the principal anti-allergic flavonoid of Perilla frutescens, used in Asian traditional medicine for respiratory allergy. A murine HDM-induced allergic rhinitis model plus ex vivo PBMC cultures from human AR patients (Frontiers in Pharmacology, 2020) showed luteolin decreased HDM-specific IgE, reduced CD4+ IL-4-secreting T cells, lowered eosinophil infiltration, and decreased nasal mucus secretion. Multiple additional murine models confirm reduction of bronchoconstriction and airway inflammation.

Adhatoda vasica is documented as a traditional remedy for allergic respiratory conditions, and preclinical studies demonstrate antihistaminic and anti-allergic mechanisms. An OVA-induced allergic asthma mouse model study showed significant reduction of allergic airway inflammation with AV extract.

Urtica dioica (stinging nettle) root extract was tested in a randomized, double-blind, placebo-controlled trial in 74 allergic rhinitis patients with confirmed skin prick tests. Treatment with 150 mg Urtica dioica for one month produced a statistically significant reduction in nasal smear eosinophil counts (p<0.01) compared to placebo, and a significant improvement in clinical symptoms on the SNOT-22 scale. An earlier double-blind trial by Mittman et al. also found global allergy symptom reduction with freeze-dried nettle leaf.

Onion is rich in quercetin and kaempferol, flavonoids that inhibit mast cell secretion and histamine release, thereby attenuating respiratory allergic responses. A 2021 comprehensive PMC review documented both experimental and clinical evidence for A. cepa and its constituents on allergic and immunologic disorders. Human studies show that quercetin-containing supplements added to standard therapy produce superior symptom improvement compared with conventional treatment alone.

Perilla frutescens extract enriched for rosmarinic acid was tested in a 21-day randomized, double-blind, placebo-controlled trial in seasonal allergic rhinoconjunctivitis patients and significantly decreased neutrophils and eosinophils in nasal lavage fluid versus placebo. Perilla has a centuries-long traditional use in East Asian medicine for respiratory allergy. A multicomponent nutraceutical (Lertal®) containing Perilla, quercetin, and vitamin D3 showed efficacy in multiple clinical studies in adults and children with allergic rhinitis.

Pine bark extract is included in the list of conditions beneficially affected in a systematic review of 39 RDP trials, including respiratory health and allergies. Clinical trials show it reduces allergic airway inflammation via anti-inflammatory and antihistaminic mechanisms. Traditional use for respiratory allergic symptoms also exists.

Pycnogenol (pine bark extract) has been tested in randomized, double-blind, placebo-controlled (RDP) trials for allergic rhinitis and asthma. It reduces nasal and ocular symptoms in hay fever patients and lowers leukotriene levels, an inflammatory mediator involved in both asthma and hay fever. Multiple RDP trials support respiratory allergy benefit.

Preclinical studies show Platycodon root extract suppresses mast cell-derived allergic mediators including IgE, prostaglandin D2, leukotriene C4, and IL-6. Platycodin D inhibits Th2 cytokine production via the NF-κB pathway in allergic asthma models. Evidence remains predominantly in vitro and animal-based with no completed human RCTs specifically for respiratory allergy.

Platycodon root and its principal saponin platycodin D have been shown in preclinical studies to suppress Th2-driven allergic responses, including IgE, IL-4, IL-5, and eosinophil infiltration. Animal models of ovalbumin-induced allergic airway inflammation show reduced airway hyperresponsiveness with platycodon extract treatment. Clinical human data remain limited, but the mechanistic evidence is well-characterized.

Pycnogenol (French maritime pine bark extract, standardized procyanidins and catechins) was evaluated in a randomized, double-blind, placebo-controlled exploratory trial for allergic rhinitis in birch-pollen-allergic subjects. In the second year (39 subjects, treatment 5–8 weeks before pollen season), Pycnogenol showed 35% lower eye symptom scores and 20.5% lower nasal symptom scores versus placebo, and the increase in birch-specific IgE post-season was substantially lower in the Pycnogenol group. Several clinical trials also suggest relief of allergic asthma symptoms.

Quercetin inhibits mast cell degranulation and suppresses histamine release, directly addressing IgE-mediated respiratory allergic responses. In vitro and murine allergic rhinitis models consistently show reduced sneezing, nasal congestion, and Th2 cytokine levels. Two small clinical trials using bioavailable formulations (including a nutraceutical with quercetin, Perilla, and vitamin D3) showed significantly superior symptom improvement over antihistamine monotherapy in grass-pollen allergic rhinitis patients. Typical clinical dosing is 500–1000 mg/day.

Rosmarinic acid, a polyphenolic phytochemical enriched in Perilla frutescens, was directly tested in a 21-day randomized double-blind placebo-controlled trial in seasonal allergic rhinoconjunctivitis patients and significantly reduced neutrophils and eosinophils in nasal lavage fluid versus placebo. It suppresses passive cutaneous anaphylaxis and reduces allergen-specific IgE responses in murine models. Rosmarinic acid inhibits IgE-mediated mast cell degranulation and complement activation.

Preclinical studies demonstrate that Saposhnikovia divaricata aqueous extract suppresses IgE-mediated allergic rhinitis in OVA-sensitized mice, reducing sneezing, mast cell infiltration, and pro-inflammatory cytokines (IL-4, IL-5, TNF-α) while upregulating IL-10 and IFN-γ. Network pharmacology analyses further confirm multi-target anti-allergic mechanisms via TLR4/NF-κB and STAT3 pathways. All current evidence is from animal or in vitro models; no human clinical trials have been published.

Spirulina (Arthrospira platensis) modulates immune function and inhibits histamine release from mast cells. A randomized double-blind placebo-controlled 12-week trial in allergic rhinitis patients showed high-dose Spirulina significantly reduced IL-4 levels by 32%, demonstrating a protective anti-allergic immunological effect. It is one of the few dietary supplements with direct RCT evidence specifically in allergic rhinitis.

SPMs, particularly lipoxins and E-series resolvins, counter the type 2 immune responses driving allergic airway disease. Reduced LXA4 levels have been documented in human allergic airway disease. SPMs inhibit IgE-mediated mast cell degranulation and suppress eosinophil trafficking to airways.

Sulforaphane upregulates phase II antioxidant enzymes in the nasal and bronchial mucosa, dampening oxidant-driven allergic airway inflammation. A placebo-controlled human trial showed oral SFN induced mucosal phase II enzyme expression in the upper airway. Clinical reviews note supportive roles in allergic rhinitis therapy.

Tinospora cordifolia (guduchi/giloya) was evaluated in a randomized double-blind placebo-controlled trial of 75 allergic rhinitis patients over 8 weeks. Treatment with TC extract produced 100% relief from sneezing in 83% of patients, relief from nasal discharge in 69%, nasal obstruction in 61%, and nasal pruritus in 71%, with highly significant differences versus placebo. It has been used in Ayurveda for centuries as an antiallergic, anti-inflammatory, and immunomodulatory agent.

Multiple controlled human trials have tested Tylophora leaf or extract in patients with asthma and allergic rhinitis, showing symptom relief superior to placebo. The crossover double-blind study by Shivpuri et al. (J Allergy, 1969) enrolled 110 patients and demonstrated significant improvement in 62% of the Tylophora group versus 28% of the placebo group after one week. Laboratory work shows tylophorine interferes with mast-cell activation and suppresses anaphylactic responses, providing a mechanistic basis for the antiallergic effect.

Vitamin D modulates Th1/Th2 immune balance, inhibits IL-5 and IL-13 production, and vitamin D deficiency correlates with increased allergic rhinitis severity and elevated IgE. A 2025 systematic review and meta-analysis found adjuvant vitamin D supplementation significantly reduced total nasal symptom scores (TNSS) and IgE levels in allergic rhinitis patients. A 2024 systematic review also confirmed heterogeneous but mostly positive effects of vitamin D on AR symptom outcomes.

Vitamin D3 (cholecalciferol) is the active supplemental form of vitamin D evaluated in clinical trials for allergic rhinitis. It modulates Th1/Th2 immune balance, reduces IL-5 and IL-13, and promotes regulatory T cells. Meta-analyses confirm adjuvant vitamin D3 supplementation reduces total nasal symptom scores and IgE levels in AR patients. It is a component of clinically validated combination nutraceuticals (with quercetin and Perilla) that demonstrated 39% greater symptom improvement over standard antihistamine therapy in seasonal AR.

Xanthium strumarium (Cang-Er-Zi) has been used for millennia in TCM to treat allergic rhinitis and is listed in over 60 pharmacopeial formulas for nasal-allergic disorders. Animal studies demonstrate that caffeoylquinic acids from its fruits reduce allergic symptom scores, lower pro-inflammatory cytokines, and inhibit histamine release. Network pharmacology and metabolomics studies have mapped its mechanism to arachidonic acid metabolism and Fc epsilon RI signaling.

Adrenal cortex extract is listed among proposed alternative uses for respiratory allergies in evidence databases, based on the anti-inflammatory and immune-modulating role of cortisol. Early practitioners reportedly used it for allergic conditions. No human clinical trial data support OTC adrenal cortex supplements for respiratory allergies.

Cat's claw is traditionally used in Peruvian and Brazilian medicine as an antiasthmatic and anti-allergic agent, with its use for allergies documented in ethnobotanical records. A 2024 Frontiers systematic review notes it is 'widely used in Peruvian and Brazilian traditional medicine as an anti-inflammatory, antinociceptive, and antiasthmatic agent.' No dedicated clinical trials on respiratory allergy have been conducted.

Eucalyptus has a traditional role in managing respiratory allergy symptoms through its decongestant and anti-inflammatory actions, clearing nasal passages and reducing airway inflammation. Clinical evidence in rhinitis or respiratory allergy specifically is limited; the benefit is likely indirect through its mucolytic and anti-inflammatory mechanisms. No dedicated allergy RCTs with eucalyptus as the primary intervention have been identified.

Goldenrod is classified in Western herbal medicine as an anti-allergenic and anticatarrhal with traditional use for respiratory allergy symptoms including sneezing, nasal congestion, and watery eyes. Its anti-inflammatory and mast-cell-stabilizing flavonoids (quercetin) provide pharmacological plausibility. No clinical trials have confirmed this specifically.

H. italicum is traditionally used across Mediterranean Europe for allergy-related conditions, including respiratory allergic symptoms. Its anti-inflammatory and anti-histaminic-type activities provide biological plausibility, but clinical evidence specific to respiratory allergies is absent; research cited is limited to general anti-inflammatory mechanisms and contact dermatitis models.

Mullein has been traditionally used for hay fever and allergic respiratory complaints, attributed to its antihistamine and anti-inflammatory constituents. Herbalists historically employed it to reduce congestion and mucous membrane irritation triggered by allergens. No controlled clinical trials in allergic rhinitis patients have been conducted.

Plantago species contain antiallergic flavonoids (baicalein, scutellarein) and mucilaginous compounds used traditionally to soothe allergic airway inflammation. Their immunomodulatory and anti-inflammatory properties are documented experimentally. Traditional use for respiratory allergy symptoms is recorded across European and Asian herbal medicine systems.

Schizonepeta's TCM indications include respiratory allergic patterns with runny nose, sneezing, and itchy eyes. Its anti-allergic and immunomodulatory properties have been demonstrated preclinically via mast cell inhibition. No human clinical trials for respiratory allergies specifically have been published.

S. baicalensis has documented anti-allergic mechanisms including histamine suppression, IgE reduction, and Th2 cytokine downregulation. Baicalein is noted as beneficial for allergic respiratory diseases including asthma in a 2023 MDPI review. TCM prescribes it for allergic conditions and hay fever.

Whole adrenal glandular has a documented historical and traditional use for respiratory allergies, grounded in the early observation that adrenal-derived extracts contain cortisone-like compounds with anti-inflammatory and anti-allergic properties. Pre-synthetic-steroid era physicians employed desiccated adrenal preparations for allergic conditions. Modern formulations are processed to remove significant hormone content, removing the pharmacological rationale, and no clinical trials of whole adrenal glandular for allergies exist.