The Effect of the Thai Herbal Suksaiyad Formula on Platelet Aggregation in Healthy Volunteers: A Quasi-experimental, Single-dose Study

Titchaphorn  Palo; Nalinthika  Nathananwanit; Pravit  Akarasereenont; Suksalin Booranasubkajorn

doi:10.33192/smj.v77i2.271976

Authors

Titchaphorn Palo Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Nalinthika Nathananwanit Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Pravit Akarasereenont Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Suksalin Booranasubkajorn Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v77i2.271976

Keywords:

Thai Herbal Suksaiyad formula, Herbal medicine, Platelet aggregation, Thai traditional medicine

Abstract

Objective: To investigate the effects of the Thai Herbal Suksaiyad formula (SSF) on platelet aggregation in healthy volunteers.

Material and Methods: In a quasi-experimental study, thirty healthy volunteers received a single dose of 2,000 mg SSF. Blood samples were taken at 0, 3, 6, and 24 hours after SSF administration for platelet aggregation analysis using aggregometry. Platelets were induced with epinephrine, adenosine diphosphate, and collagen.

Results: SSF significantly decreased platelet aggregation at 3 and 6 hours post-administration. Sub-analysis revealed no significant differences between males and females. SSF significantly decreased platelet aggregation in normal and hyperaggregation groups but had no effect on the disaggregation group. The effect of SSF was short-lived, reverting to pre-dose values after 24 hours for all agonists. Adverse events included flatulence (1 participant) and diarrhea (1 participant).

Conclusion: Caution is advised when using SSF in patients with blood disorders. Potential herb-drug interactions between SSF and drugs that impact platelet aggregation, such as aspirin, should be closely monitored. These interactions could result in fluctuations that may enhance or diminish the effectiveness of concurrent antiplatelet therapies, potentially increasing the risk of bleeding or decreasing therapeutic outcomes.

References

Narcotic Drugs Act B.E. 2522 (Includes additional amendments) [Internet]. [cited 22 Oct 2024]. Available from: https://catalog.fda.moph.go.th/gl/dataset/law-narcotic/resource/88e1084c-4cb3-4ecf-b537-bade8507aa26

Narcotic Drugs Act (Issue 7) B.E. 2562 [Internet]. [cited 22 Oct 2024]. Available from: https://catalog.fda.moph.go.th/gl/dataset/law-narcotic/resource/91905ef7-033b-4558-b053-2f734191a2c9

Vaibhav K, Shrivastava P, Javed H, Khan A, Ahmed ME, Tabassum R, et al. Piperine suppresses cerebral ischemia-reperfusion-induced inflammation through the repression of COX-2, NOS-2, and NF-kappaB in middle cerebral artery occlusion rat model. Mol Cell Biochem. 2012;367(1-2):73-84.

The National Library. Thart Phra Narai Scripture. palm-leaf book. Thai alphabet. Thai language. stylus-inscribed lines. raw palm-leaf version, no. 1143. medicine section

Prince Damrong Rajanupab. Tamra Phra Osot Phra Narai, Third printing for distribution at the funeral of Mr. Pan Chaisuwan1923, (B.E.2466).

Chayan Pichiansuntorn MC, Wichian Jeerawong. Explanation of King Narai’s drug formulas (Tamra Phra Osot Phra Narai) The edition published in commemoration of His Majesty the King’s 72nd Birthday Anniversary, 5 December 1999. Bangkok: Amarin Printing and Publishing; 2001.

Thailand. National Drug System Development Committee. The National List of Essential Medicines 2023: Specific medicine list. Government Gazette no. 140, section 130. June 2, 2023.

Reitsma SE, Lakshmanan HHS, Johnson J, Pang J, Parra-Izquierdo I, Melrose AR, et al. Chronic edible dosing of Delta9-tetrahydrocannabinol (THC) in nonhuman primates reduces systemic platelet activity and function. Am J Physiol Cell Physiol. 2022;322(3):C370-C81.

De Angelis V, Koekman AC, Weeterings C, Roest M, de Groot PG, Herczenik E, et al. Endocannabinoids control platelet activation and limit aggregate formation under flow. PLoS One. 2014;9(9):e108282.

Formukong EA, Evans AT, Evans FJ. The inhibitory effects of cannabinoids, the active constituents of Cannabis sativa L. on human and rabbit platelet aggregation. J Pharm Pharmacol. 1989;41(10):705-9.

Bordia A, Verma S K, Srivastava K C. Effects of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids. 1997;56(5):379-84.

Srivas KC. Effects of aqueous extracts of onion, garlic and ginger on platelet aggregation and metabolism of arachidonic acid in the blood vascular system: in vitro study. Prostaglandins Leukot Med. 1984;13(2):227-35.

Liao YR, Leu YL, Chan YY, Kuo PC, Wu TS. Anti-platelet aggregation and vasorelaxing effects of the constituents of the rhizomes of Zingiber officinale. Molecules. 2012;17(8):8928-37.

Yen H-F, Wang S-Y, Wu C-C, Lin W-Y, Wu T-Y, Chang F-R, et al. Cytotoxicity, anti-platelet aggregation assay and chemical components analysis of thirty-eight kinds of essential oils. J Food Drug Anal. 2012;20(2):478-83.

Kang JW, Min BS, Lee JH. Anti-platelet activity of erythro-(7S,8R)-7-acetoxy-3,4,3',5'-tetramethoxy-8-O-4'-neolignan from Myristica fragrans. Phytother Res. 2013;27(11):1694-9.

Enomoto S, Asano R, Iwahori Y, Narui T, Okada Y, Singab AN, et al. Hematological studies on black cumin oil from the seeds of Nigella sativa L. Biol Pharm Bull. 2001;24(3):307-10.

Waqar MA, Mahmood Y, Saleem A, Saeed SA. An Investigation of Platelet Anti-aggregation Activity in Inigenous Medicinal Herbs. Journal of the Chemical Society of Pakistan. 2009;31(2):324-28.

Limsuvan S, Palo T, Mamaethong D, Yuthanarat N, Booranasubkajorn S, Lumlerdkij N, et al. The Effect of The Thai Herbal Wattana Formula on Platelet Aggregation and The Relationship with Innate Dhatu Chao Ruean. Siriraj Med J. 2023;75(5):321-9.

Born GV. Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature. 1962;194:927-9.

Cattaneo M. Light Transmission Aggregometry and ATP Release for the Diagnostic Assessment of Platelet Function. Semin Thromb Hemost. 2009;35:158-67.

Ketsa-Ard K, Poungvarin N, Juengchareon M, Jarerat S, Kittigul L. Clinical study on antithrombotic effects of ticlopidine in ischemic stroke. J Med Assoc Thai. 1991;74(6):331-9.

Akarasereenont P, Tripatara P, Chotewuttakorn S, Palo T, Thaworn A. The effects of estrone, estradiol and estriol on platelet aggregation induced by adrenaline and adenosine diphosphate. Platelets. 2006;17(7):441-7.

Nieswandt B, Watson SP. Platelet-collagen interaction: is GPVI the central receptor? Blood. 2003;102(2):449-61.

Aslam M, Sedding D, Koshty A, Santoso S, Schulz R, Hamm C, et al. Nucleoside triphosphates inhibit ADP, collagen, and epinephrine-induced platelet aggregation: role of P2Y(1) and P2Y(1)(2) receptors. Thromb Res. 2013;132(5):548-57.

Evangelou AM, Malamas MP, Vezyraki P, Karkabounas SC. Is epinephrine-induced platelet aggregation autoregulated by its metabolic degradation products in vivo? In Vivo. 1998;12(3):321-5.

Lanza F, Beretz A, Stierle A, Hanau D, Kubina M, Cazenave JP. Epinephrine potentiates human platelet activation but is not an aggregating agent. Am J Physiol. 1988;255(6 Pt 2):H1276-88.

Lindkvist M, Fernberg U, Ljungberg LU, Falker K, Fernstrom M, Hurtig-Wennlof A, et al. Individual variations in platelet reactivity towards ADP, epinephrine, collagen and nitric oxide, and the association to arterial function in young, healthy adults. Thromb Res. 2019;174:5-12.

Peace AJ, Egan K, Kavanagh GF, Tedesco AF, Foley DP, Dicker P, et al. Reducing intra-individual variation in platelet aggregation: implications for platelet function testing. J Thromb Haemost. 2009;7(11):1941-3.

Jones CI. Platelet function and aging. Mamm Genome. 2016;27(7-8):358-66.

Carazo A, Hrubsa M, Konecny L, Skorepa P, Paclikova M, Musil F, et al. Sex-Related Differences in Platelet Aggregation: A Literature Review Supplemented with Local Data from a Group of Generally Healthy Individuals. Semin Thromb Hemost. 2023;49(5):488-506.

Sokol J, Skerenova M, Ivankova J, Simurda T, Stasko J. Association of Genetic Variability in Selected Genes in Patients With Deep Vein Thrombosis and Platelet Hyperaggregability. Clin Appl Thromb Hemost. 2018;24(7):1027-32.

Bhalerao S, Deshpande T, Thatte U. Prakriti (Ayurvedic concept of constitution) and variations in platelet aggregation. BMC Complement Altern Med. 2012;12:248.