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The role of camel milk in the reactivation of liver damaged by Sudanese liquor (Aragi) The role of camel milk in the reactivation of liver damaged by Sudanese liquor (Aragi)

Authors:
  • University of Science & Technology, Sudan

Abstract

background: Alcoholism is "a primary, chronic disease characterized by impaired control on drinking, preoccupation with alcohol dependence, use of alcohol despite adverse consequences, and distortions in thinking. Camel milk is used as one of traditional cures used to improve impaired liver functions. Aim: To determine the effect of camel milk on reactivation of rat liver functions damaged by the Sudanese liquor (Aragi). Materials and Methods: The study was conducted on 30 adult male and female Wister albino rats; six of which were slaughtered at day (0) for histological investigation of the liver. The other (24) rats were divided equally between the control and the tested groups. Since day (0) up to day (30) the test group was given a calculated dose of Aragi while the control was given water. The levels of Glutamate Oxaloacetate Transaminase (GOT), Glutamate Pyruvate Transaminase (GPT) and Alkaline Phosphatase (ALP) were measured at days (0), (15), (30), (45), (60) for both groups. Liver samples were investigated for histological changes at days (30) and (60) for both groups. results and discussion: The results showed a statistically significant increase (p≤0.01) in the levels of GOT, GPT and ALP respectively, thirty days from the administration of Aragi, as compared to the control. Camel milk resulted in reducing the level of these enzymes to almost the same level of day (0) before Aragi intake. The reductions in the levels of GOT, GPT and ALP from day (30) to day (60) were 73.2 %, 53.9% and 65.4%, respectively. Conclusion: Camel milk can be used as an herbal remedy for treatment of alcoholism and other liver diseases which affect the hepatic enzymes as well as the liver tissues.
157
original article
The role of camel milk in the reactivation of
liver damaged by Sudanese liquor (Aragi)
The role of camel milk in the reactivation of liver damaged by
Sudanese liquor (Aragi)
Alaa Siddig Ahmed1 B.Sc, Nasma hyder Abdalbagi1 B.Sc, Howeida Abdullah Mustafa2 PhD, Alkhair Abd
Almahmoud Idris3 M.Sc, Ahmed Mohammed Ali Ismail1 PhD and Rashid Eltayb A/Alla4 PhD
1- School of health Sciences, Ahfad University for Women - Sudan.
2- School of Medicine, Ahfad University for Women - Sudan
3- Centre for Sciences Technology, Ahfad University for Women - Sudan.
4- School of Pharmacy, Ahfad University for women - Sudan.
Correspondence:
Alkhair Abd Almahmoud Idris, Centre for Science and Technology, Ahfad University for Women, Omdurman - Sudan,
P.O. Box: 167 Omdurman, Sudan. Tel: (+249) 9247063310, E-mail: alkhair20@hotmail.com
ABSTRACT
Background: Alcoholism is “a primary, chronic disease characterized by impaired control on drinking,
preoccupation with alcohol dependence, use of alcohol despite adverse consequences, and distortions
in thinking. Camel milk is used as one of traditional cures used to improve impaired liver functions.
Aim: To determine the effect of camel milk on reactivation of rat liver functions damaged by the Sudanese
liquor (Aragi). Materials and Methods: The study was conducted on 30 adult male and female Wister
albino rats; six of which were slaughtered at day (0) for histological investigation of the liver. The other
(24) rats were divided equally between the control and the tested groups. Since day (0) up to day (30) the
test group was given a calculated dose of Aragi while the control was given water. The levels of Glutamate
Oxaloacetate Transaminase (GOT), Glutamate Pyruvate Transaminase (GPT) and Alkaline Phosphatase
(ALP) were measured at days (0), (15), (30), (45), (60) for both groups. Liver samples were investigated for
histological changes at days (30) and (60) for both groups. Results and discussion: The results showed

the administration of Aragi, as compared to the control. Camel milk resulted in reducing the level of these
enzymes to almost the same level of day (0) before Aragi intake. The reductions in the levels of GOT, GPT and
ALP from day (30) to day (60) were 73.2 %, 53.9% and 65.4%, respectively. Conclusion: Camel milk can
be used as an herbal remedy for treatment of alcoholism and other liver diseases which affect the hepatic
enzymes as well as the liver tissues.
Key words: Aragi, camel milk, enzymes, histology, liver, rats.
INTRODUCTION
Alcoholism is the most widely used term to describe
patients with alcohol problems(1). Alcohol causes
1.8 million deaths (3.2% of total) and a loss of 58.3
million (4% of total) of Disability-Adjusted Life
Years (DALY)(2). Unintentional injuries alone account
for about one third of the 1.8 million deaths, while
neuro-psychiatric conditions account for close to
40% of the 58.3 million DALYs. The burden is not
equally distributed among the countries. Alcohol
consumption is the leading risk factor for disease
burden in low mortality developing countries and
the third largest risk factor in developed countries. In
Europe alone, alcohol consumption was responsible
for over 55 000 deaths among young people aged
15–29 Years in 1999(3).
An association between liver disease and heavy
alcohol consumption was recognized more than
200 years ago(4). Long-term heavy alcohol use
is the most prevalent single cause of illness and
death from liver disease in the United States(5). The
liver is particularly susceptible to alcohol-related
injury because it is the primary site of alcohol
metabolism. The liver is one of the largest organs
in the body; it has not only considerable reserves
but also the ability to regenerate itself. Heavy
long-term alcohol consumption clearly plays a
major role in the development of alcohol-related
liver damage. Yet, no more than one-half of heavy
drinkers develop alcoholic hepatitis or cirrhosis(6).
Alcohol has been a constant presence in African
social life for centuries as it has been in most parts
of the world(7).
158
original article
The role of camel milk in the reactivation of
liver damaged by Sudanese liquor (Aragi)
Aragi is the native alcoholic drink commonly used
in the Sudan; it has been the drink of choice to most
people who take alcohol, due to its affordable price
and availability
(8)
. Both the amount of the drink
consumed and the number of people taking it are
assumed to have risen. This implies an increase in the
risk of the emergence of toxicity due to Aragi intake
(9)
.
Medications of alcoholism revealed many side
effects including diarrhea, dyspepsia (indigestion),
headache, nausea, vomiting, rash and itching.
Recently folkloric treatment using natural products
is preferred as a replacement to the synthetic
     
side effects and secondly for their affordable
costs. The common herbs used worldwide for
treatment of alcoholism are St. John’s wort
(Hypericum perforatum, HPE), kudzu (Pueraria
lobata) and ibogaine (Tabernanthe iboga) and
Milk thistle
(10)
. In Sudan and the Arabic World,
Eruca sativa(garden rocket) and camel milk are
used traditionally to improve the impaired liver
functions. In Sudan, camel milk is almost number
one choice in many tribes. Camel milk is different
from other ruminant milk; having low cholesterol,
low sugar, high minerals (sodium, potassium, iron,
copper, zinc and magnesium), high vitamin C
(11)
,
low protein and large concentrations of insulin.
There are no allergens, and it can be consumed
      
weak immune systems. The milk is considered
as having medicinal properties. In Sahara, fresh
butter is not eaten, but is often used as a base for
medicines. The products developed also include
cosmetics or pharmaceuticals
(12)
. It is claimed
that the value of camel milk is to be found in the
high concentrations of volatile acids especially,
linoleic acid and polyunsaturated acids, which are
essential for human nutrition. A series of metabolic
and autoimmune diseases are successfully being
treated with camel milk. In India, camel milk is used
therapeutically against dropsy, jaundice, problems
of the spleen, tuberculosis, asthma, anaemia, piles
and diabetes
(13)

chronic pulmonary tuberculosis patients has been
observed
(14)
. In repeated trials, it was observed that
there was 30-35 percent reduction in daily doses
of insulin in patients of type 1 diabetes receiving
raw camel milk
(15-16)
.
Some medications of alcoholism are toxic and
        
motivated us to search for new medications; one of
them is camel’s milk. This study aimed to determine
the effect of camel’s milk on reactivation of rat liver
functions damaged by the Sudanese liquor (Aragi).
MATERIALS AND METHODS
Preparation of traditional Aragi
A small amount of yeast was added to boiled water
and then poured onto washed dates in a clean pot.
         
after which the fermented liquor was distilled and
collected in a clean bottle, and then it was diluted
to 50%. The absolute Aragi was checked using an
ignition test.
Source of Camel milk
Fresh camel milk was obtained from Alaa,s farm,
every 3 days. The stock was kept in the refrigerator.
Experimental animals
Adult Wistar albino rats were used for this study.
This research was conducted in adult male and
female Wistar albino rats weighing (109-142
grams). All animals received humane care according
to the guidelines outlined by the Committee for the
Purpose of Control and Supervision on Experiments
on Animals(17).
Study areas
This study was carried out at Laboratory (7) -
Ahfad University for Women. Biochemical analysis
was conducted at the National Health Laboratory.
Histological examination was performed at Faculty
of Veterinary Medicine – University of Khartoum.
Diet of rats
The diet given to the rats consisted of (dried chicken
.
Study design
This experimental laboratory based study, was
conducted in a total number of 30 rats, 6 of which
were slaughtered at day (0) for histological
investigation of the liver (which was dissected
and preserved in 10% formaldehyde). The
other 24 rats were divided equally between the
control and the tested groups i.e. each group was
represented by 12 rats. Both groups were kept
under the same environmental conditions and
were provided with the same amount of water
and food. Rats were kept in their new location
for 10 days before starting the experiment (as
a period of adaptation). Since day (0) up to day
(30) the test group was given a calculated dose of
Aragi (equivalent to two cups taken by a human
being). The control group was given water instead
of Aragi. Blood samples (from both groups) were
159
collected (by means of capillary tubes from
the retro – orbital plexus of the rats’ eyes in
heparinized sample containers) at days 0, 15 and
30 for biochemical analysis of GOT, GPT and ALP.
The levels of these enzymes were determined
using Plasmatec kits. Furthermore at day (30), six
rats of each group were slaughtered for collection
of autopsy samples from the liver. The Aragi
drinkers were then given a dose corresponding
500 mls taken by a human being. Each rat was
given a calculated dose according to its body
weight. Administration of camel milk continued
till day (60) (i.e. for one month after abstinence
of Aragi). Blood samples for biochemical analysis
of the liver enzymes was conducted at days (45)
and (60) and all rats were then slaughtered for
histological investigation of the liver.
Biochemical analysis
Blood samples were collected into heparinized
sample containers and after mild shaking were
centrifuged at 3000 revolutions/minute (rpm)
       
separated from the cellular part using a dropper
and the plasma was placed in a new plane sample
container labeled according to the study group,
rat number, time and date of collection. The levels
of GOT, GPT and ALP enzymes were determined
using Plasmatec kits. Histopathological
examination: The specimens were collected
     
     
      
examined. The histopathological processing
   
wax impregnation, section cutting, staining;
examination
(18)
. And then light microscopic

of 4x, 10x and 40x. Histopathological 
      
fatty degeneration, were expressed qualitatively
with + sign(s) (+: slight, ++: moderate and
+++: severe) according to the dissemination of
     
present or absent
(19)
.
Statistical analysis
Mean values in plasma parameters were compared
using the student’s t-test to detect the difference.
Change in individual serum parameters against
. Chi-square was
applied to estimate the correlation between plasma
parameters and time.
RESULTS
According to visual observation the following
  
the Aragi drinkers showed more food consumption,
The Aragi drinkers showed different behaviours, a
few minutes after intake of Aragi including: a curved
- back posture with a hidden head, an unstable gait
(walking), lying with hands and legs up. After one
month of continuous alcohol intake it was noticed
that some rats were so aggressive that they badly
injured each other.
Biochemical analysis
   
(15) and (30) respectively, in the blood level of
GOT hepatic enzyme, after administration of the
Sudanese traditional liquor (Aragi) to the Aragi
drinker group, as compared to the control (Table 1)
Table (1):
Effect of Aragi on the level of GOT enzyme
Day 30 Day 15 Day 0
24.25 ±
2.02 U/L
29.08 ±
2.38 U/L
26.33 ±
1.66 U/L
Control
group
127.58 ±
14.16 U/L **
73.17 ±
3.79 U/L **
33.50 ±
1.73 U/L
Aragi
drinkers
(Data were expressed in mean± standard error of mean)

Effect of camel’s milk on reduction of the elevated
level of GOT
This elevation was reduced to almost the same level
of day (0) after stopping Aragi and administering
camel’s milk to the same group (Aragi drinkers)
        
milk, exerted a reduction of 46.7% on the level of
GOT from day (30) to day (45) and a reduction of
46.8% from day (45) to day (60). The one-month
administration of camel’s milk revealed a reduction
of 73.2% in the level of GOT. Camel’s milk succeeded
in bringing the elevated level of GOT, to almost the

original article
The role of camel milk in the reactivation of
liver damaged by Sudanese liquor (Aragi)
160
Figure (1):
Note:
From day (0) to day (30) = Administration of Aragi
From day (30) to day (60) = Abstinence of Aragi and
administration of camel’s Milk.
Effect of Aragi on level of GPT enzyme
      
days (15) and (30) respectively, in the blood level
of GPT hepatic enzyme, after administration of
the Sudanese traditional liquor (Aragi) to the
Aragi drinker group, as compared to the control
(Table 2).
Table (2):
Effect of Aragi on level of GPT enzyme
Day 30 Day 15 Day 0
28.2500 ±
3.0154 U/L
29.50 ±
3.68 U/L
30.42 ±
3.23 U/L
Control
group
110.83 ±
7.91 U/L **
76.25±
7.04 U/L **
41.75 ±
2.2195 U/L
Aragi
drinkers
(Data were expressed in mean± standard error of mean)

Effect of camel’s milk on reduction of the elevated
level of GPT
Abstinence of Aragi and administration of camel’s
milk for one month resulted in a 21.9 % reduction
of the level of GPT from day (30) to day (45), and
a reduction of 53.1 % from day (45) to day (60).
Camel’s milk revealed a 53.9% reduction in the level
of GPT from day (30) to day (60), as demonstrated
  
elevated level of GPT, to almost the same level before

original article
The role of camel milk in the reactivation of
liver damaged by Sudanese liquor (Aragi)
Figure (2):
Note:
From day (0) to day (30) = Administration of Aragi
From day (30) to day (60) = Abstinence of Aragi and
administration of camel milk.
Effect of Aragi on level of ALP enzyme:
      
days (15) and (30) respectively, in the blood level
of ALP hepatic enzyme, after administration of
the Sudanese traditional liquor (Aragi) to the
Aragi drinker group, as compared to the control
(Table 3).
Table (3):
Effect of Aragi on the level of ALP enzyme
Day 30 Day 15 Day 0
76.42 ±
7.27 U/L
76.45 ±
8.58 U/L
76.33 ±
7.91 U/L
Control
group
268.75 ±
30.47 U/L **
172.91 ±
22.99 U/L **
81.50 ±
5.14 U/L
Aragi
drinkers
(Data were expressed in mean± standard error of mean)

Effect of camel milk on reduction of the elevated
level of ALP
Abstinence of Aragi and administration of camel
milk for one month resulted in a 74.9% reduction
of the level of ALP from day (30) to day (45), and
an elevation of 27.4 % from day (45) to day (60).
The reduction exerted by camel milk since day (30)
till day (60) was as high as 65.4%, as demonstrated
        
elevated level of ALP, to almost the same level before
Aragi intake (Figure 3).
Fig. 1
Eff ect o f Cam el milk on n orma liza tion o f Arag i
damaged GOT
0
20
40
60
80
100
120
140
Day 0 Day 30 Day 60
[GOT] U/L
Level of GOT
Fig 2
Effect of Camel milk on normalization
of Aragi damaged GPT
120
100
[GPT] U/L
80
Level of GPT60
40
20
0
Day 0Day 30 Day 60
161
Figure (3):
Note:
From day (0) to day (30) = Administration of Aragi
From day (30) to day (60) = Abstinence of Aragi and
administration of camel milk.
Histopathological findings

livers of the different study groups were expressed
in table (4).
Table (4): 
Histological
findings
Control
Day 0
Control
( day 30)
Aragi
drinkers
(day 30)
Camel
milk
(day 60)
N = 6 N = 6 N = 6 N = 6
In portal tract

Slight(+) - - - -
Medium(++) - - 1 2
Severe(+++) - - 1 -
Fibrosis
Slight(+) - - - 2
Medium(++) - - 1 -
Severe(+++) - - - -
Focal necrosis
Slight(+) - - - -
Medium(++) - - 1 -
Severe(+++) - - 1 -
Fatty degeneration
Slight(+) - - 2 2
Medium(++) - - 2 -
Severe(+++) - - - -
N=number of rats.

DISCUSSION

        
hepatic enzymes GOT, GPT and ALP one month after
administration of Aragi to adult Wistar Albino rats.
A previous study reported that various biochemical
     
use disorder. Another study revealed that plasma

group compared to the control (P<0.01)(19).
      
no histological alterations in day (0) and in the
control group. On the other hand, the Aragi drinkers
     

as well as slight and medium fatty degeneration.
A previous study reported that accumulation of fat
in liver developed in all the rats that received alcohol
as part of their diets(19-20).
A previous study mentioned that chronic ethanol
administration to rodents has been demonstrated
to lead to a number of hepatic changes including
   
  
proliferation of the smooth endoplasmic reticulum,
and mitochondrial aberrations. All these changes
also occurred in the early phase of human alcoholic
liver disease, demonstrating the relevance of the
experimental models(21).
The next part of this study was a treatment trial
using camel milk to reactivate the hepatic cells and
enzymes damaged by Aragi.
The results of this research showed a very high
       
and ALP as well as repairing the damaged cells and
tissues to almost normal structures. A four weeks`
administration of camel milk to Aragi drinker rats,
succeeded in improving the levels of the Aragi
damaged liver enzymes to their normal level at day
(0) before Aragi intake. Furthermore, camel milk

necrosis and fatty degeneration resulted due to
Aragi intake.
A previous study proved that the brown rice extracts
rich in Gamma-amino butyric acid (GABA) seemed
to protect animals from the liver-damaging effects

or effective in man requires research(22).
Some studies found that the medicinal herbs
help in the recovery process by supporting and
healing the liver, detoxifying the body. One of the
best known and respected herbs for protecting
the liver is milk thistle (Silybum marianum). The
original article
The role of camel milk in the reactivation of
liver damaged by Sudanese liquor (Aragi)
Fig 3
Effect of Camel milk on normalization
of the level of Aragi damaged ALP
350
300
250
200
0
50
100
150
Day 0 Day
30 Day60
Level of ALP
[ALP] U/L
162
Silymarin contained in the seeds acts to help the
liver better eliminate toxins, including alcohol.
Studies conducted in Austria and Hungary have
demonstrated silymarin administration resulted
in a normalization of serum liver enzyme and
total bilirubin levels in patients with alcoholic
liver disease, in addition to improved liver tissue
histology
( 23)
. In patients with cirrhosis, long-term
(41 months) administration of silymarin at 420 mg

compared to the placebo group
(24)
.
Other studies performed on St. John’s Wort (Hypericum
perforatum) (often used to treat depression), helped
in reducing alcohol consumption. Animal studies
suggested that the use of this herb in alcoholism is
appropriate(25).
Some researches suggested that kudzu (a Chinese
herb), can help to dampen the desire to drink.
There is stronger evidence to suggest that kudzu

toxins(26).
    
effectiveness of camel’s milk on reduction of the
hepatic enzymes GOT, GPT and ALP, which were
elevated due to excessive alcohol intake. A one
month administration of camel’s milk reduced
these enzymes to almost the same level before
Aragi intake. Furthermore, the multinuclear
      
degeneration resulted due to excessive Aragi intake,
were moderately improved after administration of
camel milk for one month.
The achieved results lead to a conclusion that
camel’s milk can be used as a traditional remedy
for treatment of alcoholism and other liver diseases
which affect hepatic enzymes as well as the liver
tissues.
This study highly recommends that camel’s milk
should be included among the medications used for
treatment of liver diseases and further research is
        
size.
Acknowledgement:
We would like to thank Professor Gasim Badri for
his support and the administration of the National
Centre for Researches and to the technologists of
the histopathology laboratory/ Faculty of Veterinary
Medicine/University of Khartoum. Great thanks
to the members of the Electron Microscope Unit/
Faculty of Sciences/ University of Khartoum and to
the technologists of the Department of the Quality
Control / National Health Laboratory.
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... It is known to have a therapeutic potential against many diseases including cancer [42]. It has long been utilized for its beneficial effect in broad range of disease conditions, such as insulin-dependent diabetes mellitus (IDDM) [6], infant diarrhea [121], hepatitis [24,30], allergy [105], lactose intolerance [28], autism [104] and alcohol-induced liver damage [8]. Its benefits can be attributed to the presence of many immunologically important molecules such as lysozymes, lactoferrin and lactoperoxidase. ...
... Milk fatty acid composition is one of the aspects related to the health effects of camel's milk and its products. However, the fatty acid composition of camel milk is not well documented [8]. Human milk fat contains a higher content of unsaturated fatty acids compared with bovine, but camel's milk seems to be very different from other mammalian milks in terms of unsaturated fatty acid composition and in its low content of short-chain fatty acids. ...
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Camel milk is known as the white gold of the desert because it contains a variety of nutrients in it which play a key role in the human diet. The health benefits of camel milk have been described in a variety of diseases such as diabetes, kidney disease, Autism, hepatitis, etc. including improved overall survival. It causes a major health burden of liver diseases worldwide, and the ninth leading cause of death is due to liver cirrhosis in Western countries. The treatment is mostly not effective for cirrhosis, fatty liver, and chronic hepatitis which are the most common diseases of the liver, carry the risk of side effects, and are often extremely expensive, particularly in the developing world. A systematic review of studies was performed to determine the association of consumption of camel milk on multiple diseases of the liver. The impact of camel milk on the laboratory tests related to liver disorder, viral hepatitis, nonalcoholic fatty liver disease (NAFLD), cirrhosis, and hepatocellular carcinoma (HCC) were evaluated. The consumption of camel milk was ac-companied to modulate the values of serum gamma-glutamyl transferase, aspartate aminotransferase, and alanine aminotransferase in the persons who are at the risk of liver disease. In the patients with chronic liver disease, it was observed that they have low rates of mortality and low chances of progression to cirrhosis when they consume camel milk. Therefore, in patients with liver diseases, the addition of camel milk into their normal daily diet plan should be encouraged. In this review, camel milk's impact on the different kinds of liver diseases or any disorder associated with liver functioning was evaluated. The camel milk has a therapeutic as well as a preventive role in the maintenance and improving the metabolic regulations of the body.
... It is expected to have a therapeutic potential against many diseases including cancer. It has long been utilized for its benefit in broad range of diseases like Insulin Dependent Diabetes Mellitus (IDDM) ( Agrawal et al., 2002;Agrawal et al., 2003;Agrawal et al., 2005), infant diarrhea (Yagil, 2013), hepatitis (El-Fakharany et al., 2008), allergy, lactose intolerance ( El-Agamy et al., 2009;Konuspayeva et al., 2009;Cardoso et al. 2010) and alcohol induced liver damage (Ahmed et al., 2011). Its benefits can be attributed to the presence of many immunologically important molecules such as lysozymes, lactoferrin, lactoperoxidase, etc. ( El-Agamy et al., 1996). ...
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