A dietary strategy for the management of artemether-lumefantrine-induced cardiovascular and renal toxicity.
BACKGROUND
Unsweetened natural cocoa has antimalarial properties. Unsweetened natural cocoa powder (UNCP), obtained as a result of the removal of cocoa butter from a cocoa bean protects against malaria episodes. Cocoa powder, which is prepared after removal of the cocoa butter, contains about 1.9 % theobromine and 0.21 % caffeine. Concomitant consumption of cocoa and artemether/lumefantrine (A/L) is a common practice in Ghana, West Africa. This study seeks to determine the elemental composition of UNCP and its protective effect on the heart and kidney against (A/L) administration.


METHODS
Energy dispersive x-ray fluorescence spectroscopy was used to detect the quality and quantity of the elemental composition in UNCP. Thereafter, 30 nonmalarious male guinea pigs were divided into five groups of six animals each. One group was administered with 75 mg/kg body weight A/L only and another group distilled water (control group). The rest received 300 mg/kg, 900 mg/kg and 1500 mg/kg body weight UNCP for 14 days orally and A/L for the last 3 days (ie day 11 to day 14). Biochemical and histopathological examinations were carried out after euthanisation of the animals.


RESULTS
A total of thirty-eight (38) micro and macro elements were detected with the ED-XRF. Macro elements like sodium (Na), magnesium (Mg), aluminium (Al), phosphorus (P), chlorine (Cl), potassium (K), calcium (Ca), manganese (Mn) and iron (Fe) and micro elements like chromium (Cr), copper (Cu), zinc (Zn), arsenic (As), and lead (Pb) were identified and evaluated. Biochemical analysis revealed increases in HDL levels (p>0.05) while there were decreases in LDL levels (p>0.05), creatine kinase and AST levels (P<0.05) in animals that received UNCP compared to A/L only administered group. Urea levels reduced significantly by 53 % (p<0.05) in group that received 1500 mg/kg UNCP. Histopathological examinations of the heart and kidney buttressed the protective effects of cocoa administration.


CONCLUSIONS
The percentage of recommended daily allowance of UNCP for chromium is 3750 % for men and 5250 % for women while % RDA for copper corresponds to 103.6 % in both sexes. UNCP proved to possess cardioprotective and renoprotective potential during artemether-lumefantrine administration.
Department of Pharmacology and Toxicology, College of Health Sciences, University of Ghana School of Pharmacy, P. O. Box LG 43, Legon, Ghana. asiedugyekye@yahoo.co.uk.
Isaac Julius
IJ
Asiedu-Gyekye
Department of Medical Laboratory Sciences, College of Health Sciences, School of Biomedical and Allied Health Sciences, Legon, Ghana.
Mahmood Abdulai
MA
Seidu
Department of Pharmacology and Toxicology, College of Health Sciences, University of Ghana School of Pharmacy, P. O. Box LG 43, Legon, Ghana.
Banga Benoit
BB
N'guessan
Department of Pharmaceutical Chemistry, College of Health Sciences, University of Ghana School of Pharmacy, Legon, Ghana.
Samuel
S
Frimpong-Manso
Department of Pharmacognosy and Herbal Medicine, College of Health Sciences, University of Ghana School of Pharmacy, Legon, Accra, Ghana.
Joseph Edusei
JE
Sarkodie
Department of animal experimentation unit, College of Health Sciences, Noguchi Memorial Institute for Medical Research, Legon, Accra, Ghana.
Samuel
S
Adjei
Department of Pharmacology and Toxicology, College of Health Sciences, University of Ghana School of Pharmacy, P. O. Box LG 43, Legon, Ghana.
Schevadnazy
S
Kutu
Department of Pharmacology and Toxicology, College of Health Sciences, University of Ghana School of Pharmacy, P. O. Box LG 43, Legon, Ghana.
Joseph
J
Osei-Little
Department of Pharmacology and Toxicology, College of Health Sciences, University of Ghana School of Pharmacy, P. O. Box LG 43, Legon, Ghana.
Alexander Kwadwo
AK
Nyarko
Department of Pharmaceutics and Microbiology, College of Health Sciences, University of Ghana School of Pharmacy, Legon, Ghana.
Philip
P
Debrah
D000818:Animals; D000962:Antimalarials / Q000009:adverse effects* / Q000737:chemistry; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000009:adverse effects* / Q000737:chemistry; D002099:Cacao / Q000737:chemistry*; D003402:Creatine Kinase / Q000097:blood; D004338:Drug Combinations; D064420:Drug-Related Side Effects and Adverse Reactions / Q000178:diet therapy*; D004983:Ethanolamines / Q000009:adverse effects* / Q000737:chemistry; D005449:Fluorenes / Q000009:adverse effects* / Q000737:chemistry; D006168:Guinea Pigs; D007668:Kidney / Q000187:drug effects; D008055:Lipids / Q000097:blood; D008297:Male; D028321:Plant Preparations / Q000008:administration & dosage / Q000627:therapeutic use*
D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; D008055:Lipids; D028321:Plant Preparations; D003402:Creatine Kinase
Artemether-Lumefantrine; Cocoa; EDXRF; Histopathology; Lipid profile; Renal function test