Blood Res 2019; 54(1): 31-37  https://doi.org/10.5045/br.2019.54.1.31
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, Amal Mahmoud Saeed6
1Department of Physiology, Faculty of Medicine, 2Clinical Genetics, Faculty of Medicine, Al Neelain University, 3Department of
Hematology, 4Department of Pediatrics, Military Hospital Khartoum, 5Department of Community Medicine, Faculty of Medicine, Al
Neelain University, 6Department of Physiology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
Correspondence to: Lamis AbdelGadir Kaddam, Ph.D. Department of Physiology, Faculty of Medicine, Al Neelain University, P.O. Box 11121, Khartoum 12702, Sudan E-mail: lamiskaddam@hotmail.com
Received: May 27, 2018; Revised: September 13, 2018; Accepted: October 1, 2018; Published online: March 31, 2019.
© The Korean Journal of Hematology. All rights reserved.

cc 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 ClinicalTrials.gov (identifier: NCT0246725).

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


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