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Connes P, Stauffer E, Liem RI, Nader E. Exercise and training in sickle cell disease: Safety, potential benefits, and recommendations. Am J Hematol 2024. [PMID: 39132839 DOI: 10.1002/ajh.27454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/28/2024] [Accepted: 07/23/2024] [Indexed: 08/13/2024]
Abstract
Sickle cell disease (SCD) is a genetic disorder characterized by complex pathophysiological mechanisms leading to vaso-occlusive crisis, chronic pain, chronic hemolytic anemia, and vascular complications, which require considerations for exercise and physical activity. This review aims to elucidate the safety, potential benefits, and recommendations regarding exercise and training in individuals with SCD. SCD patients are characterized by decreased exercise capacity and tolerance. Acute intense exercise may be accompanied by biological changes (acidosis, increased oxidative stress, and dehydration) that could increase the risk of red blood cell sickling and acute clinical complications. However, recent findings suggest that controlled exercise training is safe and well tolerated by SCD patients and could confer benefits in disease management. Regular endurance exercises of submaximal intensity or exercise interventions incorporating resistance training have been shown to improve cardiorespiratory and muscle function in SCD, which may improve quality of life. Recommendations for exercise prescription in SCD should be based on accurate clinical and functional evaluations, taking into account disease phenotype and cardiorespiratory status at rest and in response to exercise. Exercise programs should include gradual progression, incorporating adequate warm-up, cool-down, and hydration strategies. Exercise training represents promising therapeutic strategy in the management of SCD. It is now time to move through the investigation of long-term biological, physiological, and clinical effects of regular physical activity in SCD patients.
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Affiliation(s)
- Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team «Vascular Biology and Red Blood Cell», Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Emeric Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team «Vascular Biology and Red Blood Cell», Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Explorations Fonctionnelles Respiratoires, Médecine du sport et de l'Activité Physique, Hospices Civils de Lyon, Hôpital Croix Rousse, Lyon, France
| | - Robert I Liem
- Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team «Vascular Biology and Red Blood Cell», Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
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Connes P. Blood rheology and vascular function in sickle cell trait and sickle cell disease: From pathophysiological mechanisms to clinical usefulness. Clin Hemorheol Microcirc 2024; 86:9-27. [PMID: 38073384 DOI: 10.3233/ch-238122] [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] [Indexed: 02/24/2024]
Abstract
Sickle cell disease (SCD) is an autosomal recessive disorder. Although the molecular mechanisms at the origin of SCD have been well characterized, its clinical expression is highly variable. SCD is characterized by blood rheological abnormalities, increased inflammation and oxidative stress, and vascular dysfunction. Individuals with only one copy of the mutated β-globin gene have sickle cell trait (SCT) and are usually asymptomatic. The first part of this review focuses on the biological responses of SCT carriers during exercise and on the effects of combined SCT and diabetes on vascular function, several biomarkers and clinical complications. The second part of the review focuses on SCD and shows that the magnitude of red blood cell (RBC) rheological alterations is highly variable from one patient to another, and this variability reflects the clinical and hematological variability: patients with the less deformable RBCs have high hemolytic rate and severe anemia, and are prone to develop leg ulcers, priapism, cerebral vasculopathy, glomerulopathy or pulmonary hypertension. In contrast, SCD patients characterized by the presence of more deformable RBCs (but still rigid) are less anemic and may exhibit increased blood viscosity, which increases the risk for vaso-occlusive events. Several genetic and cellular factors may modulate RBC deformability in SCD: co-existence of α-thalassemia, fetal hemoglobin level, oxidative stress, the presence of residual mitochondria into mature RBCs, the activity of various non-selective cationic ion channels, etc. The last part of this review presents the effects of hydroxyurea and exercise training on RBC rheology and other biomarkers in SCD.
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Affiliation(s)
- Philippe Connes
- Laboratory LIBM EA7424, University of Lyon 1, "Vascular Biology and Red Blood Cell" Team, Lyon, France
- Laboratory of Excellence Labex GR-Ex, Paris, France
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3
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Mitochondrial function in sickle cell disease. Blood 2022; 139:1616-1617. [PMID: 35298608 DOI: 10.1182/blood.2021015216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/13/2022] [Indexed: 11/20/2022] Open
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Kengne Fotsing CB, Pieme CA, Biapa Nya PC, Chedjou JP, Dabou S, Nguemeni C, Teto G, Mbacham WF, Gatsing D. Relation between haptoglobin polymorphism and oxidative stress status, lipid profile, and cardiovascular risk in sickle cell anemia patients. Health Sci Rep 2022; 5:e465. [PMID: 35229039 PMCID: PMC8865067 DOI: 10.1002/hsr2.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The haptoglobin (Hp) gene located on chromosome 16q22 exhibits a polymorphism that can impact its capacity to inhibit the deleterious oxidative activity of free hemoglobin. We aimed to determine the influence of Hp polymorphism on oxidative stress, lipid profile, and cardiovascular risk in Cameroonian sickle cell anemia patients (SCA patients). METHOD The Hp genotypes of 102 SCA patients (SS), 60 healthy individuals (AA), and 55 subjects with sickle cell trait (AS) were determined by allele-specific PCR, and the blood parameters were assessed using standard methods. RESULTS Hp2-2 genotype was significantly (P < .05) present in SS (54%) than in AS (42%) and AA (38%). Levels of catalase and cell reactive protein were higher, while levels of total antioxidant capacity, triglycerides, low-density lipoprotein cholestetol, blood pressure, Framingham score, and body mass index were lower in the SCA patients. These parameters appeared to be unrelated to the haptoglobin genotypes. SCA patients with Hp1-1 genotype presented a higher oxidative stress index (0.53 ± 0.31) than those with Hp2-1 (0.33 ± 0.18). Lipid profile and cardiovascular risk were not significantly different between various Hp genotypes in SCA patients. CONCLUSION Haptoglobin polymorphism did not affect lipid profile, cardiovascular risk, and oxidative stress status of SCA patients. Nevertheless, SCA patients with Hp1-1 genotype tended to be more prone to oxidative stress than those with Hp2-1.
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Affiliation(s)
- Christian Bernard Kengne Fotsing
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of ScienceUniversity of DschangDschangCameroon
- Research Unit of Biochemistry of Medicinal Plants, Food Science and Nutrition, Department of Biochemistry, Faculty of ScienceUniversity of DschangDschangCameroon
| | - Constant Anatole Pieme
- Laboratory of Biochemistry, Department of Biochemistry and Physiological Science, Faculty of Medicine and Biomedical ScienceUniversity of Yaounde IYaoundeCameroon
| | - Prosper Cabral Biapa Nya
- Research Unit of Biochemistry of Medicinal Plants, Food Science and Nutrition, Department of Biochemistry, Faculty of ScienceUniversity of DschangDschangCameroon
| | - Jean Paul Chedjou
- Laboratory for Public Health Research Biotechnology, Department of BiochemistryUniversity of Yaounde IYaoundeCameroon
| | - Solange Dabou
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of ScienceUniversity of DschangDschangCameroon
| | - Carine Nguemeni
- Department of NeurologyUniversity Hospital of WürzburgWürzburgGermany
| | - Georges Teto
- Centre International de Recherche Chantal BiyaYaoundeCameroon
| | - Wilfred Fon Mbacham
- Laboratory for Public Health Research Biotechnology, Department of BiochemistryUniversity of Yaounde IYaoundeCameroon
| | - Donatien Gatsing
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of ScienceUniversity of DschangDschangCameroon
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Smith KN, Baynard T, Fischbach PS, Hankins JS, Hsu LL, Murphy PM, Ness KK, Radom-Aizik S, Tang A, Liem RI. Safety of maximal cardiopulmonary exercise testing in individuals with sickle cell disease: a systematic review. Br J Sports Med 2021; 56:764-769. [PMID: 34285054 DOI: 10.1136/bjsports-2021-104450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We evaluated the safety of maximal cardiopulmonary exercise testing (CPET) in individuals with sickle cell disease (SCD). Maximal CPET using gas exchange analysis is the gold standard for measuring cardiopulmonary fitness in the laboratory, yet its safety in the SCD population is unclear. DESIGN Systematic review. DATA SOURCES Systematic search of Medline (PubMed), EMBASE, Cochrane, ClinicalTrials.gov and professional society websites for all published studies and abstracts through December 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Two reviewers independently extracted data of interest from studies that assessed safety outcomes of maximal CPET in children and adults with SCD. A modified version of the Newcastle-Ottawa Scale was used to assess for risk of bias in studies included. RESULTS In total, 24 studies met inclusion/exclusion criteria. Adverse events were reported separately or as part of study results in 36 (3.8%) of 939 participants with SCD undergoing maximal CPET in studies included. Most adverse events were related to transient ischaemic changes on ECG monitoring or oxygen desaturation during testing, which did not result in arrhythmias or other complications. Only 4 (0.43%) of 939 participants experienced pain events due to maximal CPET. CONCLUSION Maximal CPET appears to be a safe testing modality in children and adults with SCD and can be used to better understand the physiological basis of reduced exercise capacity and guide exercise prescription in this population. Some studies did not focus on reporting adverse events related to exercise testing or failed to mention safety monitoring, which contributed to risk of bias.
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Affiliation(s)
- Kellsey N Smith
- Division of Hematology, Oncology & Stem Cell Transplant, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Tracy Baynard
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Peter S Fischbach
- Sibley Heart Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Jane S Hankins
- Department of Hematology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Lewis L Hsu
- Division of Pediatric Hematology/Oncology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Peggy M Murphy
- Division of Hematology, Oncology & Stem Cell Transplant, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Kiri K Ness
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, University of California Irvine, Irvine, California, USA
| | - Amy Tang
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Robert I Liem
- Division of Hematology, Oncology & Stem Cell Transplant, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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Gouraud E, Connes P, Gauthier-Vasserot A, Faes C, Merazga S, Poutrel S, Renoux C, Boisson C, Joly P, Bertrand Y, Hot A, Cannas G, Hautier C. Impact of a submaximal mono-articular exercise on the skeletal muscle function of patients with sickle cell disease. Eur J Appl Physiol 2021; 121:2459-2470. [PMID: 34023973 DOI: 10.1007/s00421-021-04716-2] [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: 01/29/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Sickle cell disease (SCD) patients exhibit a limited exercise tolerance commonly attributed to anaemia, as well as hemorheological and cardio-respiratory abnormalities, but the functional status of skeletal muscle at exercise is unknown. Moreover, the effect of SCD genotype on exercise tolerance and skeletal muscle function has been poorly investigated. The aim of this study was to investigate skeletal muscle function and fatigue during a submaximal exercise in SCD patients. METHODS Nineteen healthy individuals (AA), 28 patients with sickle cell anaemia (SS) and 18 with sickle cell-haemoglobin C disease (SC) performed repeated knee extensions exercise (FAT). Maximal isometric torque (Tmax) was measured before and after the FAT to quantify muscle fatigability. Electromyographic activity and oxygenation by near-infrared spectroscopy of the Vastus Lateralis were recorded. RESULTS FAT caused a reduction in Tmax in SS (- 17.0 ± 12.1%, p < 0.001) and SC (- 21.5 ± 14.5%, p < 0.05) but not in AA (+ 0.58 ± 29.9%). Root-mean-squared value of EMG signal (RMS) decreased only in SS after FAT, while the median power frequency (MPF) was unchanged in all groups. Oxygenation kinetics were determined in SS and AA and were not different. CONCLUSION These results show skeletal muscle dysfunction during exercise in SCD patients, and suggest different fatigue aetiology between SS and SC. The changes in EMG signal and oxygenation kinetics during exercise suggest that the greater skeletal muscle fatigue occurring in SCD patients would be rather due to intramuscular alterations modifications than decreased tissue oxygenation. Moreover, SS patients exhibit greater muscle fatigability than SC.
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Affiliation(s)
- Etienne Gouraud
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Philippe Connes
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Institute of Universities of France, Paris, France
| | - Alexandra Gauthier-Vasserot
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Hematology and Oncology Pediatric Unit, University Hospital of Lyon, Lyon, France.,Reference Centre in Sickle Cell Disease, Thalassemia and Rare Red Blood Cell and Erythropoiesis Diseases, Hospices Civils de Lyon, Lyon, France
| | - Camille Faes
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Salima Merazga
- Reference Centre in Sickle Cell Disease, Thalassemia and Rare Red Blood Cell and Erythropoiesis Diseases, Hospices Civils de Lyon, Lyon, France
| | - Solène Poutrel
- Reference Centre in Sickle Cell Disease, Thalassemia and Rare Red Blood Cell and Erythropoiesis Diseases, Hospices Civils de Lyon, Lyon, France.,Internal Medicine Department, Edouard-Herriot Hospital, Lyon, France
| | - Céline Renoux
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Laboratory of Biochemistry of Erythrocyte Pathologies, Biology Centre East, Bron, France
| | - Camille Boisson
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Philippe Joly
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Laboratory of Biochemistry of Erythrocyte Pathologies, Biology Centre East, Bron, France
| | - Yves Bertrand
- Hematology and Oncology Pediatric Unit, University Hospital of Lyon, Lyon, France.,Reference Centre in Sickle Cell Disease, Thalassemia and Rare Red Blood Cell and Erythropoiesis Diseases, Hospices Civils de Lyon, Lyon, France
| | - Arnaud Hot
- Reference Centre in Sickle Cell Disease, Thalassemia and Rare Red Blood Cell and Erythropoiesis Diseases, Hospices Civils de Lyon, Lyon, France.,Internal Medicine Department, Edouard-Herriot Hospital, Lyon, France
| | - Giovanna Cannas
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Reference Centre in Sickle Cell Disease, Thalassemia and Rare Red Blood Cell and Erythropoiesis Diseases, Hospices Civils de Lyon, Lyon, France.,Internal Medicine Department, Edouard-Herriot Hospital, Lyon, France
| | - Christophe Hautier
- Inter-University Laboratory of Human Movement Sciences (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", University Claude Bernard Lyon 1, Villeurbanne, France. .,Laboratory of Excellence "GR-Ex", Paris, France.
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de Araujo Junior JA, Antonelli Rossi DA, Carneiro Valadão TF, Milan-Mattos JC, Catai AM, Sato TDO, Hueb JC, Zanati Bazan SG, Hokama POM, Hokama NK, Roscani MG. Cardiovascular benefits of a home-based exercise program in patients with sickle cell disease. PLoS One 2021; 16:e0250128. [PMID: 33979369 PMCID: PMC8115779 DOI: 10.1371/journal.pone.0250128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/30/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Physical inactivity is an important risk factor for cardiovascular disease. The benefits of exercise in patients with chronic diseases, including cardiovascular diseases, are well established. For patients with sickle cell disease, medical recommendation was to avoid physical exercise for fear of triggering painful crises or increasing the impairment of the cardiopulmonary function. Only recently, studies have shown safety in exercise programs for this population. Despite that, there is no report that assess the effects of physical exercise on cardiac parameters in patients with sickle cell disease. OBJECTIVE This study aimed to evaluate the impact of regular physical exercise (a home-based program) on cardiovascular function in patients with sickle cell disease. DESIGN A quasi-randomized prospective controlled trial. SETTING During the years 2015 and 2016, we started recruiting among adult patients treated at a Brazilian Center for Patients with Sickle Cell Disease to participate in a study involving a home exercise program. The experimental (exercise) and control groups were submitted to clinical evaluation and cardiovascular tests before and after the intervention. Analysis of variance was applied to compare groups, considering time and group factors. PARTICIPANTS Twenty-seven adult outpatients with a sickle cell disease diagnosis. INTERVENTIONS Exercise group (N = 14): a regular home-based aerobic exercise program, three to five times per week not exceeding give times per week, for eight weeks; no prescription for the control group (N = 13). MAIN OUTCOME MEASURES Echocardiographic and treadmill test parameters. RESULTS The exercise group showed significant improvement in cardiovascular tests, demonstrated by increased distance traveled on a treadmill (p<0.01), increased ejection fraction (p < 0.01) and improvement of diastolic function assessed by mitral tissue Doppler E' wave on echocardiography (p = 0.04). None of the patients presented a sickle cell crisis or worsening of symptoms during the exercise program. CONCLUSION The selected home-based exercise program is safe, feasible, and promotes a favorable impact on functional capacity and cardiovascular function in sickle cell disease patients.
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Affiliation(s)
- Jonas Alves de Araujo Junior
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | | | - Taina Fabri Carneiro Valadão
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | | | - Aparecida Maria Catai
- Department of Physiotherapy, Federal University of Sao Carlos–UFSCar, São Carlos, Brazil
| | | | - Joao Carlos Hueb
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | - Silmeia Garcia Zanati Bazan
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | | | - Newton Key Hokama
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | - Meliza Goi Roscani
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
- Department of Medicine, Federal University of Sao Carlos–UFSCar, São Carlos, Brazil
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Tauseef U, Anjum M, Ibrahim M, Baqai HS, Tauseef A, Tauseef M, Asghar MS, Zafar M, Rasheed U, Shaikh N. OCCURRENCE OF UNUSUAL HAEMOGLOBINOPATHIES IN BALOCHISTAN: HB SD AND HB SE - PRESENTATION WITH OSTEOMYELITIS. ACTA ACUST UNITED AC 2021; 39:e2019365. [PMID: 33566985 PMCID: PMC7870096 DOI: 10.1590/1984-0462/2021/39/2019365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/21/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To describe two cases of unusual variants of sickle cell disease. CASE DESCRIPTION We present two cases of sickle cell disease variants (haemoglobinopathies), from unrelated families, in the state of Balochistan (Pakistan). One was diagnosed with sickle cell disease in the haemoglobin electrophoresis, whereas the other was diagnosed with sickle cell SE disease. Both were diagnosed based on the presentation of osteomyelitis. COMMENTS Haemoglobin SD disease (Hb SD) and haemoglobin SE disease (Hb SE) are rare haemoglobinopathies in the world. The lack of available literature suggests that both are variants of sickle cell disease (SCD), with heterogeneous nature. The prevalence of sickle cell disease with compound heterozygotes was found at a variable frequency in the population of the Asian Southeast. The frequency of osteomyelitis in SCD is 12 to 18%, but its occurrence among variant haemoglobinopathies is little reported. Both reported cases presented with osteomyelitis as a characteristic of the disease presentation.
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Affiliation(s)
- Usman Tauseef
- National Institute of Child Health, Karachi, Pakistan
| | - Misbah Anjum
- National Institute of Child Health, Karachi, Pakistan
| | | | | | | | | | | | - Maryam Zafar
- Dow University of Health Sciences, Karachi, Pakistan
| | - Uzma Rasheed
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Nimra Shaikh
- Liaquat National Hospital and Medical College, Karachi, Pakistan
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Gueye Tall F, Martin C, Ndour EHM, Faes C, Déme Ly I, Pialoux V, Connes P, Gueye PM, Ndiaye Diallo R, Renoux C, Diagne I, Diop PA, Cissé A, Sall PL, Joly P. Influence of Oxidative Stress Biomarkers and Genetic Polymorphisms on the Clinical Severity of Hydroxyurea-Free Senegalese Children with Sickle Cell Anemia. Antioxidants (Basel) 2020; 9:antiox9090863. [PMID: 32937882 PMCID: PMC7555380 DOI: 10.3390/antiox9090863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/16/2022] Open
Abstract
Oxidative stress would play a role in the pathophysiology of sickle cell anemia (SCA). We tested the impact of common SCA genetic modifiers (alpha-thalassemia, G6PD deficiency, HbF quantitative trait loci; QTL) and pro/antioxidant genes polymorphisms (SOD2 rs4880, XO rs207454, MPO rs233322) on oxidative stress biomarkers (AOPP, MDA, MPO, XO, MnSOD, CAT, GPx) and clinical severity in 301 Senegalese SCA hydroxyurea-free children at steady-state (median age 9.1 years, sex ratio H/F = 1.3). Plasma oxidative stress biomarkers were compared with those of a control group (AA). CAT activity, AOPP, and MDA levels were higher in SCA than in AA individuals while XO, GPX, and MnSOD activities were lower. The presence of alpha-thalassemia decreased MDA level and MPO activity but no effect of the HbF QTL or G6PD deficiency was observed. SCA children who experienced their first hospitalized complication before 3 years old had higher MnSOD and CAT activities than the other children while those with no hospitalized VOC in the previous 2 years presented higher GPX activity. Age of the first hospitalized complication and AOPP levels were affected by the MPO rs2333227 SNP. Our results suggest that alpha-thalassemia modulates oxidative stress in SCA, presumably because of a reduction in the MPO activity.
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Affiliation(s)
- Fatou Gueye Tall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Cyril Martin
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
| | - El hadji Malick Ndour
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Camille Faes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
| | - Indou Déme Ly
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
- Service Universitaire de Pédiatrie-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal;
| | - Vincent Pialoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
| | - Papa Madieye Gueye
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Rokhaya Ndiaye Diallo
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- UF Biochimie des Pathologies Erythrocytaires, Laboratoire de Biochimie et Biologie Moleculaire Grand-Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 69500 Bron, France
| | - Ibrahima Diagne
- Service Universitaire de Pédiatrie-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal;
- UFR des Sciences de la Santé–Universite Gaston Berger, Saint-Louis 32002, Senegal
| | - Pape Amadou Diop
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Aynina Cissé
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Philomène Lopez Sall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
- UF Biochimie des Pathologies Erythrocytaires, Laboratoire de Biochimie et Biologie Moleculaire Grand-Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 69500 Bron, France
- Correspondence:
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10
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Messonnier LA, Gellen B, Lacroix R, Peyrot S, Rupp T, Mira J, Peyrard A, Berkenou J, Galactéros F, Bartolucci P, Féasson L. Physiological Evaluation for Endurance Exercise Prescription in Sickle Cell Disease. Med Sci Sports Exerc 2020; 51:1795-1801. [PMID: 30920486 DOI: 10.1249/mss.0000000000001993] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Although strenuous exercise may expose sickle cell disease (SCD) patients to risks of vaso-occlusive crisis, evidence suggests that regular endurance exercise may be beneficial. This study aimed to test (i) the safety and usefulness of a submaximal incremental exercise in evaluating physical ability of SCD patients and identify a marker for the management of endurance exercise and (ii) the feasibility of endurance exercise sessions in SCD patients. METHODS Twenty adults with SCD (12 men and 8 women) performed a submaximal incremental exercise used to determine the first lactate threshold (LT1) and stopped as soon as blood lactate concentration ([lactate]b) reached ≥4 mmol·L. Fifteen of those patients (8 men and 7 women) also performed three 30-min endurance exercise sessions at ~2.5 mmol·L of [lactate]b on separate occasions. RESULTS LT1 occurred at 47 ± 3 and 33 ± 3 W for men and women, respectively, demonstrating the extreme deconditioning and, thus, low physical ability of adult SCD patients. During endurance exercise, peripheral oxygen saturation and [lactate]b most often remained stable and within acceptable ranges. CONCLUSIONS The proposed strategy of submaximal incremental exercise allowed safe determination of LT1, an important parameter of patients' physical ability. The study also demonstrated the feasibility and safety of individually tailored endurance exercises at ~2.5 mmol·L of [lactate]b. These latter results suggest that endurance training programs may be considered for adult SCD patients and that the method proposed here may be helpful in that regard.
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Affiliation(s)
- Laurent A Messonnier
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Barnabas Gellen
- Department of Cardiac Rehabilitation, Henri-Mondor University Hospital, AP-HP, Creteil, FRANCE.,ELSAN, Polyclinique de Poitiers, Poitiers, FRANCE
| | - Roxane Lacroix
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Sandrine Peyrot
- Department of Cardiac Rehabilitation, Henri-Mondor University Hospital, AP-HP, Creteil, FRANCE
| | - Thomas Rupp
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - José Mira
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Arthur Peyrard
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Jugurtha Berkenou
- Sickle Cell Referral Center, Department of Internal Medicine, Henri-Mondor University Hospital-UPEC, AP-HP, Créteil, FRANCE
| | - Frédéric Galactéros
- Sickle Cell Referral Center, Department of Internal Medicine, Henri-Mondor University Hospital-UPEC, AP-HP, Créteil, FRANCE.,IMRB, Henri-Mondor Hospital-UPEC, GRex, Créteil, FRANCE
| | - Pablo Bartolucci
- Sickle Cell Referral Center, Department of Internal Medicine, Henri-Mondor University Hospital-UPEC, AP-HP, Créteil, FRANCE.,IMRB, Henri-Mondor Hospital-UPEC, GRex, Créteil, FRANCE
| | - Léonard Féasson
- Inter-university Laboratory of Human Movement Sciences, University of Lyon, UJM-Saint-Etienne, EA7424, Saint-Etienne, FRANCE.,Myology Unit, Referent Center of Rare Neuromuscular Diseases, Euro-NmD, University Hospital of Saint-Etienne, Saint-Etienne, FRANCE
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11
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Impact of A Six Week Training Program on Ventilatory Efficiency, Red Blood Cell Rheological Parameters and Red Blood Cell Nitric Oxide Signaling in Young Sickle Cell Anemia Patients: A Pilot Study. J Clin Med 2019; 8:jcm8122155. [PMID: 31817545 PMCID: PMC6947402 DOI: 10.3390/jcm8122155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 01/06/2023] Open
Abstract
Patients with sickle cell anemia (SCA) show impaired ventilatory efficiency, altered blood rheology, high levels of oxidative/nitrosative stress and enhanced hemolysis with large amounts of circulating free hemoglobin, which reduces nitric oxide (NO) bioavailability. The aim of the study was to investigate whether physical exercise could improve these physiological and biological markers described to contribute to SCA pathophysiology. Twelve SCA patients participated in a controlled six weeks training program with moderate volume (two sessions per week with 15–30 min duration per session) and intensity (70% of the first ventilatory threshold). Parameters were compared before (T0) and after (T1) training. Daily activities were examined by a questionnaire at T0 and one year after the end of T1. Results revealed improved ventilatory efficiency, reduced nitrosative stress, reduced plasma free hemoglobin concentration, increased plasma nitrite levels and altered rheology at T1 while no effect was observed for exercise performance parameters or hematological profile. Red blood cell (RBC) NO parameters indicate increased NO bioavailability which did not affect RBC deformability. Participants increased their daily life activity level. The data from this pilot study concludes that even low intensity activities are feasible and could be beneficial for the health of SCA patients.
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12
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Nader E, Skinner S, Romana M, Fort R, Lemonne N, Guillot N, Gauthier A, Antoine-Jonville S, Renoux C, Hardy-Dessources MD, Stauffer E, Joly P, Bertrand Y, Connes P. Blood Rheology: Key Parameters, Impact on Blood Flow, Role in Sickle Cell Disease and Effects of Exercise. Front Physiol 2019; 10:1329. [PMID: 31749708 PMCID: PMC6842957 DOI: 10.3389/fphys.2019.01329] [Citation(s) in RCA: 165] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/04/2019] [Indexed: 01/07/2023] Open
Abstract
Blood viscosity is an important determinant of local flow characteristics, which exhibits shear thinning behavior: it decreases exponentially with increasing shear rates. Both hematocrit and plasma viscosity influence blood viscosity. The shear thinning property of blood is mainly attributed to red blood cell (RBC) rheological properties. RBC aggregation occurs at low shear rates, and increases blood viscosity and depends on both cellular (RBC aggregability) and plasma factors. Blood flow in the microcirculation is highly dependent on the ability of RBC to deform, but RBC deformability also affects blood flow in the macrocirculation since a loss of deformability causes a rise in blood viscosity. Indeed, any changes in one or several of these parameters may affect blood viscosity differently. Poiseuille's Law predicts that any increase in blood viscosity should cause a rise in vascular resistance. However, blood viscosity, through its effects on wall shear stress, is a key modulator of nitric oxide (NO) production by the endothelial NO-synthase. Indeed, any increase in blood viscosity should promote vasodilation. This is the case in healthy individuals when vascular function is intact and able to adapt to blood rheological strains. However, in sickle cell disease (SCD) vascular function is impaired. In this context, any increase in blood viscosity can promote vaso-occlusive like events. We previously showed that sickle cell patients with high blood viscosity usually have more frequent vaso-occlusive crises than those with low blood viscosity. However, while the deformability of RBC decreases during acute vaso-occlusive events in SCD, patients with the highest RBC deformability at steady-state have a higher risk of developing frequent painful vaso-occlusive crises. This paradox seems to be due to the fact that in SCD RBC with the highest deformability are also the most adherent, which would trigger vaso-occlusion. While acute, intense exercise may increase blood viscosity in healthy individuals, recent works conducted in sickle cell patients have shown that light cycling exercise did not cause dramatic changes in blood rheology. Moreover, regular physical exercise has been shown to decrease blood viscosity in sickle cell mice, which could be beneficial for adequate blood flow and tissue perfusion.
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Affiliation(s)
- Elie Nader
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Sarah Skinner
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Marc Romana
- Laboratory of Excellence GR-Ex, Paris, France.,Biologie Intégrée du Globule Rouge, Université de Paris, UMR_S1134, BIGR, INSERM, F-75015, Paris, France.,Biologie Intégrée du Globule Rouge, The Université des Antilles, UMR_S1134, BIGR, F- 97157, Pointe-a-Pitre, France
| | - Romain Fort
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Département de Médecine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Nathalie Lemonne
- Unité Transversale de la Drépanocytose, Hôpital de Pointe-a-Pitre, Hôpital Ricou, Pointe-a-Pitre, France
| | - Nicolas Guillot
- Laboratoire Carmen INSERM 1060, INSA Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France
| | - Alexandra Gauthier
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | | | - Céline Renoux
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Laboratoire de Biochimie et de Biologie Moleìculaire, UF de Biochimie des Pathologies Eìrythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Marie-Dominique Hardy-Dessources
- Laboratory of Excellence GR-Ex, Paris, France.,Biologie Intégrée du Globule Rouge, Université de Paris, UMR_S1134, BIGR, INSERM, F-75015, Paris, France.,Biologie Intégrée du Globule Rouge, The Université des Antilles, UMR_S1134, BIGR, F- 97157, Pointe-a-Pitre, France
| | - Emeric Stauffer
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Philippe Joly
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Laboratoire de Biochimie et de Biologie Moleìculaire, UF de Biochimie des Pathologies Eìrythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Yves Bertrand
- d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Philippe Connes
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
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13
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Merlet AN, Chatel B, Hourdé C, Ravelojaona M, Bendahan D, Féasson L, Messonnier LA. How Sickle Cell Disease Impairs Skeletal Muscle Function: Implications in Daily Life. Med Sci Sports Exerc 2019; 51:4-11. [PMID: 30095751 DOI: 10.1249/mss.0000000000001757] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Sickle cell disease (SCD) is the most frequent life-threatening genetic hemoglobinopathy in the world and occurs due to the synthesis of abnormal hemoglobin S (HbS). hemoglobin S-containing red blood cells (RBC) are fragile, leading to hemolysis and anemia, and adhere to the endothelium, leading to hemorheological and hemodynamical disturbances. In its deoxygenated form, HbS may polymerize, leading to sickling of red blood cells and potentially to vasoocclusive crises. Recent findings observed that SCD patients demonstrate significant skeletal muscle remodeling and display reduced muscle functional capacities, contributing to exercise intolerance and poor quality of life. Although acute high-intensity exercise is not recommended for SCD patients because it may increase the risk of sickling, regular moderate-intensity physical activity could have beneficial effects on skeletal muscle and more generally on the well-being of SCD patients. This article reviews the literature regarding the impact of the disease on muscular tissue characteristics and function, as well as the corresponding implications for SCD patients' quality of life.
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Affiliation(s)
- Angèle N Merlet
- Inter-university Laboratory of Human Movement Sciences, University of Lyon, UJM Saint-Etienne, Saint-Etienne, FRANCE
| | - Benjamin Chatel
- Inter-university Laboratory of Human Movement Sciences, University of Savoie Mont Blanc, Chambéry, FRANCE.,Aix-Marseille University, Marseille, FRANCE
| | - Christophe Hourdé
- Inter-university Laboratory of Human Movement Sciences, University of Savoie Mont Blanc, Chambéry, FRANCE
| | - Marion Ravelojaona
- Inter-university Laboratory of Human Movement Sciences, University of Lyon, UJM Saint-Etienne, Saint-Etienne, FRANCE.,Myology Unit, Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, FRANCE
| | | | - Léonard Féasson
- Inter-university Laboratory of Human Movement Sciences, University of Lyon, UJM Saint-Etienne, Saint-Etienne, FRANCE.,Inter-university Laboratory of Human Movement Sciences, University of Savoie Mont Blanc, Chambéry, FRANCE.,Aix-Marseille University, Marseille, FRANCE.,Myology Unit, Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, FRANCE
| | - Laurent A Messonnier
- Inter-university Laboratory of Human Movement Sciences, University of Savoie Mont Blanc, Chambéry, FRANCE
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14
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Grau M, Jerke M, Nader E, Schenk A, Renoux C, Collins B, Dietz T, Bizjak DA, Joly P, Bloch W, Connes P, Prokop A. Effect of acute exercise on RBC deformability and RBC nitric oxide synthase signalling pathway in young sickle cell anaemia patients. Sci Rep 2019; 9:11813. [PMID: 31413300 PMCID: PMC6694163 DOI: 10.1038/s41598-019-48364-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/02/2019] [Indexed: 01/29/2023] Open
Abstract
Sickle cell anaemia (SCA) is characterized by reduced red blood cell (RBC) deformability and nitric oxide (NO) bioavailability. The aim of the study was to investigate whether exercise might affect these parameters in SCA. SCA patients and healthy controls (AA) performed an acute submaximal exercise test until subjects reached the first ventilatory threshold (VT 1). Blood was sampled at rest and at VT 1. At rest, free haemoglobin level was higher and RBC count, haemoglobin and haematocrit were lower in SCA compared to AA. RBC deformability was lower in SCA. Exercise had no effect on the tested parameters. RBC NO level was higher in SCA compared to AA at rest and significantly decreased after exercise in SCA. This might be related to a reduction in RBC-NO synthase (RBC-NOS) activation which was only observed in SCA after exercise. Free radical levels were higher in SCA at rest but concentration was not affected by exercise. Marker for lipid peroxidation and antioxidative capacity were similar in SCA and AA and not affected by exercise. In conclusion, a single acute submaximal bout of exercise has no deleterious effects on RBC deformability or oxidative stress markers in SCA, and seems to modulate RBC-NOS signalling pathway.
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Affiliation(s)
- Marijke Grau
- German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Cologne, Germany.
| | - Max Jerke
- German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Cologne, Germany
| | - Elie Nader
- University of Lyon, University Claude Bernard Lyon 1, Interuniversity Laboratory of Human Movement Biology EA7424, "Vascular Biology and Red Blood Cell" team, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Alexander Schenk
- German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Cologne, Germany
| | - Celine Renoux
- University of Lyon, University Claude Bernard Lyon 1, Interuniversity Laboratory of Human Movement Biology EA7424, "Vascular Biology and Red Blood Cell" team, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France.,East Biology Centre, UF "Biochemistry of Red Blood Cell Disease", Academic Hospital of Lyon, HCL, Lyon, France
| | - Bianca Collins
- German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Cologne, Germany
| | - Thomas Dietz
- German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Cologne, Germany
| | - Daniel Alexander Bizjak
- German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Cologne, Germany
| | - Philippe Joly
- University of Lyon, University Claude Bernard Lyon 1, Interuniversity Laboratory of Human Movement Biology EA7424, "Vascular Biology and Red Blood Cell" team, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France.,East Biology Centre, UF "Biochemistry of Red Blood Cell Disease", Academic Hospital of Lyon, HCL, Lyon, France
| | - Wilhelm Bloch
- German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Cologne, Germany
| | - Philippe Connes
- University of Lyon, University Claude Bernard Lyon 1, Interuniversity Laboratory of Human Movement Biology EA7424, "Vascular Biology and Red Blood Cell" team, Villeurbanne, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Aram Prokop
- Children's Hospital Amsterdamer Straße Cologne; Clinic for Children and Youth Medicine, Paediatric Oncology/Haematology, Cologne, Germany
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15
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Kato GJ. Exercise training: a prescription for sickle-cell disease? LANCET HAEMATOLOGY 2019; 5:e502-e503. [PMID: 30389033 DOI: 10.1016/s2352-3026(18)30178-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Gregory J Kato
- Division of Hematology-Oncology and the Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
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16
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Ogunsile FJ, Bediako SM, Nelson J, Cichowitz C, Yu T, Patrick Carroll C, Stewart K, Naik R, Haywood C, Lanzkron S. Metabolic syndrome among adults living with sickle cell disease. Blood Cells Mol Dis 2019; 74:25-29. [DOI: 10.1016/j.bcmd.2018.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/18/2018] [Accepted: 10/18/2018] [Indexed: 01/10/2023]
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17
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Melo HN, Stoots SJM, Pool MA, Carvalho VO, Aragão MLDC, Gurgel RQ, Agyemang C, Cipolotti R. Objectively measured physical activity levels and sedentary time in children and adolescents with sickle cell anemia. PLoS One 2018; 13:e0208916. [PMID: 30521638 PMCID: PMC6283592 DOI: 10.1371/journal.pone.0208916] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to identify the levels of physical activity and sedentary behaviour of children and adolescents with sickle cell disease (SCA) compared to healthy individuals. A cross-sectional study with a quantitative approach was performed at a reference center for the treatment of patients with hemoglobinopathies in northeastern Brazil. Patients were recruited between October 2015 and January 2017. Eligible participants answered a Physical Activity Questionnaire for Older Children and Adolescents (PAQ-C) and were instructed to use an ActiGraph wGT3X-BT triaxial accelerometer for seven consecutive days. Fifty patients (and their 50 controls matched for age and sex) were then evaluated. We observed lower moderate (19.2 ± 11.9 and 27.1 ± 13.8 min/d; p<0.01) and vigorous PA (3.6 ± 4.1 and 7.8 ± 7.4 min/d; p<0.01) in cases than controls, respectively. There was also a significant difference among cases and controls in the following variables: total of steps (51010 ± 19600 and 59105 ± 22650; p = 0.04) and "total caloric expenditure" (1015 ± 516 and 2404 ± 1308; p<0.01), with the lowest values for the patients with SCA for all variables. Children and adolescents with SCA presented lower levels of physical activity than healthy children and adolescents, either when evaluated by PAQs or by accelerometer.
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Affiliation(s)
| | | | | | | | | | | | - Charles Agyemang
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
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18
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Gellen B, Messonnier LA, Galactéros F, Audureau E, Merlet AN, Rupp T, Peyrot S, Martin C, Féasson L, Bartolucci P, Habibi A, Guillet E, Gellen-Dautremer J, Ribeil JA, Arlet JB, Mattioni S, Berkenou J, Delrieux N, Lionnet F, Grenot JF, Mira J, Peyrard A, Lacroix R, Garcin A, Di Liberto G, Hourdé C. Moderate-intensity endurance-exercise training in patients with sickle-cell disease without severe chronic complications (EXDRE): an open-label randomised controlled trial. LANCET HAEMATOLOGY 2018; 5:e554-e562. [PMID: 30389037 DOI: 10.1016/s2352-3026(18)30163-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 01/17/2023]
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19
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Abstract
The primary β-globin gene mutation that causes sickle cell disease (SCD) has significant pathophysiological consequences that result in hemolytic events and the induction of the inflammatory processes that ultimately lead to vaso-occlusion. In addition to their role in the initiation of the acute painful vaso-occlusive episodes that are characteristic of SCD, inflammatory processes are also key components of many of the complications of the disease including autosplenectomy, acute chest syndrome, pulmonary hypertension, leg ulcers, nephropathy and stroke. We, herein, discuss the events that trigger inflammation in the disease, as well as the mechanisms, inflammatory molecules and cells that propagate these inflammatory processes. Given the central role that inflammation plays in SCD pathophysiology, many of the therapeutic approaches currently under pre-clinical and clinical development for the treatment of SCD endeavor to counter aspects or specific molecules of these inflammatory processes and it is possible that, in the future, we will see anti-inflammatory drugs being used either together with, or in place of, hydroxyurea in those SCD patients for whom hematopoietic stem cell transplants and evolving gene therapies are not a viable option.
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Affiliation(s)
- Nicola Conran
- Hematology Center, University of Campinas - UNICAMP, Cidade Universitária, Campinas-SP, Brazil
| | - John D Belcher
- Department of Medicine, Division of Hematology, Oncology and Transplantation, Vascular Biology Center, University of Minnesota, Minneapolis, MN, USA
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20
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Charrin E, Dubé JJ, Connes P, Pialoux V, Ghosh S, Faes C, Ofori-Acquah SF, Martin C. Moderate exercise training decreases inflammation in transgenic sickle cell mice. Blood Cells Mol Dis 2018. [DOI: 10.1016/j.bcmd.2017.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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21
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Chirico EN, Faës C, Connes P, Canet-Soulas E, Martin C, Pialoux V. Role of Exercise-Induced Oxidative Stress in Sickle Cell Trait and Disease. Sports Med 2017; 46:629-39. [PMID: 26666745 DOI: 10.1007/s40279-015-0447-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Sickle cell disease is a class of hemoglobinopathy in humans, which is the most common inherited disease in the world. Although complications of sickle cell disease start from polymerization of red blood cells during its deoxygenating phase, the oxidative stress resulting from the biological processes associated with this disease (ischaemic and hypoxic injuries, hemolysis and inflammation) has been shown to contribute to its pathophysiology. It is widely known that chronic exercise reduces oxidative stress in healthy people, mainly via improvement of antioxidant enzyme efficiency. In addition, recent studies in other diseases, as well as in sickle cell trait carriers and in a mouse model of sickle cell disease, have shown that regular physical activity could decrease oxidative stress. The purpose of this review is to summarize the role of oxidative stress in sickle cell disease and the effects of acute and chronic exercise on the pro-oxidant/antioxidant balance in sickle cell trait and sickle cell disease.
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Affiliation(s)
- Erica N Chirico
- EA 647 Centre de Recherche et d'Innovation sur le Sport, Université Claude Bernard Lyon 1, Université de Lyon, 69622, Villeurbanne, France
- Cardiovascular, Metabolism, Diabetes, and Nutrition (CarMeN INSERM U-1060), Faculty of Medicine Lyon Sud, Université Claude Bernard Lyon 1, Oullins, France
| | - Camille Faës
- EA 647 Centre de Recherche et d'Innovation sur le Sport, Université Claude Bernard Lyon 1, Université de Lyon, 69622, Villeurbanne, France
- Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Philippe Connes
- EA 647 Centre de Recherche et d'Innovation sur le Sport, Université Claude Bernard Lyon 1, Université de Lyon, 69622, Villeurbanne, France
- Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France
- Institut Universitaire de France, Paris, France
| | - Emmanuelle Canet-Soulas
- Cardiovascular, Metabolism, Diabetes, and Nutrition (CarMeN INSERM U-1060), Faculty of Medicine Lyon Sud, Université Claude Bernard Lyon 1, Oullins, France
| | - Cyril Martin
- EA 647 Centre de Recherche et d'Innovation sur le Sport, Université Claude Bernard Lyon 1, Université de Lyon, 69622, Villeurbanne, France
- Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Vincent Pialoux
- EA 647 Centre de Recherche et d'Innovation sur le Sport, Université Claude Bernard Lyon 1, Université de Lyon, 69622, Villeurbanne, France.
- Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France.
- Institut Universitaire de France, Paris, France.
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22
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Gomez S, Diawara A, Gbeha E, Awadalla P, Sanni A, Idaghdour Y, Rahimy MC. Comparative Analysis of Iron Homeostasis in Sub-Saharan African Children with Sickle Cell Disease and Their Unaffected Siblings. Front Pediatr 2016; 4:8. [PMID: 26942167 PMCID: PMC4762986 DOI: 10.3389/fped.2016.00008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 02/01/2016] [Indexed: 01/19/2023] Open
Abstract
Iron is an essential trace element subject to tight regulation to ensure adequate running of biological processes. In sub-Saharan Africa where hemoglobinopathies are common, iron homeostasis is likely to be impaired by these conditions. Here, we assessed and compared key serum proteins associated with iron metabolism between sub-Saharan African children with sickle cell disease (SCD) and their unaffected siblings. Complete blood counts and serum concentrations of four key proteins involved in iron regulation (ferritin, transferrin, sTfR, and hepcidin) were measured for 73 children with SCD and 68 healthy siblings in Benin, West Africa. We found significant differences in concentration of transferrin, sTfR, and ferritin between the two groups. Hepcidin concentrations were found at unusually high concentrations but did not differ among the two groups. We found a significant negative correlation between hepcidin levels and both MCH and MCV in the SCD group and report that sTfR concentrations show a correlation with MCV and MHC in opposite directions in the two groups. These results highlight the unusually high levels of hepcidin in the Beninese population and the patterns of differential iron homeostasis taking place under SCD status. These results lay the foundation for a systematic evaluation of the underlying mechanisms deregulating iron homeostasis in populations with SCD or high prevalence of iron deficiency.
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Affiliation(s)
- Selma Gomez
- Laboratoire de Biochimie et de Biologie Moléculaire, Faculté des Sciences et Techniques, University of Abomey-Calavi, Cotonou, Benin; Centre de Prise en charge Médicale Intégrée du Nourrisson et de la Femme Enceinte atteints de Drépanocytose, Faculté des Sciences de la Santé, University of Abomey-Calavi, Cotonou, Benin
| | - Aïssatou Diawara
- Biology Program, Division of Science and Mathematics, New York University Abu Dhabi , Abu Dhabi , United Arab Emirates
| | - Elias Gbeha
- Sainte-Justine Research Centre, Centre Hospitalier et Universitaire Sainte Justine , Montréal, QC , Canada
| | - Philip Awadalla
- Sainte-Justine Research Centre, Centre Hospitalier et Universitaire Sainte Justine , Montréal, QC , Canada
| | - Ambaliou Sanni
- Laboratoire de Biochimie et de Biologie Moléculaire, Faculté des Sciences et Techniques, University of Abomey-Calavi , Cotonou , Benin
| | - Youssef Idaghdour
- Biology Program, Division of Science and Mathematics, New York University Abu Dhabi , Abu Dhabi , United Arab Emirates
| | - M Cherif Rahimy
- Centre de Prise en charge Médicale Intégrée du Nourrisson et de la Femme Enceinte atteints de Drépanocytose, Faculté des Sciences de la Santé, University of Abomey-Calavi , Cotonou , Benin
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23
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Martin C, Pialoux V, Faes C, Charrin E, Skinner S, Connes P. Does physical activity increase or decrease the risk of sickle cell disease complications? Br J Sports Med 2015; 52:214-218. [PMID: 26701924 DOI: 10.1136/bjsports-2015-095317] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 12/11/2022]
Abstract
Sickle cell disease (SCD) is the most common inherited disease in the world. Red blood cell sickling, blood cell-endothelium adhesion, blood rheology abnormalities, intravascular haemolysis, and increased oxidative stress and inflammation contribute to the pathophysiology of SCD. Because acute intense exercise may alter these pathophysiological mechanisms, physical activity is usually contra-indicated in patients with SCD. However, recent studies in sickle-cell trait carriers and in a SCD mice model show that regular physical activity could decrease oxidative stress and inflammation, limit blood rheology alterations and increase nitric oxide metabolism. Therefore, supervised habitual physical activity may benefit patients with SCD. This article reviews the literature on the effects of acute and chronic exercise on the biological responses and clinical outcomes of patients with SCD.
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Affiliation(s)
- Cyril Martin
- Center of Research and Innovation on Sports (CRIS EA647), Team 'Vascular Biology and Red Blood Cell', University of Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Vincent Pialoux
- Center of Research and Innovation on Sports (CRIS EA647), Team 'Vascular Biology and Red Blood Cell', University of Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France, Paris, France
| | - Camille Faes
- Center of Research and Innovation on Sports (CRIS EA647), Team 'Vascular Biology and Red Blood Cell', University of Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Emmanuelle Charrin
- Center of Research and Innovation on Sports (CRIS EA647), Team 'Vascular Biology and Red Blood Cell', University of Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Sarah Skinner
- Center of Research and Innovation on Sports (CRIS EA647), Team 'Vascular Biology and Red Blood Cell', University of Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Philippe Connes
- Center of Research and Innovation on Sports (CRIS EA647), Team 'Vascular Biology and Red Blood Cell', University of Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France, Paris, France
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24
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Charlot K, Moeckesch B, Jumet S, Romana M, Waltz X, Divialle-Doumdo L, Hardy-Dessources MD, Petras M, Tressières B, Pichon A, Tarer V, Hue O, Etienne-Julan M, Antoine-Jonville S, Connes P. Physical activity level is not a determinant of autonomic nervous system activity and clinical severity in children/adolescents with sickle cell anemia: A pilot study. Pediatr Blood Cancer 2015; 62:1962-7. [PMID: 25989908 DOI: 10.1002/pbc.25604] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/28/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Autonomic nervous system (ANS) activity has been suggested to modulate the clinical severity of sickle cell anemia (SCA) by increasing the risk for vaso-occlusive events. Regular physical activity (PA) is known to improve ANS activity and health status in several cardiovascular and metabolic diseases. Whether regular PA improves the health status of SCA patients remains unknown. PROCEDURE Twenty-two patients with SCA and 15 healthy (AA) children/adolescents participated to the study. Heart rate variability was measured in supine position and after a tilt-test to quantify the ANS activity. PA energy expenditure (PAEE) was assessed with questionnaire. RESULTS 1) PAEE was lower in SCA compared to AA (190 ± 152 vs. 432 ± 277 kcal · d(-1), respectively, P < 0.01), 2) overall ANS activity was lower in SCA compared to AA, 3) parasympathetic withdrawal was observed in SCA with aging, 4) ANS reactivity was slightly impaired in SCA compared to AA (reduction in HFnu: -38 ± 27 vs. -58 ± 14%, respectively, P < 0.05), 5) ANS indices, PAEE, and rates of clinical events were not correlated. CONCLUSION Both the level of PA and ANS activity are reduced in SCA compared to AA children/adolescents, particularly in those older than 15 years. Neither PAEE, nor ANS activity seem to influence the clinical severity of children/adolescents with SCA.
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Affiliation(s)
- Keyne Charlot
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France
| | - Berenike Moeckesch
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France
| | - Stéphane Jumet
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
| | - Marc Romana
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France
| | - Xavier Waltz
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France
| | - Lydia Divialle-Doumdo
- Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Marie-Dominique Hardy-Dessources
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France
| | - Marie Petras
- Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Benoît Tressières
- Centre Investigation Clinique Antilles Guyane 1424 Inserm, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Aurélien Pichon
- Laboratory MOVE, EA6314, University of Poitiers, Poitiers, France
| | - Vanessa Tarer
- Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Olivier Hue
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
| | - Maryse Etienne-Julan
- Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Sophie Antoine-Jonville
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
| | - Philippe Connes
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.,Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France.,Institut Universitaire de France (IUF), Paris, France.,Laboratory CRIS EA647, Section Vascular Biology and Red Blood Cell, University of Lyon, Lyon, France
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25
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Charlot K, Waltz X, Hedreville M, Sinnapah S, Lemonne N, Etienne-Julan M, Soter V, Hue O, Hardy-Dessources MD, Connes P. Impaired oxygen uptake efficiency slope and off-transient kinetics of pulmonary oxygen uptake in sickle cell anemia are associated with hemorheological abnormalities. Clin Hemorheol Microcirc 2015; 60:413-21. [PMID: 25261432 DOI: 10.3233/ch-141891] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Keyne Charlot
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Xavier Waltz
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Mona Hedreville
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Emergency Care Department, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Stéphane Sinnapah
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
| | - Nathalie Lemonne
- Sickle cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Maryse Etienne-Julan
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
- Sickle cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Valérie Soter
- Direction of Research and Innovation, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Olivier Hue
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
| | - Marie-Dominique Hardy-Dessources
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Philippe Connes
- UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
- Institut Universitaire de France (IUF), Paris, France
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26
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Liem RI, Onyejekwe K, Olszewski M, Nchekwube C, Zaldivar FP, Radom-Aizik S, Rodeghier MJ, Thompson AA. The acute phase inflammatory response to maximal exercise testing in children and young adults with sickle cell anaemia. Br J Haematol 2015; 171:854-61. [PMID: 26456230 DOI: 10.1111/bjh.13782] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/20/2015] [Indexed: 01/27/2023]
Abstract
Although individuals with sickle cell anaemia (SCA) have elevated baseline inflammation and endothelial activation, the acute phase response to maximal exercise has not been evaluated among children with SCA. We measured the acute phase response to maximal exercise testing for soluble vascular cell adhesion molecule (sVCAM) as well as interleukin 6 (IL6), total white blood cell (WBC) count, C-reactive protein (CRP) and D-dimer in a cohort of children with SCA and matched controls at baseline, immediately after, and 30, 60 and 120 min following exercise. Despite higher baseline levels of all biomarkers except CRP, the acute phase response from baseline to immediately after exercise was significantly greater in subjects versus controls for CRP (2·1 vs. 0·2 mg/l, P = 0·02) and D-dimer (160 vs. 10 μg/l, P < 0·01) only. Similar between-group trends were observed over time for all biomarkers, including sVCAM, IL6, total WBC, CRP and D-dimer. Lower fitness, defined by peak oxygen consumption (VO2 ), was independently associated with greater acute phase responses to exercise for sVCAM. Our results suggest maximal exercise may not be associated with any greater escalation of endothelial activation or inflammation in SCA and provide preliminary biomarker evidence for the safety of brief, high-intensity physical exertion in children with SCA.
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Affiliation(s)
- Robert I Liem
- Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kasiemobi Onyejekwe
- Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Marie Olszewski
- Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Chisalu Nchekwube
- Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank P Zaldivar
- Pediatric Exercise Research Center, University of California Irvine, Irvine, CA, USA
| | - Shlomit Radom-Aizik
- Pediatric Exercise Research Center, University of California Irvine, Irvine, CA, USA
| | | | - Alexis A Thompson
- Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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27
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Tewari S, Brousse V, Piel FB, Menzel S, Rees DC. Environmental determinants of severity in sickle cell disease. Haematologica 2015; 100:1108-16. [PMID: 26341524 PMCID: PMC4800688 DOI: 10.3324/haematol.2014.120030] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 06/05/2015] [Indexed: 12/13/2022] Open
Abstract
Sickle cell disease causes acute and chronic illness, and median life expectancy is reduced by at least 30 years in all countries, with greater reductions in low-income countries. There is a wide spectrum of severity, with some patients having no symptoms and others suffering frequent, life-changing complications. Much of this variability is unexplained, despite increasingly sophisticated genetic studies. Environmental factors, including climate, air quality, socio-economics, exercise and infection, are likely to be important, as demonstrated by the stark differences in outcomes between patients in Africa and USA/Europe. The effects of weather vary with geography, although most studies show that exposure to cold or wind increases hospital attendance with acute pain. Most of the different air pollutants are closely intercorrelated, and increasing overall levels seem to correlate with increased hospital attendance, although higher concentrations of atmospheric carbon monoxide may offer some benefit for patients with sickle cell disease. Exercise causes some adverse physiological changes, although this may be off-set by improvements in cardiovascular health. Most sickle cell disease patients live in low-income countries and socioeconomic factors are undoubtedly important, but little studied beyond documenting that sickle cell disease is associated with decreases in some measures of social status. Infections cause many of the differences in outcomes seen across the world, but again these effects are relatively poorly understood. All the above factors are likely to account for much of the pathology and variability of sickle cell disease, and large prospective studies are needed to understand these effects better.
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Affiliation(s)
- Sanjay Tewari
- Department of Molecular Haematology, King's College London School of Medicine, King's College Hospital, London, England
| | - Valentine Brousse
- Reference Centre for Sickle Cell Disease, Pediatric Department, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris; Université Paris Descartes, France
| | | | - Stephan Menzel
- Department of Molecular Haematology, King's College London School of Medicine, King's College Hospital, London, England
| | - David C Rees
- Department of Molecular Haematology, King's College London School of Medicine, King's College Hospital, London, England
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28
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FRAJACOMO FERNANDOTADEU, KANNEN VINICIUS, DEMINICE RAFAEL, GERALDINO THAISHERRERO, PEREIRA-DA-SILVA GABRIELA, UYEMURA SERGIOAKIRA, JORDÃO-JR ALCEUAFONSO, GARCIA SERGIOBRITTO. Aerobic Training Activates Interleukin 10 for Colon Anticarcinogenic Effects. Med Sci Sports Exerc 2015; 47:1806-13. [DOI: 10.1249/mss.0000000000000623] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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29
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Key NS, Connes P, Derebail VK. Negative health implications of sickle cell trait in high income countries: from the football field to the laboratory. Br J Haematol 2015; 170:5-14. [PMID: 25754217 DOI: 10.1111/bjh.13363] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Worldwide, sickle cell trait is a highly prevalent gene carrier state. While generally a benign condition with a normal life expectancy, it is becoming increasingly clear that the sickle trait is associated with certain adverse outcomes. This article will focus on three of these outcomes, namely exertional rhabdomyolysis and sudden death, chronic renal dysfunction, and venous thromboembolism. In each case, the epidemiological evidence for the association is reviewed, together with the existing data on potential underlying mechanisms. Because newborn screening programmes for sickle cell anaemia also identify those with sickle cell trait, it is imperative that further studies determine what, if any, preventive measures can be taken to reduce the burden of these uncommon but potentially morbid complications in affected individuals.
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Affiliation(s)
- Nigel S Key
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Philippe Connes
- Laboratoire CRIS EA647, Section 'Vascular Biology and Red Blood Cell', Université Claude Bernard Lyon 1, Lyon, France.,Institut Universitaire de France, Paris, France
| | - Vimal K Derebail
- Division of Nephrology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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30
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Charrin E, Aufradet E, Douillard A, Romdhani A, Souza GD, Bessaad A, Faes C, Chirico EN, Pialoux V, Martin C. Oxidative stress is decreased in physically active sickle cell SAD mice. Br J Haematol 2014; 168:747-56. [DOI: 10.1111/bjh.13207] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/29/2014] [Indexed: 01/17/2023]
Affiliation(s)
- Emmanuelle Charrin
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Emeline Aufradet
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Aymeric Douillard
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Aymen Romdhani
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Genevieve De Souza
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Amine Bessaad
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Camille Faes
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Erica N. Chirico
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Vincent Pialoux
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
| | - Cyril Martin
- EA 647; Center of Research and Innovation on Sports; University of Lyon; Lyon France
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31
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32
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Hedreville M, Charlot K, Waltz X, Sinnapah S, Lemonne N, Etienne-Julan M, Soter V, Hue O, Hardy-Dessources MD, Barthélémy JC, Connes P. Acute moderate exercise does not further alter the autonomic nervous system activity in patients with sickle cell anemia. PLoS One 2014; 9:e95563. [PMID: 24740295 PMCID: PMC3989338 DOI: 10.1371/journal.pone.0095563] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/27/2014] [Indexed: 12/16/2022] Open
Abstract
A decreased global autonomic nervous system (ANS) activity and increased sympathetic activation in patients with sickle cell anemia (SCA) seem to worsen the clinical severity and could play a role in the pathophysiology of the disease, notably by triggering vaso-occlusive crises. Because exercise challenges the ANS activity in the general population, we sought to determine whether a short (<15 min) and progressive moderate exercise session conducted until the first ventilatory threshold had an effect on the ANS activity of a group of SCA patients and a group of healthy individuals (CONT group). Temporal and spectral analyses of the nocturnal heart rate variability were performed before and on the 3 nights following the exercise session. Standard deviation of all normal RR intervals (SDNN), total power, low frequencies (LF) and high frequencies powers (HF) were lower but LF/HF was higher in SCA patients than in the CONT group. Moderate exercise did not modify ANS activity in both groups. In addition, no adverse clinical events occurred during the entire protocol. These results imply that this kind of short and moderate exercise is not detrimental for SCA patients.
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Affiliation(s)
- Mona Hedreville
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Emergency Care Department, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Keyne Charlot
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- UMR Inserm U1134 French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Xavier Waltz
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- UMR Inserm U1134 French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Stéphane Sinnapah
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
| | - Nathalie Lemonne
- Sickle cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Maryse Etienne-Julan
- UMR Inserm U1134 French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Sickle cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Valérie Soter
- Direction of Research and Innovation, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Olivier Hue
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
| | - Marie-Dominique Hardy-Dessources
- UMR Inserm U1134 French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
| | - Jean-Claude Barthélémy
- Laboratory EA4607 SNA-EPIS, Jean Monnet University of Saint-Etienne, PRES Lyon, Saint-Etienne, France
| | - Philippe Connes
- Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- UMR Inserm U1134 French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), PRES Sorbonne, Paris, France
- Institut Universitaire de France (IUF), Paris, France
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Waltz X, Connes P. Pathophysiology and physical activity in patients with sickle cell anemia. ACTA ACUST UNITED AC 2014. [DOI: 10.1051/sm/2013105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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