Introduction
Allergic rhinitis is an IgE-mediated inflammatory disorder of the nasal mucosa characterized by sneezing, rhinorrhea, nasal obstruction, nasal itching, and postnasal drip. It involves sensitization to environmental allergens such as dust mites, pollen, animal dander, and molds, leading to mast cell degranulation and release of histamine, leukotrienes, and pro-inflammatory cytokines.
Conventional management includes antihistamines, intranasal corticosteroids, leukotriene receptor antagonists, and allergen avoidance. However, recurrence, incomplete symptom control, and long-term medication use remain clinical challenges. In this context, Ayurvedic polyherbal formulations such as Haridra khanda and Brihat manjisthadi kwath are explored for their anti-allergic, anti-inflammatory, immunomodulatory, and detoxification-oriented actions.
Pathophysiology of allergic rhinitis
Modern immunological mechanisms include:
- IgE-mediated hypersensitivity reaction (Type I allergy)
- Mast cell degranulation and histamine release
- Elevated Th2 cytokines (IL-4, IL-5, IL-13)
- Eosinophilic infiltration of nasal mucosa
- Increased vascular permeability and mucus secretion
Ayurvedic correlation considers allergic rhinitis as a manifestation of Kapha–Vata predominance with Ama involvement, leading to Pratishyaya-like symptoms.
Haridra khanda
Composition and key phytoconstituents:
Haridra khanda is a classical Ayurvedic formulation primarily containing:
- Haridra (Curcuma longa)
- Triphala group herbs
- Vasa (Adhatoda vasica)
- Trikatu (ginger, black pepper, long pepper)
- Til taila and sugar base
Key bioactives include curcumin, piperine, flavonoids, and tannins.
Pharmacological properties:
- Antihistaminic activity
- Mast cell stabilization
- Anti-inflammatory action via NF-κB inhibition
- Antioxidant and free radical scavenging effects
- Immunomodulatory effects on Th2 cytokines
Therapeutic role in allergic rhinitis:
Haridra khanda reduces nasal mucosal inflammation by suppressing histamine release and modulating allergic immune responses.1 It improves symptoms such as sneezing, rhinorrhea, and nasal itching while enhancing mucosal resilience against allergens.
Advantages:
- Targets allergic inflammation at multiple levels
- Reduces symptom severity and recurrence
- Suitable for long-term use in chronic allergic conditions
- Provides systemic immunomodulatory support
Brihat manjisthadi kwath
Composition and key phytoconstituents:
Brihat manjisthadi kwath is a decoction-based polyherbal formulation containing:
- Manjistha (Rubia cordifolia)
- Neem (Azadirachta indica)
- Haridra (Curcuma longa)
- Guduchi (Tinospora cordifolia)
- Triphala components
- Other blood-purifying herbs
Major phytochemicals include anthraquinones, glycosides, curcuminoids, and alkaloids.
Pharmacological properties:
- Blood-purification (Rakta shodhana) activity
- Anti-inflammatory effects
- Immunomodulatory action
- Antimicrobial and anti-allergic properties
- Antioxidant activity
Therapeutic role in allergic rhinitis:
Brihat manjisthadi kwath is considered beneficial in allergic rhinitis with systemic hypersensitivity components.2 It reduces inflammatory mediators, supports detoxification pathways, and improves skin–mucosa immune balance, thereby decreasing allergic predisposition and chronicity.
Advantages:
- Systemic anti-allergic and detoxifying action
- Reduces recurrence in chronic allergic states
- Supports immune regulation and inflammatory balance
- Useful in multi-system allergic presentations
Combined therapeutic rationale
The combination of Haridra khanda (local respiratory anti-allergic action) and Brihat manjisthadi kwath (systemic immunomodulation) provides a dual therapeutic approach:
- Local nasal mucosal symptom control
- Systemic reduction of allergic predisposition
- Modulation of Th2-mediated immune response
- Reduction of oxidative stress and inflammatory burden
Advantages of Ayurvedic formulation-based therapy
- Multitarget pharmacological action
- Immunomodulatory rather than purely symptomatic relief
- Potential reduction in antihistamine dependence
- Better long-term tolerability profile in traditional use
- Holistic correction of systemic allergic tendencies
Limitations and considerations
- Limited large-scale randomized clinical trials
- Variability in formulation standardization
- Need for dose optimization based on patient constitution
- Adjunct rather than replacement therapy in acute severe allergic rhinitis
- Monitoring required in patients with comorbid metabolic conditions
Conclusion
Haridra khanda and Brihat manjisthadi kwath demonstrate significant therapeutic potential in allergic rhinitis through complementary mechanisms of local anti-allergic action and systemic immunomodulation. Their pharmacological properties—antihistaminic, anti-inflammatory, antioxidant, and detoxifying—align with the underlying pathophysiology of allergic rhinitis.
Current evidence suggests their role as effective adjunctive therapies to conventional management, particularly in chronic and recurrent allergic conditions. Further well-designed clinical trials are required to standardize dosing, validate efficacy, and integrate these formulations into evidence-based allergic rhinitis care.
References:
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- CMM R. A Clinical Study to Evaluate the Efficacy of Haridrakhanda in the Management of Allergic Rhinitis in Paediatric Age Group. International Journal of Ayurveda and Pharma Research. August 2022; Vol 10; Issue 8. DOI:10.47070/ijapr.v10i8.2488. https://www.researchgate.net/publication/363806955_A_Clinical_Study_to_Evaluate_the_Efficacy_of_Haridrakhanda_in_the_Management_of_Allergic_Rhinitis_in_Paediatric_Age_Group
- Bhowmik R, Shaharyar MA, Kanakal MM, et al. Ayurvedic herbal formulations Haridra Khanda and Manjisthadi Kwath (brihat) in the management of allergic rhinitis: A pharmacological study. Heliyon. 2024;10(11):e31937. Published 2024 May 28. doi:10.1016/j.heliyon.2024.e31937. https://pmc.ncbi.nlm.nih.gov/articles/PMC11167347/