University of Khartoum

Phytochemical Constituents, Antioxidants Activity and Clinical Trials Provide Evidence for the Traditional use of Grewia tenax Fruits in Reversing Iron Deficiency Anemia

Phytochemical Constituents, Antioxidants Activity and Clinical Trials Provide Evidence for the Traditional use of Grewia tenax Fruits in Reversing Iron Deficiency Anemia

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Title: Phytochemical Constituents, Antioxidants Activity and Clinical Trials Provide Evidence for the Traditional use of Grewia tenax Fruits in Reversing Iron Deficiency Anemia
Author: AlMahdi, Randa AlSadig AlSiddig
Abstract: Background Replenishment of iron for patients with iron deficiency anemia (IDA) is facing real challenges like the limited bioavailability, complicated absorptive mechanisms and high toxicity. Alternative treatments of IDA also exist, among them standing prominently the traditional use of Grewia tenax fruit pericarp (GP) in Sudan. The aim of this research work was to validate the efficacy of GP in the treatment of IDA. Methodology The dried fruit pericarp GP and chewable tablets based on Grewia tenax fruit pericarp of Sudanese origin, under the trade name Tonigrow® were extracted by aqueous alcohol. The concentrated extracts were sequentially fractionated by chloroform and ethyl acetate. Each of the extracts and their respective fractions were subjected to different qualitative and quantitative analyses to identify contents of proteins, fibers, vitamin C and minerals (magnesium, calcium, copper, iron and zinc). Secondary metabolites were identified by applying liquid chromatography coupled to tandem mass spectrometry (LC/MS/MS) and in vitro inhibition of 2,2-diphenyl-1-picrylhydrazyl (DPPH) was done to assess the radical scavenging powers of the extract and its fractions. An in vitro model involving the everted rat gut sac (ERGS) model was to study the effect of GP on iron transfer across the rats' duodenal membrane. Two interventional clinical trials approved by the University of Science and Technology Research Ethical Committee, were conducted, in adults and in children. Thirty four consented adults were recruited in age ranges of 18-50 years, in whom, Tonigrow® tablets were compared to the standard ferrous preparation (FP) over one month. For the thirty children selected from a private clinic in Khartoum, Tonigrow® tablets were added to half of the participants to be compared with the regimen without GP. The treatment was extended for two and a half months. The obtained hematological measurements of participants were directly discussed on individual bases. Results Constituents in GP extract and Tonigrow® tablets revealed approximately more or less similar quantities of fibers, ascorbic acid, potassium, magnesium, iron , calcium and zinc. Twenty two secondary metabolites, known to have potent radical scavenging activities, were identified in the aqueous GP extract and its respective fractions. The in vitro inhibition of DPPH has confirmed potent radical scavenging activities of GP extract and fractions. Results of hematological measurements in the clinical trials, have shown modest increase in many participants. Conclusion Grewia tenax pericarp has improved IDA in some of the subjects, in a different pattern from that of ferrous salts with initial improvement on hematological picture, followed by inhibition of iron absorption. This paradox may be explained by presence of the prominent antioxidants which “optimize” iron absorption, at the cellular level of iron homeostasis. It was concluded that the traditional use of GP against IDA is justified and it may be a good candidate in the treatment of IDA.
Description: 222page
URI: http://khartoumspace.uofk.edu/123456789/23888


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