Effects of Nigella sativa oil on Th1/Th2, cytokine balance, and improvement of asthma control in children

Main Article Content

Wisnu Barlianto
Maria Rachmawati
Muhammad Irawan
Desy Wulandari


Background Asthma is a chronic inflammatory disease of the airways characterized by involvement of a variety of inflammatory cells. Asthma is associated with imbalances between Th1/Th2 cells and their characteristic cytokine profiles. Nigella sativa is a plant that possesses immunomodulatory and anti-inflammatory properties.

Objective To investigate the potential anti-asthmatic effect of Nigella sativa oil on Th1/Th2 cells, IFN-ɣ/IL-4 cytokines, and improvement of asthma control.

Methods Children aged 6-15 years with asthma in Dr. Saiful Anwar Hospital, Malang, were enrolled in this study. All patients were treated based on standard treatment guidelines for asthma. Nigella sativa oil (NSO) was given per oral as supplementary treatment at a dose of 15-30 mg/kg/day for 8 weeks, in a randomized, single-blind, controlled trial. Peripheral Th1 and Th2 cells were counted by flow cytometry and IFN-ɣ and IL-4 cytokines were measured by ELISA. Improvement of asthma control was assessed by the  asthma control test (ACT) score.

Results Twenty-eight patients completed the study, 14 in the NSO treatment group and 14 in standard treatment group. No significant differences were found in the number of Th1 and Th2 cells, or in the Th1/Th2 ratio between groups after treatment (P=0.074, P=0.481, and P=0.265, respectively). Compared to the control, the NSO group showed a significant elevation of IFN-ɣ (P=0.046) and reduction of IL-4 (P=0.002). At the end of study, ACT score was not significantly different between groups (P=0.413).

Conclusion Supplementation with Nigella sativa oil improves IFN-ɣ/IL-4 balance and asthma control in children with asthma.

Article Details

How to Cite
Barlianto W, Rachmawati M, Irawan M, Wulandari D. Effects of Nigella sativa oil on Th1/Th2, cytokine balance, and improvement of asthma control in children. PI [Internet]. 5Jan.2018 [cited 16Sep.2019];57(5):223-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1399
Received 2017-05-16
Accepted 2017-10-16
Published 2018-01-05


1. Global Initiative for Asthma (GINA). Global Asthma Strategy of Management and Prevention Revised. Cape Town: National Heart, Lung and Blood Institute; 2014. p.1-15
2. Vock C, Hauber HP, Wegmann M. The other T helper cells in asthma pathogenesis. JAllergy. 2010:519298.
3. Deo SS, Mistry KJ, Kakade AM, Niphadkar PV. Role played by Th2 type cytokines in IgE mediated allergy and asthma. Lung India. 2010;27:66–71.
4. Toldi G, Molvarec A, Stenczer B, Muller V, Eszes N, Bohacs A, et al. Peripheral Th1/Th2/Th17/regulatory T-cell balance in asthmatic pregnancy. Int Immunol. 2011;23:669–77.
5. Ling MF, Luster AD. Allergen-specific CD4 T cells in human asthma. Ann Am Thorac Soc. 2016;13:25-30.
6. Abbas AK, Lichtman AH, Pillai S. Basic immunology: functions and disorders of the immune system. 5th ed. St. Louis: Elsevier; 2016. p.132-6.
7. Lloyd CM, Hessel EM. Functions of T cells in asthma: more than just T(H)2 cells. Nat Rev Immunol. 2010;10:838-48.
8. Bosnjak B, Stelzmueller B, Erb KJ, Epstein MM. Treatment of allergic asthma: modulation of Th2 cells and their responses. Respir Res. 2011;12:114.
9. Canonica GW, Baena-Cagnani CE, Blaiss MS, Dahl R, Kaliner MA, Valovirta EJ, et al. Unmet needs in asthma: Global Asthma Physician and Patient (GAPP) Survey: global adult findings. Allergy. 2007;62:668-74.
10. Tembhurne SV, Feroz S, More BH, Sakarkar DM. A review on therapeutic potential of Nigella sativa (kalonji) seeds. J Med Plants Res. 2014;8:167-177.
11. Ahmad J, Khan RA, Malik MA. Study of Nigella sativa oil in the management of wheeze associated lower respiratory tract illness in children. African J Pharm Pharmacol. 2009;3:248-51.
12. Kardani AK, Fitri LE, Barlianto W, Olivianto E, Kusuma HC. The effect of house dust mite immunotherapy, probiotic and Nigella sativa in the number of Th17 cell and asthma control test score. IOSR J Dent Med Sci. 2013;6:37-47.
13. Koshak A, Wei L, Koshak E, Wali S, Alamoudi O, Demerdash A, et al. Nigella sativa supplementation improves asthma control and biomarkers: a randomized, double- blind, placebo-controlled trial. Phytother Res. 2017;31:403-9.
14. Boskabady MH, Keyhanmanesh R, Khamneh S, Ebrahimi MA. The effect of Nigella sativa extract on tracheal responsiveness and lung inflamation in ovaalbumin- sensitized guinea pigs. Clinics (Sao Paulo). 2011;66:879-87.
15. Ahmad A, Asif H, Mohd M, Shah AK, Abul K, Nasir AS, Zoheir A, Damanhouri, Firoz A. A review on therapeutic potential of Nigella sativa: A miracle herb. Asian Pac J Trop Biomed. 2013;3:337-352.
16. Boskabady MH, Farhadi F. The possible prophylactic effect of Nigella sativa seed aqueous extract on respiratory symptoms and pulmonary function tests on chemical war victims: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med. 2008;14:1137- 44.
17. Majdalawieha AF, Hmaidan R, Carr RI. Nigella sativa modulates splenocyte proliferation, Th1/Th2 cytokine profile, macrophage function and NK anti-tumor activity. J Ethnopharmacol. 2010;131:268–75.
18. Salem AM, Bamosa AO, Qutub HO, Gupta RK, Badar A, Elnour A, Afzal MN. Effect of Nigella sativa supplementation on lung function and inflammatory mediatorsin partly controlled asthma: a randomized controlled trial. Ann Saudi Med. 2017;37:64-71.
19. Maier E, Duschl A, Horejs-Hoeck J. STAT6-dependent and –independent mechanisms in Th2 polarization. Eur J Immunol. 2012;42:2827–33.
20. Guo HW, Yun CX, Hou GH, Du J, Huang X, Lu Y, et al. Mangiferin attenuates Th1/Th2 cytokine imbalance in an ovalbumin-induced asthmatic mouse model. PLoS One. 2014;9:e100394.
21. Machura E, Mazur B, Rusek-Zychma M, Bar´c-Czarnecka M. Cytokine production by peripheral blood CD4+ and CD8+ T cells in atopic childhood asthma. Clin Dev Immunol. 2010;2010:606139.
22. Ito C, Okuyama-Dobashi K, Miyasaka T, Masuda C, Sato M, Kawano T, et al. CD8+ T cells mediate female-dominant IL-4 production and airway inflammation in allergic asthma. PLoS One. 2015;10:e0140808.
23. Betts RJ, Kemeny DM. CD8+ T cells in asthma: friend or foe? Pharmacol Ther. 2009;121:123-31.
24. Wang X, Wang J, Xing CY, Zang R, Pu YY, Yin ZX. Comparative analysis of the role of CD4(+) and CD8(+) T cells in severe asthma development. Mol Biol. 2015;49:482-90.