Abstract
<p><strong>Objective: </strong>Kāntam based formulations are unique herbo-metallic preparations, used in Siddha system of medicine (Indian traditional medicine) for managing various haematological complications. Their therapeutic doses were also well established in Siddha literature. In this work an attempt was made to understand the comparative effect of three different kāntam formulations in the management of hemolytic complications.</p><p><strong>Methods: </strong>Hemolysis was induced in Wistar rats by intraperitoneal injection of acetylphenylhydrazine. Three different kāntam formulations (Kāntac centūram1 (K1), Kāntac centūram2 (K2) and Kāntap paṟpam (K3) were administered with proper controls at their therapeutic doses (20.0 mg/day) for a period of 20 d. Cage side observations, hematological, biochemical and histopathological analysis were performed to understand the effect of the formulations.</p><p><strong>Results: </strong>Cage-side observations revealed that only K1 is effective in curing oral ulcers formed during hemolysis. Haematological analysis revealed the effect of K1 and K3 in regulating reticulocyte maturation and effect of K1, K2 and K3 in the removal of extracellular haemoglobin. Histopathological analysis revealed the effect of K1 in regulating stress erythropoiesis and effect of K1, K2 and K3 in regulating kupffer cells in the liver. Overall, the kāntam formulations demonstrate an appreciable relevance (in managing hemolytic conditions) within the contemporary pharmacological parlance.<strong></strong></p><p><strong>Conclusion: </strong>Our study demonstrated the effective role of Kāntam formulations in the treatment of hemolytic complications by promoting reticulocyte maturation, removing extracellular haemoglobin, regulating stress erythropoiesis in the spleen, regulating kupffer cells in the liver and preventing oral ulcers. However, all the three formulations did not show all the activities and differ in efficacy profile.</p>
Highlights
Hemolysis, a mechanism that involves rupture of erythrocytes is relatively rare pathological process seen in some types of poisoning [1], snake bites [2], infections [3, 4], blood transfusions and autoimmune disorders [5]
Oral ulcers appeared in animals of all the groups injected with acetyl phenylhydrazine (APH) on the day1
APH is an oxidant chemical that primarily destroys the mature erythrocytes by its effect on enzymes involved in energy metabolism, which, in turn, induces erythropenia leading to an accelerated erythropoiesis resulting in reticulocytosis [24]
Summary
A mechanism that involves rupture of erythrocytes is relatively rare pathological process seen in some types of poisoning [1], snake bites [2], infections [3, 4], blood transfusions and autoimmune disorders [5]. The associated pathologies of hemolysis mainly include fever, splenomegaly, hepatomegaly and anemia [9]. The conventional management of autoimmune hemolysis includes corticosteroids and immunosuppressive drugs [10]. Management of drug/agent-induced hemolytic anemia includes the immediate removal of the offending agent followed by supportive care along with the conventional therapies [6]. Various approaches have been proposed to reduce drug-induced hemolysis such as drug polymer conjugation, modification in molecular chemistry of drug molecules, co-administration of botanical agents, etc., [11]. When the hemolysis, irrespective of the cause, gets severe, the treatment is a very challenging task and may results in splenectomy if the patient is not responsive to first line of conventional therapies [12]. The requirement for other alternative drugs is wide open in managing hemolytic complications
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