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Table of Contents
RESEARCH ARTICLE
Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 88-96

Benefits of gum arabic, for a solitary kidney under adverse conditions: A case study


Department of Integrative Medicine, Dubai Specialized Medical Center and Medical Research Lab, Affiliated with Dubai Medical College and Dubai Pharmacy College, Dubai, United Arab Emirates

Date of Web Publication9-Oct-2018

Correspondence Address:
Dr. Mehrab Dashtdar
Department of Integrative Medicine, Dubai Specialized Medical Center and Medical Research Lab, Affiliated with Dubai Medical College and Dubai Pharmacy College, Dubai
United Arab Emirates
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CMAC.CMAC_22_18

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  Abstract 


Gum Arabic (GA, called E-414 in the EU food industry), a natural biopolymer resin is a dried exudation obtained from the stems and branches of natural strains of Acacia Senegal (L) Willdenow. It consists mainly of high molecular weight polysaccharides and their calcium, potassium, and magnesium, which on hydrolysis yield arabinose, galactose, rhamnose, and glucuronic acid. Fermentable natural fiber of gum Arabic act as probiotics improves the absorption of minerals, especially calcium and helps to maintain a healthy balance of bacteria in the gastrointestinal (GI) tract. Extraction, transformation, or reprocessing of nitrogenous wastes (ammonia, urea, and uric acid) by the GI tract is a potentially low-cost means of switching for missing renal function. Binding of nitrogen compounds to be inert orally by administration of gum Arabic is the safe solution either in normal renal function or renal failures. In this study, clinically, we observed a case of solitary kidney under adverse condition long-term treating with gum Arabic the vast potential of bioactive phytochemicals as a nontoxic, efficient with uric acid and bilirubin lowering agent and anti-inflammatory effects, considering the gum Arabic as a potential therapeutic supplement, beneficial in chronic renal failure, cardiovascular disease, pain management, and dental health. Despite the nonexistent background concerning the benefits of gum Arabic, for a solitary kidney under adverse conditions, our study has confirmed that long-term consumption of gum Arabic not only has no side effect but also protects multi-organs damage from drug adverse reactions and consequences of baseline disease, including renal, vascular, dental and inflammatory diseases.

Keywords: Acacia Senegal, chronic renal failure, emulsifier, gum Arabic, natural fiber, probiotics, solitary kidney


How to cite this article:
Dashtdar M, Kardi K. Benefits of gum arabic, for a solitary kidney under adverse conditions: A case study. Chin Med Cult 2018;1:88-96

How to cite this URL:
Dashtdar M, Kardi K. Benefits of gum arabic, for a solitary kidney under adverse conditions: A case study. Chin Med Cult [serial online] 2018 [cited 2021 Jan 22];1:88-96. Available from: https://www.cmaconweb.org/text.asp?2018/1/2/88/242576






  Introduction Top


In the absence of this emulsifier, the black-colored goes back to the bottle surface. We could not drink soft drinks. Either consume sweets and medicines, including fixed gum coating or eat yogurt, which it does not thicken the texture, nor to drink wine, which reduces the aggressive tannins or print newspapers, on which it secures the ink. Gum Arabic (GA, called E-414 in the food industry within the E numbers and Acacia gum according to the list of additives in the European Union) is a dietary fiber extracted from the dried oozing of Acacia Senegal. The newly secreted gum is pale golden yellow, semi-liquid consistency, odorless, and generally tasteless material. As it solidifies takes different colorations, until a reddish yellow with the fullness of its consistency, in which it is difficult to pulverize. Gum Arabic which is extracted from the bark of the Acacia Senegal had been a trade for over four thousand years, i.e., its importance to the African people, since it is the source major revenue. The substance is commercially produced throughout the Sahel, from Senegal to the Sudan and Somaliland. While the extract is applied for its curative properties and especially its use is in the pharmacological industry (binder, emulsifier) in food (gelling agent and emulsifier), cosmetology and textiles (solidification), some medicinal properties of the same have as well as emerged recently.[1],[2],[3] It is moreover, used in confectionery as a basis for the production of marshmallows and chewing gum. Gum Arabic is also authorized as protective colloid young wines to improve stability in the bottle, to avoid precipitating the matter unstable coloring (pigments and tartrates) and increase balance and organoleptic characteristics of the wine, reducing bitterness and astringency, increasing the smoothness, and improving sensation of the wine.[4]

Gum Arabic is a natural resin consisting of polysaccharides, and glycoprotein is extracted from two species of Acacia sub-Saharan Africa, more specifically the species Acacia Senegal and Acacia seyal. Acacia Senegal is part of the African healing plants. Egyptians used it in the mummification process and the development of some cosmetics and perfumes. The use of this plant for its medicinal properties is lost gradually and dark into oblivion, but its advantage was rediscovered by European navigators in the fifteenth century in sub-Saharan Africa. Its commercial importance was such that in the seventeenth, century gave rise to the War of gum, opposing French, Dutch, Portuguese, and British in the struggle for control of the coastal region of the current Mauritania and Senegal. This conflict resulted in the establishment of a true French monopoly on the gum Arabic trade for the European market. Gum Arabic had been the cause civil war in Sudan and other African countries over the time.[5] In Africa, only its flowers, leaves, and bark are still used for their therapeutic properties astringent and emollient, calming, antipyretic, and antitussive. It is administered for the treatment against diarrhea and bronchitis, to stop bleeding, respiratory tract infections and sore throats, to reduce fevers and soothe burns. Research reveals no clinical data or report on a solitary kidney under adverse conditions throughout the world.

The benefits of oral consumption of gum Arabic in human health

The special natural hallmark of gum Arabic helps it to be the best claimant as a natural prebiotic. It can combat the acidic effect inside the stomach and resist the alkaline effect of bile salts and other digestive enzymes inside the large intestine. It is considered to be a full-spectrum probiotic, which complete ferments inside the entire large intestine, selectively motivates the growth and/or activity of intestinal bacteria for elimination of pathogenic bacteria, which significantly contributes to mucosal barrier preventing pathogenic bacteria invade the gastrointestinal (GI),[6] thus can impact in developing the immune system of the body. Studies have shown that no Acacia gum is found in human and rat feces fed with Acacia gum, indicating that this is completely fermented by flora human gut.

Probiotics are live microorganisms found in some food products or supplements, and whose consumption in sufficient amounts can be beneficial for health. Probiotics help to maintain a healthy balance of bacteria in the GI tract. The most common types of probiotic bacteria are strains of Lactobacillus and Bifidobacterium, sometimes combined with Streptococcus thermophilus.[7],[8] Probiotics are often commonly found in fermented dairy products. Fermentable fiber sources could improve the absorption of minerals, especially calcium. There are several potential mechanisms that may explain the favorable effect of prebiotic oligosaccharides in the absorption of minerals.[9]

  • It could significantly alleviate adverse effects of CRF[10]
  • Offers more protection in the digestive tract, when dissolved and forms a sticky gel that acts as a protective cover and prevents harmful substances; It can absorb water, increasing the volume of stool, have affinities' specific adsorption of ammonia, urea, creatinine, bile acids, and phosphate bond agent[10],[11]
  • Fermentable natural fiber of gum Arabic act as probiotics improves the absorption of minerals, especially calcium and helps to maintain a healthy balance of bacteria in the GI tract
  • Epidemiological studies suggest that adequate intake of fiber constantly reduces the risk of cardiovascular disease and coronary heart disease, mainly through a reduction in levels of low-density lipoprotein. The results of randomized clinical trials are inconsistent, but suggest that fiber may play a beneficial role in reducing levels of C-reactive protein, Apolipoprotein levels and blood pressure, all of which are biomarkers for heart disease[12],[13]
  • Gum Arabic is the richest source of essential amino acids
  • Gum Arabic has attractive antioxidant properties. Experimental evidence shows that there is an association between the antioxidant and protein fraction, mainly by amino acid residues such as histidine, tyrosine and lysine, which are generally considered as antioxidant molecules.[14]


Nutritionally beneficial

Gum Arabic is a 100% vegetable and natural, nongenetically modified, classified as a food additive in the list of permitted additives in Europe without quantitative limitations swallowed. It also has the approval of the US Food and Drug administration organization. The Acacia gum has a great advantage in the international fight against obesity, by providing only 1.5 kcal/g. It is considered as noncariogenic additive due to its low carbohydrate content. On the contrary, the Acacia gum is very rich in vegetables and water-soluble fibers (85% according to the Association of Official Agricultural Chemists method), which adds to its nutritional and functional value that contributes to a balanced diet in the consumption of liquid food.

Side effects

Gum Arabic causes allergies both by ingestion and by inhalation. This is used during the manufacture of confectionery, butter, chewing gum, baked goods, salad dressings, laxatives, toothpaste, and even in some medication's additives. When using orally, Acacia is not harmful but if you are allergic to dust, you can develop injuries or suffer asthma attacks when you start taking Acacia. Gum Acacia produces some unpleasant side effects. During the 1st week, the supplement created an irritating sensation of the mouth, nausea and mild diarrhea, and swelling. In a study, gum Arabic-specific immunoglobulin E (IgE) antibodies of a patient were directed mainly against the carbohydrate fraction of the material; due to the repetitive polysaccharide sequence of gum Arabic, several epitopes for the cross-linking of IgE should exist.[15],[16],[17]

In our case study except some minor skin rashes, we did not observe any other noxious reactions.

Composition and properties of gum Arabic

Gum Arabic is edible; readily soluble in water, homogeneous, viscous, and clear solution. It is insoluble in organic solvents. This gum is the acidic salt of a complex mixture of glycoproteins and polysaccharide that contains polyphenols, calcium, magnesium, and potassium. The complexity of gum Arabic makes it impossible to describe it structurally; however, its hydrolysis yields L-arabinose, L-rhamnose, D-galactose, and D-glucuronic acid [Table 1]. It is a substance yellowish to brown, but a flammable high flash point (>250°C), very soluble in water (approximately 500 g/L) and an lethal dose (LD) (median LD50) >16,000 mg/kg. The active ingredients of chemically vary depending on weather conditions, the age of the tree, the soil environment and the type of tree species. Chemically, gum Arabic is a carbohydrate polymer, which during digestion, is partly degraded in the large intestine.[18],[19],[20],[21] Water solutions of gum Arabic are slightly acidic and have a pH of 4.5–5.5. It's gum lower viscosity even at high concentrations. It has a neutral taste and is odorless. Gum Arabic is highly soluble in water, concentrations up to 40% are feasible without a major impact on viscosity[22] rendering it an attractive candidate compound for various applications, like beverages. The results achieved with gum Arabic in murky drinks are excellent. In the case of flavored milk drinks, gum Acacia stabilizes the aromatic particles in milk, preventing their precipitation in the background, which favors a homogeneous structure and a pleasant mouth feel. Gum Arabic has a totally neutral odor and taste, allowing a perfect release of the own scent of emulsions or flavorings in atomized powder.
Table 1: Amino acids content in gum Arabic taken from Acacia Senegal (Mahendran et al., 2008)

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  Case Presentation Top


A 56-year-old, Mr. M.D, Persian, has been a patient of the DSMC with chief complaint of unexplained hip joint pain (limit hip lateral rotation and abduction), history of claudication on exercise, and fatigue for 6 years.

Past history

Right side radical nephrectomy due to nephroblastoma (Wilms' tumor) in childhood, History of renal calculi 15 years ago, well-established of type 2 diabetes since 19 years ago, history of Proteinuria (± to +++) since childhood, beta-thalassemia minor.

Family history

His family history reveals that his mother had type 2 diabetes mellitus; four siblings has beta thalassemia minor.

Past and present medication

Diabetic medicine and angiotensin converting enzyme inhibitors for prophylaxis of hypertension. No other medication due to solitary kidney.

Presentation and examination

Well-established diabetes, present with unexplained hip joint pain (limit hip lateral rotation and abduction), history of claudication on exercise and fatigue since 2 years. Multiple lesions of syringoma on the upper cheeks and lower eyelids, puffy tongue with teeth marks along the side (scalloped tongue), tongue coating thick and white, and bilateral leg pitting edema.

Abdominal ultrasound

Right side radical nephrectomy, left kidney 10 mm simple cyst.

Hip joint magnetic resonance imaging

Normal imaging.

All signs and symptoms of the disease in this patient were severely under close observation during treatment. All significant changes and theirs duration's show the signs and symptoms which observed during treatment [Table 2].
Table 2: The sign and symptom which observed during treatment

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Supplement appearance and notice

Gum Arabic is conventionally presented in pieces and grainy, but there is also a gum Acacia instant powder, which we use in our study [Figure 1], [Figure 2], [Figure 3]. Acacia Senegal powder-like all soluble fiber supplements needs plenty of water into the gut to work properly. However, this powder does not condense in a regular glass and thus has no obstructing risk, so you do not need to take a large glass of water with therapeutic dose.
Figure 1: Raw material amber-colored gum Arabic. Natural gum Arabic (raw material) is in chunks crystals, roughly pulverized product, granulated, it is possible to obtain grain-like, or powdery form. Gum Arabic has a bland taste and is odorless

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Figure 2: Processed powder form

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Figure 3: Gum Arabic was provided in a powder form purchased from Dubai market

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Dosage

A total of 12.5 g of Acacia Senegal powder [Figure 2] and [Figure 3] (one table spoon), dissolved in 250 ml warm milk or water and had it with breakfast and dinner for first 3 months, then continued once a day for 1 year.


  Results Top


The results of the present study shows in [Table 3].
Table 3: Various parameters changes before and 1 year after consumption of gum Arabic

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  Discussion Top


Diabetes is the most common cause of kidney failure and constitutes >44% of new cases.[23] Even when diabetes is controlled; the disease can lead to chronic kidney disease (CKD) and kidney failure. Most people with diabetes suffer from CKD not severe enough to develop into renal failure. Drug adverse reactions are considered as one of the main problems of drug therapy. They are associated with morbidity, mortality, decreased compliance and success of therapy, as well as directly and indirectly with high medical costs. When there are the side effects of hypoglycemic drugs along with consequences of diabetes; like diabetic nephropathy potentially increasing the risk of death from cardiovascular disease and other complications. Increased serum phosphorus has been considered an independent risk factor for death in patients with CKD and end-stage nephritic disease on dialysis. As renal function decreases, the change of serum phosphorus diet, although it is important, it is increasingly difficult to make without simultaneously occurring protein deficiency. Accordingly, it is necessary to reduce selectively the intestinal absorption of phosphorus. This requires use of phosphorus-binding agents. Patients with CKD are at increased risk of dying from a cardiovascular event than to require dialysis for end-stage renal disease (ESRD) if they survive. The network of intestinal phosphate absorption is approximately 70%–80% of intake but may be somewhat lower in patients with ESRD. Phosphorus is not absorbed in the stomach. PH 1–3.5, phosphorus exists as weak acid (H3 PO4) and ion H2 PO4-monobasic (pK = 2.1). In the duodenum, the pH level is 2–6.4; in the jejunum is 6 and 7. Ileum phosphorus exists in various proportions as H2 PO4-monobasic and dibasic ion HPO42-(pK = 6.8). About 35% of the phosphorus is absorbed in the duodenum, 25% in the jejunum and 40% in the ileum.[10] Aluminum compounds are effective trapping agent's phosphor is still used when a rapid reduction in serum phosphorus is required, while other agents have failed in this function. Unfortunately, their high toxicity prevents their long-term use. Studies have revealed the superiority of calcium acetate on calcium carbonate. However, the use of both agents is accompanied by a significant incidence of hypercalcemia.[24] Relevant incidence of toxicity of phosphorus-binding agents and difficult accessibility prevents their long-term use in undeveloped countries. Gum Arabic acts as phosphate binding agents, is a safe treatment of hyperphosphatemia in the intestinal tract. The goal of herbal medicine therapy is to obtain certain healing achievements that improve the quality of life of patients and ensure minimal risks. There are inherent to botanical remedy risks, both known and unknown, associated with the therapeutic use of herbs. As shown in previously published work,[25],[26],[27],[28] and despite the nonexistent background concerning the benefits of gum Arabic, for a solitary kidney under adverse conditions, our study has confirmed the safety of long-term consumption of gum Arabic. Using it not only has no side effect but also protects multi-organs damage from drug adverse reactions and consequences of baseline disease, including renal, vascular, dental, and inflammatory diseases, we could confirm here the previously reported effects. In this study we observed, by the end of the 3 months of treatment, serum urea levels, serum creatinine and uric acid levels, urine protein significantly decreased by compared against the baseline.

Consequents of hyperuricemia; cardiovascular and renal diseases

The uric acid is a by-product of the chemical decomposition of compounds called purines, which exist in the cells of our body and in our food. The two purines, adenine and guanine, they are in the body, mainly as components of acid nucleic, ribonucleic acid, and deoxyribonucleic acid. Excessive intakes of foods rich in purines in the metabolic process are transformed into uric acid are the most important cause of hyperuricemia. Purines are natural elements present in red meat, organ meats, game fish (anchovies, sardines, herring, trout, and salmon), shellfish, cold cuts of pork, and some vegetables such as celery, watercress, asparagus, peas, green beans and white, lentils, radishes, cauliflower, spinach, and coffee. The most common cause of hyperuricemia is a decreased renal clearance of uric acid. Another usual cause of hyperuricemia is the intake of medications such as diuretics, regular in the elderly, and should always be suspected the possibility of kidney failure is also cause hyperuricemia. Only a small percentage of patients estimated <10%, hyperuricemia results from an increase in the intrinsic production of uric acid, either by some rare enzyme defects or increased catabolism of purine's internal source in situ ations such as hemolytic anemia, polycythemia vera, or accompanying various neoplasms or treatment. Gout is a disease that results from the deposit of monosodium urate crystals caused by overproduction or uric acid hypo excretion. Usually but not always, the disease is associated with elevated levels of uric acid in plasma. Serum urate is higher in men than in women. It thus is defined as hyperuricemia, in the first, the existence of higher values to seven mg/dl and in the latter, which exceed 6 mg/dl. Urate excreted into the urine is approximately 70% of daily production. The remainder is excreted in feces.[29] Clinical manifestations include acute arthritis and chronic, tophi, interstitial renal disease and nephrolithiasis uric acid. The diagnosis is based on the identification of urate crystals in the joints or body tissues. Hyperuricemia is the critical factor in the occurrence of gouty arthritis.[30],[31] This is because a majority of a defect in the urinary excretion of uric acid, but approximately 20% of cases the cause is an overproduction of uric acid, which crystallizes as monosodium salt in over saturated periarticular synovial fluid environment. In gouty arthritis, monosodium urate crystals are the stimulus that initiates the inflammatory response and extends through the inflammasome and route of interleukin 1 β.[32],[33] The acute inflammatory process usually occurs in the articular or periarticular structures, including bursa and tendons. Several epidemiological studies show the relationship between elevated levels of uric acid in blood and the future development of renal failure, loss of nephritic function, hypertension, cardiovascular events and cardiovascular and overall mortality, being the pathogenic mechanism proposed endothelial injury. Initially, it was believed that uric acid was the only pathogen as extracellular molecules, and the reservoir forming crystals would be the pathogenic mechanism. However, it has been found that the lesion is intracellular, more specifically the endothelium. In this sense, studies in animals (rats) who find that there is a relationship between elevated uric acid and endothelial damage.[34],[35],[36],[37],[38],[39],[40] One of the main roles of the normal, healthy kidney, besides its regulatory, endocrine, and metabolic functions, is the removal of waste products. Any impairment of excretory function can lead to the agglomeration of a combination of nitrogenous waste materials including, urea, creatinine, and uric acid. High concentrations of waste products in the blood stream can aggravate renal failure and promote kidney stones. Moreover, nitrogen-bearing solutes in the blood stream promote osmotic diffusion into the lumen of intestine because of the concentration gradient across the intestinal wall. This diffusion mechanism conducted to the concept of oral sorbents to augment gut-based clearance of nitrogen-bearing waste products. This study shows oral consumption of gum Arabic reduced blood concentration of urea, creatinine, and uric acid. We achieved the treatment goals include completion acute attack, prevention of recurrence, and the prevention of complications associated with the deposition of uric acid crystals in tissues.

Vascular pain in diabetes respects all the vessels of the body, regardless of their size and the tissues they irrigate. This pain sometimes has clinical translation: conventionally, distinguishes microvascular complications (kidney, eye, and nerve) of macrovascular complications, which consist of accelerated atherosclerosis, with some specifics. The presence of diabetes significantly increases the risk of more occlusive arterial disease (increased 6–10 times) than that of coronary artery disease (increased 2–4 times) or ischemic stroke (2 times). Pathological alteration of the coronary arteries characterized by abnormal deposition of lipids and fibrous tissue in the arterial wall, which disrupts the architecture, the function of the vessels and reduces variably, blood flow to the myocardium.

Vascular calcification in the calcium phosphate deposition in the form of crystals bio apatite (similar to bone) can occur in blood vessels and heart valves.[41] Thus, arterial calcification has been divided into calcification of the intima (ally with atheromatous plaques),[42] and Mönckeberg's arteriosclerosis or medial calcification, where calcium deposits are found in the muscular middle layer of the walls of arteries (the tunica media), linked to the vascular stiffness by mineralization of elastic fibers and arteriosclerosis. This condition occurs as an age-related degenerative process, diabetes and CKD.[43]

Some studies show that there is a relationship between calcification of blood vessels and bone loss that occurs with osteoporosis. That is, the decalcification of the bones involved age could occur in parallel to the process of calcification of blood vessels.[44],[45] Over the years, the bones become demineralizing. It will be less resistant, reduce flexibility and increase its fragility, which leads to osteoporosis, a disease now known as a silent epidemic, is the cause of one in three women and one in five men suffer bone fractures. Until now, it was believed to be separate processes, but this group of researchers has proven that there is a relationship. In one study, researchers found that increased vascular calcification that enhances with age, are simultaneously associated with an increased incidence of vertebral fractures due to bone loss. During those 4 years, through different tests they found that patients in which the aortic calcifications were increasing, also lost more bones and suffered more fractures. “This suggests that these two phenomena, increasing calcifications in the vessels and bone loss could be interrelated,” they conclude. They also conducted a second study in patients with chronic renal failure (CRF) on hemodialysis since because of their underlying disease as well suffer bone decalcification. They found similar results: four out of five patients on hemodialysis had some types of calcification in the cups. Moreover, those with more vascular calcifications were at increased risk of vertebral fractures. The objective was to identify molecular mechanisms occur in our body to vascular calcification and bone loss are so closely related. It seems that the mechanism is triggered in these animals goes beyond the simple deposition of calcium. In these animals, the cells in the wall of blood vessels stop behaving-like muscle cells to acquire properties of the cells that form bone, osteoblasts. The authors have renamed vascular osteoblasts, able to mineralize the walls of the arteries. As above numerous studies with dietary fiber in which it is found a reduced risk of vascular pain in diabetes, atherosclerotic disease in men and women, especially coronary disease and cerebrovascular and possibly peripheral artery disease. In this study, patient who suffering from claudication on exercise was relieved after 3 months of gum Arabic consumption, which strongly confirmed previous reports.

Dental calculus

Tooth decay is a disease of bacterial etiology more common among humans, and it is still regarded as a problem public health in many parts of the world, because it affects the quality life and personality of individuals affected also requires a staff and important government investment is incalculable the number of man hours lost in work, study and housework to result of dental disease and its treatment.

In odontology, calculus or tartar is a form of hardened dental plaque. It is caused by precipitation of minerals from saliva and gingival crevicular fluid in plaque on the teeth. It also contains waste products of bacteria as an invisible film formed that extends continuously around the teeth and dentures in the mouth. It is a sticky, almost imperceptible film formed by the bacteria in the oral cavity that extends constantly around the teeth and dentures in the mouth. Toxins not only affect the gum, but also destroy the underlying bone supporting the teeth causing periodontitis, damage tooth enamel and lead to cavities. Chronic inflammation of the gums by the accumulation of plaque often causes the formation of periodontal pockets. Plaque becomes dental calculus or tartar through a mineralization process thereof. A balanced demineralization and remineralization process has considered as the only way to maintain healthy and strong natural teeth, generating embryonic stem cells to a very significant impact on prevention of dental caries. The proportion or relationship that is saved between demineralization and remineralization is the difference between the development and prevention the process of decay. Tooth decay is the result of a series of changes triggered by bacteria specific, including  Streptococcus mutans Scientific Name Search in the biofilm of supragingival plaque. These bacteria by their virulence factors are capable of causing mineral loss and subsequent formation of a cavity due to the ion imbalance in the process mineralization and demineralization of hard tissues of the tooth resulting carbohydrate metabolism by these bacteria. Streptococcus mutans, bacterial species belonging to the group mutans streptococci and widely distributed in the world's population, has it has been implicated as the major causative agent of dental caries. Some studies suggested that gum Arabic could inhibit the formation of plaque and enhance dental remineralization, performing as a potential preventive agent in the formation of caries. Such properties are associated to the high salt component of Ca2+, Mg2+, and K of polysaccharides in gum Arabic, and the effect of the gum in the metabolism of calcium and phosphate.[46],[47]

Factors involved in the process of dental caries

Dental caries are a multifactorial disease of origin where there is an interaction of three main factors: the host (oral hygiene, saliva, and teeth), the micro flora (bacterial infections) and substrate (cariogenic diet). In addition to these factors, it should take into account one more time. For a cavity is formed it is necessary that the conditions of each factor are favorable; i.e. a susceptible host, a cariogenic oral flora and an appropriate substrate that must be present for a certain period.[48],[49],[50],[51]

Germ's plates are encompassed in a rich organic matrix protein and polysaccharides, with some lipids and inorganic constituents such as potassium, sodium, phosphate, magnesium, and calcium fluoride. The matrix proteins originate mainly in saliva and to a lesser extent, in their own plaque bacteria. Saliva is supersaturated solution in calcium and fluorine-containing phosphate, proteins, and enzymes, buffering agents, immunoglobulins and glycoproteins, among other elements important to prevent the formation of cavities.[4] The mineralization of plaque starts with substances chelation between the organic matrix and mineral salts present in saliva. In turn, degrade filamentous bacteria and salivary glycoproteins originating sucrose and chelating compounds such as saccharate glycinate and lactates. Then, primary crystal nuclei are formed, in the presence of basic pH, chelating agents react with inorganic ions such as calcium, from the crevicular fluid, phosphate, from hydrolysis of the phosphoric esters of saliva. These initial crystal nuclei bind phosphate ions, originating amorphous calcium phosphate. Finally, they are incorporated carbonates, mucopolysaccharides and calcium apatite forming compounds, with the result of a completely intermicrobial mineralized matrix. More concerning about oral hygiene, halitosis is defined as an unpleasant or offensive odor emitted from the mouth, usually it has a mouth cause, particularly derived from bacterial metabolism on the substrates and sulfur containing amino acids. The findings of the various investigations documented that the vast majority of the causes of halitosis are related to the oral cavity 2, with a prevalence ranging between 85% and 90%.[52],[53],[54],[55],[56],[57] For a long time, was conceived as a consequence of periodontal disease. The American Dental Association advises cleaning between the teeth once a day. This is important because plaque that is not detached by brushing and flossing can subsequently harden into calculus or tartar. According to this study, we suggest instead of flossing, use Gum Arabic for cleaning, shining, decolorizing the teeth and removing malodor (caused by periodontal or metabolic disease) along with many other physiological benefits.

Syringoma

Syringoma, usually multiple, is yellowish or covered by normal skin, popular lesions. Most often affect women from puberty. They are located in eyelids and cheeks fundamentally. They may also appear in abdomen, armpit, penis, and vulva. It affects 20% of patients carrying female Down syndrome. It described a variant of linear distribution; and another in which abruptly, multiple lesions appear on the trunk of young people called “Hidradenoma eruptive Darier-Jaquet.” Dermatopathology shown in the thickness of a fibrous stroma multiple ductal formations limited by two layers of epithelial cells, peripheral thin epithelial cords described as “tadpole tail” project. There is a histological variety called “syringoma clear cell” composed of clear cell lobes. This appearance is due to the accumulation of glycogen and therefore stains with PAS staining. It may be associated with diabetes. They have been treated with electrocoagulation and cryotherapy. Today, lasers can be applied to remove these lesions, but according to this study, using gum Arabic is affordable and effective for Universal access.[58],[59],[60],[61],[62]

Diabetes

Since this patient using allopathic medicine for lowering blood sugar simultaneously, we could not be able to evaluate the effects of gum Arabic on HbA1c and fasting blood sugar, so these results, we cannot take into account. For this reason, more clinical study will reveal the fact.


  Conclusion Top


The high prevalence diabetes mellitus type 2 and other chronic noncommunicable diseases observed in all poor and underdeveloped countries which affect people with a lower education and economy level, what shows that the poorest people bear the brunt. Diabetes results in various microvascular complications, making it one of the leading causes of amaurosis, nontraumatic amputation, and ESRD. In addition, diabetes increases to more than double the risk of coronary heart disease, stroke and peripheral vascular disease. Clinically, we observed a case of solitary kidney under adverse conditions long term treating with gum Arabic the vast potential of bioactive phytochemicals as a non-toxic, efficient with uric acid and bilirubin lowering agent and anti-inflammatory effects, considering the gum Arabic as a potential therapeutic supplement, beneficial in CRF, cardio-vascular disease, pain management, and dental health. Despite the nonexistent background concerning the benefits of gum Arabic, for a solitary kidney under adverse conditions, our study has confirmed that long term consumption of gum Arabic not only has no side effect but also protects multi-organs damage from drug adverse reactions and consequences of baseline disease, including renal, vascular, dental and inflammatory diseases. Finally, it is advisable to continue further studies continue to be performed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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    Figures

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    Tables

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