Safety and Efficacy of Ankaferd Hemostat (ABS) in the Chemotherapy-Induced Oral Mucositis

Abstract

Oral mucositis, characterized by ulcerative lesions in the oral mucosa of patients undergoing chemotherapy, is currently considered to be the most severe complication of anti-cancer therapy which is affecting 40-80% of those patients. Ankaferd hemostat, (ABS) is the first topical hemostatic agent regarding the red blood cell (RBC)-fibrinogen interactions tested in the clinical trials. ABS also has pleiotropic effects particularly in the tissue healing and has anti-infective properties. The aim of this study is to assess the safety and efficacy of ABS in the management of chemotherapy-induced oral mucositis in adult patients with hematological malignancies. ABS was topically applied to the patients with grade 3-4 mucositis according to the WHO classification. Patients were said to mouthwash and swallow the five milliliters of ABS. Twenty patients with oral mucositis were evaluated. Eleven patients with acute myeloid leukemia, four acute lymphoblastic leukemia, three non-hodgkin lymphoma, one hemophagocytosis with acute myleoid leukemia and one hemophagocytosis were included in study. Median extract amount was calculated as 74.50 ml (30-100 ml) and median healing time was 6.6 days (3-10). Consequently, ABS is an effective agent in the treatment of chemotherapy related severe oral mucositis in patients with hematological malignancies. Further experimental and clinical trials about ABS shall focus on the interrelationships between proteomic content, fibrinogen gamma, and vital erythroid aggregation due to ABS.

Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines — part 2: honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents

“…Considering the limited data for each of these probiotics, no guideline is possible. Miscellaneous agents that were tested for the management of OM and included in this systematic review are Phenylbutyrate gelformulation mouthwash [72][73][74], phenytoin [75], oral beta-glucan [76] and platelet gel supernatant [77], and ankaferd hemostat [ Table 6] [78]. No guideline was possible for any of these interventions.…”

Ankaferd hemostat (ABS) as a potential mucosal topical agent for the management of COVID-19 syndrome based on its PAR-1 inhibitory effect and oestrogen content

“…This protein complex mainly depends on the interplay between ABS and blood proteins, particularly with fibrinogen-gamma [7] . In addition to these diverse biological activities, ABS also have substantial anti-inflammatory and wound-healing properties [13] , [14] , [18] , [19] , [45] . Although the exact pathophysiology underlying the unique effect of ABS remains an area of active investigation, the anti-inflammatory effect of ABS is reported to be based on the effect of proinflammatory cytokines including IL-6, IL-1β and TNF-α.…”

“…Topical ABS has been already administered for the management of cancer-associated chemotherapy/ radiotherapy-induced severe oral mucositis in the patients with pediatric age groups and adults [18] , [19] . Likewise, pulmonar mucosal hemorrhages and resistant severe hemoptysis due to lung lesions had been controlled via the endobronchial administration of ABS [14] .…”

“…There are preliminary evidence that ABS has in vitro anti-viral actions on the Bovine Herpes virus type 1 (BHV-1) [13] as well as other established anti-infective properties in a wide variety of pathogens [11] , [12] , [13] , [16] , [17] . Most importantly, topical ABS applications for severe oral mucositis in patients with pediatric and adult cancer receiving chemotherapy/ radiotherapy [18] , [19] and mucosal healing of the pulmonary tissue in lung-bleeding patients [14] demonstrated the efficacy and safety of the drug for mucosal disease control in clinical backgrounds. Therefore, we herein hypothesize that ABS could be a possible topical drug candidate for the management of COVID-19-induced mucositis based on its pharmacobiology [5] , [6] , [7] and the nature of the SARS-CoV-2 [20] , [21] induced widespread oropharyngeal and pulmonary mucosal damages.…”

Oral mucositis in patients with oncological pathology of the oropharyngeal region: review

“…Изучено также влияние жидкости для полоскания рта с фенилбутиратным гелем [103], фенитоина [104], перорального бета-глюкана [105], супернатанта тромбоцитарного геля [106] и анкаферда [107]. Ни для одного из этих средств невозможно было разработать какие-либо рекомендации.…”