Blood: The essential fluid that carries out the critical functions of transporting oxygen and nutrients to our cells and getting rid of carbon dioxide, ammonia, and other waste products.
The average adult has about five liters of blood
Red Blood Cells (RBCs)
White Blood Cells (WBCs)
Platelets or Thrombocytes
Red Blood Cells (RBCs): A cell that transports oxygen and carbon dioxide to and from the tissues, contains hemoglobin, and lacks a nucleus. Also called erythrocyte, red cell, also called red corpuscle.
White Blood Cells: A cell that lack hemoglobin, colorless and with nucleus. Its primary role involves the body's immune system, protecting the body against invading microorganisms and foreign particles.
Blood Plasma: Pale-yellow liquid normally holds blood cells in whole blood in suspension. It makes up about 55% of total blood volume.
Platelets (Thrombocytes): Platelets are small blood components that help the clotting process by sticking to the lining of blood vessels. Platelets are made in the bone marrow and survive in the circulatory system. A normal platelet count in a healthy individual is between 150,000 and 450,000 per ?L (microlitre) of blood.
Thrombocytopenia is a lower than normal number of platelets (Low Platelet Count) in the blood. The number of platelets in the blood is referred to as the platelet count and is normally between 150,000 to 450,000 per micro liter (one millionth of a liter) of blood. Platelet counts less than 150,000 are termed thrombocytopenia.
Bleeding of the gums
Rash (red, pinprick-sized spots on the skin)
Skin discoloration such as bruising
Severe or uncontrollable bleeding
Liver Cirrhosis / Dialysis
Idiopathic Thrombocytopenic Purpura (ITP)
Drug Induced Thrombocytopenia
Malaria / Viral
Treatment may vary as per origin, few very common treatment options-
A. Corticosteroids Limitations:
No significant difference between the patient groups regarding their lowest platelet count or the duration they were treated with corticosteroids.
European Journal of Hematology 83 (497-498)
Adverse effects: Osteoporosis, high blood sugar, cataracts, insomnia, weight gain, bloating, acne, stomach problems, etc.
Relapse after discontinuing corticosteroids.
B. High dose Intravenous immunoglobulin & anti-D immune globulin Limitations:
According to new researches immunoglobulin has been failed to produce desired results (Am J Trop Med Hyg. 2007 Dec; 77(6):1135-8.)
Adverse effects: occur soon after infusions and can include headache, flushing, chills, wheezing, tachycardia, lower back pain, nausea, and hypotension.
No oral therapy is available, inconvenient to patient
Cost of Therapy - 16000 to 48000 Iviglob-EX from VHB [Human Normal Immunoglobulin] - MRP- 15999/-
C. Thrombopoietin & Thrombopoietin mimetics Limitations: 1. Adverse effects:
Marrow fibrosis possibly due to abnormal increase in megakaryocytic
2. Injectable form, very inconvenient
D. Eltrombopag (thrombopoetin receptor antagonist)E.g. Revolade - GSK
Indicated only for adult chronic immune (idiopathic) thrombocytopenic purpura (ITP) Cost of therapy - 25,000 to 50,000
Liver problems : Eltrombopag may damage liver & cause serious, even life threatening illness
Hyper -stimulation of bone marrow
Nausea / diarrhea / vomiting
Headache, numbness or tingling of skin
E. Platelet Transfusion Limitations:
Cost/Transfusion Symptomatic recovery as bone marrow remain in depressed state.
Natural product drug discovery programs play a significant role in the clinical development of new therapies in the biopharmaceutical industry. Looking back at the outcome of the drug discovery process since 1994 illustrates this to be true as nearly half of all drugs were based on natural products. Some commonly used naturally derived medicines are:
In various clinical references, it has been demonstrated that natural remedies like papaya leaf extract increase low blood platelet count instantly. Various dosage forms of Papaya leaf extracts as single drug or in combination of other drugs is an ideal solution of Thrombocytopenia. Numerous patents had been applied worldwide after looking into the potential of natural remedies for a complex problem. C. papaya & T. cordifolia has been classified in Indian Pharmacopeia as well.
Pharmacological classification: Dietary Supplement
Carica papaya extract
Tinospora cordifolia extract
Pharmacological ActionBone marrow stimulator
CarIca papaya is a rich source of complex biochemical constituents including flavonoids, glycosides, alkaloids, glutathione & glucosinolates that helps boost the number of platelets by stimulating bone marrow. C. papaya increases ALOX-12 & PTAFR gene expression by 15 & 13.42 folds that further boost the platelet count by increasing megakaryocytic production. It can also prevent platelet destruction in the blood and thereby increase the life of the platelet in circulation.
Carica papaya & Tinospora cordifolia extracts show immunomodulatory activity. Various studies have shown T. Cordifolia exhibit increase in the WBC counts & bone marrow cells significantly indicating stimulatory effect on haemopoetic system.
Carica papaya & Tinospora cordifolia also demonstrate excellent free radical scavenging activity. Various studies shown that C. Papaya quenches free radicals like nitric oxide, super oxide & hydroxyl radical. Carica papaya & Tinospora cordifolia inhibits lipid peroxidation & counter oxidative stress.