Melatonin May Enhance effect of Corticosteroid Therapy in Allergic Asthma, suggests study

A new study published in the Frontiers in Medicine that melatonin combined with corticosteroids may offer a promising therapeutic approach for allergic asthma by improving asthma control through modulation of inflammation and regulation of circadian rhythms. However, further studies are needed to clarify the mechanisms and confirm long-term benefits

Asthma affects millions worldwide and is typically managed with inhaled or systemic glucocorticoid that help control airway swelling and prevent flare-ups. Despite their effectiveness, some patients continue to experience symptoms. Thus, this study focused on the potential role of melatonin's anti-inflammatory and immune-modulating properties. This research hypothesized that these properties might interact beneficially with glucocorticoids in asthma management.

This case–control clinical study evaluated asthma patients using asthma control scores, biochemical inflammatory markers, exhaled nitric oxide (FeNO) and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI).

The patients with better sleep quality and higher melatonin levels tended to have improved asthma control. According to these findings, melatonin and circadian rhythm regulation may play a previously underappreciated role in respiratory health.

The study also included laboratory experiments using an animal model of allergic airway inflammation. These experiments examined how melatonin alone and in combination with the glucocorticoid dexamethasone affected airway inflammation and circadian rhythm gene expression.

Melatonin treatment alone reduced markers of allergic airway inflammation and helped stabilize the expression of genes associated with circadian rhythm regulation. However, the most significant improvements were noticed when melatonin was administered along with dexamethasone. The combination therapy produced a stronger anti-inflammatory effect than either treatment alone, which indicated a potential synergistic interaction.

This synergy may occur as melatonin influences inflammatory pathways while also aligning biological rhythms that affect immune responses and respiratory function. Since asthma symptoms often worsen at night (nocturnal asthma) the circadian effects of melatonin could be particularly relevant.

Overall, the findings suggest that melatonin could emerge as a low-cost adjunct therapy that enhances existing treatments and improves quality of life for asthma patients. While the findings are promising, more research is imperative before melatonin becomes a standard component of asthma therapy. Larger clinical trials will be required to confirm the benefits, determine optimal dosing strategies, and evaluate long-term safety.

Reference:

Zhang, Z., Wang, J., Ma, T., Zhang, X., Chen, G., & Wang, B. (2026). Synergistic interactions of melatonin and glucocorticoids in alleviating allergic airway inflammation. Frontiers in Medicine, 13, 1738965. https://doi.org/10.3389/fmed.2026.1738965