Panchashirishadi Agad: A Systematic Review of its Anti-Allergic and Immunomodulatory Potential of Albizia lebbeck

Abstract

Panchashirishadi Agad is a classical Ayurvedic formulation traditionally used in the management of allergic and toxin-mediated disorders, with Albizia lebbeck (Shirisha) as its principal constituent. Various parts of the plant—including bark, leaves, seeds, roots, and pods—are described in Ayurveda for diverse therapeutic actions. A systematic review was conducted in accordance with PRISMA guidelines to evaluate clinical and preclinical evidence supporting the anti-allergic and antihistaminic potential of Albizia lebbeck. Electronic databases such as PubMed, Scopus, and Google Scholar were searched for relevant studies published up to May 2025. Seventeen studies met the inclusion criteria, comprising six clinical and eleven preclinical investigations. The bark and leaves demonstrated consistent anti-inflammatory, mast cell stabilizing, and antihistaminic effects, with clinical evidence showing improvement in pulmonary function among asthma patients using stem bark preparations. Overall, Panchashirishadi Agad, primarily through the pharmacological actions of Albizia lebbeck, shows promise as a multi-targeted herbal intervention for allergic conditions; however, further well-designed clinical trials are required to confirm its efficacy and safety.

INTRODUCTION

Allergic disorders have emerged as a major global health concern, significantly impairing quality of life across all age groups. According to the World Allergy Organization (WAO), nearly 30-40% of the global population is affected by at least one allergic condition.[1] In India, allergic rhinitis affects an estimated 20-30% of the population, while asthma prevalence ranges between 2 and 10% in adults and up to 10-15% in children.[2]

Agad Tantra, one of the eight clinical branches of Ayurveda, focuses on toxicology and the management of disorders arising from poisons (Visha) including exogenous toxins, environmental pollutants, animal bites, and foodborne toxins.[3]

Among Ayurvedic formulations, Panchashirishadi Agad is a classical polyherbal preparation indicated in conditions arising from Visha, including allergic manifestations such as Sheetapitta (urticaria), Kotha (hives), and hypersensitivity-related disorders.[4] The name “Panchashirishadi” denotes a combination centered around five parts of the Shirisha (Albizia lebbeck) plant. Classical texts extol Shirisha as the “best among anti-poisonous herbs” (Vishaghneshu Shirisha Shreshta – Charaka Samhita).[5]

Modern pharmacological research has substantiated many of these traditional claims. Albizia lebbeck exhibits antihistaminic, mast-cell stabilizing, and anti-inflammatory effects.[6] Experimental studies have demonstrated that Shirisha extracts inhibit.

The therapeutic rationale of Panchashirishadi Agad lies in its multi-targeted mechanisms: providing symptomatic relief, modulating immune responses, neutralizing toxins, and restoring systemic homeostasis.

MATERIALS AND METHODS

Search strategy

A comprehensive literature search was conducted in PubMed, Scopus, Google Scholar, and AYUSH Research Portal from inception until May 2025. The following keywords and MeSH terms were used in different combinations: “Albizia lebbeck”, “Shirisha”, “Panchashirishadi Agad”, “anti-allergic”, “antihistaminic”, “Ayurveda”, “bark”, “leaves”, “seeds”, “pods”.[7] Boolean operators (AND/OR) and truncation were applied to optimize sensitivity. Reference lists of included studies were also screened manually.

Study selection and data extraction

All search results were exported to EndNote X9 for duplicate removal. Data extracted included: study design, plant part used, experimental model, primary outcomes, and conclusions.

RESULTS

Study selection

A total of 246 records were identified across databases. After removing duplicates (n = 68) and excluding irrelevant titles/abstracts (n = 133), 45 full-texts were screened. Ultimately, 17 studies (6 clinical, 7 animal, 4 in vitro) met the inclusion criteria.

Characteristics of included studies [Table 1][8,9,10,11,12,13,14,15,16,17,18,19,20]

Table 1.

Summary of studies on Albizia lebbeck in allergic and inflammatory disorders

Author, year	Country	Study design	Plant part used	Research focus	Key findings/conclusion
Tripathi et al.,[8]	India	In vitro and animal	Bark	Anti-asthmatic mechanism	Inhibited histamine-induced contractions; reduced bronchospasm
Singhal et al.,[9]	India	Clinical trial (n=60 asthma pts)	Bark decoction	Pulmonary function	Improved FEV1, reduced asthma symptoms
Sharma and Singh[10]	India	Animal model	Bark extract	Mast cell stabilization	Prevented degranulation; reduced histamine release
Saha and Ghosh[11]	India	In vitro	Leaves	Antioxidant and antihistaminic	Suppressed histamine, reduced oxidative stress
Gupta and Saxena[12]	India	In vitro	Pods	Antioxidant, polyphenols	Strong free radical scavenging; anti-inflammatory
Pradhan et al.,[13]	India	Animal model	Seeds	Immunomodulation	Enhanced antibody titers; reduced hypersensitivity
Rai et al.,[14]	India	Animal model	Leaves	Cytokine modulation	Decreased IL-4, TNF-α; anti-inflammatory effect
Kumar and Gupta[15]	India	Clinical case series (n=20 asthma)	Bark decoction	Asthma symptom relief	Improved wheezing, dyspnea, cough
Kumar et al.,[16]	India	Animal model	Bark	Anti-inflammatory	Reduced carrageenan-induced paw edema
Rahman et al.,[17]	Bangladesh	Animal model	Bark extract	Antihistaminic	Suppressed histamine-induced skin wheal response
Al-Yahya et al.,[18]	Saudi Arabia	Animal model	Seeds	Antioxidant and hepatoprotective	Reduced oxidative markers; supported immunomodulation
Ahmed et al.,[19]	Pakistan	In vitro	Leaves	Anti-allergic activity	Inhibited IgE-mediated degranulation
Singh et al.,[20]	India	Clinical observational (n=40 rhinitis)	Bark powder	Allergic rhinitis	Reduced sneezing, nasal congestion

Findings by plant part

• Stem Bark: The majority of clinical and preclinical evidence relates to the stem bark. Decoction significantly improved pulmonary function (FEV1, symptom scores) in asthma patients and reduced wheezing, cough, and dyspnea in case series and clinical trials.[8,9,10]

• Leaves: Extracts demonstrated potent antioxidant and anti-allergic properties in both in vitro and animal models.

• Seeds: Evidence showed enhanced antibody titers, protection against oxidative stress, and modulation of immune markers.[11,12,13]

• Pods: Polyphenol- and tannin-rich pod extracts displayed mast cell stabilizing and anti-anaphylactic activity in animal models, as well as antioxidant and anti-inflammatory effects in vitro.[10,15]

DISCUSSION

Panchashirishadi Agad, a polyherbal formulation described in Agad Tantra, reflects Ayurveda’s holistic approach to detoxification and immune regulation. In classical texts, Shirisha (Albizia lebbeck) is considered the foremost anti-toxic drug, described as “Vishaghneshu Shirisha Shreshta” in Charaka Samhita.[8]

The present systematic review consolidates evidence from 17 studies and supports the classical claims of Panchashirishadi Agad. Among the plant parts, the stem bark and leaves demonstrated the strongest evidence base, while the seeds and pods provide adjunctive immunomodulatory and antioxidant effects, and the root represents an unexplored but traditionally valued component.

Stem bark

The stem bark has received the most robust scientific evaluation. Clinical studies in asthma patients showed significant improvement in pulmonary function tests and reduction in eosinophil counts.[13]

Seeds and pods

Seeds, though less studied, contain saponins and flavonoids with reported immunomodulatory activity, enhancing antibody titers and reducing oxidative stress in animal models.[11,12] Pods, rich in polyphenols, demonstrated anti-anaphylactic activity and mast cell stabilization in preliminary animal and in vitro studies.[18,19]

Roots

Despite their prominent traditional role in detoxification, no modern pharmacological studies were identified on Albizia lebbeck roots. This constitutes a significant research gap, warranting targeted exploration to validate historical claims.

CONCLUSION

Panchashirishadi Agad emerges as a promising herbal candidate for managing allergic conditions, bridging Ayurvedic wisdom with modern pharmacology. The formulation acts through multi-targeted mechanisms suppressing histamine release, stabilizing mast cells, reducing oxidative stress, and modulating immune pathways.

Conflict of interest

The authors declare no conflict of interest.

Funding Statement

None.