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Original Article

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Blood Res 2019; 54(1):

Published online March 31, 2019

https://doi.org/10.5045/br.2019.54.1.31

© The Korean Society of Hematology

Biochemical effects and safety of Gum arabic (Acacia Senegal) supplementation in patients with sickle cell anemia

Lamis AbdelGadir Kaddam1*, Imad Fdl-Elmula2, Omer Ali Eisawi3, Haydar Awad Abdelrazig4, Mustafa Khidir Elnimeiri5, and Amal Mahmoud Saeed6

Author Info. +

1Department of Physiology, Faculty of Medicine, Al Neelain University, Khartoum, Sudan.

2Department of Clinical Genetics, Faculty of Medicine, Al Neelain University, Khartoum, Sudan.

3Department of Hematology, Military Hospital Khartoum, Khartoum, Sudan.

4Department of Pediatrics, Military Hospital Khartoum, Khartoum, Sudan.

5Department of Community Medicine, Faculty of Medicine, Al Neelain University, Khartoum, Sudan.

6Department of Physiology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Correspondence to : Correspondence to Lamis AbdelGadir Kaddam, Ph.D. Department of Physiology, Faculty of Medicine, Al Neelain University, P.O. Box 11121, Khartoum 12702, Sudan. lamiskaddam@hotmail.com

Received: May 27, 2018; Revised: September 13, 2018; Accepted: October 1, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Background

Sickle cell anemia (SCA) is a hereditary chronic hemolytic anemia with several clinical consequences. Intravascular sickling of red blood cells leads to multi-organ dysfunction. Moreover, several biochemical abnormalities have been associated with SCA. Gum arabic (GA) is an edible dried gummy exudate obtained from Acacia Senegal tree. GA showed antioxidant and cytoprotective activities and demonstrated protection against hepatic, renal, and cardiac toxicities in experimental rats. We hypothesized that regular intake of GA improves renal and liver functions in patients with SCA.

Methods

Forty-seven patients (5–42 yr) carrying hemoglobin SS were recruited. The patients received 30 g/day GA for 12 weeks. Blood samples were collected before administering GA and then after 4, 8, and 12 weeks. Liver enzymes, total protein, albumin, electrolytes, urea, creatinine, and uric acid were determined in the serum. The study was approved by the Al Neelain University Institutional Review Board and Research Ethics Committee Ministry of Health. The trial was registered at (identifier: ).

Results

GA significantly decreased direct bilirubin level [statistical significance (P-value)=0.04]. It also significantly decreased serum alanine transaminase level after 4 weeks, which was sustained till the 8th week. GA, however, had no effect on serum aspartate transaminase level. In terms of renal function, GA decreased serum urea level but the effect was not sustained after the first month.

Conclusion

GA may alter the disease severity in SCA as demonstrated by its ability to decrease direct bilirubin and urea levels in the serum.

Keywords Sickle cell anemia, Gum arabic, Bilirubin, Urea, Liver enzyme

Article

Original Article

Blood Res 2019; 54(1): 31-37

Published online March 31, 2019 https://doi.org/10.5045/br.2019.54.1.31

Copyright © The Korean Society of Hematology.

Biochemical effects and safety of Gum arabic (Acacia Senegal) supplementation in patients with sickle cell anemia

Lamis AbdelGadir Kaddam1*, Imad Fdl-Elmula2, Omer Ali Eisawi3, Haydar Awad Abdelrazig4, Mustafa Khidir Elnimeiri5, and Amal Mahmoud Saeed6

1Department of Physiology, Faculty of Medicine, Al Neelain University, Khartoum, Sudan.

2Department of Clinical Genetics, Faculty of Medicine, Al Neelain University, Khartoum, Sudan.

3Department of Hematology, Military Hospital Khartoum, Khartoum, Sudan.

4Department of Pediatrics, Military Hospital Khartoum, Khartoum, Sudan.

5Department of Community Medicine, Faculty of Medicine, Al Neelain University, Khartoum, Sudan.

6Department of Physiology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Correspondence to:Correspondence to Lamis AbdelGadir Kaddam, Ph.D. Department of Physiology, Faculty of Medicine, Al Neelain University, P.O. Box 11121, Khartoum 12702, Sudan. lamiskaddam@hotmail.com

Received: May 27, 2018; Revised: September 13, 2018; Accepted: October 1, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Sickle cell anemia (SCA) is a hereditary chronic hemolytic anemia with several clinical consequences. Intravascular sickling of red blood cells leads to multi-organ dysfunction. Moreover, several biochemical abnormalities have been associated with SCA. Gum arabic (GA) is an edible dried gummy exudate obtained from Acacia Senegal tree. GA showed antioxidant and cytoprotective activities and demonstrated protection against hepatic, renal, and cardiac toxicities in experimental rats. We hypothesized that regular intake of GA improves renal and liver functions in patients with SCA.

Methods

Forty-seven patients (5–42 yr) carrying hemoglobin SS were recruited. The patients received 30 g/day GA for 12 weeks. Blood samples were collected before administering GA and then after 4, 8, and 12 weeks. Liver enzymes, total protein, albumin, electrolytes, urea, creatinine, and uric acid were determined in the serum. The study was approved by the Al Neelain University Institutional Review Board and Research Ethics Committee Ministry of Health. The trial was registered at (identifier: ).

Results

GA significantly decreased direct bilirubin level [statistical significance (P-value)=0.04]. It also significantly decreased serum alanine transaminase level after 4 weeks, which was sustained till the 8th week. GA, however, had no effect on serum aspartate transaminase level. In terms of renal function, GA decreased serum urea level but the effect was not sustained after the first month.

Conclusion

GA may alter the disease severity in SCA as demonstrated by its ability to decrease direct bilirubin and urea levels in the serum.

Keywords: Sickle cell anemia, Gum arabic, Bilirubin, Urea, Liver enzyme

Fig 1.

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Figure 1.

Effects of GA on liver function (a)significant difference from baseline). (A) Effects of GA on direct bilirubin level (P=0.008). (B) Effects of GA on total bilirubin level (P=0.590). (C) Effects of GA on serum albumin level (P=0.186). (D) Effects of GA on total proteins level (P=0.155). b)Indicate outliers' value.

Blood Research 2019; 54: 31-37https://doi.org/10.5045/br.2019.54.1.31

Fig 2.

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Figure 2.

Effects of GA on liver enzymes (a)significant difference from baseline). (A) Effects of GA on serum ALT Level (P=0.077). (B) Effects of GA on serum AST level (P=0.190). (C) Effects of GA on serum ALP level (P=0.211). b)Indicate outliers' value

Blood Research 2019; 54: 31-37https://doi.org/10.5045/br.2019.54.1.31

Fig 3.

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Figure 3.

Effects of GA on renal function (a)significant difference from baseline). (A) Effects of GA on serum urea level (P=0.196). (B) Effects of GA on serum creatinine level (P=0.205). b)Indicate outliers' value.

Blood Research 2019; 54: 31-37https://doi.org/10.5045/br.2019.54.1.31

Fig 4.

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Figure 4.

Effects of GA on serum electrolytes. (A) Effects of GA on serum sodium level (P=0.503). (B) Effects of GA on serum potassium level (P=0.560). a)Indicate outliers' value.

Blood Research 2019; 54: 31-37https://doi.org/10.5045/br.2019.54.1.31

Fig 5.

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Figure 5.

Effects of GA on serum uric acid Serum level (P=0.721).

Blood Research 2019; 54: 31-37https://doi.org/10.5045/br.2019.54.1.31

Table 1 . Demographics characteristics and biochemical profile of the patients at baseline..

a)Not normally distributed based on Kolmogorov-Smirnov test and Shapiro-Wilk test..

Abbreviations: ALT, alanine transaminase; ALP, alkaline phosphatase; AST, aspartate transaminase..
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