Effect of Gum Arabic (Acacia senegal) on C-reactive protein level among sickle cell anemia patients

Lamis AbdelGadir Kaddam, Anas Suliman Kaddam, Lamis AbdelGadir Kaddam, Anas Suliman Kaddam

Abstract

Objectives: Inflammation is ongoing process among sickle cell anemia even during steady state. C reactive protein (CRP) is cardinal marker that utilized widely as inflammatory indicator. Gum Arabic (GA) is gummy exudates from Acacia senegal tree. Fermentation by colonic bacteria increases serum butyrate concentrations, so considered as prebiotic agent. Gum Arabic (GA) has anti-inflammatory activity through butyrate. Earlier we proved that regular intake of GA increased fetal hemoglobin and anti-oxidant capacity most likely through raised level of butyrate, which would ameliorate symptoms of sickle cell anemia. Best of our knowledge this is the first study conducted to investigate GA intake on inflammatory markers among sickle patients.

Results: This was a retrospective study conducted on stored samples from trial of Gum Arabic and sickle cell anemia. Quantitative CRP was measured by Mindray BS 200 before and after Gum Arabic consumption for 12 weeks. Daily intake of GA significantly decreased C reactive protein level (P.V = 001) (95% CI 0.943-3.098). No correlation between CRP and age, fetal hemoglobin, hemolysis markers and white blood cells. Our findings revealed novel effect of GA as anti-inflammatory agent could be consumed as natural dietary supplement to modulate disease severity and downregulate inflammatory process.

Trial registration: ClinicalTrials.gov Identifier: NCT02467257. Registered 3rd June 2015.

Keywords: CRP and butyrate; Gum Arabic; Inflammation; Sickle cell.

Conflict of interest statement

No conflicts of interest, financial or otherwise, are declared by the authors.

Figures

Fig. 1
Fig. 1
Effect of GA intake on CRP (P value = 0.001). *Indicates significant difference from baseline

References

    1. Fathallah H, Atweh GF. Induction of fetal hemoglobin in the treatment of sickle cell disease. Hematol Am Soc Hematol Educ Program. 2006;9:58–62. doi: 10.1182/asheducation-2006.1.58.
    1. Diallo D, Tchernia G. Sickle cell disease in Africa. Curr Opin Hematol. 2002;9(2):111–116. doi: 10.1097/00062752-200203000-00005.
    1. Makani J, Ofori-Acquah SF, Nnodu O, Wonkam A, Ohene-Frempong K. Sickle cell disease: new opportunities and challenges in Africa. Sci World J. 2013;2013:193252. doi: 10.1155/2013/193252.
    1. Belcher JD, Bryant CJ, Nguyen J, Bowlin PR, Kielbik MC, Bischof JC, et al. Transgenic sickle mice have vascular inflammation. Blood. 2003;101(10):3953–3959. doi: 10.1182/blood-2002-10-3313.
    1. Bhagat S, Patra PK, Thakur AS. Association of inflammatory bioker C-reactive protein, lipid peroxidation and antioxidant capacity marker with HbF level in sickle cell disease patients from Chattisgarh. Indian J Clin Biochem. 2012;27(4):394–399. doi: 10.1007/s12291-012-0231-x.
    1. Krishnan S, Setty Y, Betal SG, Vijender V, Rao K, Dampier C, et al. Increased levels of the inflammatory biomarker C-reactive protein at baseline are associated with childhood sickle cell vasocclusive crises. Br J Haematol. 2010;148(5):797–804. doi: 10.1111/j.1365-2141.2009.08013.x.
    1. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest. 2003;111(12):1805–1812. doi: 10.1172/JCI200318921.
    1. Hirschfield GM, Pepys MB. C-reactive protein and cardiovascular disease: new insights from an old molecule. QJM. 2003;96(11):793–807. doi: 10.1093/qjmed/hcg134.
    1. Archer DR, Stiles JK, Newman GW, Quarshie A, Hsu LL, Sayavongsa P, et al. C-reactive protein and interleukin-6 are decreased in transgenic sickle cell mice fed a high protein diet. J Nutr. 2008;138(6):1148–1152. doi: 10.1093/jn/138.6.1148.
    1. Bourantas KL, Dalekos GN, Makis A, Chaidos A, Tsiara S, Mavridis A. Acute phase proteins and interleukins in steady state sickle cell disease. Eur J Haematol. 1998;61(1):49–54. doi: 10.1111/j.1600-0609.1998.tb01060.x.
    1. Ali BH, Ziada A, Blunden G. Biological effects of gum arabic: a review of some recent research. Food Chem Toxicol. 2009;47(1):1–8. doi: 10.1016/j.fct.2008.07.001.
    1. Babiker R, Merghani TH, Elmusharaf K, Badi RM, Lang F, Saeed AM. Effects of Gum Arabic ingestion on body mass index and body fat percentage in healthy adult females: two-arm randomized, placebo controlled, double-blind trial. Nutr J. 2012;11:111. doi: 10.1186/1475-2891-11-111.
    1. Ballal A, Bobbala D, Qadri SM, Foller M, Kempe D, Nasir O, et al. Anti-malarial effect of gum Arabic. Malar J. 2011;10:139. doi: 10.1186/1475-2875-10-139.
    1. Tulung B, Remesy C, Demigne C. Specific effect of guar gum or gum arabic on adaptation of cecal digestion to high fiber diets in the rat. J Nutr. 1987;117(9):1556–1561. doi: 10.1093/jn/117.9.1556.
    1. Matsumoto N, Riley S, Fraser D, Al-Assaf S, Ishimura E, Wolever T, et al. Butyrate modulates TGF-beta1 generation and function: potential renal benefit for Acacia(sen) SUPERGUM (gum arabic)? Kidney Int. 2006;69(2):257–265. doi: 10.1038/sj.ki.5000028.
    1. Luhrs H, Gerke T, Muller JG, Melcher R, Schauber J, Boxberge F, et al. Butyrate inhibits NF-kappaB activation in lamina propria macrophages of patients with ulcerative colitis. Scand J Gastroenterol. 2002;37(4):458–466. doi: 10.1080/003655202317316105.
    1. Luhrs H, Gerke T, Schauber J, Dusel G, Melcher R, Scheppach W, et al. Cytokine-activated degradation of inhibitory kappaB protein alpha is inhibited by the short-chain fatty acid butyrate. Int J Colorectal Dis. 2001;16(4):195–201. doi: 10.1007/s003840100295.
    1. Nasir O. Renal and extrarenal effects of gum arabic (Acacia senegal)–what can be learned from animal experiments? Kidney Blood Press Res. 2013;37(4–5):269–279. doi: 10.1159/000350152.
    1. Ali BH, Al-Husseni I, Beegam S, Al-Shukaili A, Nemmar A, Schierling S, et al. Effect of gum arabic on oxidative stress and inflammation in adenine-induced chronic renal failure in rats. PLoS ONE. 2013;8(2):e55242. doi: 10.1371/journal.pone.0055242.
    1. Kamal E, Kaddam LA, Dahawi M, Osman M, Salih MA, Alagib A, et al. Gum arabic fibers decreased inflammatory markers and disease severity score among rheumatoid arthritis patients, Phase II Trial. Int J Rheumatol. 2018;2018:4197537. doi: 10.1155/2018/4197537.
    1. Nasir O, Umbach AT, Rexhepaj R, Ackermann TF, Bhandaru M, Ebrahim A, et al. Effects of gum arabic (Acacia senegal) on renal function in diabetic mice. Kidney Blood Press Res. 2012;35(5):365–372. doi: 10.1159/000336359.
    1. Kaddam L, Fadl-Elmula I, Eisawi OA, Abdelrazig HA, Salih MA, Lang F, et al. Gum Arabic as novel anti-oxidant agent in sickle cell anemia, phase II trial. BMC Hematol. 2017;17:4. doi: 10.1186/s12878-017-0075-y.
    1. Kaddam L, FdleAlmula I, Eisawi OA, Abdelrazig HA, Elnimeiri M, Lang F, et al. Gum Arabic as fetal hemoglobin inducing agent in sickle cell anemia; in vivo study. BMC Hematol. 2015;15:19. doi: 10.1186/s12878-015-0040-6.
    1. Doumatey AP, Zhou J, Adeyemo A, Rotimi C. High sensitivity C-reactive protein (Hs-CRP) remains highly stable in long-term archived human serum. Clin Biochem. 2014;47(4–5):315–318. doi: 10.1016/j.clinbiochem.2013.12.014.
    1. Aziz N, Fahey JL, Detels R, Butch AW. Analytical performance of a highly sensitive C-reactive protein-based immunoassay and the effects of laboratory variables on levels of protein in blood. Clin Diagn Lab Immunol. 2003;10(4):652–657.
    1. Tugirimana PL, Holderbeke AL, Kint JA, Delanghe JR. A new turbidimetric method for assaying serum C-reactive protein based on phosphocholine interaction. Clin Chem Lab Med. 2009;47(11):1417–1422. doi: 10.1515/CCLM.2009.312.
    1. Diallo DA, Guindo A. Sickle cell disease in sub-Saharan Africa: stakes and strategies for control of the disease. Curr Opin Hematol. 2014;21(3):210–214. doi: 10.1097/MOH.0000000000000038.
    1. Damanhouri GA, Jarullah J, Marouf S, Hindawi SI, Mushtaq G, Kamal MA. Clinical biomarkers in sickle cell disease. Saudi J Biol Sci. 2015;22(1):24–31. doi: 10.1016/j.sjbs.2014.09.005.
    1. Sakamoto TM, Lanaro C, Ozelo MC, Garrido VT, Olalla-Saad ST, Conran N, et al. Increased adhesive and inflammatory properties in blood outgrowth endothelial cells from sickle cell anemia patients. Microvasc Res. 2013;90:173–179. doi: 10.1016/j.mvr.2013.10.002.
    1. Pathare A, Al KS, Alnaqdy AA, Daar S, Knox-Macaulay H, Dennison D. Cytokine profile of sickle cell disease in Oman. Am J Hematol. 2004;77(4):323–328. doi: 10.1002/ajh.20196.
    1. Francis RB, Jr, Haywood LJ. Elevated immunoreactive tumor necrosis factor and interleukin-1 in sickle cell disease. J Natl Med Assoc. 1992;84(7):611–615.
    1. Owusu-Ansah A, Ihunnah CA, Walker AL, Ofori-Acquah SF. Inflammatory targets of therapy in sickle cell disease. Transl Res. 2016;167(1):281–297. doi: 10.1016/j.trsl.2015.07.001.
    1. Cani PD, Possemiers S, Van de Wiele T, Guiot Y, Everard A, Rottier O, et al. Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut. 2009;58(8):1091–1103. doi: 10.1136/gut.2008.165886.
    1. Kang Y, Cai Y, Zhang X, Kong X, Su J. Altered gut microbiota in RA: implications for treatment. Z Rheumatol. 2017;76(5):451–457. doi: 10.1007/s00393-016-0237-5.
    1. Khanna S, Jaiswal KS, Gupta B. Managing rheumatoid arthritis with dietary interventions. Front Nutr. 2017;4:52. doi: 10.3389/fnut.2017.00052.
    1. Cavaglieri CR, Nishiyama A, Fernandes LC, Curi R, Miles EA, Calder PC. Differential effects of short-chain fatty acids on proliferation and production of pro- and anti-inflammatory cytokines by cultured lymphocytes. Life Sci. 2003;73(13):1683–1690. doi: 10.1016/S0024-3205(03)00490-9.
    1. Jison ML, Munson PJ, Barb JJ, Suffredini AF, Talwar S, Logun C, et al. Blood mononuclear cell gene expression profiles characterize the oxidant, hemolytic, and inflammatory stress of sickle cell disease. Blood. 2004;104(1):270–280. doi: 10.1182/blood-2003-08-2760.
    1. Emokpae MA, Uadia PO, Gadzama AA. Correlation of oxidative stress and inflammatory markers with the severity of sickle cell nephropathy. Ann Afr Med. 2010;9(3):141–146. doi: 10.4103/1596-3519.68363.
    1. Biswal S, Rizwan H, Pal S, Sabnam S, Parida P, Pal A. Oxidative stress, antioxidant capacity, biomolecule damage, and inflammation symptoms of sickle cell disease in children. Hematology. 2018;16:1–9.

Source: PubMed

3
订阅