Precipitating factors and targeted therapies in combating the perils of sickle cell disease--- A special nutritional consideration

Abstract

Nutritional research in sickle cell disease has been the focus in recent times owing to not only specific nutritional deficiencies, but also the improvements associated with less painful episodes. Though hydroxyurea remains the drug of choice, certain adverse health effects on long term supplementation makes room for researches of different compounds. Macro and micro nutrient deficiencies, along with vitamins, play an important role in not only meeting the calorific needs, but also reducing clinical complications and growth abnormalities. Symptoms of hyper protein metabolism, increased cell turnover, increased cardiac output, and appetite suppression due to enhanced cytokine production, might give us leads for better understanding of the mechanisms involved. Different nutritional approaches comprising of traditional herbal therapies, antioxidants, flavonoids, vitamins, minerals etc., reducing oxidative stress and blood aggregation, have been tried out to increase the health potential. Nutritional therapies may also serve complementary to the newer therapies using ozone, hematopoietic stem cell transplantation, antifungal medications, erythropoietin etc. Herein we try to present a holistic picture of the different patho-physiological mechanisms, and nutritional strategies adopted.

Effects of living at moderate altitude on pulmonary vascular function and exercise capacity in mice with sickle cell anaemia

“…Hb S polymerizes within the erythrocyte during deoxygenation to cause the classic sickle‐shaped morphology and the associated reduced red blood cell (RBC) deformability that leads to the impediment of microvascular blood flow and promotion of haemolysis (Gladwin, ; Khan et al . ; Mehari & Klings, ). The resulting extravascular haemolysis leads to increased spleen and hepatic iron accumulation, as well as increased plasma levels of lactate dehydrogenase and bilirubin.…”

Current therapies in alleviating liver disorders and cancers with a special focus on the potential of vitamin D

“…The potential of vitamin D deficiency in health conditions from obesity to cancers has been well researched (see Table 2 ). Its implication in hematological disorders is also of great interest as the metabolic burden on liver may cause a decreased production of the binding protein of vitamin D. Vitamin D supplementation has also shown to improve vaso-occlusive crisis (VOC) and acute pain in sickle cell disease (SCD) [ 38 , 39 ].…”

<p>Nutrition in sickle cell disease: recent insights</p>

“…Derivatives from plants have been shown to contain antioxidant properties from bioactive components such as phytochemicals and flavanols. 44 Exploration for the use of extracts from the tropical plant Moringa oleifera is in progress, to determine the antioxidant capacity in the treatment of oxidative stress in sickle cell disease. Ethanol extracts of Moringa oleifera showed antioxidant values between 77 and 4,458 μg/ml.…”