impact of sappan wood extract as iron chelator adjuvant on iron concentration and macrophage polarization in rat spleen

Background: iron accumulation in the spleen of thalassemia patients disrupts macrophage polarization, impairs immune function, and increases mortality. sappan wood (biancaea sappan l.) extract exhibits iron-chelating and immunomodulatory properties, making it a potential adjuvant with deferiprone (dfp). this study aimed to assess the effects of sappan wood extract (swe) as a dfp adjuvant in rat models of iron overload. methods: this experimental study was conducted from january to march 2024 at padjadjaran university, indonesia. thirty-five rats were divided into seven groups: normal, iron overload (io) induced by iron dextran (id) at a cumulative dose of 60 mg/kg body weight (bw), positive control receiving dfp, and four groups receiving dfp+swe at different doses of 50, 100, 150, and 200 mg/kg bw. iron levels and macrophage polarization (pro-inflammatory m1 and anti-inflammatory m2) in the spleen were assessed. results: swe at 50 mg/kg bw significantly reduced spleen iron levels to 60.77 ppm/mg and increased m2 intensity (p<0.001 compared to the io group). at 100 mg/kg bw, swe effectively decreased m1 macrophage intensity (p=0.001 compared to the io group).conclusion: swe at 50 mg/kg bw was comparable to dfp in reducing the spleen iron levels and m1 macrophage intensity, while 100 mg/kg bw enhanced m2 macrophage polarization. these findings highlighted swe’s potential as a therapeutic adjuvant in io conditions.