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

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.