Synergistic effects of ethanolic leaf extract of Justicia carnea and recombinant human erythropoietin on hematological indices in Phenylhydrazine-induced anemic Wistar Rats

Background: Anaemia remains a significant public health challenge, particularly in sub-Saharan Africa. Justicia carnea  is a traditionally used anti-anaemic plant, while recombinant human erythropoietin (rHuEPO) is a potent erythropoietic agent. This study investigated the synergistic haematological effects of their combined administration in phenylhydrazine (PHZ) induced anaemic Wistar rats.
Methods: Thirty female Wistar rats were randomly assigned to five groups (n = 6): Group A (control), Group B (PHZ alone), Group C (PHZ + ELJC 250 mg/kg), Group D (PHZ + rHuEPO 10 mg/kg), and Group E (PHZ + ELJC + rHuEPO). PHZ was administered for two weeks to induce haemolytic anaemia, followed by three weeks of treatment. Haematological parameters, including RBC count, haemoglobin (Hb), packed cell volume (PCV), MCV, MCH, MCHC, WBC, platelet count, and body weight, were assessed using a Sysmex XT-2000i automated analyzer. Data were analyzed by one way ANOVA with post hoc LSD and paired t test at p ≤ 0.05.
Results: PHZ administration significantly reduced RBC, Hb, and PCV in Group B (p ≤ 0.05). ELJC treatment (Group C) partially restored these indices. rHuEPO monotherapy (Group D) produced the most pronounced individual improvements in RBC, Hb, and PCV. The combined treatment (Group E) demonstrated synergistic benefits, with significant increases in RBC, Hb, and PCV compared to the PHZ group. MCV was elevated in Groups B, D, and E relative to control. WBC changes were non-significant across groups. Platelet counts were significantly elevated in Group B and significantly reduced in Groups D and E. All treatment groups showed significant body weight gains.
Conclusion: Both ELJC and rHuEPO effectively mitigated PHZ induced haematotoxicity. rHuEPO demonstrated the strongest erythropoietic effect individually, while their combination produced superior synergistic outcomes. These findings support the potential integration of J. carnea extract with erythropoietic agents in the management of haemolytic anaemia.