Ginkgo biloba extract (EGb 761) attenuates oxidative stress induction in erythrocytes of sickle cell disease patients

Abstract

Sickle cell disease promotes hemolytic anemia and occlusion of small blood vessels due to the presence of high concentrations of hemoglobin S, resulting in increased production of reactive oxygen species and decreased antioxidant defense capacity. The aim of this study was to evaluate the protective action of a standardized extract of Ginkgo biloba (EGb 761), selected due to its high content of flavonoids and terpenoids, in erythrocytes of patients with sickle cell anemia (HbSS, SS erythrocytes) subjected to oxidative stress using tert-butylhydroperoxide or 2,2-azobis-(amidinepropane)-dihydrochloride, in vitro. Hemolysis indexes, reduced glutathione, methemoglobin concentrations, lipid peroxidation, and intracellular reactive oxygen species were determined. SS erythrocytes displayed increased rates of oxidation of hemoglobin and membrane lipid peroxidation compared to normal erythrocytes (HbAA, AA erythrocytes), and the concentration of EGb 761 necessary to achieve the same antioxidant effect in SS erythrocytes was at least two times higher than in normal ones, inhibiting the formation of intracellular reactive oxygen species (IC50 of 13.6 µg/mL), partially preventing lipid peroxidation (IC50 of 242.5 µg/mL) and preventing hemolysis (IC50 of 10.5 µg/mL). Thus, EGb 761 has a beneficial effect on the oxidative status of SS erythrocytes. Moreover, EGb 761 failed to prevent oxidation of hemoglobin and reduced glutathione at the concentrations examined.

Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast

“…These are rheological disorders related to stress reticulocyte adhesion, blood hypercoagulability, and inflammation. On this basis, vasodilator drugs such as ginko biloba [ 3 ], inhaled nitric oxide [ 16 ], anticoagulants [ 5 ], and NSAIDs [ 6 – 8 ] have failed to demonstrate the ability to significantly reduce the duration or intensity of crises.…”

“…These intracellular polymers increase the rigidity of erythrocytes, causing a distortion of their membrane that leads to the formation of weakened “sickle-shaped” red blood cells. These abnormal red blood cells are the root cause of the characteristic chronic anaemia in the disease [ 3 ]. One of the severe symptomatic manifestations of sickle cell disease is the occurrence of very intense and painful vaso-occlusive crises (VOCs), which are sometimes resistant to usual analgesics.…”

Untitled

“…In medical conditions where the ratio between cholesterol and phospholipid is altered leading to malfunctioning of the RBC membrane, the application of P. atlantica extract helps in normalizing the RBC membrane structure 22 .The papaya leaf extracts have the capability of reducing the hemolysis in-vitro and hence, are a potent alternative for treating the diseases which result in altering the membrane structure 23 .Thus, the medicinal plant extracts have been traditionally used in medicine all over the world but for the use of these extracts, dose should be precisely formulated, else they can prove toxic to the cells as has been seen in several studies 24,25,26,27 .…”