Impact of Sappan Wood Extract as Iron Chelator Adjuvant on Iron Concentration and Macrophage Polarization in Rat Spleen.

BACKGROUND

Iron accumulation in the spleen of thalassemia patients disrupts macrophage polarization, impairs immune function, and increases mortality. Sappan wood ( L.) extract exhibits iron-chelating and immunomodulatory properties, making it a potential adjuvant with Deferiprone (DFP). This study aimed to assess the effects of Sappan wood extract (SWE) as a DFP adjuvant in rat models of iron overload.

METHODS

This experimental study was conducted from January to March 2024 at Padjadjaran University, Indonesia. Thirty-five rats were divided into seven groups: normal, iron overload (IO) induced by iron dextran (ID) at a cumulative dose of 60 mg/Kg body weight (BW), positive control receiving DFP, and four groups receiving DFP+SWE at different doses of 50, 100, 150, and 200 mg/Kg BW. Iron levels and macrophage polarization (pro-inflammatory M1 and anti-inflammatory M2) in the spleen were assessed.

RESULTS

SWE at 50 mg/Kg BW significantly reduced spleen iron levels to 60.77 ppm/mg and increased M2 intensity (P<0.001 compared to the IO group). At 100 mg/Kg BW, SWE effectively decreased M1 macrophage intensity (P=0.001 compared to the IO group).

CONCLUSION

SWE at 50 mg/Kg BW was comparable to DFP in reducing the spleen iron levels and M1 macrophage intensity, while 100 mg/Kg BW enhanced M2 macrophage polarization. These findings highlighted SWE's potential as a therapeutic adjuvant in IO conditions.