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Effects of Dang-Gui-Bu-Xue-Tang, an herbal decoction, on iron uptake in iron-deficient anemia

Authors Huang G, Chen S, Tsai P, Ganzon JG, Lee C, Shiah H, Wang C

Received 12 August 2015

Accepted for publication 14 October 2015

Published 2 March 2016 Volume 2016:10 Pages 949—957

DOI https://doi.org/10.2147/DDDT.S94309

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Prof. Dr. Wei Duan


Guan-Cheng Huang,1–3 Shih-Yu Chen,4 Po-Wei Tsai,5 Jerome G Ganzon,5 Chia-Jung Lee,6 Her-Shyong Shiah,7 Ching-Chiung Wang4,5

1School of Medicine, College of Medicine, Taipei Medical University, Taipei, 2Division of Hematology and Oncology, Department of Internal Medicine, Yuan’s General Hospital, 3Department of Leisure and Recreation Industry Management, College of Humanities and Management, Fooyin University, Kaohsiung, 4Graduate Institute of Pharmacognosy, College of Pharmacy, 5School of Pharmacy, College of Pharmacy, 6PhD Program for Clinical Drug Discovery of Chinese Herbal Medicine, College of Pharmacy, Taipei Medical University, 7Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan

Abstract: Dang-Gui-Bu-Xue-Tang (DBT), a combination of Angelicae Sinensis Radix and Astragali Radix, is a widely used herbal decoction in traditional Chinese medicine primarily to promote or invigorate the “blood”. In this study, we explored this ancient formulation and provide evidence of its blood-toning properties. We used the improvement iron uptake as promote or invigorate the “blood” indicator. Ferritin formation of Caco-2 cells in vitro assay and diet-induced anemia (DIA) in rat model were used to prove its improvement iron uptake and ameliorating effects. Finally, the iron–DBT interactions were measured by iron-bind­ing assay. We first demonstrated DBT increased uptake of ferrous iron through the biosynthesis of ferritin by Caco-2 cells and determined which complementary treatment would provide optimum results. Thereafter, effects of the treatment on improving the bioavailability of absorbed iron in the form of hemoglobin (Hb) were established using a DIA-animal model. The results showed that DBT slightly improved Hb levels compared with the baseline Hb and pretreatment with DBT for 2 hours prior to supplementation with ferrous sulfate provided the greatest gain in Hb levels in DIA rats. However, DBT and ferrous sulfate were co-treated with Caco-2 cell or DIA rats, the ferritin formation and Hb levels both were decreased. In iron-bind­ing assay, the DBT extract influenced the free Fe(II) type in the FeSO4 solution. Therefore, we suggest that complementary treatment with DBT and iron supplementation can have a strong ameliorating effect on iron-deficiency anemia in clinical settings, but needs a 2-hour interval of DBT administration prior to ferrous sulfate treatment.

Keywords: Dang-Gui-Bu-Xue-Tang, ferulic acid, iron uptake, ferritin, iron-deficiency anemia, herb–drug interaction

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