Ethnopharmacological Survey and Antisickling Activity of Plants Used in the Management of Sickle Cell Disease in Kikwit City, DR Congo

Abstract

Background. Sickle cell disease or drepanocytosis is the most known hemoglobin abnormality in the world. Recently, many medicinal plants used in the management of sickle cell disease in African traditional medicine have shown in vitro antisickling activity. Objective. This research study aims to document some Congolese plant species used in the management of sickle cell disease in Kikwit city and investigate their pharmacological property in vitro. Methods. A cross-sectional survey was done from June 2015 to March 2016 among 26 traditional healers in Kikwit city, Democratic Republic of Congo. Emmel test was used to assess in vitro antisickling activity. Habitat, morphological, biological types, phytogeographical distribution, local names, and used parts of these plant species were also determined. Results. Obtained results show that 23 plant species belonging to 16 families are used. The leaves represent the most used part (70%). Antisickling investigation showed that aqueous extracts of 18 plants (78%) exhibit a change in the shape of a sickle cell into a normal one with a normalized rate of at least 70%, confirming the in vivo effect observed by traditional healers when used as herbal medicine traditionally in the management of sickle cell disease. The evaluation of perimeter, surface, and radius of untreated and treated sickle red blood cells showed a significant difference ( $p<0.05$ ) as modification indicators of the red blood cell shape. Alchornea cordifolia, Alternanthera bettzickiana, Annona senegalensis, Dissotis brazzae, Hypoxis angustifolia, and Justicia secunda presented a very high antisickling activity with normalization >70%. Otherwise, Dissotis brazzae was the most active plant with a minimal concentration of normalization (MCN) of 11 μg/mL and a maximal normalization rate (NRmax) of 86%. Conclusion. Almost 80% of the plants studied showed interesting antisickling activity and justified their use in traditional medicine. The isolation of the molecules responsible for the biological activity of the most active plants and the determination of their chemical structures is under investigation.