Department of Zoology and Environment Sciences, Faculty of Science, University of Colombo, Colombo 3, Sri Lanka.
Industrial Technology Institute, Colombo 7, Sri Lanka; Department of Basic Science and Social Science, Faculty of Nursing, University of Colombo, Sri Jayewardenepura, Thalapathpitiya, Nugegoda, Sri Lanka.
J Ethnopharmacol. 2022 Oct 5;296:115511. doi: 10.1016/j.jep.2022.115511. Epub 2022 Jun 30.
Carica papaya L., a common fruit crop of the family Caricaceae and its leaf juice/extract is a traditionally commended preparation against dengue and other thrombocytopenic diseases by many Asian countries.
The present study posits the potential cellular mechanisms of platelet augmentation activity of mature leaf juice of Sri Lankan wild-type Carica papaya.
C. papaya leaf juice prepared from different cultivar types, maturity of the leaf, agro-climatic region, and preparation methods were orally administered to hydroxyurea-induced thrombocytopenic rats at 0.72 ml/100 g BW dosage to investigate the most potent platelet increasing preparation. The papaya juice doses; low dose (LD-0.18 ml/100 g BW), human equivalent dose (HED-0.36 ml/100 g BW), and high dose (HD-0.72 ml/100 g BW), were administered to thrombocytopenic rats (N = 6/group) daily for three consecutive days and post-treatment plasma levels of interleukin 6 (IL-6), thrombopoietin (TPO), and platelet-activating factor (PAF) were quantified using specific rat ELISA kits. The mature leaf juice of C. papaya induced IL-6 secretion from bone marrow cell (BMC) cultures was quantified using ELISA. The ability of papaya juice to protect the platelet membrane, from the damage caused by the lytic agent was analyzed in vitro using the lactate dehydrogenase (LDH) assay. The effect of the mature leaf juice of C. papaya on secondary hemostasis was investigated using blood coagulation and clot hydrolyzing activity.
The comparative analysis revealed that the platelet increasing activity of C. papaya leaf did not significantly differ among different types of cultivar, maturity of the leaf, agro-climatic regions and preparation methods (p > 0.05). Both TPO and PAF levels in thrombocytopenic rats diminished when treated with all three doses of the mature leaf juice of C. papaya (p < 0.05), yet IL-6 plasma level was unaltered (p > 0.05). Nevertheless, ex vivo treatment of the mature leaf juice of C. papaya had significantly enhanced IL-6 levels of rat BMC cultures (p < 0.05). Pre-treatment of platelets with the mature leaf juice of C. papaya at different concentrations significantly inhibited LDH leakage from platelets and may have reduced the membrane damage caused by the lytic agent (p < 0.05). Treatment of mature leaf juice of C. papaya also significantly reduced blood clotting time through the extrinsic pathway of the blood coagulation cascade (p < 0.05). Further, prolonged incubation of the plasma clot with different concentrations of the papaya leaf juice revealed dose-dependent hydrolysis of the blood clot, indicating fibrinolysis activity.
The current study exceeded the traditional medicinal claims, and scientifically affirmed the platelet augmentation activity of mature leaf juice of C. papaya. The mechanistic rationale tested herein explicated that the platelet augmentation activity of the papaya leaf juice can be partially attributed to the stimulation of bone marrow megakaryocytes via modulating thrombopoietic cytokines TPO and IL-6, and by inhibiting the secretion of PAF, while reducing the peripheral platelet destruction by stabilizing the platelet membrane. Further, mature leaf juice of C. papaya imparted both pro-coagulation and fibrinolysis activity of secondary hemostasis endorsing its potential against thrombocytopenia.
番木瓜(Carica papaya L.),番木瓜科的常见水果作物及其叶汁/提取物是许多亚洲国家传统上推荐用于对抗登革热和其他血小板减少性疾病的制剂。
本研究提出了斯里兰卡野生型番木瓜成熟叶汁对血小板增加活性的潜在细胞机制。
以羟脲诱导的血小板减少症大鼠为模型,采用不同品种、叶片成熟度、农业气候区和制备方法的番木瓜叶汁,经口给予 0.72ml/100g BW 剂量,以研究最有效的血小板增加制剂。番木瓜汁剂量;低剂量(LD-0.18ml/100g BW)、人类等效剂量(HED-0.36ml/100g BW)和高剂量(HD-0.72ml/100g BW),每日连续 3 天给予血小板减少症大鼠(每组 6 只),并使用特定的大鼠 ELISA 试剂盒检测治疗后血浆中白细胞介素 6(IL-6)、血小板生成素(TPO)和血小板激活因子(PAF)的水平。采用 ELISA 定量测定番木瓜成熟叶汁对骨髓细胞(BMC)培养物中 IL-6 分泌的影响。采用乳酸脱氢酶(LDH)测定法分析番木瓜汁对血小板膜的保护作用,防止其受到裂解剂的破坏。使用凝血和血凝块水解活性,研究番木瓜成熟叶汁对二级止血的影响。
比较分析表明,番木瓜叶的血小板增加活性在不同品种、叶片成熟度、农业气候区和制备方法之间没有显著差异(p>0.05)。用三种剂量的番木瓜成熟叶汁治疗血小板减少症大鼠后,TPO 和 PAF 水平均降低(p<0.05),但 IL-6 血浆水平未改变(p>0.05)。然而,番木瓜成熟叶汁的体外处理显著增强了大鼠 BMC 培养物中 IL-6 的水平(p<0.05)。用不同浓度的番木瓜成熟叶汁预先处理血小板,可显著抑制 LDH 从血小板中漏出,并可能减轻裂解剂引起的膜损伤(p<0.05)。番木瓜成熟叶汁的治疗还通过血液凝固级联的外源性途径显著缩短了血凝块形成时间(p<0.05)。此外,用不同浓度的番木瓜叶汁孵育血浆凝块,可观察到剂量依赖性的血凝块水解,表明存在纤维蛋白溶解活性。
本研究超出了传统医学的说法,并从科学上证实了番木瓜成熟叶汁对血小板的增加作用。在此测试的机制原理表明,番木瓜叶汁的血小板增加作用部分归因于通过调节促血小板生成细胞因子 TPO 和 IL-6 刺激骨髓巨核细胞,并通过抑制 PAF 的分泌,同时通过稳定血小板膜减少外周血小板的破坏。此外,番木瓜成熟叶汁还具有促进凝血和纤维蛋白溶解的二级止血作用,这表明其具有抗血小板减少的潜力。