The Potential Haematoprotective Effects of Hibiscus Sabdariffa against Cisplatin-Induced Thrombocytopenia: A Review

Roselle, or Hibiscus sabdariffa, is a medicinal plant containing a variety of bioactive phytochemicals such as anthocyanins, flavonoids, phenolic acids and organic acids, all of which have been linked to antioxidant and other pharmacological effects. The present review looks at the possible haematological effects of Hibiscus sabdariffa, focusing especially on platelet production and cisplatin-induced thrombocytopenia. Platelets are vital for haemostasis and their production is controlled by thrombopoietin, megakaryocytes and the relevant cellular signalling pathways. Thrombocytopenia, which is marked by a lower than normal number of platelets in the circulation, can arise due to reduced production in the bone marrow, increased destruction of platelets or an abnormal distribution. Cisplatin, a chemotherapeutic drug based on platinum, can cause haematological toxicity via oxidative stress, damage to the bone marrow, apoptosis of the haematopoietic and megakaryocytic progenitor cells and a disruption of platelet production. The evidence considered in this study indicates that Hibiscus sabdariffa has antioxidant properties and might affect various haematological parameters, such as red blood cell count, haemoglobin concentration, packed cell volume and platelet count. Yet the results differ depending on the part of the plant, the preparation used, the dosage and the length of time for which it is administered. Even though these properties point to a possible use of Roselle in protecting blood-forming tissues from toxicity caused by chemotherapy, there is still limited direct evidence showing that it is effective against cisplatin-induced thrombocytopenia. It is therefore necessary to carry out further controlled experimental studies in order to determine its efficacy, safety and the mechanisms involved.