We are pleased that our recent communication "Natural Antioxidant
Therapy For Patients With Hemolytic Anaemia"(1) has sparked some
discussion. While wheatgrass juice (WGJ) therapy has been shown to be
effective in treating illness (2,3), the exact mechanism(s) of action
yet remains uncertain. Historically, the beneficial effects of WGJ have
been ascribed to chloro-phyll, bioflavonoids, vitamins, minerals, or
some unknown bioactive substance(2). Although Pole offers a range of
possible explanations for the beneficial effect of WGJ based on the
strikingly similar structures of chlorophyll and heme, we believe
alternative explanations for the mechanism of action are more likely.
Firstly, heme metabolism does not normally have a salvage mechanism to
scavenge protoporphyrin ring structures generated as part of heme
degradation, i.e. heme is not recycled(4). Hence, it would be
unlikely that such molecules obtained from the diet would be salvaged
for heme synthesis. Secondly, the defect in beta-thalassemia is the
abnormal production of beta-globin chains and not insufficient heme
production. Nevertheless, speculation that the decreased transfusion
requirements of patients consuming WGJ may be due to greater haemoglobin
and/or red cell stability may have merit. A recent report of preliminary
studies by Ioannou et al of WGJ extract in cell culture suggest that WGJ
extract induces the production of fetal haemoglobin(5). These results,
albeit in vitro, raise the possibility that the beneficial
effects in vivo noted by Marwaha, et al.(3) were due to induction
of gamma-globin chain synthesis leading to greater fetal haemoglobin
content in the red cell; this would result in less redundant alphaglobin
chains in the red cell, less Heinz body formation, and greater red cell
stability with less red cell destruction. Unquestionably, this
hypothesis needs further study, but holds the promise of some very
exciting and simple therapeutic possibilities that may preclude the need
for repeated blood transfusions.
Caraciolo J. Fernandes,
Donough J. O'Donovan,
Department of Pediatrics,
Texas Children’s Hospital &
Baylor College of Medicine,
One Baylor Plaza
Houston, TX 77030
E-mail: [email protected]
