RESUMO
Ankaferd blood stopper is a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica and has been used as a topical hemostatic agent and with its clinical application established in randomized controlled trials and case reports. Ankaferd has been successfully used in gastrointestinal endobronchial mucosal and cutaneous bleedings and also in abdominal, thoracic, dental and oropharyngeal, and pelvic surgeries. Ankaferd's hemostatic action is thought to form a protein complex with coagulation factors that facilitate adhesion of blood components. Besides its hemostatic action, Ankaferd has demonstrated pleiotropic effects, including anti-neoplastic and anti-microbial activities and tissue-healing properties; the underlying mechanisms for these have not been well studied. Ankaferd's individual components were determined by proteomic and chemical analyses. Ankaferd also augments transcription of some transcription factors which is shown with transcriptomic analysis. The independent effects of these ingredients and augmented transcription factors are not known precisely. Here, we review what is known of Ankaferd blood stopper components from chemical, proteomic, and transcriptomic analyses and propose that individual components can explain some pleiotropic effects of Ankaferd. Certainly more research is needed focusing on individual ingredients of Ankaferd to elucidate their precise and effects.
RESUMO
BACKGROUND AND PURPOSE: Endothelial dysfunction may play a role in the pathogenesis of the slow coronary flow (SCF) phenomenon. A detailed examination of blood cellular components has not been performed for this condition. We investigated the relationship between SCF and whole blood cell counts. METHOD: Records of 17,315 patients who underwent coronary angiography between January 2006 and December 2012 were evaluated retrospectively. A total of 146 patients with SCF were compared with 148 patients with normal coronary arteries according to demographic data, complete blood count, and biochemical parameters. RESULTS: The following parameters were significantly higher in SCF patients than in patients with normal coronary arteries: percentage of smokers (36.3% vs. 25%, p=0.036), body mass index (26.69 ± 2.84 vs. 26.07 ± 3.15, p=0.049), white blood cells (WBCs) (7.52 ± 1.43 × 10(3)mm(-3) vs. 7.01 ± 1.42 × 10(3)mm(-3), p=0.002), red cell distribution width (RDW) (13.68 ± 1.42% vs. 13.15 ± 1.13%, p<0.001), platelets (250.29 ± 50.96 × 10(3)mm(-3) vs. 226.10 ± 38.02 × 10(3)mm(-3), p<0.001), plateletcrit (PCT) (0.214 ± 0.40% vs. 0.184 ±0.29%, p<0.001), mean platelet volume (8.63 ± 1.10fL vs. 8.22 ± 0.83 fL, p<0.001), platelet distribution width (PDW) (16.58 ± 0.76% vs. 16.45 ± 0.57%, p=0.028), and neutrophils (4.44 ± 1.25 × 10(3)mm(-3) vs. 4.12 ± 1.24 × 10(3)mm(-3), p=0.029). Positive PCT values [odds ratio (OR), 4.165; 95% confidence interval (CI), 2.493-6.959; p<0.001) and RDW (OR, 1.304; 95% CI, 1.034-1.645; p=0.025) were independent predictors of SCF. CONCLUSION: Although within the normal range, the increased numbers of WBCs and neutrophils in patients with SCF suggest that SCF may be a subclinical inflammatory condition. Furthermore, increased RDW and PDW in SCF patients may cause microvascular blood flow resistance due to impaired cell deformability. The PCT provides reliable data regarding total platelet mass and may be a useful predictor of SCF.
