#9 New herbal drug discovery for sickle cell disease: From ethnopharmacological claims to commercialization

Abstract

Sickle cell disease is an inherited blood disorder that affects red blood cells. People with sickle cell disease have red blood cells that contain mostly hemoglobin S, an abnormal type of hemoglobin. The most common being Sickle Cell Anemia (SS), Sickle-Hemoglobin C Disease (SC), Sickle Beta-Plus Thalassemia and Sickle Beta-Zero Thalassemia. Health maintenance for patients with sickle cell disease starts with early diagnosis, preferably in the newborn period and includes penicillin prophylaxis, vaccination against Pneumococcus bacteria and folic acid supplementation. Patients frequently experience a vicious circle of events called a “Sickle cell disease crisis”, in which low oxygen tension in tissue causes sickling, which leads to ruptured RBC and further leads to a serious decrease in RBC count and more sickling which often causes death. In search for a substance that can prevent red blood cells from sickling without causing harm to other parts of the body, hydroxyurea was found to reduce the frequency of severe pain, acute chest syndrome and the need for blood transfusions in adult patients with sickle cell disease. The health care cost of the management of sickle cell disease patients is disproportionately high compared to the number of people afflicted by the disease. Poor people cannot afford the high cost of treatment. Due to the debilitating effect and cost of managing sickle cell disease, research has been ongoing to determine the efficacy of the use of medicinal plants to tackle the multiple challenges presented in sickle cell disease. It is therefore evident that there is a very high need of new drugs which must have low toxicity and marked antisickling activity. Literature survey revealed many plants having significant antisickling and some of them are used by medical practitioners in certain parts of the world for treating Sickle cell anemia. However, despite the long-standing problem of sickle cell disease, the above information did not lead to the development of a standardized remedy for the treatment and management of Sickle cell anemia. The Research work discussed herewith comprises the development of an effective pharmaceutical dosage composition of the Wrightia tinctoria family Apocyanaceae, seeds extract for the treatment and management of Sickle cell disease. The studies include acute and sub-acute toxicity studies, Antisickling assay, and the further clinical studies of the formulation. The success story of the new drug discovery using the traditional Indian medicinal plant and its ethnomedical history has been unraveled in detail.