{{Recent studies estimate that about 89 per cent of persons with sickle cell disorder (SCD) worldwide are in Africa, of which Nigeria alone constitutes 25 per cent. Europe has the least, 0.1 per cent, while the United States of America (USA), Asia and the Mediterranean have 3.5 per cent each.}}
However, most current works on the development of specific therapy for sickle cell anaemia include the discovery of Hemoglobin modifiers, membrane modifiers and genetic modifiers among others.
Several studies have shown that some of the orthodox modes of treatment of SCD include induction of fetal hemoglobin (HbF) using HydroxyUrea (HU), Butyrate or its derivatives, oral administration of Clotrimazole, which is a potent Gardos Channel inhibitor; blood transfusion and Haematopoetic cell Transplantation (HCT).
Although, the successful use of HU was reported in children, however, side effects or poor drug efficacy of some of these agents poses problems for many patients. In addition, the high cost of HCT is hardly affordable by most sickle-cell disease patients in Nigeria and other developing countries.
However, herbal medicines have come to the rescue. They are accessible and cheap. Nigerians were last year reassured by the Minister of State for Health, Prof. Muhammad Ali Pate, that the only Nigerian herbal drug that has received global acceptance and patents for treating sickle cell anaemia, NIPRISAN, developed by researchers at the Nigeria Institute of Pharmaceutical Research and Development (NIPRD), will be back into the market after almost 10 years of stopping production due to property right and financial issues.
Scientists especially those at NIPRD have continued to identify and validate new candidates.
According to a recent study published in the journal Anaemia, three new anti-sickling herbs: Entandrophragma utile; Chenopodium ambrosioides; and Petiveria alliacea were reported in May 2011. At NIPRD, where NIPRISAN was developed, three other recipes are currently awaiting development.
Entandrophragma utile is commonly called African cedar, Sapele mahogany, Ashanti cedar and is of the plant family Meliaceae.
Commonly called Indian wormseed, sweet pigweed, Mexican tea, Jesuit’s tea, Chenopodium ambrosioides belongs to the plant family Chenopodiaceae. It is called ewe imí (leaf of excreter) in Yoruba.
Petiveria alliacea is commonly called guinea-hen weed in English and ojú sajú in Yoruba.
The study raised the hope that the search in the Tropics for more effective herbal recipes for managing sickle cell anaemia will be more fruitful with time and effort.
The study is titled “Traditional Herbal Management of Sickle Cell Anemia: Lessons from Nigeria.”
The researchers from the Department of Medicinal Chemistry and Quality Control, NIPRD, Abuja, and Department of Pharmaceutics & Medicinal Chemistry, Niger Delta University, Wilberforce Island, Amassoma, wrote: “Among the Efik and Ibibio, Hausa, Igbo, Idoma, and Yoruba: clove (Eugenia caryophyllata or “kanunfari” in Hausa; Piper guineense (“eche” in Idoma or “akwa-ose” in Igbo); grains of paradise (Aframomum melegueta or “otuta” in Idoma); Sorghum bicolor (the leaf stalk yields an extract that looks like blood); Pterocarpus osun (common in the Yoruba state of Osun) are used in various health conditions, including sickle cell anemia.
“As stated earlier E. caryophyllata, P. guineense, P. osun, and S. bicolor are the herbal components of the Yoruba recipe upon which the anti-sickling drug Niprisan is based. Prior to the era of Niprisan these herbs were either extracted with “ogogoro” (ethanolic distillate of palm wine) or with an aqueous solution trona (sodium sesquicarbonate—a mineral used in Nigeria as tenderizer). Niprisan has passed phases IIA and IIB, and is widely used in Nigeria, and is known or popular in India and the United States of America (USA).”
In 2010, Swift of COSMID Corporation, USA, stated the following: “A dried extract of four plants has been used to treat patients with SCD in Nigeria for many years (NIPRISAN).
It has been through multiple clinical trials in Nigeria and has been formally approved for use in that country since 2006 for the treatment of Sickle Cell Disease (SCD). The United States Food and Drug Administration (US FDA) has determined there is sufficient safety and efficacy data for NIPRISAN to start a Phase III clinical trial.
The US FDA Botanical Review Team (BRT) suggested a simpler formulation of NIPRISAN, development of a chemical fingerprint for the formulation using LC/MS and elucidation of some of the anti-sickling compounds in the formulation would improve standardisation and increase the probability of obtaining FDA marketing approval.”
The researchers said that to the best of their knowledge phase III trial of Niprisan is yet to be reported. “We did however suggest in 2011 that phytocannabinoids and vanilloids in E. caryophyllata and P. guineense may account for some of the useful effects of Niprisan in sickle cell crisis. Some of these compounds, including shikimic acid derivatives (vanilloids) and cannabinoids are indicated, respectively,” they wrote.
This is the testimony of one of the American doctors: “Doctors in Nigeria use Fagara (Fagara zanthoxyloides) to reduce the painful crisis of the genetic disease, sickle cell anemia.
This herb has a variety of unusual properties that reduce platelet and blood cell sticking. After reading the reports from Nigeria many years ago, I decided to try fagara’s relative prickly ash bark for the same indication.
“I made a simple tincture of 50 per cent prickly ash bark and 50 per cent ginkgo leaf, and gave it to a young African-American girl in the first grade who constantly missed school and needed to be hospitalized three to four times per year due to the painful sickle cell crisis.
I gave her about 25 drops three times a day. She immediately stopped having serious problems, her thinking was no longer fuzzy, the frequency of her attacks went down to about one per year, and the severity of the attacks decreased appreciably.
This success has continued through the years, as long as she takes her medicine. I saw her last year, and she has blossomed into a beautiful junior high school student, the sickle cell disease now only a bit-player in the background of her life.
{NgrGuardian}
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