Nigella sativa applications in allergic disease control: Narrative review

Introduction and purpose: Allergic diseases are an increasing global health problem. As standard therapies may have limited efficacy or adverse effects, interest in natural adjuncts such as Nigella sativa and its main bioactive compound, thymoquinone, has grown. This narrative review summarizes evidence from 2017-2026 on N. sativa in allergy control, focusing on clinically relevant mechanisms and therapeutic applications. State of knowledge: N. sativa exerts broad anti-allergic effects through immunomodulatory and anti-inflammatory pathways. Mechanisms include mast cell stabilization, reduced eosinophilic inflammation, IgE downregulation, Th1/Th2 balance modulation, and inhibition of inflammatory signaling pathways. Clinical studies suggest benefits in allergic rhinitis with reduced symptom severity and frequency, and in asthma with improved symptom control and pulmonary function. Promising findings exist for atopic dermatitis, mainly in preclinical models. Safety data are generally favorable, though outcomes depend on formulation, dose, and duration. Summary: Nigella sativa appears promising as an adjunct in allergic disease management, not a substitute for standard pharmacotherapy. Its value is supported by multi-target immunomodulatory activity and good tolerability. However, evidence is limited by heterogeneous preparations, small populations, and short follow-up. Further well-designed randomized controlled trials are needed to establish optimal dosing, standardization, and long-term efficacy.