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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 8  |  Issue : 2  |  Page : 54-58

Acute phase response in anemic patients who received raw liquid extract of the leaves of Solanecio biafrae (wòròwó) to increase their hematocrit


1 Department of Medical Laboratory Science, Edo University, Iyamho, Nigeria
2 Department of Medical Laboratory Science, Achievers University, Owo, Nigeria

Date of Submission28-Apr-2020
Date of Decision28-Apr-2020
Date of Acceptance14-Jul-2020
Date of Web Publication23-Sep-2020

Correspondence Address:
Mathew Folaranmi Olaniyan
Department of Medical Laboratory Science, Edo University, Iyamho
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/dmr.dmr_16_20

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  Abstract 


Study Background: Solanecio biafrae (wòròwó) leaves contain health benefit phytochemicals and phytonutrients which are being used traditionally to treat ailments.
Aim and Objective: This work was therefore designed to determine acute phase response in anemic patients who received raw liquid extract of the leaves of to increase their hematocrit. Materials and Methods: Forty-three (43) individuals with low packed cell volume (PCV) (PCV 27 ± 2.0; Female–22; Male-21; age–18–61 years) and 50 age-matched volunteers with normal PCV (PCV 41 ± 2.0; Female-25; Male-25) who were negative in reaction to Giemsa thick-blood film staining for Plasmodium spp., Stool microscopy for hookworm, Ziehl–Neelsen staining for acid fast bacilli, human immunodeficiency virus, anti-HCV and HBsAg ELISA were recruited from herbal homes in Nigeria. Plasma Haptoglobin, C–reactive protein (CRP) and fibrinogen were assayed biochemically while PCV was determine by microhematocrit capillary tube method. Results: There was a significant increase in plasma fibrinogen in Volunteers with low PCV after treatment and in control volunteers with normal PCV compared to the value of the parameter obtained before treatment (P < 0.05). There was a significant increase in hematocrit in Volunteers with low PCV after treatment and in control volunteers with normal PCV compared to the value of the parameter obtained before treatment (P < 0.05). There was a significant increase in plasma CRP in volunteers with low PCV before treatment compared with the results obtained in the control volunteers with normal PCV (P < 0.05). Conclusion: There was a significant increase in plasma fibrinogen and hematocrit following the administration of the raw liquid extract while there was a significant increase in CRP in volunteers with low PCV before the administration of the liquid extract of S. biafrae (wòròwó) which signify an increase in acute phase reaction or reactants due to the administration of raw liquid extract and when the hematocrit was low.

Keywords: Acute phase reaction, low hematocrit, raw liquid extract, Solanecio biafrae (wòròwó)


How to cite this article:
Olaniyan MF, Ojediran TB, Olayinka SG. Acute phase response in anemic patients who received raw liquid extract of the leaves of Solanecio biafrae (wòròwó) to increase their hematocrit. Dent Med Res 2020;8:54-8

How to cite this URL:
Olaniyan MF, Ojediran TB, Olayinka SG. Acute phase response in anemic patients who received raw liquid extract of the leaves of Solanecio biafrae (wòròwó) to increase their hematocrit. Dent Med Res [serial online] 2020 [cited 2020 Dec 2];8:54-8. Available from: https://www.dmrjournal.org/text.asp?2020/8/2/54/295863




  Introduction Top


Solanecio biafrae (wòròwó) is a popular vegetable in South-Western Nigeria used as dish taking along with meals. The plant extract has been used traditionally in Yoruba land, Nigeria, to stop bleeding from cuts or injury, cough-cure, and heart-troubles.[1],[2],[3]

S. biafrae (wòròwó) leaves contains health benefit bioactive phytochemicals and phytonutrients such as tannins, saponins, flavonoids, alkaloids, anthocyanin and betacyanin, glycosides, terpenoids, coumarins, Na, Ca, Fe, P, K, Zn, Cu, Mg and Mn.[4],[5],[6]

Anemia is a disease condition whereby the packed cell volume (PCV) is <35% for females and <40% for males. Blood transfusion is required when the PCV falls below 18%–24% which also depend on the clinical presentation.[7],[8],[9]

Haptoglobin is an acute phase protein or reactant whose levels in the blood increases in response to infection, inflammation, burns, surgery and trauma.[10],[11],[12] Haptoglobin is synthesized in the liver and measured to diagnose hemolytic anemia and to distinguish it from other types of anemia.[13],[14] The Haptoglobin level decreases in hemolytic anemia due to red blood cell destruction leading to release of excess hemoglobin as excess hemoglobin will in turn bind with more Haptoglobin.[10],[11],[12] Low level can also be found in liver disease. In the blood haptoglobin binds to free plasma hemoglobin, to allow degradative enzymes gain access to the hemoglobin and to prevent loss of iron through the kidneys.[10],[11],[12] It also protects the kidneys from damage by hemoglobin.[13],[14] Although haptoglobin is synthesized majorly by hepatic cells can by be produced by other tissues such as skin, lung and kidney.[13],[14],[15],[16],[17],[18],[19]

The C–reactive protein (CRP) is an acute phase reactant or protein produced in the liver present in blood plasma.[20],[21],[22],[23] The plasma concentration of CRP increases during inflammation, infections and tissue injury like myocardial infarction.[24],[25],[26] Plasma concentration of CRP occurs much earlier compared to other acute phase reactants as it can be detected in the bloodstream within 4–6 h.[24],[25],[26]

Fibrinogen is a “positive” acute-phase reactant or protein produced in the liver which the blood levels rise in response to systemic inflammation, tissue injury, cancer, and infections.[27],[28],[29],[30] It is also elevated in various cancers. Fibrinogen is a glycoprotein blood coagulation factor I.[31],[32],[33],[34],[35] It is converted to form fibrin clot under the influence of thrombin.[36],[37] Reduced plasma fibrinogen can be found in congenital and acquired human fibrinogen-related disorders, bleeding disorders, and liver disease.[33],[34],[37]

This work was therefore designed to determine acute phase reaction in anemic patients who received raw liquid extract of the S. biafrae (wòròwó) leaves to increase their PCV.


  Materials and Methods Top


Study area

The study area includes seven herbal homes in Owo local government area of Ondo state in Owo-Ose Federal constituency in Ondo State, Nigeria.

Study population

Forty-three individuals with low PCV (PCV 27 ± 2.0; Female–22; Male-21; age–18–61 years) and 50 age-matched volunteers with normal PCV (PCV 41 ± 2.0; Female-25; Male-25) who were negative in reaction to Giemsa thick-blood film staining for Plasmodium spp., Stool microscopy for hookworm, Ziehl–Neelsen staining for acid fast bacilli (AFB), human immunodeficiency virus (HIV), anti-HCV and HBsAg ELISA.

Preparation and administration of leaf extract

On daily basis especially in the morning leaves of S. biafrae (wòròwó) were plucked and presented for confirmation by the Department of Biological Sciences, Achievers University, Owo–Nigeria.

After every confirmation, the leaves were washed using sterile water/containers and blended making use of electronic blender without any addition of water. The blended leaves were pressed on a sterile sieve for the extraction of the raw liquid content. This preparation was repeated on daily basis. Sixty ml of the raw liquid extract of the leaves was given to each of the individuals with low PCV for at least 14 days until the PCV increases.

Inclusion criteria:

  1. Volunteers who were not infected with Plasmodium, hookworm, Ziehl–Neelsen AFB, HIV, HCV and HBV
  2. Volunteers with low PCV who were not on any anti-anemic therapy and volunteered to be treated in the herbal homes.


Ethical consideration

The proposal of this work was generate. The proposal was presented, reviewed and approved by the Research and Ethical Committee of the Department Of Medical Laboratory Science, Achievers University, Owo, Nigeria before the commencement of the work. The consent of each of the volunteers was also obtained.

Data analysis

The results was collated and subjected to statistical analysis using International Business Machines Corporation-IBM SPSS 20.0 in New York to determine mean, standard deviation, probability, and Student's t-test.

Laboratory methods

Giemsa thick blood film for Plasmodium, stool microscopy for hookworm, microhematocrit method for PCV and Ziehl–Neelsen staining for AFB.

These tests were determined in the subjects as described by Cheesbrough.[38]

Anti-HCV ELISA assay

This was determined in the volunteers using Abcam kit.

Human immunodeficiency virus ELISA test

HIV was determined in the volunteers using Genscreen™ ULTRA HIV Ag-Ab Biorad Kit.

The Genscreen™ ULTRA HIV Ag-Ab is an ELISA method based on the principle of the sandwich technique for the detection of HIV antigen and of the various antibodies associated with HIV-1 and/or HIV-2 virus in human serum or plasma.

HBsAg ELISA test

This was assayed in the volunteers using Biorad ELISA kit.

C-reactive protein

This was assayed in the blood samples of the volunteers using Randox kit.

Haptoglobin

This was assayed in the blood samples of the volunteers using Randox kit.

Fibrinogen

This was assayed in the blood samples of the volunteers using Randox kit.


  Results Top


There was a significant increase in plasma fibrinogen in Volunteers with low PCV after treatment and in control volunteers with normal PCV compared to the value of the parameter obtained before treatment [P < 0.05; [Table 1], [Table 2] and [Figure 1].
Table 1: Mean and standard deviation of the hematocrit, haptoglobin, C-reactive protein, and fibrinogen in the subjects

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Table 2: The probability and t-test values of hematocrit, haptoglobin, C reactive protein, and fibrinogen in the subjects

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Figure 1: Comparative description of packed cell volume, haptoglobin, fibrinogen and c reactive protein

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There was a significant increase in hematocrit in volunteers with low PCV after treatment and in control volunteers with normal PCV compared to the value of the parameter obtained before treatment [P < 0.05; [Table 1], [Table 2] and [Figure 1].

There was a significant increase in plasma CRP in volunteers with low PCV before treatment compared with the results obtained in the control volunteers with normal PCV [P < 0.05; [Table 1], [Table 2] and [Figure 1].

There was no significant difference in the value of hematocrit, CRP, haptoglobin, and fibrinogen in the results obtained in volunteers with low PCV after treatment and control volunteers with normal PCV [P > 0.05; [Table 1], [Table 2] and [Figure 1].

There was no significant difference in the plasma values of CRP and haptoglobin in volunteers with low PCV before treatment and after treatment [P > 0.05; [Table 1], [Table 2] and [Figure 1].

There was no significant difference in the plasma value of haptoglobin in volunteers with low PCV before treatment and control volunteers with normal PCV [P > 0.05; [Table 1], [Table 2] and [Figure 1].


  Discussion Top


There was a significant increase in plasma fibrinogen in volunteers with low PCV after treatment and in control volunteers with normal PCV compared to the value of the parameter obtained before treatment.

These findings can be associated with possible acute phase reaction stimulated by the administration of the raw liquid extract leading to elevated plasma fibrinogen because fibrinogen is a positive acute-phase reactant of which the blood levels rise in systemic inflammation, tissue injury, and cancers. Acute-phase response is signified by either increase in the concentrations of certain protein (positive acute-phase proteins) or decrease (negative acute-phase proteins) in response to inflammation.[39],[40]

Another reason for increase in plasma fibrinogen and hematocrit after the administration of the raw liquid extract might be due to the nutritive and antioxidant constituent of the S. biafrae (wòròwó) leaves possibly stimulating erythropoiesis and fibrinogen synthesis.[1],[2],[3],[40]

There was a significant increase in hematocrit in volunteers with low PCV after treatment and in Control volunteers with normal PCV compared to the value of the parameter obtained before treatment. This might be due to the erythropoiesis stimulating property of raw liquid extract of S. biafrae (wòròwó) as it contains hemopoetic nutritive materials.[1],[2],[3]

There was a significant increase in plasma CRP in volunteers with low PCV before treatment compared with the results obtained in the control volunteers with normal PCV. CRP is a positive acute phase reactant.[20],[21],[22],[23] This can be explained as anemia is associated with fatigue and hypoxia oxidative stress also plays a role in which may cause oxygen reperfusion injury, strokes, and heart attacks which causes oxidative stress which will in turn stimulate the release of inflammatory cytokines especially interleukin (IL) 1, and IL6, and tumor necrosis factor α into the blood circulation to induce inflammation which stimulate liver to respond by producing many acute-phase reactants such as CRP.[39],[40]


  Conclusion Top


There was a significant increase in plasma fibrinogen and hematocrit following the administration of the raw liquid extract while there was a significant increase in CRP in volunteers with low PCV before the administration of the liquid extract of S. biafrae (wòròwó) which signify an increase in acute phase reaction or reactants due to the administration of raw liquid extract and when the hematocrit was low.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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