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Potential Treatment Could 'Sweeten' Life for Sickle Cell Patients

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WebMD Health News

March 17, 2000 (Los Angeles) -- Aspartame, the artificial sweetener in NutraSweet and other products, might limit the mechanism behind sickle cell disease. Sickle cell is caused by the flattening and curling of red blood cells (RBCs), which leads to extreme pain, kidney damage, and risk of stroke. Early studies of aspartame for sickle cell disease were reported today at the annual meeting of the American Society for Clinical Pharmacology and Therapeutics.

"These preliminary results are intriguing and deserve further study," says Cage Johnson, MD, who reviewed the research for WebMD. Johnson is professor of medicine and director of the USC Comprehensive Sickle Cell Center at the University of Southern California's University Hospital in Los Angeles.

Sickle cell disease, also known as sickle cell anemia, is a genetic condition that leads to bending and flattening of the RBCs, which then form the shape of a sickle. When this occurs, the RBCs are destroyed and can no longer carry oxygen to the various parts of the body. In addition, the RBCs tend to stick together, and this can lead to the formation of blood clots, causing heart attacks and strokes. Both the sticking together and the bending of the RBCs lead to severe pain, usually in the legs, arms, back, and chest due to the clots and lack of oxygen.

Carl V. Manion, MD, and colleagues at the Oklahoma Medical Research Foundation in Oklahoma City reported at the meeting that aspartame reduced RBC sickling in all patients with the most common form of sickle cell disease. Manion tells WebMD that the protective effect occurred at all three aspartame doses tested but was most impressive at the highest dose. For a patient weighing 100 pounds, this meant swallowing 13 aspartame tablets with about one-quarter cup of water.

Aspartame apparently slides between the "sticky" hemoglobins and prevents them from sticking together, Manion tells WebMD.

Little is known about how or whether aspartame actually goes into the RBCs. "Lots of people don't believe that aspartame [gets in], so they doubt the effect. I think that RBCs are probably naive and, like our sense of taste, cannot distinguish aspartame from sugar," Manion says, adding that RBCs only break down sugar.

Johnson tells WebMD that aspartame joins two other potential treatments now in human studies for sickle cell disease: the natural amino acid glutamine and the sugar fructose diphosphate. All three aim to stabilize the RBCs and prevent sickling.

Johnson says, "The sickling is only one component of sickle cell disease, and preventing it may not solve all problems."

Aspartame is not yet ready for use as a sickle cell treatment, or even for large human studies, but the data from Manion's pilot studies have made it a sweet contender. The Oklahoma researchers plan to continue this line of research with a study in which sickle cell patients will take aspartame daily for one week, and their RBCs will be studied before and after the week of treatment.

Vital Information:

  • People with sickle cell disease have red blood cells that can become distorted and sticky, preventing them from moving through the body properly. Researchers report the common artificial sweetener aspartame, which is in NutraSweet, might stop the red blood cells from sticking together.
  • The researchers found the best results came when giving a dose of aspartame equivalent to 13 tablets for a 100 pound patient.
  • An observer says the results are intriguing, but more study is needed because not all doctors are convinced of aspartame's effect. Also, there are other facets to sickle cell disease that cannot be solved by aspartame.

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