Herbal Drug Use In Sickle Cell Disease Management; Trends And Perspectives In Sub-Saharan Africa.

Introduction Nigeria has the largest burden of Sickle Cell Disease (SCD) with estimated 100,000 new born affected annually. SCD is a hemoglobin (Hb) disorder with the major form resulting from the substitution of a polar glutamate (Glu) by non-polar Valine (Val) in an invariant region, of Hb chain-subunit. Species of Hb found in sickle cell trait are HbA and HbS at a 60:40 proportion, in SCD only HbS, in the HbC disease only HbC, and in the SC disease it's HbS and HbC in a 50:50 equal proportion. Objective This paper reviews herbal medicines usagein sub-Saharan Africa (sSA) to ameliorate the crisis associated with SCD.The model Hb tetramer, suggest a higher membrane affinity of HbS and HbC, promoting dehydration of RBCs, with concomitant in vivo crystallization. Some drawback using these herbal drugs includes; poorbioavailability and the lack of proper pharmacovigilance monitoring procedures arising from weak governance structure combined with under reporting of herbal usage tophysicians was also discussed. Probable epigenetic loci that could be targeted using phytomedicines for effective SCD management are discussed. Methods Using search engines, several databases including Google scholar, PubMed, Academic Resource Index were utilized to source for relevant publications/literatures. The protein coordinates for the Hb tetramer were obtained from the Protein Data Bank (PDB). Conclusion Manipulation of epigenetics to achieve better SCDmanagement involvescareful thinking.Herein, we discuss some epigenetic interactionsthat could be putatively tweaked with a view to enhancing solublebioactive small molecular components with potential to reactivate γ -globin genes, boosting immune response in-patient with SCD.