Phyto-Medicine in Gene(s) Targeting Future Direction for Sickle Cell Disease Management

Abstract

Sickle cell disease (SCD) is a genetic disease of hemoglobin (Hb) that occurs due to a non-conservative substitution of a polar glutamate (Glu) by non-polar valine (Val) in an invariant region, of hemoglobin β chain-subunit. This change distorts the normal Hb folding resulting in a sticky patch on the surface of the β-chains and associated complications. Nigeria has the largest burden of SCD globally with an estimated 150,000 new born affected annually.This review is aimed at analyzing the phytomedicines use in Nigeria to ameliorate the crisis associated with SCD and present probable target genetic loci/pathways that this phytomedicines could act upon for effective and enhanced management of SCD in a resource poor environment.Nucleation is essential in polymerization of Hb and phyto-medicine has been reported to inhibit this pathway. Different loci of genetic variation identified as modulator of SCD phenotype include nucleotide motifs within the β-globin gene cluster and distal genes located on different chromosomes. Fetal hemoglobin (HbF) is equally an important variable and modulator of the clinical features of SCD. Phytomedicine used in the management of SCD ameliorates oxidative stress and modulates cytokines that contributes to SCD complications. Here, we propose the use of phyto-medicine as key component for genetic modification, by twinkling, some transcription effectors/gene modulator such as B-cell lymphoma/leukemia 11A (BCL11A), or an erythroid specific transcription factor (KLF1), which are part of factors mediating HbF gene silencing.

Effect of Ciklavit® - (A Poly-Herbal Formulation) on the Pharmacokinetics of Proguanil in Healthy Nigerian Volunteers

“…Study on Cajanus cajan seed shows that Ciklavit® contains phenylalanine, carjaminose, and hydroxybenzoic acid as active constituents and are thought to be the reason for its anti-sickling effect. 19 Study also found that flavonoids such as morin and silymarin inhibit Pgp ATPase activity by inhibiting azidopine binding to P-gp. The findings of this study indicate a potential for significant flavonoid-drug interactions with P-gp substrates.…”

Different Therapeutic Interventions and Mechanisms of Action of Antisickling Agents Currently in Use in Sickle Cell Disease Management

“…3 HbF, however, has been found to have a higher affinity for oxygen than all other variants of Hb. 4 In adults, very small quantities of HbF (<2%) have been detected in the blood. Researchers found that SCD patients in Saudi Arabia and India that had high levels of HbF, even as adults, had milder anaemic episodes.…”

Functional foods: promising therapeutics for Nigerian Children with sickle cell diseases

“…In West African for example, historical and scientific records have described different names used to qualify SCD children among the three main Nigerian tribes. The Yorubas, constituting the dominant population in the west called them “abiku” translated “sufferers'' or “children that bring sadness” [ 10 , 11 ], the Ibos called them “Ogbanje” [ 12 ], and the Hausas called them “Sankara-miji” [ 13 ]. It is the major innate disorder in Nigeria, affecting about 4 million population at prevalence of 2% at birth while more than 40 million persons have sickle cell traits.…”