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Tuono De Manfouo R, Louokdom JS, Chetcha BC, Bakam Magoua LM, Nya PCB, Pieme CA, Tayou Tagny C. Involvement of haptoglobin in disease development. World J Hematol 2024; 11:94171. [DOI: 10.5315/wjh.v11.i2.94171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/28/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024] Open
Abstract
Haptoglobin (HP) is a liver glycoprotein that is actively synthesized during inflammatory and hemolytic processes. It also has pro-oxidant and proinflammatory properties, which are a function of its genotype. The genetic polymorphism of the chains leads to synthesis of three phenotypes/proteins, which are related to the number and type of chains and their molecular weight, namely HP1-1, HP1-2 and HP2-2. Patients with HP2-2 have more vascular complications, while those with HP1-1 have fewer. HP is involved in the worsening of diseases, such as HP2-2 in aggravation of vaso-occlusive crises in sickle cell disease, and worsening of the pathophysiology of other diseases. In contrast, HP1-1 confers better protection against diseases. All of this suggests that further studies should be conducted, including experimental and analytical studies focused on demonstrating the influence of different HP genotypes on individual clinical and hematological data. This would help in understanding the role played by this genetic polymorphism in the pathophysiology of diseases.
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Affiliation(s)
- Romaric Tuono De Manfouo
- Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Hematology Unit, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé 296, Cameroon
| | - Josué Simo Louokdom
- Higher Institute of Health Sciences, Université des Montagnes, Bangangté 296, Cameroon
| | - Bernard Claude Chetcha
- Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Hematology Unit, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé 296, Cameroon
| | - Larissa Michelle Bakam Magoua
- Public Health and Biotechnology Research Laboratory (LAPHER-Biotech), Faculty of Sciences, University of Yaoundé 1, Yaoundé 296, Cameroon
| | | | - Constant Anatole Pieme
- Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé 296, Cameroon
| | - Claude Tayou Tagny
- Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Hematology Unit, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé 296, Cameroon
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Obeagu EI, Obeagu GU. Malnutrition in sickle cell anemia: Prevalence, impact, and interventions: A Review. Medicine (Baltimore) 2024; 103:e38164. [PMID: 38758879 PMCID: PMC11098235 DOI: 10.1097/md.0000000000038164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/17/2024] [Indexed: 05/19/2024] Open
Abstract
Sickle Cell Anemia (SCA) is a hereditary hemoglobinopathy characterized by chronic hemolytic anemia, vaso-occlusive events, and a wide range of clinical complications. Malnutrition, often an underexplored aspect of this complex condition, plays a critical role in disease management and overall patient well-being. This publication provides a comprehensive review of the prevalence, impact, and interventions related to malnutrition in individuals with SCA. A thorough literature review reveals the multifaceted challenges faced by SCA patients in maintaining adequate nutrition. The pathophysiology of SCA, involving chronic inflammation, oxidative stress, and hypermetabolism, contributes to increased nutritional requirements and altered dietary patterns. Factors such as reduced appetite, nutrient malabsorption, dietary restrictions, and socioeconomic disparities further exacerbate the risk of malnutrition. Malnutrition is a prevalent issue among individuals with SCA, affecting patients of different age groups and disease severities. Nutritional deficiencies, including vitamins, minerals, and essential nutrients, are common in this population. The impact of malnutrition on disease outcomes is significant, with associations between nutrient status and complications such as pain crises, infections, and impaired quality of life. This paper also reviews nutritional interventions aimed at addressing malnutrition in SCA patients. While dietary counseling, supplementation, and personalized nutrition plans have shown promise in improving nutritional status, challenges such as patient adherence and access to healthcare must be addressed to optimize their effectiveness.
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Kashyap Y, Wang ZJ. Gut microbiota dysbiosis alters chronic pain behaviors in a humanized transgenic mouse model of sickle cell disease. Pain 2024; 165:423-439. [PMID: 37733476 PMCID: PMC10843763 DOI: 10.1097/j.pain.0000000000003034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/31/2023] [Indexed: 09/23/2023]
Abstract
ABSTRACT Pain is the most common symptom experienced by patients with sickle cell disease (SCD) throughout their lives and is the main cause of hospitalization. Despite the progress that has been made towards understanding the disease pathophysiology, major gaps remain in the knowledge of SCD pain, the transition to chronic pain, and effective pain management. Recent evidence has demonstrated a vital role of gut microbiota in pathophysiological features of SCD. However, the role of gut microbiota in SCD pain is yet to be explored. We sought to evaluate the compositional differences in the gut microbiota of transgenic mice with SCD and nonsickle control mice and investigate the role of gut microbiota in SCD pain by using antibiotic-mediated gut microbiota depletion and fecal material transplantation (FMT). The antibiotic-mediated gut microbiota depletion did not affect evoked pain but significantly attenuated ongoing spontaneous pain in mice with SCD. Fecal material transplantation from mice with SCD to wild-type mice resulted in tactile allodynia (0.95 ± 0.17 g vs 0.08 ± 0.02 g, von Frey test, P < 0.001), heat hyperalgesia (15.10 ± 0.79 seconds vs 8.68 ± 1.17 seconds, radiant heat, P < 0.01), cold allodynia (2.75 ± 0.26 seconds vs 1.68 ± 0.08 seconds, dry ice test, P < 0.01), and anxiety-like behaviors (Elevated Plus Maze Test, Open Field Test). On the contrary, reshaping gut microbiota of mice with SCD with FMT from WT mice resulted in reduced tactile allodynia (0.05 ± 0.01 g vs 0.25 ± 0.03 g, P < 0.001), heat hyperalgesia (5.89 ± 0.67 seconds vs 12.25 ± 0.76 seconds, P < 0.001), and anxiety-like behaviors. These findings provide insights into the relationship between gut microbiota dysbiosis and pain in SCD, highlighting the importance of gut microbial communities that may serve as potential targets for novel pain interventions.
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Affiliation(s)
- Yavnika Kashyap
- Departments of Pharmaceutical Sciences and Center for Biomolecular Science, University of Illinois, Chicago, IL, United States
| | - Zaijie Jim Wang
- Departments of Pharmaceutical Sciences and Center for Biomolecular Science, University of Illinois, Chicago, IL, United States
- Department of Neurology & Rehabilitation, and Sickle Cell Center, University of Illinois College of Medicine, Chicago, IL, United States
- Department of Biomedical Engineering, University of Illinois, Chicago, IL 60607, United States
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Tuono RDM, Simo JL, Nya PCB, Chedjou JP, Fotsing CBK, Chetcha BC, Tah CF, Tayou CT, Mbatcham WF, Pieme CA. Haptoglobin gene polymorphism and iron profile in sickle cell disease patients with inflammation in Yaounde, Cameroon. Mol Genet Genomic Med 2024; 12:e2302. [PMID: 37970725 PMCID: PMC10767582 DOI: 10.1002/mgg3.2302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/16/2023] [Accepted: 10/13/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Major sickle cell syndromes are the most common hemoglobinopathy in the world. The sickle cell patients are subjected to several factors causing inflammation, and the genetic identification of each individual allows to focus the possibility of allelic variations influence of a specific gene and then the polymorphism. This study aims at determining the distribution of HP gene (OMIM#140100) and their involvement on hematological parameters and the iron profile in the sickle cell patients presenting an inflammation condition during major sickle cell syndromes in Cameroun. METHODS A case-control analytical study has been conducted over a period of 6 months. Cases consisting of sickle cell patients in a situation of inflammation and control of non-inflamed sickle cell patients. The patients presenting major sickle cell syndromes, interned and/or followed at the Hematology Department of the Regional Hospital of Bafoussam and the Central Hospital of Yaoundé have been recruited. HP genotyping was carried out at the Laboratory for Public Health Research Biotechnologies (LAPHER-Biotech) in Yaoundé using allele-specific PCR. Also, inflammatory, hematological parameters and martial assessment were explored by standard methods. Statistical analysis of the data was performed using the statistical tool R version 4.1.1. The comparison of proportions of alleles was made with the chi-square test, and the Wilcoxon test was used to compare the median between different groups using the statistical tool R version 4.1.1. RESULTS We analyzed the samples of 149 patients. The HP polymorphism describes a significant frequency of the "1F" allele (69.8%) followed by the "2" allele (46.31%). In addition, 80 patients (53.69%), 48 (32.21%), and 21 (14.09%) presented the genotype HP 1-1, HP 2-1, and HP 2-2, respectively. And eighty-one percent (81%) patients with genotype HP 2-2 showed a significant higher relative frequency of thrombocytosis compared with the genotype HP 1-1 and HP 2-1, respectively (51.2% and 68.8%, p = 0.087). The proportion of inflammation in the HP 2-2 group was higher (57.1%) compared with the other groups (respectively 42.5% and 35.4% in the HP 1-1 and HP 2-1 groups). Furthermore, the median CRP was significantly higher in the HP 2-2 group compared with the other groups (p = 0.039). Moreover, the entire population of the HP 2-2 group showed an elevation of ferritin and IL6 unlike the HP 1-1 and HP 2-1 groups. CONCLUSION This study demonstrates a higher frequency of genotype HP 1-1 followed by the HP 2-2 genotype in patients with major sickle cell syndromes. However, a larger proportion of patients with genotype HP 2-2 are associated with hematological profile disorders, inflammation, and dysregulation of iron metabolism. Then, the haptoglobin polymorphism contributes to the severity of major sickle cell syndromes.
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Affiliation(s)
- Romaric De Manfouo Tuono
- Department of Hematology, Virology, and Infectious Disease, Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundéCameroon
- Faculty of Health SciencesUniversity of MontagnesBangangteCameroon
- Laboratory of Biochemistry, Department of Biochemistry, Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundéCameroon
| | | | | | - Jean Paul Chedjou
- Public Health and Biotechnology Research Laboratory (LAPHER‐Biotech)YaoundéCameroon
| | | | - Bernard Claude Chetcha
- Department of Hematology, Virology, and Infectious Disease, Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundéCameroon
| | - Calvino Fomboh Tah
- Public Health and Biotechnology Research Laboratory (LAPHER‐Biotech)YaoundéCameroon
| | - Claude Tagny Tayou
- Department of Hematology, Virology, and Infectious Disease, Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundéCameroon
| | - Wilfried Fon Mbatcham
- Public Health and Biotechnology Research Laboratory (LAPHER‐Biotech)YaoundéCameroon
- Department of Biochemistry, Faculty of ScienceUniversity of Yaounde IYaoundéCameroon
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Tuono RDM, Simo JL, Nya PCB, Chedjou JP, Fotsing CBK, Chetcha BC, Tah CF, Tayou CT, Mbatcham WF, Pieme CA. Haptoglobin gene polymorphism and iron profile in sickle cell disease patients with inflammation in Yaounde, Cameroon. Mol Genet Genomic Med 2024; 12. [DOI: https:/doi.org/10.1002/mgg3.2302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/13/2023] [Indexed: 04/01/2024] Open
Abstract
AbstractBackgroundMajor sickle cell syndromes are the most common hemoglobinopathy in the world. The sickle cell patients are subjected to several factors causing inflammation, and the genetic identification of each individual allows to focus the possibility of allelic variations influence of a specific gene and then the polymorphism. This study aims at determining the distribution of HP gene (OMIM#140100) and their involvement on hematological parameters and the iron profile in the sickle cell patients presenting an inflammation condition during major sickle cell syndromes in Cameroun.MethodsA case–control analytical study has been conducted over a period of 6 months. Cases consisting of sickle cell patients in a situation of inflammation and control of non‐inflamed sickle cell patients. The patients presenting major sickle cell syndromes, interned and/or followed at the Hematology Department of the Regional Hospital of Bafoussam and the Central Hospital of Yaoundé have been recruited. HP genotyping was carried out at the Laboratory for Public Health Research Biotechnologies (LAPHER‐Biotech) in Yaoundé using allele‐specific PCR. Also, inflammatory, hematological parameters and martial assessment were explored by standard methods. Statistical analysis of the data was performed using the statistical tool R version 4.1.1. The comparison of proportions of alleles was made with the chi‐square test, and the Wilcoxon test was used to compare the median between different groups using the statistical tool R version 4.1.1.ResultsWe analyzed the samples of 149 patients. The HP polymorphism describes a significant frequency of the “1F” allele (69.8%) followed by the “2” allele (46.31%). In addition, 80 patients (53.69%), 48 (32.21%), and 21 (14.09%) presented the genotype HP 1‐1, HP 2‐1, and HP 2‐2, respectively. And eighty‐one percent (81%) patients with genotype HP 2‐2 showed a significant higher relative frequency of thrombocytosis compared with the genotype HP 1‐1 and HP 2‐1, respectively (51.2% and 68.8%, p = 0.087). The proportion of inflammation in the HP 2‐2 group was higher (57.1%) compared with the other groups (respectively 42.5% and 35.4% in the HP 1‐1 and HP 2‐1 groups). Furthermore, the median CRP was significantly higher in the HP 2‐2 group compared with the other groups (p = 0.039). Moreover, the entire population of the HP 2‐2 group showed an elevation of ferritin and IL6 unlike the HP 1‐1 and HP 2‐1 groups.ConclusionThis study demonstrates a higher frequency of genotype HP 1‐1 followed by the HP 2‐2 genotype in patients with major sickle cell syndromes. However, a larger proportion of patients with genotype HP 2‐2 are associated with hematological profile disorders, inflammation, and dysregulation of iron metabolism. Then, the haptoglobin polymorphism contributes to the severity of major sickle cell syndromes.
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Affiliation(s)
- Romaric De Manfouo Tuono
- Department of Hematology, Virology, and Infectious Disease, Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaoundé Cameroon
- Faculty of Health Sciences University of Montagnes Bangangte Cameroon
- Laboratory of Biochemistry, Department of Biochemistry, Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaoundé Cameroon
| | | | | | - Jean Paul Chedjou
- Public Health and Biotechnology Research Laboratory (LAPHER‐Biotech) Yaoundé Cameroon
| | | | - Bernard Claude Chetcha
- Department of Hematology, Virology, and Infectious Disease, Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaoundé Cameroon
| | - Calvino Fomboh Tah
- Public Health and Biotechnology Research Laboratory (LAPHER‐Biotech) Yaoundé Cameroon
| | - Claude Tagny Tayou
- Department of Hematology, Virology, and Infectious Disease, Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaoundé Cameroon
| | - Wilfried Fon Mbatcham
- Public Health and Biotechnology Research Laboratory (LAPHER‐Biotech) Yaoundé Cameroon
- Department of Biochemistry, Faculty of Science University of Yaounde I Yaoundé Cameroon
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Kirkham JK, Estepp JH, Weiss MJ, Rashkin SR. Genetic Variation and Sickle Cell Disease Severity: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2337484. [PMID: 37851445 PMCID: PMC10585422 DOI: 10.1001/jamanetworkopen.2023.37484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/30/2023] [Indexed: 10/19/2023] Open
Abstract
Importance Sickle cell disease (SCD) is a monogenic disorder, yet clinical outcomes are influenced by additional genetic factors. Despite decades of research, the genetics of SCD remain poorly understood. Objective To assess all reported genetic modifiers of SCD, evaluate the design of associated studies, and provide guidelines for future analyses according to modern genetic study recommendations. Data Sources PubMed, Web of Science, and Scopus were searched through May 16, 2023, identifying 5290 publications. Study Selection At least 2 reviewers identified 571 original, peer-reviewed English-language publications reporting genetic modifiers of human SCD phenotypes, wherein the outcome was not treatment response, and the comparison was not between SCD subtypes or including healthy controls. Data Extraction and Synthesis Data relevant to all genetic modifiers of SCD were extracted, evaluated, and presented following STREGA and PRISMA guidelines. Weighted z score meta-analyses and pathway analyses were conducted. Main Outcomes and Measures Outcomes were aggregated into 25 categories, grouped as acute complications, chronic conditions, hematologic parameters or biomarkers, and general or mixed measures of SCD severity. Results The 571 included studies reported on 29 670 unique individuals (50% ≤ 18 years of age) from 43 countries. Of the 17 757 extracted results (4890 significant) in 1552 genes, 3675 results met the study criteria for meta-analysis: reported phenotype and genotype, association size and direction, variability measure, sample size, and statistical test. Only 173 results for 62 associations could be cross-study combined. The remaining associations could not be aggregated because they were only reported once or methods (eg, study design, reporting practice) and genotype or phenotype definitions were insufficiently harmonized. Gene variants regulating fetal hemoglobin and α-thalassemia (important markers for SCD severity) were frequently identified: 19 single-nucleotide variants in BCL11A, HBS1L-MYB, and HBG2 were significantly associated with fetal hemoglobin (absolute value of Z = 4.00 to 20.66; P = 8.63 × 10-95 to 6.19 × 10-5), and α-thalassemia deletions were significantly associated with increased hemoglobin level and reduced risk of albuminuria, abnormal transcranial Doppler velocity, and stroke (absolute value of Z = 3.43 to 5.16; P = 2.42 × 10-7 to 6.00 × 10-4). However, other associations remain unconfirmed. Pathway analyses of significant genes highlighted the importance of cellular adhesion, inflammation, oxidative and toxic stress, and blood vessel regulation in SCD (23 of the top 25 Gene Ontology pathways involve these processes) and suggested future research areas. Conclusions and Relevance The findings of this comprehensive systematic review and meta-analysis of all published genetic modifiers of SCD indicated that implementation of standardized phenotypes, statistical methods, and reporting practices should accelerate discovery and validation of genetic modifiers and development of clinically actionable genetic profiles.
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Affiliation(s)
- Justin K. Kirkham
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Jeremie H. Estepp
- Department of Hematology, St Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
- Now with Agios Pharmaceuticals, Cambridge, Massachusetts
| | - Mitch J. Weiss
- Department of Hematology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Sara R. Rashkin
- Department of Hematology, St Jude Children’s Research Hospital, Memphis, Tennessee
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Tuono De Manfouo R, Louokdom JS, Chetcha BC, Nya PCB, Pieme CA, Tagny CT. Homozygote drepanocytosis: Ferric status and inflammation in world and Africa: Review article and meta analysis. Health Sci Rep 2023; 6:e1609. [PMID: 37808933 PMCID: PMC10551275 DOI: 10.1002/hsr2.1609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
Background and Aims Major sickle cell syndromes are subjected to a high frequency of hemolysis, infections, oxidative stress, and vasooclusive crises which promote inflammation and iron balance disorders. We aimed to systematically review and analyze the studies in this patients addressing in general, and Africa in particular. Methods The systematic review of published articles in the Pubmed and Google Scholar databases was carried out according to the recommendations of the PRISMA model. The case-control articles have been included. The data extracted from the articles were analyzed using statistical software R. The standardized mean difference (SMD) was used to assess the extent of the disease on the different variables studied. Results At the end, 128 articles were obtained; but only 33 were elligible for meta-analysis. A SMD of -1.79 was obtained for hemoglobin between the sickle cell patients and the controls due to the deviation from the overall mean hemoglobin in the cases (8 ± 2 g/dL) and in controls (13 ± 3 g/dL). Sickle cell disease showed a significant extent on ferritin [SMD = 2.61; (95% confidence interval, CI: 2.39-2.83); (p < 0.01)] compared to non-sickle cell patients thus describing a higher risk for sickle cell sufferer to have ferritin disorders. The included studies also described the influence of sickle cell anemia on serum iron [SMD = 1.52; (95% CI: 1.32-1.76); (p < 0.01)] compared to normal subjects. The high risk of inflammation has been described as higher in sickle cell patients [SMD = 0.38; (95% CI: 0.25-0.50)], reflecting the moderate extent of sickle cell disease on inflammation. Conclusion Patients with major sickle cell syndrome in inflammation have a higher risk of iron profile disorders compared to the normal population. Further studies are needed to explore mechanisms for preventing the deleterious effects of iron from this hemolysis, for example haptoglobin genotyping.
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Affiliation(s)
- Romaric Tuono De Manfouo
- Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Faculty of Medicine and Biomedical SciencesUniversité de Yaoundé 1YaoundéCameroon
- Department of Medicine, Pharmacy, and Biomedical Sciences, Higher Institute of Health SciencesUniversité des MontagnesBangangtéCameroon
| | - Josué Simo Louokdom
- Department of Medicine, Pharmacy, and Biomedical Sciences, Higher Institute of Health SciencesUniversité des MontagnesBangangtéCameroon
| | - Bernard Claude Chetcha
- Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Faculty of Medicine and Biomedical SciencesUniversité de Yaoundé 1YaoundéCameroon
| | | | - Constant Anatole Pieme
- Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Faculty of Medicine and Biomedical SciencesUniversité de Yaoundé 1YaoundéCameroon
| | - Claude Tayou Tagny
- Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Faculty of Medicine and Biomedical SciencesUniversité de Yaoundé 1YaoundéCameroon
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Gomes ICP, Magalhães LS, Bomfim LGS, dos Santos PL, Silva RJDS, Cruz MCP, de Albuquerque LC, Neves VHD, de Oliveira PGPR, Carvalho AF, Silva LO, Aragão MT, Moura TR, Cipolotti R. Levels of inflammatory markers are differentially expressed in sickle cell anemia and sickle cell trait. EJHAEM 2023; 4:705-709. [PMID: 37601842 PMCID: PMC10435695 DOI: 10.1002/jha2.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 08/22/2023]
Abstract
Although sickle cell anemia (SCA) is related to inflammation, the profile of inflammatory markers in sickle cell trait (SCT) is poorly studied. This is a cross-sectional study of inflammatory biomarkers carried out involving adults with SCA in steady state, SCT and controls. The SCA group had higher levels of lactato dehydrogenase, IL-1β, IL-6, IL-10, and tumor necrosis factor alpha than the others, while the SCT group had similar levels to control group. In addition, SCA group had lower IL-8/IL-10 and soluble triggering receptor expressed on myeloid cells-1/IL-10 ratios. These findings indicate that individuals with SCT do not have a chronic inflammatory profile and reinforce that cytokines are involved in the maintenance of the inflammatory state in SCA.
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Affiliation(s)
- Ingrid Cristiane Pereira Gomes
- Health Sciences Graduate ProgramFederal University of SergipeAracajuSergipeBrazil
- Department of MedicineFederal University of SergipeAracajuSergipeBrazil
- Department of MedicineTiradentes UniversityAracajuSergipeBrazil
| | - Lucas Sousa Magalhães
- Health Sciences Graduate ProgramFederal University of SergipeAracajuSergipeBrazil
- Laboratory of Molecular Biology and ImmunologyFederal University of SergipeAracajuSergipeBrazil
- Sector of Parasitology and PathologyBiological and Health Sciences InstituteFederal University of AlagoasMaceióAlagoasBrazil
| | | | - Priscila Lima dos Santos
- Health Sciences Graduate ProgramFederal University of SergipeAracajuSergipeBrazil
- Laboratory of Molecular Biology and ImmunologyFederal University of SergipeAracajuSergipeBrazil
- Department of Health EducationFederal University of SergipeLagartoSergipeBrazil
| | | | - Maria Carollyne Passos Cruz
- Health Sciences Graduate ProgramFederal University of SergipeAracajuSergipeBrazil
- Department of NutritionFederal University of SergipeLagartoSergipeBrazil
| | | | | | | | | | | | - Matheus Todt Aragão
- Health Sciences Graduate ProgramFederal University of SergipeAracajuSergipeBrazil
| | - Tatiana Rodrigues Moura
- Health Sciences Graduate ProgramFederal University of SergipeAracajuSergipeBrazil
- Sector of Parasitology and PathologyBiological and Health Sciences InstituteFederal University of AlagoasMaceióAlagoasBrazil
- Department of MorphologyFederal University of SergipeSão CristóvãoSergipeBrazil
| | - Rosana Cipolotti
- Health Sciences Graduate ProgramFederal University of SergipeAracajuSergipeBrazil
- Department of MedicineFederal University of SergipeAracajuSergipeBrazil
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Alyousef YM, Alonaizan FA, Alsulaiman AA, Aldarwish MI, Alali AA, Almasood NN, Vatte C, Cyrus C, Habara AH, Koeleman BP. Oral microbiota analyses of Saudi sickle cell anemics with dental caries. Int Dent J 2022; 73:144-150. [PMID: 36180284 PMCID: PMC9875248 DOI: 10.1016/j.identj.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/06/2022] [Accepted: 06/24/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES The objectives of this study were to identify the composition of oral microbiota in a cohort of patients with sickle cell anemia (SCA) and a high mean number of decayed, missing, and filled permanent teeth (DMFT) and compare it to a cohort of patients with SCA and a low number of DMFT and elucidate the effect of fetal haemoglobin levels on the oral microbiota composition. METHODS Patients who had been diagnosed with SCA, who were homozygous for sickling β-globin mutation (βS/βS), who had Arab-Indian haplotype, and who ranged in age from 5 to 12 years were included in this study. Oral saliva from each participant (n = 100) was collected in GeneFiX™ Saliva DNA Microbiome Collection tube and DNA was extracted using GeneFiX™ DNA Isolation Kits. The composition of oral 16S rRNA from patients with SCA and high dental caries (n = 27, DMFT ≥5) and low dental caries (n = 73, DMFT ≤4) was analysed. Sequencing was performed on an Ion Personal Genome Machine using, Ion PGM Hi-Q view Sequencing 400-bp kit. RESULTS We observed an overall increase in abundance of Proteobacteria, Chloroflexi, and Bacteroidetes in the high DMFT index group compared to those with a low DMFT index. In addition, there was an overall increased abundance of microbiota from Proteobacteria, Fusobacteria, Firmicutes, and Bacteroidetes in the patients with SCA with low fetal haemoglobin compared to those with high fetal haemoglobin (P < .05). Enterobacteriaceae species were the most significant abundant species of bacteria found in both the high DMFT index group and low fetal haemoglobin cohort (P < .05). CONCLUSIONS Our data indicate that SCA in Saudi patients with high DMFT have a higher predominance of pathogenic bacteria compared to those with low DMFT. Furthermore, SCA in Saudi patients with low fetal haemoglobin have a higher predominance of pathogenic bacteria compared to those with higher fetal haemoglobin.
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Affiliation(s)
- Yousef M. Alyousef
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Faisal A. Alonaizan
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed A. Alsulaiman
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | | | - Ali A. Alali
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Naif N. Almasood
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Chittibabu Vatte
- Department of Clinical Biochemistry, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Cyril Cyrus
- Department of Clinical Biochemistry, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Alawi H. Habara
- Department of Clinical Biochemistry, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia,Corresponding author. Department of Clinical Biochemistry, College of Medicine, building 72A, Imam Abdulrahman bin Faisal University, Dammam 31441, Saudi Arabia.
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10
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de Oliveira Toledo SL, Ladeira VS, Nogueira LS, Ferreira LGR, Oliveira MM, de Oliveira Renó C, dos Santos HL, Coelho-dos-Reis JGA, Campi-Azevedo AC, Teixeira-Carvalho A, Martins-Filho OA, Rios DRA, Barros-Pinheiro M. Plasma immune mediators as laboratorial biomarkers for Sickle Cell Disease patients according to the hydroxyurea therapy and disease severity. Blood Cells Mol Dis 2022; 98:102703. [DOI: 10.1016/j.bcmd.2022.102703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/17/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
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Ben Moftah M, Eswayah A. Repurposing of Hydroxyurea Against COVID-19: A Promising Immunomodulatory Role. Assay Drug Dev Technol 2022; 20:55-62. [PMID: 34990284 DOI: 10.1089/adt.2021.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cytokine release syndrome, a prominent mechanism of morbidity and mortality in patients with coronavirus disease 2019 (COVID-19), can cause multiple bodily reactions, including excessive release of proinflammatory mediators, with tumor necrosis factor-α (TNF-α) being the most prevalent cytokine combined with persistently elevated D-dimer levels that are indicative of potential thrombotic events, low levels of endogenous nitric oxide (NO) generation, and progressive decrease in hemoglobin production. In our argument, the conceptual repurposing of hydroxyurea (HU) for managing COVID-19 can provide a promising therapeutic option originating from a rich history of investigational antiviral activity. HU as a proposed supportive therapeutic agent for treating COVID-19 can exemplify a successful remedial choice through its anti-inflammatory activity along with an intrinsic propensity to control the circulatory levels of key cytokines including TNF-α. HU has the ability to undergo in vivo NO conversion acting as NO donor together with being a prominent inducer of fetal hemoglobin (HbF) production. The combination of the mentioned two properties allows HU to possess evident capability of protecting against thrombotic events by controlling D-dimer levels. The implication of our hypothetical argument sheds light on the curative potential of HU, which can be strategically harnessed against COVID-19.
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Affiliation(s)
- Moayed Ben Moftah
- Department of Medicinal and Pharmaceutical Chemistry, Faculty of Pharmacy, University of Tripoli, Tripoli, Libya
| | - Asma Eswayah
- Department of Medicinal and Pharmaceutical Chemistry, Faculty of Pharmacy, University of Tripoli, Tripoli, Libya
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12
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Silva RCMC, Tan L, Rodrigues DA, Prestes EB, Gomes CP, Gama AM, Oliveira PLD, Paiva CN, Manoury B, Bozza MT. Chloroquine inhibits pro-inflammatory effects of heme on macrophages and invivo. Free Radic Biol Med 2021; 173:104-116. [PMID: 34303829 DOI: 10.1016/j.freeradbiomed.2021.07.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Chloroquine has been used successfully to treat Malaria, including by chloroquine-resistant Plasmodium sp., indicating that it has effects on disease itself. Since heme has inflammatory effects and contributes to the pathogenesis of hemolytic diseases, we hypothesize that the anti-inflammatory effect of chloroquine is partially due to its inhibitory effect on heme-induced macrophage activation and on inflammatory tissue damage. METHODS Bone marrow derived macrophages (BMDMs) were incubated with chloroquine before stimulation with heme, in different conditions, to evaluate cytokines secretion, ROS production, mitogen activated protein kinases (MAPK) or spleen tyrosine kinase (Syk) activation, alone or combined with LPS. The effects of chloroquine upon heme inflammation were also evaluated in vivo, through simultaneous i.p. injection of LPS and heme, intratracheal instillation of Poly-IC followed by heme injection, and in a rhabdomyolysis model. RESULTS Chloroquine inhibited TNF secretion, mitochondrial ROS production, MAPK, and Syk activation induced by heme. Inhibition of TNF production could be mimicked by zinc ionophore quercetin, but not by primaquine, a chloroquine analog with low affinity for heme. IL-6 and IL-1β secretions induced by heme in the presence of PRRs agonists were inhibited by chloroquine, but not by calcium chelator BAPTA or inhibitor of endosomal acidification concamycin B. Chloroquine also protected mice from heme inflammatory effects in vivo, inhibiting lethal synergism with PRR agonists, lung pathology caused by heme injection after intratracheal instillation of Poly-IC, and delaying death after rhabdomyolisis. CONCLUSION Our data indicate that chloroquine might be used as a supportive therapy to control heme-induced deleterious inflammation in different hemolytic diseases.
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Affiliation(s)
- Rafael Cardoso Maciel Costa Silva
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil; Institut Necker Enfants Malades. INSERM U1151-CNRS UMR8253, Paris, France; Laboratório Intermediário de Imunoreceptores e Sinalização Celular, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil
| | - Luis Tan
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil
| | - Danielle Aparecida Rodrigues
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil
| | - Elisa Beatriz Prestes
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil; Institut Necker Enfants Malades. INSERM U1151-CNRS UMR8253, Paris, France
| | - Caroline Pereira Gomes
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil
| | - Andreza Moreira Gama
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil
| | - Pedro Lagerblad de Oliveira
- Laboratório de Bioquímica de Insetos, Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Brazil
| | - Claudia Neto Paiva
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil
| | - Benedicte Manoury
- Institut Necker Enfants Malades. INSERM U1151-CNRS UMR8253, Paris, France
| | - Marcelo Torres Bozza
- Laboratório de Inflamação e Imunidade, Departamento de Imunologia. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-902, Rio de Janeiro, Brazil.
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13
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Systemic T Cell Subsets and Cytokines in Patients With Homozygous Sickle Cell Disease and Asymptomatic Urinary Tract Infections in Togo. Ochsner J 2021; 21:163-172. [PMID: 34239376 PMCID: PMC8238108 DOI: 10.31486/toj.20.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: In sickle cell disease (SCD), cytokine expression influences the pivotal pathways that contribute to disease pathogenesis. Additional infection could affect the immune profile of patients with SCD and increase disease mortality. The aim of this study was to investigate the cytokines and T helper cells profile in patients with asymptomatic urinary tract infection and homozygous SCD (HbSS). Methods: From July to September 2018, 22 HbSS subjects were recruited at Centre Hospitalier Universitaire Campus in Lomé, Togo, 12 of whom had urinary tract bacterial infections and 10 of whom were uninfected. Cytokines from plasma were measured by the enzyme-linked immunosorbent assay (ELISA) sandwich method, and immune cell profiles were performed by flow cytometry. The immunogenicity of bacteria-derived antigens isolated from the urine of HbSS subjects with asymptomatic urinary tract infections was studied in a cell culture system, and the induction of the cytokines was measured. Results: The mean age of HbSS subjects with urinary tract infections was 20.33 ± 3.58 years, and the male/female ratio was 0.09 (1:11). HbSS subjects with asymptomatic urinary tract infections had elevated plasma levels of interferon gamma (IFN-γ) and interleukin (IL)-10. CD4+Tbet+IFN-γ+ and CD4+FoxP3+IL-10+ T cell populations were decreased in HbSS subjects with asymptomatic urinary tract infections. Bacterial antigens from HbSS subjects induced the production of IL-10 but not IFN-γ in uninfected volunteer donors (HbAA). Conclusion: Our study demonstrated that patients with SCD and asymptomatic urinary tract infections had elevated IFN-γ and IL-10 levels. This chronic inflammatory condition could be a risk for this group of patients in terms of vaso-occlusive crisis. Systematic cytobacteriologic examination of the urine of HbSS subjects would be of interest.
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Evaluation of the expression of red blood cell CD36, interleukin-6 and interleukin-8 in sickle cell anemia pediatric patients. Cytokine 2021; 143:155534. [PMID: 33888402 DOI: 10.1016/j.cyto.2021.155534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/08/2021] [Accepted: 04/01/2021] [Indexed: 02/02/2023]
Abstract
Sickle cell anemia (SCA) is a complex multisystem disease characterized by acute and chronic inflammation, with alterations in inflammatory cytokines and adhesion molecules. This case-control study was carried out to assess the levels of CD36, immature reticulocytes, interleukin (IL)-6 and IL8 in SCA patients (in crisis and the steady state) and healthy controls. It included 90 children who were 2-18 years old; 60 with SCA and 30 healthy controls. Complete blood count, total reticulocyte count, reticulocyte subpopulations, immature reticulocyte fraction (IRF), percentage of CD36-positive red blood cells (RBCs), IL-6 and IL-8 levels were evaluated. The total white blood cell (WBC) and neutrophil counts, CD36-positive RBCs percentage, IRF, IL-6 and IL-8 levels were significantly higher in crises than in the steady state (P < 0.05). We also found that patients with SCA had significantly higher reticulocyte, WBC and neutrophil counts, fetal hemoglobin, CD36-positive RBCs percentage, IRF, and IL-6 and IL-8 levels than healthy children (P < 0.05). A significant positive linear correlation was reported between IL-6 and neutrophils during crises (Spearman correlation coefficient = 0.397, P = 0.03). These findings suggest that the levels of adhesion molecules and inflammatory markers and IRF, as evidenced by CD36-positive RBCs, IL-6 and IL-8, are elevated in SCA patients, both during steady state and crises, although these elevations are more marked during crises. Further knowledge about these cytokines and adhesion molecules will help in understanding the pathogenesis and improve therapy of SCA.
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Chadebech P, de Ménorval MA, Bodivit G, Jouard A, Pakdaman S, Lelong F, Habibi A, Galactéros F, Lecron JC, Pirenne F. Cytokine changes in sickle-cell disease patients as markers predictive of the onset of delayed hemolytic transfusion reactions. Cytokine 2020; 136:155259. [PMID: 32920319 DOI: 10.1016/j.cyto.2020.155259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/27/2020] [Accepted: 08/17/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Changes in cytokine production are known to contribute to the pathogenesis of sickle-cell disease (SCD), particularly in painful acute complications (crises) and episodes of post-transfusion hemolysis. Little is known about cytokine profiles in patients with these complications. STUDY DESIGN AND METHODS We investigated possible associations between cytokine profile and the onset of delayed hemolytic transfusion reactions (DHTRs), particularly during acute-phase episodes, to improve characterization of the biological parameters predictive of such events. We included SCD patients with severe acute symptoms (n = 36) or steady-state disease (n = 31), both possibly leading to a DHTR (n = 18) event. Luminex® technology was used to determine the plasma concentrations of 23 cytokines. RESULTS Regardless of clinical context, the concentrations of interleukin (IL)-6, IL-10, inducible protein-10, and macrophage inflammatory protein-1β were higher in plasma samples from SCD patients than in those from healthy controls. IL-6 and IL-10 concentrations were even higher in acute-phase plasma samples from SCD patients. In addition, IL-27 and TNFα levels were higher, and IL-6 and RANTES levels were lower in acute-phase SCD patients just before the onset of DHTR than in patients experiencing painful occlusive episodes. CONCLUSION In addition to reporting the plasma cytokine profiles of SCD patients in various clinical phases of the disease, we provide the first evidence of a significant association between low plasma TNFα concentration, high plasma IP-10 concentration and the onset of DHTR in SCD patients.
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Affiliation(s)
- Philippe Chadebech
- Etablissement Français du Sang, Île-de-France, Hôpital Henri-Mondor, Créteil, France; Inserm U955 Equipe 2 « Transfusion et Maladies du Globule Rouge », Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Laboratoire d'excellence GR-Ex, F75739 Paris, France.
| | - Marie-Amélie de Ménorval
- Etablissement Français du Sang, Île-de-France, Hôpital Henri-Mondor, Créteil, France; Inserm U955 Equipe 2 « Transfusion et Maladies du Globule Rouge », Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Gwellaouen Bodivit
- Etablissement Français du Sang, Île-de-France, Hôpital Henri-Mondor, Créteil, France; Inserm U955 Equipe 2 « Transfusion et Maladies du Globule Rouge », Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Laboratoire d'excellence GR-Ex, F75739 Paris, France
| | - Alicia Jouard
- Etablissement Français du Sang, Île-de-France, Hôpital Henri-Mondor, Créteil, France; Inserm U955 Equipe 2 « Transfusion et Maladies du Globule Rouge », Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Laboratoire d'excellence GR-Ex, F75739 Paris, France
| | - Sadaf Pakdaman
- Etablissement Français du Sang, Île-de-France, Hôpital Henri-Mondor, Créteil, France; Inserm U955 Equipe 2 « Transfusion et Maladies du Globule Rouge », Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Laboratoire d'excellence GR-Ex, F75739 Paris, France
| | - Francoise Lelong
- Laboratoire d'analyses en Immuno-Hématologie et Immunologie, AP-HP, Centre Hospitalier Intercommunal de Créteil (CHIC), Créteil, France
| | - Anoosha Habibi
- Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri-Mondor, AP-HP, Université Paris-Est, Créteil, France
| | - Frédéric Galactéros
- Inserm U955 Equipe 2 « Transfusion et Maladies du Globule Rouge », Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Laboratoire d'excellence GR-Ex, F75739 Paris, France; Université Paris-Est-Créteil (UPEC), Créteil, France; Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri-Mondor, AP-HP, Université Paris-Est, Créteil, France
| | - Jean Claude Lecron
- Université de Poitiers, UPRES EA4331, Laboratoire « Inflammation, Tissus Epithéliaux et Cytokines », CHU de Poitiers et Pôle Biologie Santé, Poitiers, France
| | - France Pirenne
- Etablissement Français du Sang, Île-de-France, Hôpital Henri-Mondor, Créteil, France; Inserm U955 Equipe 2 « Transfusion et Maladies du Globule Rouge », Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Laboratoire d'excellence GR-Ex, F75739 Paris, France; Université Paris-Est-Créteil (UPEC), Créteil, France.
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Elenga N, Cuadro-Alvarez E, Martin E, Njuieyon F, Defo A, Maniassom C. Influence of beta-cluster haplotypes, alpha-gene status and UGTA1 polymorphism on clinical and hematological data in sickle-cell disease children from French Guiana. PLoS One 2020; 15:e0238691. [PMID: 32881938 PMCID: PMC7470392 DOI: 10.1371/journal.pone.0238691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 08/21/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This cross-sectional study aimed to investigate the influence of haplotypes, alpha-gene status and UGTA1 polymorphism on the severity of sickle cell disease in children. METHODS This cross-sectional study was conducted between 2012 and 2014 at the Cayenne Hospital, in French Guiana. Acute clinical complications were grouped into (i) severe SCD defined by the presence of stroke and/or abnormal-transcranial Doppler (TCD), (ii) moderate SCD defined by the presence of at least three annual events requiring hospitalization and/or at least one acute chest syndrome, (iii) no severe SCD (in the absence of the precited events). RESULTS Among the 86 patients, 33.7% were female with a median age of 10 years (range: 6-12 years). The vast majority of patients had SCA (HbSS) phenotype (74.4%; n = 64). The severe haplotype was found in 40% of patients. 30% were BEN/BEN. Analysis of α-globin gene deletions revealed that 32 patients (37.2%) were heterozygous (loss of 2 genes in 2 cases and loss of 1 gene in 30 cases) for α-thalassemia (3.7 kb deletion). Homozygous (TA) n TA7/7 was found in 24 (28%). In the multivariate analysis, the factors associated with the severity of sickle cell disease were the first vaso-occlusive crisis before one year of age (OR 25, [95% CI = 6.0-107.0], p<0.001) and a baseline MCV >80 fL (OR 0.20 [95% CI = 0.04-0.96], p = 0.04). The area of the ROC curve was 0.90. CONCLUSION Prospective studies with greater statistical power would provide more knowledge on the relationship between UGT1A1 mutations and the clinical and hematological manifestations of SCA.
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Affiliation(s)
- Narcisse Elenga
- Pediatric Unit, Cayenne General Hospital, Cayenne, French Guiana
- * E-mail:
| | | | - Elise Martin
- Pediatric Unit, Cayenne General Hospital, Cayenne, French Guiana
| | - Falucar Njuieyon
- Pediatric Unit, Cayenne General Hospital, Cayenne, French Guiana
| | - Antoine Defo
- Pediatric Unit, Cayenne General Hospital, Cayenne, French Guiana
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Gbotosho OT, Kapetanaki MG, Ghosh S, Villanueva FS, Ofori-Acquah SF, Kato GJ. Heme Induces IL-6 and Cardiac Hypertrophy Genes Transcripts in Sickle Cell Mice. Front Immunol 2020; 11:1910. [PMID: 32973791 PMCID: PMC7473032 DOI: 10.3389/fimmu.2020.01910] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022] Open
Abstract
Emerging data indicate that free heme promotes inflammation in many different disease settings, including in sickle cell disease (SCD). Although free heme, proinflammatory cytokines, and cardiac hypertrophy are co-existing features of SCD, no mechanistic links between these features have been demonstrated. We now report significantly higher levels of IL-6 mRNA and protein in hearts of the Townes sickle cell disease (SS) mice (2.9-fold, p ≤ 0.05) than control mice expressing normal human hemoglobin (AA). We find that experimental administration of heme 50 μmoles/kg body weight induces IL-6 expression directly in vivo and induces gene expression markers of cardiac hypertrophy in SS mice. We administered heme intravenously and found that within three hours plasma IL-6 protein significantly increased in SS mice compared to AA mice (3248 ± 275 vs. 2384 ± 255 pg/ml, p ≤ 0.05). In the heart, heme induced a 15-fold increase in IL-6 transcript in SS mice heart compared to controls. Heme simultaneously induced other markers of cardiac stress and hypertrophy, including atrial natriuretic factor (Nppa; 14-fold, p ≤ 0.05) and beta myosin heavy chain (Myh7; 8-fold, p ≤ 0.05) in SS mice. Our experiments in Nrf2-deficient mice indicate that the cardiac IL-6 response to heme does not require Nrf2, the usual mediator of transcriptional response to heme for heme detoxification by heme oxygenase-1. These data are the first to show heme-induced IL-6 expression in vivo, suggesting that hemolysis may play a role in the elevated IL-6 and cardiac hypertrophy seen in patients and mice with SCD. Our results align with published evidence from rodents and humans without SCD that suggest a causal relationship between IL-6 and cardiac hypertrophy.
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Affiliation(s)
- Oluwabukola T Gbotosho
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Maria G Kapetanaki
- Department of Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Samit Ghosh
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Medicine, Center for Translational and International Hematology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Flordeliza S Villanueva
- Center for Ultrasound Molecular Imaging and Therapeutics, Heart and Vascular Institute, Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Solomon F Ofori-Acquah
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Medicine, Center for Translational and International Hematology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.,School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Gregory J Kato
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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18
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de Azevedo JTC, Malmegrim KCR. Immune mechanisms involved in sickle cell disease pathogenesis: current knowledge and perspectives. Immunol Lett 2020; 224:1-11. [PMID: 32437728 DOI: 10.1016/j.imlet.2020.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/02/2020] [Accepted: 04/18/2020] [Indexed: 12/18/2022]
Abstract
Sickle cell disease (SCD) is caused by a single point mutation in the β-chain of the hemoglobin gene that results in the replacement of glutamic acid with valine in the hemoglobin protein. However, recent studies have demonstrated that alterations in several other genes, especially immune related genes, may be associated with complications of SCD. In fact, higher chronic inflammatory status is related to more severe clinical symptoms in SCD patients, suggesting crucial roles of the immune system in SCD physiopathology. Nevertheless, although participation of innate immune cells in SCD pathogenesis has been broadly and extensively described, little is known about the roles of the adaptive immune system in this disease. In addition, the influence of treatments on the immune system of SCD patients and their complications (such as alloimmunization) are not yet completely understood. Thus, we reviewed the current knowledge about the immune mechanisms involved in SCD pathogenesis. We suggest recommendations for future studies to allow for a broader understanding of SCD pathogenesis, helping in the development of new therapies and improvement in the life quality and expectancy of patients.
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Affiliation(s)
- Júlia Teixeira Cottas de Azevedo
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Kelen Cristina Ribeiro Malmegrim
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Department of Clinical, Toxicological and Bromatological Analysis, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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High levels of proinflammatory cytokines IL-6 and IL-8 are associated with a poor clinical outcome in sickle cell anemia. Ann Hematol 2020; 99:947-953. [PMID: 32140892 DOI: 10.1007/s00277-020-03978-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/25/2020] [Indexed: 11/22/2022]
Abstract
Sickle cell anemia (SCA) pathophysiology is characterized by the activation of sickle red blood cells, reticulocytes, leukocytes, platelets, and endothelial cells, and with the expression of several inflammatory molecules. Therefore, it is conceivable that variations in levels of proinflammatory cytokines may act as a signaling of differential clinical course in SCA. Here, we evaluated the clinical impact of proinflammatory cytokines interleukin 1-β (IL-1β), interleukin 6 (IL-6), and interleukin 8 (IL-8) in 79 patients with SCA, followed in a single reference center from northeastern Brazil. The main clinical/laboratory data were obtained from patient interview and medical records. The proinflammatory markers IL-1β, IL-6, and IL-8 were evaluated by using commercially available enzyme-linked immunosorbent assay kits. According to levels of the proinflammatory markers, we observed that patients who had a higher frequency of VOC per year (P = 0.0236), acute chest syndrome (P = 0.01), leg ulcers (P = 0.0001), osteonecrosis (P = 0.0006), stroke (P = 0.0486), and priapism (P = 0.0347) had higher IL-6 levels compared with patients without these clinical complications. Furthermore, increased levels of IL-8 were found in patients who presented leg ulcers (P = 0.0184). No significant difference was found for IL-1β levels (P > 0.05). In summary, the present study emphasizes the role of inflammation in SCA pathophysiology, reveals an association of IL-8 levels and leg ulcer occurrence, and indicates that IL-6 levels can be used as a useful predictor for poor outcomes in SCA.
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Zahran AM, Nafady A, Saad K, Hetta HF, Abdallah AEM, Abdel-Aziz SM, Embaby MM, Abo Elgheet AM, Darwish SF, Abo-Elela MGM, Elhoufey A, Elsayh KI. Effect of Hydroxyurea Treatment on the Inflammatory Markers Among Children With Sickle Cell Disease. Clin Appl Thromb Hemost 2020; 26:1076029619895111. [PMID: 31942811 PMCID: PMC7098201 DOI: 10.1177/1076029619895111] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) was introduced as a potential inflammatory marker in sickle cell disease (SCD). This study aimed to evaluate the impact of hydroxyurea (HU) treatment on the value of NLR and some inflammatory mediators in SCD. METHODS The hematological parameters and clinical events were analyzed in 35 children with SCD under HU treatment and followed up for 1 year and in 20 healthy controls. Enzyme-linked immunosorbent assay was performed for the evaluation of proinflammatory cytokines, including interleukin (IL) 6, IL-8, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor α (TNF-α). RESULTS Hydroxyurea significantly improves most of the hematological parameters in children with SCD. The percentages of hemoglobin fraction S, serum levels of TNF-α and IL-6 were significantly decreased when compared to baseline value but did not reach the value of the healthy control. The HU treatment led to a significant decrease in NLR compared to the baseline values and reached healthy control values. Neutrophil-to-lymphocyte ratio was positively correlated with hs-CRP, TNF-α, and IL-8 serum levels and negatively correlated with percentage of fetal hemoglobin and hematocrit values. The cutoff value of NLR to expect a response to HU among SCD was 3.0, with 76% specificity and 85% sensitivity (area under the curve: 0.85, P < .0001). In conclusion, hydroxyurea induced a decrease in NLR and inflammatory cytokines, which represent a biomarker of inflammation in SCD. The calculation of NLR is a straightforward and cheap method for SCD outcome prediction in young children.
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Affiliation(s)
- Asmaa M. Zahran
- Department of Clinical Pathology, South Egypt Cancer Institute, Assiut, Egypt
| | - Asmaa Nafady
- Faculty of Medicine, Department of Clinical Pathology, Assiut University, Assiut, Egypt
- Qena Faculty of Medicine, Department of Clinical and Chemical Pathology, South Valley University, Qena, Egypt
| | - Khaled Saad
- Faculty of Medicine, Department of Pediatrics, Assiut University, Assiut, Egypt
- Khaled Saad, Faculty of Medicine, Department of Pediatrics, University of Assiut, Assiut 71516, Egypt. Emails: ;
| | - Helal F. Hetta
- Faculty of Medicine, Department of Medical Microbiology and Immunology, Assiut University, Assiut, Egypt
| | | | | | - Mostafa M. Embaby
- Faculty of Medicine, Department of Pediatrics, Assiut University, Assiut, Egypt
| | - Amir M. Abo Elgheet
- Faculty of Medicine, Department of Pediatrics, Assiut University, Assiut, Egypt
| | - Sanaa F. Darwish
- Faculty of Pharmacy, Department of Microbiology, Cairo University, Cairo, Egypt
| | | | - Amira Elhoufey
- Faculty of Nursing, Department of Community Health Nursing, Assiut University, Egypt
| | - Khalid I. Elsayh
- Faculty of Medicine, Department of Pediatrics, Assiut University, Assiut, Egypt
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21
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Boulassel MR, Al-Zubaidi A, Al-Zadjali S, Al-Qarni Z, Al-Naamany N, Al-Yarabi A, Elshinawy M, Wali Y. Elevated levels of circulating invariant natural killer cell subsets are skewed toward Th2-like phenotype in children with sickle cell disease. Clin Immunol 2019; 210:108308. [PMID: 31726101 DOI: 10.1016/j.clim.2019.108308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 11/24/2022]
Abstract
Invariant natural killer T (iNKT) cells are being considered as potential targets for immunotherapeutic strategies in a variety of conditions including sickle cell disease (SCD). However, relatively little is known about the fate of iNKT cell subsets in children with SCD. Herein, quantitative and qualitative analyses of circulating iNKT cell subsets were carried out in 120 children in steady state and 30 healthy controls. Children with SCD displayed significantly elevated levels of circulating iNKT cell subsets with a preferential polarization toward Th2-like cells. The known SCD modifiers did not influence levels of iNKT cell subsets, except that children carrying the Bantu haplotype exhibited elevated levels of CD4iNKT cells, and to a lesser degree CD8iNKT cells. Collectively, these findings indicate that circulating iNKT cell subsets are significantly increased in children with SCD, and highlight the existence of imbalanced production of cytokines toward Th2-like phenotype, which seems to be associated with genetic polymorphisms.
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Affiliation(s)
- Mohamed-Rachid Boulassel
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman.
| | - Abeer Al-Zubaidi
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman
| | - Shoaib Al-Zadjali
- Department of Haematology, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman
| | - Zahra Al-Qarni
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman
| | - Nidaa Al-Naamany
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman
| | - Ahmed Al-Yarabi
- Department of Medicine, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman
| | - Mohamed Elshinawy
- Department of Child Health, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman; Pediatric Department, Faculty of Medicine, Alexandria University, Egypt
| | - Yasser Wali
- Department of Child Health, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman
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22
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Abstract
BACKGROUND Thrombospondin-1 (TSP-1) and 25-hydroxyvitamin D (25-OHD) play significant roles in the pathogenesis of sickle cell anemia (SCA). TSP-1 enhances cellular adhesion/inflammation, hence contributing to vaso-occlusive crisis (VOC); vitamin D, in contrast, retards inflammation and may lower rate of pain episodes. We determined serum levels of TSP-1 and 25-OHD in Nigerian children with SCA and their matched hemoglobin AA controls; and assess the relationship between the 2 biomarkers. METHODS In total 90 children (32 SCA in steady state, 30 SCA in VOC, and 28 HbAA controls) were studied. Serum TSP-1 and 25-OHD levels were measured with ELISA and HPLC, respectively. RESULTS The mean TSP-1 of children with VOC was significantly higher than those in steady state (P=0.022) and HbAA controls (P<0.001). Similarly, the mean TSP-1 of those in steady state was higher than the controls (P=0.007). However, mean serum 25-OHD of the children with VOC was significantly lower than those in steady state (28.9±8.2 ng/mL vs. 37.1±12.3 ng/mL, P =0.004). There was a significant inverse correlation between TSP-1 and 25-OHD among the VOC subgroup, r=-0.57, P=0.001. The mean TSP-1 of the 28 children with SCA who had suboptimal vitamin D (213.5±118.6 ng/mL) was higher than 144.2±58.7 ng/mL of the 34 SCA who had normal serum vitamin D, P=0.008. CONCLUSIONS Children with SCA, especially those with VOC, had high serum TSP-1 and low 25-OHD. Also, an inverse relationship exist between serum 25-OHD and TSP-1 in children with VOC. These findings provide basis for further studies into the regulation of TSP-1 by vitamin D.
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23
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Guarda CC, Silveira-Mattos PSM, Yahouédéhou SCMA, Santiago RP, Aleluia MM, Figueiredo CVB, Fiuza LM, Carvalho SP, Oliveira RM, Nascimento VML, Luz NF, Borges VM, Andrade BB, Gonçalves MS. Hydroxyurea alters circulating monocyte subsets and dampens its inflammatory potential in sickle cell anemia patients. Sci Rep 2019; 9:14829. [PMID: 31616024 PMCID: PMC6794261 DOI: 10.1038/s41598-019-51339-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/17/2019] [Indexed: 01/27/2023] Open
Abstract
Sickle cell anemia (SCA) is a hemolytic disease in which vaso-occlusion is an important pathophysiological mechanism. The treatment is based on hydroxyurea (HU), which decreases leukocyte counts and increases fetal hemoglobin synthesis. Different cell types are thought to contribute to vaso-occlusion. Nevertheless, the role of monocytes subsets remains unclear. We investigated frequencies of monocytes subsets in blood and their response to HU therapy, testing their ability to express pro-inflammatory molecules and tissue factor (TF). We identified major changes in monocyte subsets, with classical monocytes (CD14++CD16−) appearing highly frequent in who were not taking HU, whereas those with patrolling phenotype (CD14dimCD16+) were enriched in individuals undergoing therapy. Additionally, HU decreased the production of TNF-α, IL1-β, IL-6, IL-8 as well as TF by the LPS-activated monocytes. Likewise, frequency of TF-expressing monocytes is increased in patients with previous vaso-occlusion. Moreover, activated monocytes expressing TF produced several pro-inflammatory cytokines simultaneously. Such polyfunctional capacity was dramatically dampened by HU therapy. The frequency of classical monocytes subset was positively correlated with percentage cytokine producing cells upon LPS stimulation. These findings suggest that classical monocytes are the subset responsible for multiple pro-inflammatory cytokine production and possibly drive inflammation and vaso-occlusion in SCA which is damped by HU.
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Affiliation(s)
- Caroline C Guarda
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Paulo S M Silveira-Mattos
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, Brazil.,Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador, Bahia, Brazil
| | - Sètondji C M A Yahouédéhou
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Rayra P Santiago
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Milena M Aleluia
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil
| | - Camylla V B Figueiredo
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Luciana M Fiuza
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Suellen P Carvalho
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Rodrigo M Oliveira
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil.,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Valma M L Nascimento
- Fundação de Hematologia e Hemoterapia do Estado da Bahia (HEMOBA) Salvador, Bahia, Brazil
| | - Nívea F Luz
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil
| | - Valéria M Borges
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil
| | - Bruno B Andrade
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil. .,Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil. .,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, Brazil. .,Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador, Bahia, Brazil. .,Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, Brazil. .,Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.
| | - Marilda S Gonçalves
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil. .,Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.
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24
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Nagant C, Barbezange C, Dedeken L, Besse-Hammer T, Thomas I, Mahadeb B, Efira A, Ferster A, Corazza F. Alteration of humoral, cellular and cytokine immune response to inactivated influenza vaccine in patients with Sickle Cell Disease. PLoS One 2019; 14:e0223991. [PMID: 31600331 PMCID: PMC6786629 DOI: 10.1371/journal.pone.0223991] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/02/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction Patients suffering from Sickle Cell Disease (SCD) are at increased risk for complications due to influenza virus. Annual influenza vaccination is strongly recommended but few clinical studies have assessed its immunogenicity in individuals with SCD. The aim of this study was to explore the biological efficacy of annual influenza vaccination in SCD patients by characterizing both their humoral and cell-mediated immunity against influenza antigen. We also aimed to investigate these immunological responses among SCD individuals according to their treatment (hydroxyurea (HU), chronic blood transfusions (CT), both HU and CT or none of them). Methods Seventy-two SCD patients (49 receiving HU, 9 on CT, 7 with both and 7 without treatment) and 30 healthy controls were included in the study. All subjects received the tetravalent influenza α-RIX-Tetra® vaccine from the 2016–2017 or 2017–2018 season. Results Protective anti-influenza HAI titers were obtained for the majority of SCD patients one month after vaccination but seroconversion rates in patient groups were strongly decreased compared to controls. Immune cell counts, particularly cellular memory including memory T and memory B cells, were greatly reduced in SCD individuals. Functional activation assays confirmed a poorer CD8+ T cell memory. We also document an imbalance of cytokines after influenza vaccination in SCD individuals with an INFγ/IL-10 ratio (Th1-type/Treg-type response) significantly lower in the SCD cohort. Conclusion SCD patients undergoing CT showed altered immune regulation as compared to other treatment subgroups. Altogether, the cytokine imbalance, the high regulatory T cell levels and the low memory lymphocyte subset levels observed in the SCD cohort, namely for those on CT, suggest a poor ability of SCD patients to fight against influenza infection. Nevertheless, our serological data support current clinical practice for annual influenza vaccination, though immunogenicity to other vaccines involving immunological memory might be hampered in SCD patients and should be further investigated.
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Affiliation(s)
- Carole Nagant
- Immunology Department, LHUB-ULB, Université libre de Bruxelles, Brussels, Belgium
- * E-mail:
| | | | - Laurence Dedeken
- Department of Hematology Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
| | - Tatiana Besse-Hammer
- Department of Hematology Oncology, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | | | - Bhavna Mahadeb
- Microbiology Department, LHUB-ULB, Université libre de Bruxelles, Brussels, Belgium
| | - André Efira
- Department of Hematology Oncology, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Alice Ferster
- Department of Hematology Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
| | - Francis Corazza
- Immunology Department, LHUB-ULB, Université libre de Bruxelles, Brussels, Belgium
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25
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A locus on chromosome 5 shows African ancestry-limited association with alloimmunization in sickle cell disease. Blood Adv 2019; 2:3637-3647. [PMID: 30578281 DOI: 10.1182/bloodadvances.2018020594] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/08/2018] [Indexed: 12/11/2022] Open
Abstract
Red blood cell (RBC) transfusion remains a critical therapeutic intervention in sickle cell disease (SCD); however, the apparent propensity of some patients to regularly develop RBC alloantibodies after transfusion presents a significant challenge to finding compatible blood for so-called alloimmunization responders. Predisposing genetic loci have long been thought to contribute to the responder phenomenon, but to date, no definitive loci have been identified. We undertook a genome-wide association study of alloimmunization responder status in 267 SCD multiple transfusion recipients, using genetic estimates of ancestral admixture to bolster our findings. Analyses revealed single nucleotide polymorphisms (SNPs) on chromosomes 2 and 5 approaching genome-wide significance (minimum P = 2.0 × 10-8 and 8.4 × 10-8, respectively), with local ancestry analysis demonstrating similar levels of admixture in responders and nonresponders at implicated loci. Association at chromosome 5 was nominally replicated in an independent cohort of 130 SCD transfusion recipients, with meta-analysis surpassing genome-wide significance (rs75853687, P meta = 6.6 × 10-9), and this extended to individuals forming multiple (>3) alloantibodies (P meta = 9.4 × 10-5). The associated variant is rare outside of African populations, and orthogonal genome-wide haplotype analyses, contingent on local ancestry, revealed genome-wide significant sharing of a ∼60-kb haplotype of African ancestry at the chromosome 5 locus (Bayes Factor = 4.95). This locus overlaps a putative cis-acting enhancer predicted to regulate transcription of ADRA1B and the lncRNA LINC01847, both members of larger ontologies associated with immune regulation. Our findings provide potential insights to the pathophysiology underlying the development of alloantibodies and implicate non-RBC ancestry-limited loci in the susceptibility to alloimmunization.
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Adisa AO, Adedeji TA, Bolarinwa RA, Owojuyigbe TO, Jeje OA, Glasbey J, Akinola NO. The Inflammatory Response to Surgery in Sickle Cell Disease Patients Undergoing Cholecystectomy. JSLS 2019; 23:JSLS.2019.00027. [PMID: 31285651 PMCID: PMC6596445 DOI: 10.4293/jsls.2019.00027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: Patients with sickle cell anemia (SCA) may have elevated inflammatory markers in health, and this may be heightened after open operations. The inflammatory response of patients with SCA after minimally invasive surgeries has not been fully explored. Patients and Methods: Consecutive patients with SCA and with hemoglobin AA (HbAA) undergoing laparoscopic cholecystectomy for acute cholecystitis were recruited into the study. Blood samples were taken before induction of anesthesia (0-h); at 4, 12, 24, and 48 h; and on postoperative day 7. Samples were analyzed for serum C-reactive protein and interleukin (IL)-1 through IL-18. Results: Twenty-three patients, including 9 with SCA and 14 with HbAA, were recruited with 4 cases performed by open laparotomy. At 0-h, proinflammatory IL-1 levels (6.1 versus 4.8) and C-reactive protein levels (32.5 versus 26.6) were higher in patients with hemoglobin SS (HbSS) than in patients with HbAA, respectively. Over time, inflammatory markers were generally higher at each time-point for patients with HbSS compared with patients with HbAA for both proinflammatory and anti-inflammatory cytokines, rising immediately after surgery and up to 48 hours, then returning to baseline by postoperative day 7. There was a higher mean IL-1 level across all time-points in the HbSS group than in the HbAA group (P = .04). Conclusion: This exploratory study found an enhanced inflammatory response to cholecystectomy in patients with SCA compared with patients with HbAA. Minimally invasive surgical strategies for this patient group may help to mediate this response.
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Affiliation(s)
- Adewale O Adisa
- Department of Surgery, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Tewogbade A Adedeji
- Department of Chemical Pathology, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Rahman A Bolarinwa
- Department of Haematology, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Temilola O Owojuyigbe
- Department of Haematology, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Olusola A Jeje
- Department of Chemical Pathology, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - James Glasbey
- Academic Department of Surgery, University of Birmingham, Birmingham, United Kingdom
| | - Norah O Akinola
- Department of Haematology, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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27
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Shivwanshi LR, Singh E, Kumar A. A positive correlation between sickle cell anemia and g6pd deficiency from population of Chhattisgarh, India. Gene 2019; 707:143-150. [DOI: 10.1016/j.gene.2019.04.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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28
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Allali S, Dietrich C, Machavoine F, Rignault-Bricard R, Brousse V, de Montalembert M, Hermine O, Maciel TT, Leite-de-Moraes M. Innate-like T cells in children with sickle cell disease. PLoS One 2019; 14:e0219047. [PMID: 31251783 PMCID: PMC6599217 DOI: 10.1371/journal.pone.0219047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 06/15/2019] [Indexed: 01/05/2023] Open
Abstract
Background The implication of lymphocytes in sickle cell disease pathogenesis is supported by a number of recent reports. These studies provided evidence for the activation of invariant natural killer T (iNKT) cells in adult patients, but did not investigate the involvement of other innate-like T cell subsets so far. Methods Here we present a monocentric prospective observational study evaluating the number and functional properties of both circulating conventional and innate-like T cells, namely iNKT, Mucosal-Associated Invariant T (MAIT) and gammadelta (γδ) T cells in a cohort of 39 children with sickle cell disease. Results Relative to age-matched healthy controls, we found that patients had a higher frequency of IL-13- and IL-17-producing CD4+ T cells, as well as higher MAIT cell counts with an increased frequency of IL-17-producing MAIT cells. Patients also presented increased Vδ2 γδ T cell counts, especially during vaso-occlusive crisis, and a lower frequency of IFNγ-producing Vδ2 γδ T cells, except during crisis. iNKT cell counts and the frequency of IFNγ-producing iNKT cells were unchanged compared to controls. Our study revealed positive correlations between 1) the frequency of IFNγ-producing CD4+, CD8+ and Vδ2 γδ T cells and the number of hospitalizations for vaso-occlusive crisis in the previous year; 2) the frequency of IFNγ-producing iNKT cells and patients’ age and 3) the frequency of IL-17-producing Vδ2 γδ T cells and hemoglobin S level. Conclusion These results strongly suggest a role of innate-like T cells in sickle cell disease pathophysiology, especially that of IL-17-producing MAIT and γδ T cells.
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Affiliation(s)
- Slimane Allali
- Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, Paris Descartes – Sorbonne Paris Cité University, Assistance Publique-Hôpitaux de Paris, Paris, France
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Inserm U1163, Paris, France
- Laboratory of Excellence GR-Ex, Paris, France
- * E-mail: (SA); (MLM)
| | - Céline Dietrich
- Laboratory of Immunoregulation and Immunopathology, Institut Necker-Enfants malades, Centre National de la Recherche Scientifique (CNRS) UMR 8253, Inserm UMR 1151, Paris Descartes – Sorbonne Paris Cité University, Paris, France
| | - François Machavoine
- Laboratory of Immunoregulation and Immunopathology, Institut Necker-Enfants malades, Centre National de la Recherche Scientifique (CNRS) UMR 8253, Inserm UMR 1151, Paris Descartes – Sorbonne Paris Cité University, Paris, France
| | - Rachel Rignault-Bricard
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Inserm U1163, Paris, France
- Laboratory of Immunoregulation and Immunopathology, Institut Necker-Enfants malades, Centre National de la Recherche Scientifique (CNRS) UMR 8253, Inserm UMR 1151, Paris Descartes – Sorbonne Paris Cité University, Paris, France
| | - Valentine Brousse
- Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, Paris Descartes – Sorbonne Paris Cité University, Assistance Publique-Hôpitaux de Paris, Paris, France
- Laboratory of Excellence GR-Ex, Paris, France
| | - Mariane de Montalembert
- Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, Paris Descartes – Sorbonne Paris Cité University, Assistance Publique-Hôpitaux de Paris, Paris, France
- Laboratory of Excellence GR-Ex, Paris, France
| | - Olivier Hermine
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Inserm U1163, Paris, France
- Laboratory of Excellence GR-Ex, Paris, France
- Department of Hematology, Hôpital Necker-Enfants malades, Paris Descartes – Sorbonne Paris Cité University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Thiago Trovati Maciel
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Inserm U1163, Paris, France
- Laboratory of Excellence GR-Ex, Paris, France
| | - Maria Leite-de-Moraes
- Laboratory of Immunoregulation and Immunopathology, Institut Necker-Enfants malades, Centre National de la Recherche Scientifique (CNRS) UMR 8253, Inserm UMR 1151, Paris Descartes – Sorbonne Paris Cité University, Paris, France
- * E-mail: (SA); (MLM)
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Bhagat S, Thakur AS. Influence of β-Globin Haplotypes on Oxidative Stress, Antioxidant Capacity and Inflammation in Sickle Cell Patients of Chhattisgarh. Indian J Clin Biochem 2019; 34:201-206. [PMID: 31092994 DOI: 10.1007/s12291-017-0729-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 12/22/2017] [Indexed: 01/28/2023]
Abstract
The present study was conducted to investigate the frequency of β-globin gene haplotype and their influence on oxidative stress, antioxidant level and inflammation of sickle cell patient of Chhattisgarh. The serum levels of total antioxidant capacity, oxidative stress and inflammation were measured in hundred SCD patients. The mean serum CRP and MDA levels were significantly (p < 0.0001) lower in Arab-Indian haplotype when compared with Bantu and other haplotype. However, the antioxidant capacity and HbF levels were significantly higher in Arab-Indian haplotype. These result indicate that β-globin gene haplotype have a role in modulating disease severity in SCD patients of Chhattisgarh.
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Affiliation(s)
- Sanjana Bhagat
- Department of Biotechnology, Govt. N.P.G. College of Science Raipur, GE Road, Raipur, Chhattisgarh 492010 India
| | - Amar Singh Thakur
- 2Department of Biochemistry, Govt. Medical College, Jagdalpur, Chhattisgarh India
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Costa MFH, Torres LC, Matta MCD, Araújo ADS, Souza AI. Interleukin-6 in pregnancy with sickle cell disease. Hematol Transfus Cell Ther 2019; 41:298-302. [PMID: 31133499 PMCID: PMC6978540 DOI: 10.1016/j.htct.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/08/2019] [Accepted: 02/12/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Despite advances in health care for sickle cell disease patients, as well as in the improvement in reproductive issues mainly in women with the disease, pregnancy is still a challenge, both for the mother and the child, with high rates of maternal and fetal morbidity and mortality. Besides their chronic hemolytic status and vaso-occlusive events that confer systemic complications, pregnant women also have higher rates of pain episodes, infections, abortion, intrauterine growth retardation, pre-term births, eclampsia, stillbirth and the hemolysis, elevated liver enzymes and low platelets syndrome. The physiologic mechanisms of the disease in pregnancy are still unknown and chronic inflammatory responses may interfere in the adverse outcomes. The cytokine and chemokine profiles in pregnancy with sickle cell disease remain unknown. The aim of this study was to evaluate the cytokine profile of the inflammatory response of pregnant women with sickle cell disease. METHOD Blood samples from 20 pregnant women with sickle cell disease, 24 women with sickle cell disease in steady state, 16 healthy pregnant women and a control group with 9 women at childbearing age were assayed for interleukin-6. MAIN RESULTS Pregnant women with sickle cell disease presented high serum levels of interleukin-6, compared to healthy pregnant women (p=0.0115). CONCLUSION These data suggest that the increased production of interleukin-6 may occur during pregnancy with sickle cell disease and that the role of this cytokine in the sickle cell disease pathophysiology and pregnancy complications should be further studied.
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Affiliation(s)
| | | | | | | | - Ariani Impieri Souza
- Instituto de Medicina Integral Prof. Fernando (IMIP), Recife, PE, Brazil; Faculdade Pernambucana de Saúde (FPS), Recife, PE, Brazil
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Toledo SLDO, Guedes JVM, Alpoim PN, Rios DRA, Pinheiro MDB. Sickle cell disease: Hemostatic and inflammatory changes, and their interrelation. Clin Chim Acta 2019; 493:129-137. [PMID: 30825426 DOI: 10.1016/j.cca.2019.02.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/26/2019] [Accepted: 02/26/2019] [Indexed: 12/23/2022]
Abstract
Sickle cell disease, the most common genetic blood disorder in the world, has high clinical variability, negatively impacts quality of life and contributes to early mortality. Sickled erythrocytes cause blood flow obstruction, hemolysis, and several hemostatic changes that promote coagulation. These events, in turn, induce chronic inflammation, characterized by elevated plasma levels of pro-inflammatory markers, which aggravates the already unfavorable state of the circulatory system. Empirical evidence indicates that the hemostatic and inflammatory systems continuously interact with each other and thereby further propagate the hypercoagulability and inflammatory conditions. In this review article, we discuss the pathophysiological aspects of sickle cell disease and the hemostatic and inflammatory changes that underlie its pathogenesis.
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Affiliation(s)
- Sílvia L de O Toledo
- Federal University of São João del-Rei (UFSJ), Dona Lindu Center-West Campus, Sebastião Gonçalves Coelho Street, 400, Chanadour, 35501-296 Divinópolis, MG, Brazil
| | - João V M Guedes
- Federal University of São João del-Rei (UFSJ), Dona Lindu Center-West Campus, Sebastião Gonçalves Coelho Street, 400, Chanadour, 35501-296 Divinópolis, MG, Brazil
| | - Patrícia N Alpoim
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais (MG), Brazil
| | - Danyelle R A Rios
- Federal University of São João del-Rei (UFSJ), Dona Lindu Center-West Campus, Sebastião Gonçalves Coelho Street, 400, Chanadour, 35501-296 Divinópolis, MG, Brazil
| | - Melina de B Pinheiro
- Federal University of São João del-Rei (UFSJ), Dona Lindu Center-West Campus, Sebastião Gonçalves Coelho Street, 400, Chanadour, 35501-296 Divinópolis, MG, Brazil.
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Alladagbin DJ, Fernandes PN, Tavares MB, Brito JT, Oliveira GGS, Silva LK, Khouri NA, Oliveira MB, Amorim T, Matos CM, Ribeiro GS, Lopes AA, Gonçalves MS, dos-Santos WLC. The sickle cell trait and end stage renal disease in Salvador, Brazil. PLoS One 2018; 13:e0209036. [PMID: 30557319 PMCID: PMC6296547 DOI: 10.1371/journal.pone.0209036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 11/27/2018] [Indexed: 12/12/2022] Open
Abstract
Background Carriers of the sickle cell trait (HbAS) usually remain asymptomatic. However, under conditions of low tissue oxygenation, red blood cell sickling and vascular obstruction may develop. Chronic kidney disease (CKD) can arise from conditions promoting low-oxygen in kidney tissue, which may be aggravated by the presence of the sickle cell trait. In addition, CKD can arise from other genetic traits. Aim To compare the frequency of HbAS among hemodialysis patients and the general newborn population of Salvador (Bahia-Brazil), as well as to investigate the frequencies of apolipoprotein L1 risk variants in patients undergoing hemodialysis. Methods A cross-sectional study included 306 patients with ESRD (End Stage Renal Disease) on hemodialysis for no more than three years. Hemoglobin profiles were characterized by high-performance liquid chromatography. To estimate the sickle cell trait frequency in the general population of Salvador, we analyzed data collected by a local neonatal screening program between 2011 and 2016. To exclude the potential contributing effect of the apolipoprotein L1 (APOL1) gene variants, we performed genotyping by PCR and DNA sequencing of 45 patients. Results The frequency of HbAS was significantly higher in hemodialysis patients (9.8%) than in the general population (4.6%): Odds Ratio = 2.32 (95% CI = 1.59–3.38). No differences in demographic, clinical or laboratory data were found among patients with or without the sickle cell trait. The frequency of patients with none, one or two APOL1 risk haplotypes (G1 and G2) for CKD were 80%, 18% and 2%, respectively. Conclusions The frequency of the sickle cell trait is higher in patients with ESRD on hemodialysis compared to the general population. APOL1 haplotypes do not seem to be the determinant of ESRD in these patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Tatiana Amorim
- Serviço de Referência em Triagem Neonatal—SRTN, Salvador, Brazil
| | | | - Guilherme S. Ribeiro
- Instituto Gonçalo Moniz-FIOCRUZ-Bahia, Salvador, Brazil
- Universidade da Bahia, Salvador, Brazil
| | | | - Marilda S. Gonçalves
- Instituto Gonçalo Moniz-FIOCRUZ-Bahia, Salvador, Brazil
- Universidade da Bahia, Salvador, Brazil
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Biswal S, Rizwan H, Pal S, Sabnam S, Parida P, Pal A. Oxidative stress, antioxidant capacity, biomolecule damage, and inflammation symptoms of sickle cell disease in children. ACTA ACUST UNITED AC 2018; 24:1-9. [PMID: 30010491 DOI: 10.1080/10245332.2018.1498441] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The phenotypic expression of sickle cell disease (SCD) is a complex pathophysiologic condition. However, sickle erythrocytes might be the cause for multiple sources of pro-oxidant processes with consequent linked to chronic and systemic oxidative stress. Herein, we explored the SCD phenomena could be the result in formation of oxidative stress as well as inflammation in children. MATERIAL AND METHODS Blood samples of 147 SCD subjects were evaluated. A control group was formed of 156 individuals without SCD. Different oxidative stress markers and inflammatory mediators were measured by using various biochemical techniques. Plasma samples were collected from blood for the measurement of antioxidants and reactive oxygen species (ROS). RESULTS The levels of plasma hydroxyl radical (HO•), and nitric oxide (NO) production were higher in SCD children in compared to control groups. The plasma antioxidants capacities such as superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), glutathione peroxidase (GPx) and protein thiol levels were significantly reduced in SCD children. The plasma lipid peroxidation, protein carbonylation, DNA damage markers were significantly altered in different age groups of SCD children. Further, our results showed that SCD children have chronic inflammatory disease due to persistent alteration of haemoglobin content, reticulocyte, total bilirubin, platelet, creatinine, leukocytes, and altered expression of inflammatory mediators in compared to control groups. CONCLUSION SCD children have high oxidative stress, and conversely, decreased antioxidant activity. Decrease in antioxidant activity might explained the reduction in lipid peroxidation, protein carbonylation and increased inflammation, which in turn intensify the symptoms of SCD in children.
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Affiliation(s)
- Sebaranjan Biswal
- a Department of Paediatrics , KIMS, Kalinga Institute of Industrial Technology , Bhubaneswar , India
| | - Huma Rizwan
- b School of Biotechnology , Kalinga Institute of Industrial Technology , Bhubaneswar , India
| | - Sweta Pal
- b School of Biotechnology , Kalinga Institute of Industrial Technology , Bhubaneswar , India
| | - Silpa Sabnam
- b School of Biotechnology , Kalinga Institute of Industrial Technology , Bhubaneswar , India
| | - Preetinanda Parida
- c Department of Biochemistry , KIMS, Kalinga Institute of Industrial Technology , Bhubaneswar , India
| | - Arttatrana Pal
- d Department of Zoology, School of Life Sciences , Mahatma Gandhi Central University , Motihari , India
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Adegoke SA, Smith OS, Adekile AD, Figueiredo MS. Relationship between serum 25-hydroxyvitamin D and inflammatory cytokines in paediatric sickle cell disease. Cytokine 2017; 96:87-93. [PMID: 28390266 DOI: 10.1016/j.cyto.2017.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 01/12/2017] [Accepted: 03/31/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Alteration in the concentration of inflammatory cytokines may contribute to pathogenesis in sickle cell anaemia (SCA). Vitamin D may suppress pro-inflammatory cytokines and enhance anti-inflammatory cytokines. OBJECTIVE To compare steady state levels of pro-and anti-inflammatory cytokines of Nigerian SCA children with age- and sex-matched healthy controls, and determine the relationship with 25-hydroxyvitamin-D (25-OHD). Effects of three months of vitamin D supplementation on cytokines of SCA children with suboptimal 25-OHD were also evaluated. METHODS Serum 25-OHD, IL-1β, 2, 6, 8, 11, 12, 13, 17, 18 of 95 SCA children and 75 matched controls were determined using HPLC. The 12 SCA children with suboptimal 25-OHD received 2000IU of vitamin D daily for 3months, and their post supplementation cytokines and 25-OHD levels were compared with the baseline values. RESULTS IL-2, 6, 8, 12, 17 and 18 were higher in SCA children than the controls (p≤0.001), but no significant variation in IL-11 and 13 (p=0.131 and 0.057 respectively). Patients with suboptimal serum 25-OHD had higher IL-6, 8 and 18 (p=0.003, 0.010 and 0.002 respectively) and lower levels of IL-11 (p=0.005). Significant positive treatment effects were observed: post-supplementation, serum 25-OHD increased by 23.3ng/mL, p<0.001; proinflammatory cytokines IL-2, 6, 8, 17 and 18 (p<0.001) were reduced and anti-inflammatory cytokine IL-11 was increased, p<0.001. CONCLUSIONS Suboptimal 25OHD is associated with enhanced levels of pro-inflammatory markers in children with SCA. Three months of daily vitamin D supplementation reversed the trend. Hence; Vitamin D supplementation may reduce the inflammatory milieu and serve as an anti-inflammatory agent in the management of SCA.
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Affiliation(s)
- Samuel Ademola Adegoke
- Haematology and Blood Transfusion Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Brazil; Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Olufemi Samuel Smith
- Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - Adekunle D Adekile
- Department of Paediatrics, Faculty of Medicine, Kuwait University, Kuwait
| | - Maria Stella Figueiredo
- Haematology and Blood Transfusion Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Brazil
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Quantitative sensory testing and pain-evoked cytokine reactivity: comparison of patients with sickle cell disease to healthy matched controls. Pain 2017; 157:949-956. [PMID: 26713424 DOI: 10.1097/j.pain.0000000000000473] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Sickle cell disease (SCD) is an inherited blood disorder associated with significant morbidity, which includes severe episodic pain, and, often, chronic pain. Compared to healthy individuals, patients with SCD report enhanced sensitivity to thermal detection and pain thresholds and have altered inflammatory profiles, yet no studies to date have examined biomarker reactivity after laboratory-induced pain. We sought to examine this relationship in patients with SCD compared to healthy control participants. We completed quantitative sensory testing in 83 patients with SCD and sequential blood sampling in 27 of them, whom we matched (sex, age, race, body mass index, and education) to 27 healthy controls. Surprisingly, few quantitative sensory testing differences emerged between groups. Heat pain tolerance, pressure pain threshold at the trapezius, thumb, and quadriceps, and thermal temporal summation at 45°C differed between groups in the expected direction, whereas conditioned pain modulation and pain ratings to hot water hand immersion were counterintuitive, possibly because of tailoring the water temperature to a perceptual level; patients with SCD received milder temperatures. In the matched subsample, group differences and group-by-time interactions were observed in biomarkers including tumor necrosis factor alpha, interleukin-1ß, interleukin-4, and neuropeptide Y. These findings highlight the utility of laboratory pain testing methods for understanding individual differences in inflammatory cytokines. Our findings suggest amplified pain-evoked proinflammatory cytokine reactivity among patients with SCD relative to carefully matched controls. Future research is warranted to evaluate the impact of enhanced pain-related cytokine response and whether it is predictive of clinical characteristics and the frequency/severity of pain crises in patients with SCD.
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Alapan Y, Fraiwan A, Kucukal E, Hasan MN, Ung R, Kim M, Odame I, Little JA, Gurkan UA. Emerging point-of-care technologies for sickle cell disease screening and monitoring. Expert Rev Med Devices 2016; 13:1073-1093. [PMID: 27785945 PMCID: PMC5166583 DOI: 10.1080/17434440.2016.1254038] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Sickle Cell Disease (SCD) affects 100,000 Americans and more than 14 million people globally, mostly in economically disadvantaged populations, and requires early diagnosis after birth and constant monitoring throughout the life-span of the patient. Areas covered: Early diagnosis of SCD still remains a challenge in preventing childhood mortality in the developing world due to requirements of skilled personnel and high-cost of currently available modalities. On the other hand, SCD monitoring presents insurmountable challenges due to heterogeneities among patient populations, as well as in the same individual longitudinally. Here, we describe emerging point-of-care micro/nano platform technologies for SCD screening and monitoring, and critically discuss current state of the art, potential challenges associated with these technologies, and future directions. Expert commentary: Recently developed microtechnologies offer simple, rapid, and affordable screening of SCD and have the potential to facilitate universal screening in resource-limited settings and developing countries. On the other hand, monitoring of SCD is more complicated compared to diagnosis and requires comprehensive validation of efficacy. Early use of novel microdevices for patient monitoring might come in especially handy in new clinical trial designs of emerging therapies.
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Affiliation(s)
- Yunus Alapan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Arwa Fraiwan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Erdem Kucukal
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - M. Noman Hasan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Ryan Ung
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Myeongseop Kim
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Isaac Odame
- Division of Haematology/Oncology, The Hospital for Sick Children; Toronto, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jane A. Little
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Seidman Cancer Center at University Hospitals, Case Medical Center, Cleveland, OH, USA
| | - Umut A. Gurkan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Department of Orthopedics, Case Western Reserve University, Cleveland, OH, USA
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Hu X, Jhun EH, Yao Y, He Y, Molokie RE, Wilkie DJ, Wang ZJ. IL1A rs1800587 associates with chronic noncrisis pain in sickle cell disease. Pharmacogenomics 2016; 17:1999-2006. [PMID: 27883292 DOI: 10.2217/pgs-2016-0085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM Pain is prevalent in sickle cell disease (SCD) patients who display great heterogeneity in pain severity and frequency. Hypothesizing that inflammatory factors are involved in the pathogenesis of SCD pain, we focused on the IL1A C/T polymorphism rs1800587 that is an SNP located in a cis-transcriptional regulatory region. METHODS We genotyped IL1A rs1800587 and performed association studies with phenotype data obtained by a multidimensional pain assessment tool using the PAINReportIt® Questionnaire. RESULTS Each T allele was associated with a 3.9 increase in composite pain index score (p = 0.04) as determined by multiple linear regression. CONCLUSION IL1A rs1800587 may influence chronic pain in SCD.
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Affiliation(s)
- Xiaoyu Hu
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Ellie H Jhun
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Yingwei Yao
- Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Ying He
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA.,Comprehensive Sickle Cell Center, University of Illinois at Chicago, IL, USA
| | - Robert E Molokie
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA.,Comprehensive Sickle Cell Center, University of Illinois at Chicago, IL, USA.,Jesse Brown Veteran's Administration Medical Center, Chicago, IL, USA.,Division of Hematology/Oncology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Diana J Wilkie
- Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA.,Comprehensive Sickle Cell Center, University of Illinois at Chicago, IL, USA
| | - Zaijie J Wang
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA.,Comprehensive Sickle Cell Center, University of Illinois at Chicago, IL, USA
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Boettger PC, Knupp CL, Liles DK, Walker K. Vitamin D Deficiency in Adult Sickle Cell Patients. J Natl Med Assoc 2016; 109:36-43. [PMID: 28259214 DOI: 10.1016/j.jnma.2016.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/19/2016] [Accepted: 10/12/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Vitamin D levels in adult black Americans with sickle cell disease (SCD) are comparatively lower than those found in the general population of black Americans. The objectives of this study were to examine the prevalence of Vitamin D deficiency (VDD) in adults with various subtypes of sickle cell disease and identify risk factors for vitamin D deficiency. METHODS In a retrospective study serum Vitamin D25(OH)D and/or VitaminD1,25(OH)2D levels were obtained in 120 subjects with sickle cell disease. Baseline studies also included LFTs, total protein, albumin, total bilirubin, and creatinine levels. In a portion of subjects that were treated with oral ergocalciferol vitamin D levels and chemistries were obtained within 6 months of treatment. Data was statistically analyzed with Welch two sample t-tests and individual simple linear regressions (including logarithmic values) for each variable. RESULTS Vitamin D25(OH)D levels were found to be significantly lower in a group of subjects with Hgb SS disease, than in a group with other subtypes of sickle cell disease. In both groups combined, significant (p = 0.05) and clinically suggestive negative correlations with Vitamin D25(OH)D were seen for total bilirubin and total protein, respectively. When total bilirubin and total protein levels were compared between the Hgb SS and HgbS/other groups, t-test revealed these levels were significantly higher in the Hgb SS group levels at p < 0.001 and p = 0.005, respectively. IMPLICATIONS Low total Vitamin D25(OH)D levels in adults with sickle cell disease may be a reflection of chronic inflammation and overall disease severity.
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Affiliation(s)
- Peter C Boettger
- East Carolina University School of Medicine, Deptarment of Internal Medicine, Division of Hematology-Oncology, 600 Moye Blvd., Greenville, NC 27834, USA.
| | - Charles L Knupp
- East Carolina University School of Medicine, Deptarment of Internal Medicine, Division of Hematology-Oncology, 600 Moye Blvd., Greenville, NC 27834, USA
| | - Darla K Liles
- East Carolina University School of Medicine, Deptarment of Internal Medicine, Division of Hematology-Oncology, 600 Moye Blvd., Greenville, NC 27834, USA
| | - Kaitlyn Walker
- East Carolina University School of Medicine, Deptarment of Internal Medicine, Division of Hematology-Oncology, 600 Moye Blvd., Greenville, NC 27834, USA
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Inheritance of the Bantu/Benin haplotype causes less severe hemolytic and oxidative stress in sickle cell anemia patients treated with hydroxycarbamide. J Hum Genet 2016; 61:605-11. [PMID: 26961071 DOI: 10.1038/jhg.2016.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/01/2016] [Accepted: 02/03/2016] [Indexed: 12/13/2022]
Abstract
Beta S-globin gene cluster haplotypes (β(S)-haplotypes) can modulate the response to hydroxycarbamide (HC) treatment in sickle cell anemia (SCA) patients. In Brazil, the most common haplotypes are Bantu and Benin, and both confer a poor prognosis for patients when untreated with HC. We evaluated oxidative and hemolytic biomarkers in 48 SCA patients undergoing HC treatment separated in three subgroups: Bantu/Bantu, Bantu/Benin and Benin/Benin haplotype. On the basis of reduced haptoglobin (HP) levels, patients with Bantu/Bantu haplotypes had 3.0% higher hemolysis degree when compared with those with Bantu/Benin haplotypes (P=0.01). The Benin/Benin patients had 53.6% greater lipid peroxidation index than the Bantu/Bantu patients (P=0.01) because of evaluated thiobarbituric acid reactive species levels. The Bantu/Benin subgroup had intermediate levels of hemolytic and oxidative stress markers compared with the homozygous subgroups. Through strict inclusion criteria adopted, as well as consolidated and well-described hemolytic and the oxidative parameters evaluated, we suggest a haplotype-interaction response to HC treatment mediated by a 'balance' between the genetic factors of each haplotype studied.
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Sickle cell anemia induces changes in peripheral lymphocytes E-NTPDase/E-ADA activities and cytokines secretion in patients under treatment. Biomed Pharmacother 2015. [PMID: 26211589 DOI: 10.1016/j.biopha.2015.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Sickle cell anemia (SCA) is characterized by hemoglobin polymerization that results in sickle-shaped red blood cells. The vascular obstruction by sickle erythrocytes is often inflammatory, and purinergic system ecto-enzymes play an important role in modulating the inflammatory and immune response. This study aimed to evaluate the E-NTPDase and E-ADA activities in lymphocytes of SCA treated patients, as well as verify the cytokine profile in this population. Fifteen SCA treated patients and 30 health subjects (control group) were selected. The peripheral lymphocytes were isolated and E-NTPDase and E-ADA activities were determined. Serum was separated from clot formation for the cytokines quantification. E-NTPDase (ATP and ADP as substrate) and E-ADA (adenosine as substrate) activities were increased in lymphocytes from SCA patients (P<0.001). The TNF-α and IL-6 serum cytokines showed decreased on SCA patients comparing to control (P<0.001). The regulation of extracellular nucleotides released in response to hypoxia and inflammation through E-NTPDase and E-ADA enzymes represent an important control of purine-mediated in the SCA disease, avoiding elevated adenosine levels in the extracellular medium and consequent organ injuries in these patients. The pro-inflammatory cytokines decreased levels by use of hydroxyurea occur in attempt to reduce the pro-inflammatory response and prevent vaso-oclusive crisis.
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Noble JA, Duru KC, Guindo A, Yi L, Imumorin IG, Diallo DA, Thomas BN. Interethnic diversity of the CD209 (rs4804803) gene promoter polymorphism in African but not American sickle cell disease. PeerJ 2015; 3:e799. [PMID: 25755928 PMCID: PMC4349147 DOI: 10.7717/peerj.799] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/03/2015] [Indexed: 12/27/2022] Open
Abstract
Elucidating the genomic diversity of CD209 gene promoter polymorphism could assist in clarifying disease pathophysiology as well as contribution to co-morbidities. CD209 gene promoter polymorphism has been shown to be associated with susceptibility to infection. We hypothesize that CD209 mutant variants occur at a higher frequency among Africans and in sickle cell disease. We analyzed the frequency of the CD209 gene (rs4804803) in healthy control and sickle cell disease (SCD) populations and determined association with disease. Genomic DNA was extracted from blood samples collected from 145 SCD and 231 control Africans (from Mali), 331 SCD and 379 control African Americans and 159 Caucasians. Comparative analysis among and between groups was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Per ethnic diversification, we found significant disparity in genotypic (23.4% versus 16.9% versus 3.2%) and allelic frequencies (48.7% versus 42.1% versus 19.8%) of the homozygote mutant variant of the CD209 (snp 309A/G) gene promoter between Africans, African Americans and Caucasians respectively. Comparative evaluation between disease and control groups reveal a significant difference in genotypic (10.4% versus 23.4%; p = 0.002) and allelic frequencies (39.7% versus 48.7%; p = 0.02) of the homozygote mutant variant in African SCD and healthy controls respectively, an observation that is completely absent among Americans. Comparing disease groups, we found no difference in the genotypic (p = 0.19) or allelic (p = 0.72) frequencies of CD209 homozygote mutant variant between Africans and Americans with sickle cell disease. The higher frequency of CD209 homozygote mutant variants in the African control group reveals a potential impairment of the capacity to mount an immune response to infectious diseases, and possibly delineate susceptibility to or severity of infectious co-morbidities within and between groups.
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Affiliation(s)
- Jenelle A Noble
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology , Rochester, NY , USA
| | - Kimberley C Duru
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology , Rochester, NY , USA
| | - Aldiouma Guindo
- Centre de Recherche et de Lutte contre la Drepanocytose , Bamako , Mali
| | - Li Yi
- School of Statistics, Shanxi University of Finance and Economics , Shanxi , China
| | - Ikhide G Imumorin
- Animal Genetics and Genomics Lab, Office of International Programs, Cornell University , Ithaca, NY , USA
| | - Dapa A Diallo
- Centre de Recherche et de Lutte contre la Drepanocytose , Bamako , Mali
| | - Bolaji N Thomas
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology , Rochester, NY , USA
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42
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Sarray S, Saleh LR, Lisa Saldanha F, Al-Habboubi HH, Mahdi N, Almawi WY. Serum IL-6, IL-10, and TNFα levels in pediatric sickle cell disease patients during vasoocclusive crisis and steady state condition. Cytokine 2015; 72:43-7. [PMID: 25569375 DOI: 10.1016/j.cyto.2014.11.030] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/20/2014] [Accepted: 11/27/2014] [Indexed: 10/24/2022]
Abstract
Vaso-occlusive crisis (VOC) is a significant complication of sickle cell disease (SCD), and altered production of pro-inflammatory and anti-inflammatory molecules contributed to its pathogenesis. In view of the association of chronic inflammation with VOC onset, and given the capacity of interleukin (IL)-10 as anti-inflammatory, and IL-6, and TNFα as pro-inflammatory cytokines, we tested the association of altered IL-10, IL-6, and TNFα secretion with VOC pathogenesis and its severity. Study subjects comprised 147 SCD patients with active VOC (VOC Group), and 63 pain-free SCD patients for at least 9 months before blood collection (Steady-state Group). Serum cytokine concentrations were determined by ELISA. IL-10 levels were significantly reduced, while IL-6 levels were increased in VOC compared to Steady-state groups; serum TNFα levels were comparable between both groups. There was enrichment of low IL-10, but high IL-6 and TNFα quartiles in VOC Group, which translated into increased VOC risk. In contrast, high IL-10, but low IL-6 and TNFα quartiles were seen in Steady-state Group. Correlation analysis demonstrated significant association between reduced IL-10 levels and the frequency, type, severity, and duration of VOC and requirement for hydroxyurea treatment, while IL-6 correlated with duration of VOC episodes. Our data support strong association of reduced IL-10 and increased IL-6 levels with VOC, and their modulation of VOC-related parameters.
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Affiliation(s)
- Sameh Sarray
- Department of Medical Biochemistry, Arabian Gulf University, Manama, Bahrain.
| | - Layal R Saleh
- Department of Medical Biochemistry, Arabian Gulf University, Manama, Bahrain
| | - F Lisa Saldanha
- Department of Medical Biochemistry, Arabian Gulf University, Manama, Bahrain
| | - Hebah H Al-Habboubi
- Department of Medical Biochemistry, Arabian Gulf University, Manama, Bahrain
| | - Najat Mahdi
- Department of Pediatrics, Salmaniya Medical Complex, Manama, Bahrain
| | - Wassim Y Almawi
- Department of Medical Biochemistry, Arabian Gulf University, Manama, Bahrain
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43
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Vicari P, Adegoke SA, Mazzotti DR, Cançado RD, Nogutti MAE, Figueiredo MS. Interleukin-1β and interleukin-6 gene polymorphisms are associated with manifestations of sickle cell anemia. Blood Cells Mol Dis 2014; 54:244-9. [PMID: 25595815 DOI: 10.1016/j.bcmd.2014.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/18/2014] [Accepted: 12/21/2014] [Indexed: 11/28/2022]
Abstract
Sickle cell anemia (SCA), a disorder characterized by both acute and chronic inflammation, exhibits substantial phenotypic variability. Interleukin-1 beta (IL-1β) and IL-6 are important in acute and chronic diseases, and their single nucleotide polymorphisms (SNPs) have been considered as predictors of prognosis in several inflammatory conditions. This study aims at exploring possible association of IL-1β and IL-6 SNPs as potential genetic modifiers and or predictors of SCA clinical and laboratory phenotypes. This cross-sectional study involved 107 SCA patients and 110 age, sex and ethnicity-matched healthy individuals. The SNPs were identified by PCR-RFLP for IL-1β (-511C>T and +3954C>T) and IL-6 (-597G>A and -174G>C) genes. Associations between these SNPs and the clinical and laboratory profiles of patients with SCA were then determined. Allelic and genotypic frequencies of IL-1β and IL-6 SNPs between patients with SCA and controls were similar and followed HWE. IL-1β +3954C>T SNP was associated with increased risk of osteonecrosis, elevated pulmonary arterial pressure and lower absolute reticulocyte count, while IL-6 -597G>A was associated with higher likelihood of retinopathy and leg ulcer. These data indicate that IL-1β and IL-6 gene SNPs are associated with SCA complications among Brazilian patients and may act as genetic predictors of SCA clinical heterogeneity.
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Affiliation(s)
- Perla Vicari
- Disciplina de Hematologia e Hemoterapia, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil
| | - Samuel A Adegoke
- Disciplina de Hematologia e Hemoterapia, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil
| | | | - Rodolfo Delfini Cançado
- Disciplina de Hematologia e Oncologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
| | | | - Maria Stella Figueiredo
- Disciplina de Hematologia e Hemoterapia, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil.
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44
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Okocha C, Manafa P, Ozomba J, Ulasi T, Chukwuma G, Aneke J. C-reactive Protein and Disease Outcome in Nigerian Sickle Cell Disease Patients. Ann Med Health Sci Res 2014; 4:701-5. [PMID: 25328778 PMCID: PMC4199159 DOI: 10.4103/2141-9248.141523] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: Evidence suggests that sickle cell disease (SCD) is associated with a chronic inflammatory state. C-reactive protein (CRP) is known to modulate inflammation. Its role in the chronic inflammation of SCD may make it valuable as a therapeutic target. Aim: The aim was to determine CRP levels in SCD subjects in asymptomatic steady state (ASS) and crisis and correlate these with severity scores in the ASS. Subjects and Methods: We measured the level of CRP in 30 hemoglobin SS (HbSS) individuals in ASS and seven in crisis. As controls, we measured CRP in 50 individuals each who were hemoglobin AS and hemoglobin AA respectively, using enzyme linked immunoabsorbent assay based commercially available kits from East Wing Diagnostic Limited Full blood count (white blood cell [WBC]) was done for the ASS HbSS individuals using a cell counter and their disease severity calculated by an objective scoring method. Results: Our results showed that ASS HbSS individuals had significantly higher CRP levels compared with the controls. The HbSS individuals in crisis also had a significantly higher level of CRP compared to the ASS HbSS individuals. Disease severity and WBC were found to be negatively correlated with CRP levels (P = 0.17; and 0.73, respectively). Conclusion: Our results suggest that increased levels of CRP in ASS HbSS individuals may play a protective role in SCD leading to better disease outcome, and may have value as a therapeutic target.
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Affiliation(s)
- Ce Okocha
- Department of Hematology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Po Manafa
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University Nnewi Campus, Nnewi, Anambra State, Nigeria
| | - Jo Ozomba
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University Nnewi Campus, Nnewi, Anambra State, Nigeria
| | - To Ulasi
- Department of Pediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Go Chukwuma
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University Nnewi Campus, Nnewi, Anambra State, Nigeria
| | - Jc Aneke
- Department of Hematology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
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45
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Comment on "Molecular analysis and association with clinical and laboratory manifestations in children with sickle cell anemia". Rev Bras Hematol Hemoter 2014; 36:315-8. [PMID: 25305161 PMCID: PMC4318385 DOI: 10.1016/j.bjhh.2014.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/01/2014] [Indexed: 12/30/2022] Open
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46
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Sarray S, Mahdi N, Saleh LR, Almaoui WY. Reduction in serum IL-10 levels is a surrogate marker for predicting vaso-occlusive crisis in sickle cell disease. Am J Hematol 2014; 89:789-90. [PMID: 24723483 DOI: 10.1002/ajh.23736] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 04/07/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Sameh Sarray
- Department of Medical Biochemistry; Arabian Gulf University; Manama Bahrain
| | - Najat Mahdi
- Department of Pediatrics; Salmaniya Medical Complex; Manama Bahrain
| | - Layal R. Saleh
- Department of Medical Biochemistry; Arabian Gulf University; Manama Bahrain
| | - Wassim Y. Almaoui
- Department of Medical Biochemistry; Arabian Gulf University; Manama Bahrain
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47
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Torres LDS. Comment on "Influence of βS-globin haplotypes and hydroxyurea on tumor necrosis factor-alpha levels in sickle cell anemia". Rev Bras Hematol Hemoter 2014; 36:102-3. [PMID: 24790532 PMCID: PMC4005505 DOI: 10.5581/1516-8484.20140023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Lidiane de Souza Torres
- Universidade Estadual Paulista, São José do Rio Preto, SP, Brazil, Universidade Estadual Paulista (UNESP), São José do Rio Preto, SP, Brazil
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