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

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: NCT02467257).

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: Bilirubin; Gum arabic; Liver enzyme; Sickle cell anemia; Urea.

Conflict of interest statement

Authors' Disclosures of Potential Conflicts of Interest: No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 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.

Fig. 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

Fig. 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.

Fig. 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.

Fig. 5. Effects of GA on serum uric acid Serum level (P=0.721).