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Therapeutic and Immunologic Effects of Zingiber officiale in Allergic Rhinitis

Written By

Abdulghani Mohamed Alsamarai, Mohamed Abdulsatar Hamid and Amina Hamed Ahmed Alobaidi

Submitted: 26 September 2014 Published: 22 April 2015

DOI: 10.5772/59377

From the Edited Volume

Allergic Diseases - New Insights

Edited by Celso Pereira

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1. Introduction

Allergic diseases are the most common problem in our community an d globally [1]. Allergic rhinitis is one of the most common allergic diseases in Iraq and probably in the world and nowadays it is increasing. It is with a chronic natural history and may appear at any age of life and subsequently converted into asthma [2] Up to now, there is no curative treatment for allergic rhinitis and most of the drugs that are used can only induce symptomatic relief and some of them have serious side effects and can cause withdrawal symptoms which lead the patients to continue treatment ending in more side effects [1]. There are marked increase in allergic diseases in developing countries as reported recently [3,4].

Allergic rhinitis with possibility of either under diagnosis in a countries with lower prevalence or difference in risk factors in these areas of the world [5]. In Iraq, the allergic diseases were increased with time including AR [6]. To date there were no curative treatment for AR, however, many pharmacotherapeutic treatment evaluated in different studies and suggested a variable clinical response [3]. Recently an interest was launched which is the evaluation of plant products in the treatment of allergic rhinitis [7].

Environmental control measures and allergen avoidance, pharmacological management, and immunotherapy are the main three approaches for treatment of allergic rhinitis [8-10]. However, most of these approaches are palliative and not curative and may be not cost effective due to the chronicity of the disease [11,12]. Although allergic rhinitis is not a life-threatening condition, various complications can occur and result in significant impairment in quality of life [11,12], eventually leading to increase medical cost and may be converted into asthma [1]. Immunotherapy another option of treatment is reserved for patients with a less than adequate response to usual treatments and reported to be effective [13,14]. Although the effectiveness of SIT in the treatment of allergic rhinitis and allergic asthma has been proven, however its delayed time of action and adverse local and systemic side effects have limited its use as a treatment modality by majority of the patients [15-19].

Ginger is the rhizome of the plant Zingiber officinal, belong to Zingiberaceae plant family and it used as therapy in ancient medicine, spice or a tea [20]. Reported studies [21-26] suggest that ginger extract may exert its benefit as medicine through blocking of serotonin receptors, antioxidant activity, antiglycating mechanisms. In addition, ginger extract may be effective in treating nausea, vomiting and heart burn [27-31] and demonstrate antibacterial activity [32]. However, the extract should be not used during pregnancy because of it is mutagenic [28]. Furthermore, ginger may have analgesic, antipyretic, and antitumor activity [33-39].

Ginger adverse reactions that include some drugs interaction, increase of bile secretion, and induction of allergic reaction, may restrict its usage as medicine [40,41]. Since reported studies suggested the anti-inflammatory, suppressive effects on production of cytokines and reduction of IgE serum level [42-44], we conduct this study to evaluate the therapeutic effect of ginger in allergic rhinitis.

Aim of the study:

The aim of this study is to study the clinical and immunological efficacy of Zingiber officinale (Z.O) on the treatment of allergic rhinitis.


2. Materials and methods

2.1. Patients

A total of 79 patients allergic rhinitis were included in the study. Those patients were recruited from patients attending Aljumhory Teaching Hospital in Mosul and were selected on the basis that was with high total IgE serum levels. The study done during the period from November 2010 to October 2012. The patients were with age of > 10 years old. The patients divided into active and control group. The active group includes 42 patient and 37 patients were in control group. Each patients in active group received Zingiber officinale (Z.O) capsules, twice daily after meal. While each patient in control group received the same dose of sucrose powder capsules for 2 months, through which clinical follow up occurred completely in each monthly visit with recording the notes.

2.2. Diagnosis of asthma and allergic rhinitis

Allergic rhinitis diagnosis was performed according to previously reported guidelines [45].

2.3. Skin prick test

The skin prick tests were performed for all patients and control and evaluated in accordance with European Academy of Allergy and Clinical [1]. Immunology subcommittee on allergy standardization and skin tests using standards allergen panel (Stallergen, France). The panel for skin test include: dust mite (Dermatophagoides farina, Dermatophagoides peteronyssinus), Aleternaria, Cladosprium, Penicillum mixture, Aspergillus mixture, Grasses mixture, Feather mixture, Dog hair, Horse hair, Cat fur, Fagacae, Oleaceae, Betulaceae, Plantain, Bermuda grass, Chenopodium and Mugworth. All tests were performed in the outpatient Asthma and Allergy Centre, Mosul by a physician using a commercial allergen extracts (Stallergen, France) and a lancet skin prick test device. A wheal diameter of 3 mm or more in excess of the negative control was considered as positive test result.

2.4. Determination of total serum IgE

ELISA was performed to estimate the total serum IgE level as a serological marker for treatment response monitoring [1]. Total serum IgE was determined by enzyme linked immunosorbant assay kit (Biomaghreb). Results were interpreted as allergy not probable if serum IgE was lower than 20 IU/ml, allergy is possible if IgE value is between 20 and 120 IU/ml and allergy is very probable if IgE is more than 120 IU/ml.

2.5. Treatment schedule and assessment

Z. officinale was given as capsules, one capsule twice daily after each meal. Each capsule contained about 0.5 gm (500 mg) of Z.O powder.

The control group received the same capsules but they were contained sucrose sugar powder, the treatment was given for 2 months. The results were recorded on the patient's questionnaire in each visit. The same routine physical examination & laboratory investigations as mentioned earlier were done in each visit & recorded with clinical evaluation which was done according to the following criteria and as reported previously[6]:

  1. Clinical assessment (symptoms score); during each visit, the patients was examined clinically for vital signs & questioned about the improvement in his day & night symptoms (rhinorrhoea, nasal obstruction, paroxysm of sneezing, night snoring, chest tightness, wheezes, cough, shortness of breath, work & school attendance, skin wheals, itchy skin, swelling & the lip or eye lid, shortness on exertion.....etc).

  2. Tolerability to the exacerbating factors: Many precipitating factors such as aeroallergens exposure, cold exposure, infection (sinusitis), drugs, exertion....etc. may precipitate the condition, so the response to the exacerbating factors were assessed in each visit.

2.6. Side effects

Side effects that were shown by the patients were recorded in all patients & for all allergies type.

2.7. Statistical analysis

SPSS version 19 analytic system: Paired Samples test; Independent Samples test & Descriptive Statistics were used to compare between active & placebo groups. Chi square also was used in this statistics of the research.


3. Results

3.1. Baseline estimation

A total of 79 patients were included, 51.9 % (41patients) male and 48.1% (38 patients) female. Those patients were classified according to their disease pattern into seasonal 39.2 % (31 patients) and perennial 60.7 % (48 patients), of the total 49.3 % (39 patients) had positive family history of atopic diseases while 50.6 % (40 patients) were with negative family history of atopic disease. They were subdivided into active (42 patients) and control group (37 patients) as show in Table 1.

Total number 79
Gender Male 41
Female 38
Type Seasonal 31
Perennial 48
Family history Positive 39
Negative 40
Smoking Positive 27
Negative 52
Subgroups Active 42
Control 37

Table 1.

Allergic rhinitis patients baseline information.

3.2. Frequency distribution of the patients according to the age

Table 2 shows the frequency distribution of patients according to their ages. It shows that the peak incidence age occurred within the age of 10-19 years which account for 30.3% (24 patients).

Age/year Number of patients
10-19 years 24 (30.3%)
20-29 years 19 (24%)
30-39 years 16 (20.2%)
40- above 20 (25.3%)

Table 2.

Frequency distribution of the patients according to the age

3.3. Frequency distribution of the patients according to the duration of the disease

Table 3 shows the frequency distribution of the patients according to their duration of the disease. It shows that the peak incidence duration of the disease range between 1-5 years and this account for 64.5% (51patients).

Duration/ years Number of patients
1-5 years 51 (64.5%)
6-10 years 14 (17.7%)
11-15 years 8 (10.1%)
16-20 years 1 (1.2%)
21- above years 5 (6.3%)

Table 3.

Frequency distribution of the patients according to the duration of the disease

3.4. Relationship between family history of atopic disease and total IgE level in allergic rhinitis patients

The relationship between family history of atopic disease and total IgE level in allergic rhinitis patients is shown in Table 4. There was a significant relationship (p= 0.001) between family history of atopy and total IgE serum level.

Family history of atopy Patients number mean Standard deviation P value
Negative history 40 206.8 54.9 0.001
Positive history 39 335.2 223.2

Table 4.

Relationship between family history of atopic disease and total IgE level in allergic rhinitis patients

Independent Samples test

3.5. Relationship between smoking and total IgE level in allergic rhinitis patients

There was a non-significant relationship (p=0.124) between smoking and total IgE serum level in allergic rhinitis as shown in (Table 5).

Smoking Patients number Mean Standard deviation P value
Negative history 52 248.5 146.8 0.124
Positive history 27 311.9 211.6

Table 5.

Relationship between smoking and total IgE level in allergic rhinitis patients

Independent Samples test

3.6. Subgroups of allergic rhinitis patients

Table 6 shows the subgroups of allergic rhinitis patients : active group of allergic rhinitis included 42 patients (22 male, 20 female), (19 seasonal, 23 perennial), (21 positive family history of atopy while 21 with negative family history),(28 smoking cigarette while 14 not smoking cigarette). On the other hand, control group included 37(19 male,18 female), (12 seasonal,25 perennial),(18 had positive family history of atopy while 19 had not),(25 smoke cigarette, 12 not).

Group Active Control
Number 42 37
Sex Male 22 19
Female 20 18
Type Seasonal 19 12
Perennial 23 25
Family history Positive 21 18
negative 21 19
Smoke Positive 28 25
negative 14 12

Table 6.

Subgroups of allergic rhinitis patients

3.7. Immunological effect (on total IgE level) after 2 months treatment

The effect of treatment on total IgE level is shown in Table 7 : It shows that the effect of Z. officinale is highly significant after the first month of treatment (p = 0.027) which also stayed significant after the second month treatment (p =0.002). While in case of placebo capsules, there is no significant decrease in the level of total IgE after first month (p= 0.112) nor after second month (p= 0.64).

Group Month Number of patients Mean Standard
P value
Active 0 42 258.4 170.5 -------
1 42 229.3 133.7 0.027
2 42 175.7 85.5 0.002
Control 0 37 383.6 177.2 ------
1 37 256.1 157.8 0.112
2 37 239.2 108.5 0.64

Table 7.

Immunological Effect of treatment on Total IgE level in AR patients

3.8. Clinical effect after 2 months treatment

Clinical improvement after 2 months of treatment for both groups is seen in Table 8, from total, 78.5 %(33 patients) were improved in the active group after first month of treatment while 21.4 %(9 patients) were improved from placebo treating group. There was a significant difference (p=0.010) between active and placebo treated groups. At the end of 2nd month, the result stayed significant (p=0.011) with 92.8 %(39 patients) were improved from active group corresponding to 35.1 %(13 patients) were improved from placebo treating group.

Months of
Subgroups Improved patients
Not improved
P value
Month 1 Active 33 (78.5%) 9 (21.4%) 0.010
Control 10 (27 %) 27 (72.9 %)
Month 2 Active 39 (92.8%) 3 (7.1%) 0.011
Control 13 (35.1 %) 24 (64.8 %)

Table 8.

Clinical improvement in general condition in A.R patients after treatment

3.9. Effect on specific clinical features

The comparison between the improvement in specific nasal allergic symptoms in both subgroups(experimental and placebo) after 2 months of treatment is shown in Table 9. It shows that sinusitis had improved in 83.3% (35 patient) of experimental group while only 21.6% (8 patients) in control group demonstrate improvement and this difference was significant(p=0.002). Nasal itching had improved in 78.5% (33 patients) in experimental patients while it improved in 32.4 % (12 patients) in control group (p=0.027). While rhinorrhoea had improved in 69.0% (29 patients) in active group corresponding to 37.8 % (14 patients) in control group which is insignificant (p=0.126). Sneezing had decreased in 61.9% (26 patients) in experimental group while in control group it had improved in 24.3%(9 patients) with significant difference (p=0.033).

Clinical features Active group
improved patients
Control group
patients improved
P value
Sinusitis 35 (83.3%) 8 (21.6%) 0.002
Nasal itching 33 (78.5%) 12 (32.4%) 0.027
Rhinorrhoea 29 (69.0%) 14 (37.8%) 0.126
Sneezing 26 (61.9%) 9 (24.3%) 0.033
Post nasal drainage 17 (40.4%) 5 (13.5%) 0.042
Conjunctivitis 11 (26.1%) 6 (16.2%) 0.385
Others 8 (19.0%) 4 (10.8%) 0.381

Table 9.

Effect on specific clinical features after 2 months treatment

Chi square test

Post nasal drainage had decreased significantly (p=0.042) in 40.4% (17 patients) of active group while it had decreased in 13.5 % (5 patients) of control group. Conjunctivitis had decreased in 26.1% (11 patients) in experimental group but it had decreased in 16.2% (6 patients) in control group, but not with significant difference (p=0.381) result.

3.10. Medication score

Medication score of conventional therapy had been decreased in 71.4 % (30 patients) in active group and in 27.4 % (10 patients) in control in 1st month of treatment and the difference was significant (p=0.021). The significance degree became larger in the second month (p=0.004), which statistically measured the results of decreased conventional therapy use in active group which account for 88 % (37 patients) corresponding to 27 %(10 patients) in the placebo treating group.

Months of treatment Subgroups Patients with decreased medication Patients not with decreased medications P value
Month 1 Active 30
Control 10
Month 2 Active 37
Control 10

Table 10.

Medication score

Chi square test


4. Discussion

Pharmacotherapy is still the corner stone in the management of allergic disease followed by immunotherapy. All therapeutic strategies have many side effects. Some of them may prove dangerous or even lethal, in addition, mostly there is no curative therapy [3,4]. One of the good substitutions is the use of herbal medicine and one of the ancient herb that was used medically for many diseases was Zingiber officinale [21,22]. This herb has been used for many diseases since no signs of serious adverse effects were known in antiquity.

Male were affected slightly more with AR than female. This result accords with other studies that showed no sex difference or slight male predominance [46]. About 54% of patients were less than 30 years old which means that the onset mainly started at the days of childhood adolescence. This goes in line with other studies [47] because allergy is a less common cause of rhinitis in elderly as compared with form of rhinitis like atrophic rhinitis [48].

Concerning duration of the disease, 64.5% of patients had duration less than 5 years. That means the allergic state in Iraq increased progressively in the last years especially after the last war in 2003 due to increased air pollutions. Our study demonstrated a significant association between family history and IgE serum level in allergic rhinitis patients. This finding is in accordance with well documented fact in allergic diseases [49-51].

The present study not shows a significant relationship between smoking and IgE serum level and this result is not agreed with that reported for Canada [52]. Z.O treatment showed a significant effect on total IgE level. This is not strange for Z.O because it has potent immunological effect in different studies [42-44]. Ginger extract seems to be with a wide range of therapeutic effects that include multiorgan [53] such as the immune response, metabolism, and gastrointestinal.

In the present study the patients showed excellent improvement in clinical symptoms and clinical response after 2 months treatment duration especially in patients as compared with control group. This may be due to the anti-mucous effect mainly, in addition to anti allergic effect that present in its contents. Ginger demonstrate effective therapeutic effects in the treatment of asthma and other respiratory diseases through its ability to loosen and expel phlegm from the sinuses and lungs [42].

In Japanese cedar pollinosis patients, and in the most sever cedar pollen scattering period, allergy symptoms (blowing the nose, itching eyes....etc) were significantly relieved in experimental group taking tea containing ginger extract for 13 weeks as compared with placebo group. Stuffy nose, sore throat medication score were significantly relieved. [54].

Medication score showed good decrease in conventional treatment of allergic rhinitis after 2 months uses of Z.O therapy as compared with control group. These results were a reflection and explanation of the improvement in clinical symptoms and augment the idea that says herbal treatment is benefit in medical fields.

In conclusion, Zingiber officinale is effective treatment for allergic rhinitis and significantly reduced serum total IgE after 4 weeks of treatment course.


  1. 1. Alhalwani M, Alobaidi AH, Alsamarai AGM. Evaluation of the Therapeutic Effect of Combined Conventional Asthma Drugs with Tianeptine in Treatment of Asthma: Double-Blind Controlled Trial. Pharmacothewrapy 2014, IN Tech, in press.
  2. 2. Alsamarai AM, Alwan AM, Ahmed AH. The relationship between asthma and allergic rhinitis in Iraqi population. Allergology International 2009;58:549-555.
  3. 3. Sur DK, Scandale S. Treatment of allergic rhinitis. Am Fami Physician 2010;81:1440-1446.
  4. 4. Alsamarai AGM, Amina Hamed Ahmad Alobaidi, Sami Mezher Alrefaiei and Amar Mohamed Alwan. House Dust Mite Immunotherapy in Iraqi Patients with Allergic Rhinitis and Asthma, Pharmacotherapy 2012, Dr. Farid Badria (Ed.), ISBN: 978-953-51-0532-9, InTech, Available from: books/ pharmacotherapy /house-dust-mite-immunotherapy-in-iraqi-patients-withallergic-rhinitis-and-asthma.
  5. 5. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis & a topic eczema: ISAAC. The International study of Asthma & Allergies in childhood (ISAAC) Steering committee. Lancet 1998; 351: 1225- 1232.
  6. 6. Alsamarai AGM, Abdul Satar M, Alobaidi AHA. Evaluation of Therapeutic Efficacy of Nigella sativa (Black Seed) for Treatment of Allergic Rhinitis", Allergic Rhinitis,2012, Prof. Marek Kowalski (Ed.), ISBN: 978-953-51-0288-5, InTech, Available from: /books/allergic-rhinitis/evaluation-of-therapeutic-efficacy-of-nigella-sativa-blackseed-for-treatment-of-allergic-rhinitis].
  7. 7. Alsamarai AGM, Abdulsatar M, Alobaidi AHA. Evaluation of topical black seed in the treatment of allergic rhinitis. AIAAMC 2014.
  8. 8. Platts-Mills TA. Allergen avoidance. J. Allergy Clin. Immunol. Mar 2004,113(3),388-91.
  9. 9. Denisek, S.; Stephanie, S. Treatment of Allergic Rhinitis. Am. Fam. Physician. 2010, 81(12), 1440-1446.
  10. 10. Alzakar, E.; Alsamarai, A. Efficacy of immunotherapy for treatment of asthma in children. Asthma Allergy Proceeding, 2010, 31,324-330.
  11. 11. Blaiss MS. Quality of life in allergic rhinitis. Ann. Allergy Asthma Immunol., Nov 1999,83(5),449-54..
  12. 12. Thompson, A.K.; Juniper, E.; Meltzer, E.O. Quality of life in patients with allergic rhinitis. Ann. Allergy Asthma Immunol. Nov 2000,85(5),338-47.
  13. 13. Passalacqua, G.; Durham, S.R. Allergic rhinitis and its impact on asthma update: allergen immunotherapy. J. Allergy Clin. Immunol. 2007, 119,881-891.
  14. 14. Jacobsen, L.; Niggemann, B.; Dreborg, S.; et al. Specific immunotherapy has long term preventive effect of seasonal and perennial asthma: 10 year follow up on the PAT study. Allergy, 2007, 62,943-948.
  15. 15. Cohn, J.R.; Pizzi, A. Determinants of patient’s compliance with allergen immunotherapy. J. Allergy Clin. Immunol., 1993, 91,734-737.
  16. 16. Tinkelman, D.G.; Cole, W.Q.; Tunno, J. Immunotherapy: a one year prospective study to evaluate risk factors of systemic reactions. J. Allergy Clin. Immunol., 1995, 95,8-14.
  17. 17. Taubi, E.; Kessel, A.; Blant, A.; Golan, T.D. Follow-up after systemic adverse reactions of immunotherapy. Allergy, 1999, 54,617-620.
  18. 18. Tamir, R.; Levy, I.; Duer, S.; et al. Immediate adverse reactions to immunotherapy in allergy. Allergy, 1992, 47, 260-263.
  19. 19. Zeldin, Y.; Weiler, Z.; Magen, E.; Tiosano, L.; Kidon, M.I. Safety and efficacy of allergen immunotherapy in the treatment of allergic rhinitis and asthma in real life. IMAJ, 2008, 10,869-872.
  20. 20.
  21. 21. Nievergelt A, Huonker P, Schoop R, Altmann KH, Gertsch J. Identification of serotonin 5-HTIA receptor partial agonists in ginger. Bioorganic & Medicinal Chemistry. 2010;18(9): 3345-51.
  22. 22. pdf
  23. 23.
  24. 24. Saraswat M, Suryanarayana P, Reddy PY, Patil M, ABalakrishna N, Reddy GB. Antiglycating potential of Zingiber officinalis and delay of diabetic cataract in rats. Molecular Vision. 2010; 16: 1525-37.
  25. 25. Al-Amin ZM, Thomson M, Al-Qattan KK, Peltonen- Shalaby R, Ali M. Anti- diabetic and hypolipidaemic properties of ginger (Zingiber officinale) in streptozotocin- induced diabetic rats. British Journal of Nutrition (Cambridge University Press) 2006;96 (4): 660-666. doi: 10.1079/BJN20061849. PMID 17010224.
  26. 26. Afshari, Ali taghizadeh et al.; Shirpoor, A; Farshid, A; Saadation, R; Rasmi, Y; Saboory, E; Ilkhanizadeh, B; Allameh, A. The effect of ginger on diabetic nephropathy, plasma antioxidant capacity and lipid peroxidation in rate. Food Chemistry (Elsevier) 2007;101 (1): 148-153. doi: 10.1016/j.foodchem.2006.01.013.
  27. 27.
  28. 28. Ernst, E, Pittler, M.H. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. British Journal of Anesthesia 200;84 (3): 367-371. PMID 10793599.
  29. 29. Wood C, Pittler MH. Comparison of ginger with various anti motion sickness drugs. British J Anaesthesia 2000;84 (3): 367-71. PMID 10793599.
  30. 30. Grøntved A, Hentzer E. Vertigo reducing effect of ginger root. A controlled clinical study. J Otorhinoryngol Relat Spec 1986;48:282-6.
  31. 31.,. Ginger NCCAM Herbs at a Glance. Nccam.
  32. 32. Chen, Jaw-Chyun; Li-Jiau Huang, Shih- Lu Wu, Sheng-Chu Kuo, Tin-Yun Ho, Chien-Yun Hsiang. Ginger and Its Bioactive Component Inhibit Enter toxigenic Escherichia coli Heat- Labile Enterotoxin- Induced Diarrhoea in Mice. Journal of Agricultural and Food Chemistry 2007;55 (21): 8390-8397. doi: 10.1021/jf071460f. PMID 17880155.
  33. 33., University of Meryland Medical Centre (2006). Ginger.
  34. 34. O'Hara, Mary; Kiefer, David; Farrell, Kim; Kemper, Kathi. A Review of 12 Commonly Used Medicinal Herbs. Archives of Family Medicina 1998;7(7): 523-536. doi: 10.1001/archfami.7.6.523. PMID 9821826.
  35. 35. Rhode, J.; Fogoros, S.; Zick, S.; Wahl, H.; Griffith, K.A.; Huang, J.; Liu, J. R. Ginger inhibits cell growth and modulates angiogenic factres in ovarian cancer cells. BMC Complementary & Alternative Medicine 2007;7: 44. doi: 10.1186/1472-6882-7-44. PMC 2241638. PMID 18096028.
  36. 36. Kim, J.S.; et al., Sa Im; Park, Hye Won; Yang, Jae Heon; Shin, Tae-Yong; Kim, Youn-Chul; Baek, Nam=In; Kim, Sung-Hoon et al. Cytotoxic components from the dried rhizomes of Zingiber officinale Roscoe. Archeves of pharmacal Research 2008;31 (4): 415-418. doi: 10.1007/s12272-001-1172-y. PMID 18449496.
  37. 37. Choudhury, D.; Amlan; Bhattacharya, Abhijit; Chakrabarti, Gopal. Aqueous extract of ginger shows antiproliferative activity through disruption of microtubule network of cancer cells. Food Chem Toxicol. 2010;48(10): 2872-2880. doi10.1016/j.fct.2010.07.020.
  38. 38. Oyagbemi, A.A.; Saba, A. B.; Azeez, O.I. Molecular targets of [6]- gingerol: Its potential roles in cancer chemoprevention. Biofactors 2010;36(3): 169- 178. doi: /Pp. 425-426. ISBN 0-684-80001-2.
  39. 39. Jakes, Susan. Beverage of Champions. Times on- line.
  40. 40. MDidea Extracts Professional. Dosage and Administration of Ginger.2010.
  41. 41. Mayo Clinic (1 May 2006). "drugs & Supplements: Ginger (Zingiber officinale Foscoe)".
  42. 42.
  43. 43. Ueda H., Ippoushi K, Takeuchi A. Repeated oral administration of a squeezed ginger (Zingiber officiale) extract augmented the serum corticosterone level & had anti- inflammatory properties. Biosci Biotechnol Biochem. 2010; 74(11): 2248-52.
  44. 44. Ahui ML, champy, Ramadan A, pham van L, Araujo L, Brou Andre K., Diem S, Damotte D, Kati- conlibaly S, Offoumou MA, Dym, Thieblemant N, Herbelin A. Ginger prevents Th2- mediated immune response in a mouse model of airway inflammation, Int. Immuno pharmacol.2008 ;8 (12): 1626-32.
  45. 45. Dykeewicz M, Fineman S, Skoner D, Diagnosis and management of rhinitis. Complete guidelines of the joint task fore on practice parameters in allergy, asthma, and immunology. Ann Allergy, Asthma, Immunol 1998; 81:478.
  46. 46. Durham SR, Jories AS. Mechanisms & treatment of allergic rhinitis & intrinsic rhinitis in Jans. Mackay and T.R> Bull "Scott- Brown's" otolaryngo- logngology 1997, 6th eition, part 4: ch: 6: 4/6/1- 4/6/16, ch.9:4/9/1- 4/9/7.
  47. 47. Abba I. Terr, A topic disease in Danial P. stites, Abba I. Terr, Tristram G. Basic & clinical Immunology G. parslow 1994 8th edition, ch. 25:327-345.
  48. 48. Isabella A., Eli O., Peter H. Management of allergic rhinitis & it's impact on asthma A pocked Guide for physician & nurse 2001, 3-15.
  49. 49. King H C. An Otolaryngologist's Guide to allergy. New York: 1990: 54.
  50. 50. Barker JR. (ed) primer on allergic & immunologic diseases JAMA 1997;278, 1804- 2025.
  51. 51. Durham S. ABC of allergies BMJ 1998.
  52. 52. Warren CPW, Holford- Strevens V, Wang C, Manfreda J. The relationship between smoking & total IgE levels, Journal of allergy & clinical Immunology, Vol. 69, issue 4, April 1982, P. 370-375.
  53. 53. Badreldin H. Ali, Gerald Blunded, Musbah O., Tanira Abderrahim Nemmar. Some phyto chemical, pharmacological & toxicological properties of ginger (Zingiber Officinale) A review of recent research, Food Chemical Toxicology, 2008; 46:409-420.
  54. 54. Maeda- Yamamoto M, Emak, Shibuichi L, In vitro and in vivo anti allergic effects of benifuuki green tea containing O-Methylated catechin & ginger extract enhancement. Cytotechnology 2007; 55 (2-3): 135-42, doi: 10.1007/s 10616- 007-9112-1 Epub 2007 Nov. 25.

Written By

Abdulghani Mohamed Alsamarai, Mohamed Abdulsatar Hamid and Amina Hamed Ahmed Alobaidi

Submitted: 26 September 2014 Published: 22 April 2015