The Role of Iron Chelation Activity of Wheat Grass Juice in Blood Transfusion Requirement of Intermediate Thalassaemia.

Background: Previously it was thought that the chlorophyll of wheat grass (Triticum astevum) may be the substitute of haemoglobin of RBC having resemblance of similar structure. A group of Austrelian scientists tried to prove that wheat grass juice increases the foetal haemoglobin level 3–5 folds in intermediate thalassaemia patients. A pilot study with wheat grass juice in major thalassaemia patients were done by Dr. Marwa et al in IPGMR, Chandigarh, India. But there is no satisfactory explanation behind the reduced blood transfusion requirements after consumption of wheat grass juice for a long period. The aim of our study was to see the effect of wheat grass juice in blood transfusion requirement in intermediate thalassaemia patients and also do the biochemical analysis of the wheat grass juice. Material & Methods: During period from January 2003 to December 2006 we selected 200 intermediate thalassaemia patients (E-thalassaemia, E-Beta & Sickle thal) in the paediatric oncology department of Netaji Subhash Chandra Bose Cancer Research Institute. The age range of the patients was 1 year to 35 years (median age 18 years). The different types of thalasssaemia were E-Beta Thalassaemia 80% (160 patients), E-Thalassaemia 15% (30 patients) and Sickle Thalassaemia 5% (10 patients). When the wheat grasses were 5–7 days old, the fresh leaves including steams were made fresh juice and had given 30ml of juice daily to all our 200 patients for continuous 6 months. Wheat grass juice was analysed by column chromatography and found to be rich in oxalic acid and malic acid which might have some role in dietary absorption of iron from intestine. Beside that the wheat grass juice was found to contain a unique iron chelating property which was performed by deoxyribose degradation assay. We compared aqueous soluble extract of 5–7th day plant and our dose dependant study showed a significant iron chelating activity of crude extract in comparison to known standard iron chelator desferroxamine (DFO). The active compounds of crude extract of wheat grass may chelate catalytic iron in iron overload disorders when taking systematic dose. Result: The mean levels of haemoglobin before starting wheat grass juice were 6.2gm%. After 6months of wheat grass therapy the mean value for haemoglobin was 7.8gm% (pvalue <. 005). Twenty four patients (12%) require blood transfusion (haemoglobin < 6gm%). The performance status was improved from 60% to 80% (Karnofsky) after wheat grass treatment. The ferritin level of all patients before the study was found to be decreased significantly after wheat grass juice consumption. The mean interval between transfusion were found increased. Being a natural potent iron chelator and H2O2 quencher, it prevents the hydroxyl radical production by Fenton reaction in the RBC. Thus it may prevent the breakdown of plasma membrane of RBC and haemoglobin level becomes stable for a prolonged period. Conclusion: We may conclude that wheat grass juice is an effective alternative of blood transfusion. It’s use in intermediate thalassaemia patients should be encouraged.