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Feugray G, Grall M, Dumesnil C, Brunel V, Benhamou Y, Quillard Muraine M, Billoir P. Lipid and hemolysis parameters predicting acute chest syndrome in adulthood with sickle cell disease. Lipids Health Dis 2024; 23:140. [PMID: 38755670 PMCID: PMC11100209 DOI: 10.1186/s12944-024-02135-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
Sickle cell disease (SCD) is a lifelong blood disorder affecting approximately 100,000 people in the United States and is one of the most common monogenic diseases. A serious complication of SCD is acute chest syndrome (ACS). ACS is a condition with a high rate of morbidity and mortality. The aim of the study was to assess hemolysis and lipid parameters in a cohort of confirmed SCD patients to predict ACS development in the following year.Standard lipid were performed (triglycerides, total cholesterol, high-density cholesterol, low-density cholesterol) panel to calculate of non-HDL-C, large buoyant LDL cholesterol (lbLDL-C) and small dense LDL cholesterol (sdLDL-C) with Sampson equation. Hemolysis and hematologic parameters were also evaluated.Among 91 patients included between September 2018 and June 2021, thirty-seven patients had history of ACS and 6 patients developed ACS during following year. In unadjusted logistic regression, total bilirubin was associated with ACS occurrence (RR: 1.2 [1.05-1.51] p = 0.013). Concerning lipid profile, non-HDL-C (RR: 0.87 [0.0.67-0.99] p = 0.04) and sdLDL-C (RR: 0.78 [0.49-0.96] p = 0.03) were associated with ACS occurrence decrease. C-reactive protein was associated with ACS occurrence (RR: 1.27 [1.065-1.85] p = 0.011).Based on these findings, this study demonstrated that several biomarker easily available can be used at steady state to predict ACS in the following year. The validation of these results are required to ensure the reproducibility of the findings.
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Affiliation(s)
- Guillaume Feugray
- Department of General Biochemistry, Normandie Univ, UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Rouen, F-76000, France.
- Service de Biochimie, Centre hospitalier Universitaire Charles Nicolle, 1 rue de Germont, Rouen, 76031, France.
| | - Maximilien Grall
- Department of Internal Medicine, CHU Rouen, Rouen, F-76000, France
| | - Cécile Dumesnil
- Department of Pediatric Onco-Hematology, CHU Rouen, Rouen, F-76000, France
| | - Valéry Brunel
- Department of General Biochemistry, CHU Rouen, Rouen, F-76000, France
| | - Ygal Benhamou
- Department of Internal Medicine, Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Rouen, F-76000, France
| | - Muriel Quillard Muraine
- Department of General Biochemistry, Normandie Univ, UNIROUEN, INSERM U1404 INSERMU1073 ADEN, CHU Rouen, CIC-CRB, Rouen, F-76000, France
| | - Paul Billoir
- Normandie Univ, UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Vascular Hemostasis Unit, Rouen, F-76000, France
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Dantas MT, Lopes A, Ladeia AMT. Association Between Lipid Profile and Clinical Manifestations in Sickle Cell Anemia: A Systematic Review. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20220010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Valente-Frossard TNS, Cruz NRC, Ferreira FO, Belisario AR, Pereira BM, Gomides AFDF, Resende GAD, Carlos AM, Moraes-Souza H, Velloso-Rodrigues C. Polymorphisms in genes that affect the variation of lipid levels in a Brazilian pediatric population with sickle cell disease: rs662799 APOA5 and rs964184 ZPR1. Blood Cells Mol Dis 2019; 80:102376. [PMID: 31670185 DOI: 10.1016/j.bcmd.2019.102376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 12/31/2022]
Abstract
This cross-sectional study investigated associations between SNPs in metabolizing lipid genes, alpha-thalassemia and laboratory parameters in two forms of sickle cell disease (SCD), sickle cell anemia (SCA) and hemoglobin SC disease (HbSC) in a pediatric population. Among the groups SCA and HbSC was found a higher proportion of increased triglycerides (TG) in SCA. High levels of TG were significantly associated with lower hemoglobin (p = 0.006) and HDL-C (p = 0.037), higher white blood cell count (p = 0.027), LDH (p = 0.004) and bilirubins (p < 0.05) in SCD. Patients with HDL-C ≤40 mg/dL had higher markers hemolytic levels. Therapy of HU significantly influenced several hematological and biochemical parameters but not lipid fractions. Genotypes of the APOA5 rs662799 were not associated with lipid levels. The G-risk allele rs964184/ZPRI ZNF259/ZPR1 gene (GC + GG genotypes) was associated with increased levels of TG in children ≥10 years old (p = 0.045) and the atherogenic ratio TG/HDL-C (p = 0.032) in SCD. The use of HU improves levels of hemolysis and inflammation markers in SCD with high TG and, while not interfering with lipid levels, seems to overlap the effect of the G-risk allele in on them. This study reported for the first time that rs964184 SNP could be a genetic modifier of TG in SCD.
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Affiliation(s)
- Thaisa Netto Souza Valente-Frossard
- Departments of Basic Science of Life, Institute of Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Nilcemar Rodrigues Carvalho Cruz
- Departments of Nutrition, Institute of Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Fernanda Oliveira Ferreira
- Departments of Basic Science of Life, Institute of Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | | | - Brisa Machado Pereira
- Departments of Basic Science of Life, Institute of Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Antônio Frederico de Freitas Gomides
- Departments of Basic Science of Life, Institute of Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | | | - Aline Menezes Carlos
- Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil; Uberaba Regional Blood Center, Uberaba, Minas Gerais, Brazil
| | - Helio Moraes-Souza
- Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil; Uberaba Regional Blood Center, Uberaba, Minas Gerais, Brazil
| | - Cibele Velloso-Rodrigues
- Departments of Basic Science of Life, Institute of Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
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Vendrame F, Olops L, Saad STO, Costa FF, Fertrin KY. Differences in heme and hemopexin content in lipoproteins from patients with sickle cell disease. J Clin Lipidol 2018; 12:1532-1538. [PMID: 30219641 DOI: 10.1016/j.jacl.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/13/2018] [Accepted: 08/02/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND High blood cholesterol is associated with atherogenesis and endothelial dysfunction. The latter is present in hemolytic diseases, such as sickle cell anemia, whose carriers have hypocholesterolemia and low incidence of coronary artery disease. OBJECTIVE We aimed to characterize cholesterol fractions in patients with sickle cell disease and explore the relationship among lipoproteins, varying degrees of hemolysis, and its biomarkers. METHODS We recruited 37 healthy individuals, 39 with hemoglobin SC disease, and 40 with sickle cell anemia and quantified cholesterol fractions, heme resulting from hemoglobin breakdown, and its main scavenger protein hemopexin. RESULTS Hypocholesterolemia was most significant in patients with sickle cell anemia, and cholesterol levels correlated positively with hemopexin. Nevertheless, patients still had higher relative low-density lipoprotein (LDL) oxidation than healthy subjects. Analysis of lipoproteins isolated by density ultracentrifugation showed that the LDL fraction contained higher concentrations of heme than the high-density lipoprotein (HDL) fraction, whereas HDL contained more hemopexin than LDL, albeit greatly reduced in patients. CONCLUSION Our findings show that the abnormally low lipoprotein levels in sickle cell anemia correlate with hemolysis markers, particularly with hemopexin concentrations, along with significant reduction of this heme scavenger in HDL fractions. This may suggest an important role for HDL in the defense against heme-induced endothelial dysfunction in hemolytic diseases.
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Affiliation(s)
- Felipe Vendrame
- Hematology and Hemotherapy Center, University of Campinas-UNICAMP, Campinas, Brazil
| | - Leticia Olops
- Hematology and Hemotherapy Center, University of Campinas-UNICAMP, Campinas, Brazil
| | | | | | - Kleber Yotsumoto Fertrin
- Hematology and Hemotherapy Center, University of Campinas-UNICAMP, Campinas, Brazil; Division of Hematology, University of Washington, Seattle, WA, USA.
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Yalamanoglu A, Deuel JW, Hunt RC, Baek JH, Hassell K, Redinius K, Irwin DC, Schaer DJ, Buehler PW. Depletion of haptoglobin and hemopexin promote hemoglobin-mediated lipoprotein oxidation in sickle cell disease. Am J Physiol Lung Cell Mol Physiol 2018; 315:L765-L774. [PMID: 30047285 DOI: 10.1152/ajplung.00269.2018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Intravascular sickling and lysis of red blood cells, a hallmark feature of sickle cell disease (SCD), releases hemoglobin (Hb) into the circulation. Increased cell-free Hb has been linked to vasculopathy and in vitro lipid oxidation. Scavenger plasma proteins haptoglobin (Hp) and hemopexin (Hpx) can attenuate cell-free Hb and total plasma heme lipid-oxidative capacity but are depleted in SCD. Here, we isolated lipids from BERK-SS mice, guinea pigs (GP) infused with heme-albumin, and patients with SCD undergoing regular exchange transfusion therapy and evaluated the level of lipid oxidation. Malondialdehyde formation, an end product of lipid peroxidation, was increased in BERK-SS mice, purified lipid fractions of the heme-albumin infused GP, and patients with SCD compared with controls. In humans, the extent of lipid oxidation was associated with the absence of Hp as well as decreased Hpx in plasma samples. Postmortem pulmonary tissue obtained from patients with SCD demonstrated oxidized LDL deposition in the pulmonary artery. The relationship between no Hp and low Hpx levels with greater LDL and HDL oxidation demonstrates the loss of protection against cell-free Hb and total plasma heme-mediated lipid oxidation and tissue injury in SCD. Strategies to protect against plasma lipid oxidation by cell-free Hb and total plasma heme (e.g., therapeutic Hp and Hpx replacement) may diminish the deleterious effects of cell-free Hb and total plasma heme toward the vascular system in SCD.
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Affiliation(s)
- Ayla Yalamanoglu
- Laboratory of Biochemistry and Vascular Biology, United States Food and Drug Administration, Silver Spring, Maryland
| | - Jeremy W Deuel
- Division of Internal Medicine, University Hospital of Zurich , Zurich , Switzerland
| | - Ryan C Hunt
- Division of Plasma Protein Therapeutics, United States Food and Drug Administration , Silver Spring, Maryland
| | - Jin Hyen Baek
- Laboratory of Biochemistry and Vascular Biology, United States Food and Drug Administration, Silver Spring, Maryland
| | - Kathryn Hassell
- Division of Hematology, University of Colorado , Aurora, Colorado
| | - Katie Redinius
- Cardiovascular and Pulmonary Research Laboratory, University of Colorado, Aurora, Colorado
| | - David C Irwin
- Cardiovascular and Pulmonary Research Laboratory, University of Colorado, Aurora, Colorado
| | - Dominik J Schaer
- Division of Internal Medicine, University Hospital of Zurich , Zurich , Switzerland
| | - Paul W Buehler
- Laboratory of Biochemistry and Vascular Biology, United States Food and Drug Administration, Silver Spring, Maryland
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Lalanne-Mistrih ML, Connes P, Lamarre Y, Lemonne N, Hardy-Dessources MD, Tarer V, Etienne-Julan M, Mougenel D, Tressières B, Romana M. Lipid profiles in French West Indies sickle cell disease cohorts, and their general population. Lipids Health Dis 2018; 17:38. [PMID: 29506549 PMCID: PMC5836466 DOI: 10.1186/s12944-018-0689-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/27/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The pathophysiology of sickle cell disease (SCD) and the variability of its clinical expression remain not fully understood, whether within or between different SCD genotypes. Recent studies have reported associations between lipid levels and several SCD complications. If lipid levels have been previously described as low in sickle cell anemia (SCA), few data have been provided for sickle cell SC disease (SCC). We designed our epidemiological study to isolate lipid levels and profiles by genotype in Guadeloupian cohorts of SCA and SCC adult patients, at steady state. We compared SCD lipid levels with those of the Guadeloupian general population (GGP), and analyzed potential associations between lipid levels and SCD complications (vaso-occlusive crises, acute chest syndrome and osteonecrosis). METHODS Lipids, apolipoproteins, biological variables and anthropometric evaluation, were collected at steady state from medical files for 62 SCC and 97 SCA adult patients. Clinical SCD complications were collected from the clinical files. Analysis was conducted by genotype for all variables. RESULTS Different SCC and SCA lipid profiles, both distinct from their GGP's, were identified. Compared to SCC and GGP, higher triglyceride (TG) levels were observed in SCA patients, independent of hydroxyurea, hemolysis, gender, age, body mass index (BMI), abdominal obesity and clinical nutritional status. Our survey highlights also subsequent anthropometrical phenotypes, with an over-representation of abdominal obesity with normal BMI in SCA patients, and affecting almost exclusively females in both genotypes. Moreover, more frequent positive history of acute chest syndrome (ACS) was observed in SCA patients with TG level higher than 1.50 g/l, and of osteonecrosis in SCC patients having non high-density lipoprotein-cholesterol level (Non HDL-C) higher than 1.30 g/l. CONCLUSIONS This study reveals that SCA and SCC patients exhibit distinct lipid profiles and suggests that high TG and Non HDL-C levels are associated with past histories of ACS and osteonecrosis in SCA and SCC patients, respectively.
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Affiliation(s)
- Marie-Laure Lalanne-Mistrih
- Université des Antilles, CHU de Pointe-à-Pitre, Guadeloupe, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge UMR_S1134, laboratoire d'Excellence GR-Ex, Paris, France
- Centre d'investigation Clinique Antilles Guyane, Inserm/DGOS CIC 14-24, enceinte de l'Institut Pasteur, Pointe-À-Pitre, Guadeloupe, France
| | - Philippe Connes
- Université des Antilles, CHU de Pointe-à-Pitre, Guadeloupe, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge UMR_S1134, laboratoire d'Excellence GR-Ex, Paris, France
- Institut Universitaire de France, Paris, France
- Laboratoire LIBM EA7424, Equipe « Biologie Vasculaire et du Globule Rouge », Laboratoire d'Excellence GR-Ex, Université de Lyon, Lyon, France
| | - Yann Lamarre
- Université des Antilles, CHU de Pointe-à-Pitre, Guadeloupe, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge UMR_S1134, laboratoire d'Excellence GR-Ex, Paris, France
| | - Nathalie Lemonne
- Unité Transversale de la Drépanocytose, CHU de Pointe à Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Marie-Dominique Hardy-Dessources
- Université des Antilles, CHU de Pointe-à-Pitre, Guadeloupe, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge UMR_S1134, laboratoire d'Excellence GR-Ex, Paris, France
| | - Vanessa Tarer
- Unité Transversale de la Drépanocytose, CHU de Pointe à Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Maryse Etienne-Julan
- Unité Transversale de la Drépanocytose, CHU de Pointe à Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Dominique Mougenel
- Unité Transversale de la Drépanocytose, CHU de Pointe à Pitre, Pointe-à-Pitre, Guadeloupe, France
| | - Benoît Tressières
- Centre d'investigation Clinique Antilles Guyane, Inserm/DGOS CIC 14-24, enceinte de l'Institut Pasteur, Pointe-À-Pitre, Guadeloupe, France
| | - Marc Romana
- Université des Antilles, CHU de Pointe-à-Pitre, Guadeloupe, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge UMR_S1134, laboratoire d'Excellence GR-Ex, Paris, France.
- UMR Inserm 1134, Hôpital Ricou, CHU de Pointe-à-Pitre, 97 157, Pointe-à-Pitre, Guadeloupe, France.
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Soupene E, Larkin SK, Kuypers FA. Featured Article: Depletion of HDL 3 high density lipoprotein and altered functionality of HDL 2 in blood from sickle cell patients. Exp Biol Med (Maywood) 2017; 242:1244-1253. [PMID: 28436274 DOI: 10.1177/1535370217706966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In sickle cell disease (SCD), alterations of cholesterol metabolism is in part related to abnormal levels and activity of plasma proteins such as lecithin cholesterol acyltransferase (LCAT), and apolipoprotein A-I (ApoA-I). In addition, the size distribution of ApoA-I high density lipoproteins (HDL) differs from normal blood. The ratio of the amount of HDL2 particle relative to the smaller higher density pre-β HDL (HDL3) particle was shifted toward HDL2. This lipoprotein imbalance is exacerbated during acute vaso-occlusive episodes (VOE) as the relative levels of HDL3 decrease. HDL3 deficiency in SCD plasma was found to relate to a slower ApoA-I exchange rate, which suggests an impaired ABCA1-mediated cholesterol efflux in SCD. HDL2 isolated from SCD plasma displayed an antioxidant capacity normally associated with HDL3, providing evidence for a change in function of HDL2 in SCD as compared to HDL2 in normal plasma. Although SCD plasma is depleted in HDL3, this altered capacity of HDL2 could account for the lack of difference in pro-inflammatory HDL levels in SCD as compared to normal. Exposure of human umbilical vein endothelial cells to HDL2 isolated from SCD plasma resulted in higher mRNA levels of the acute phase protein long pentraxin 3 (PTX3) as compared to incubation with HDL2 from control plasma. Addition of the heme-scavenger hemopexin protein prevented increased expression of PTX3 in sickle HDL2-treated cells. These findings suggest that ApoA-I lipoprotein composition and functions are altered in SCD plasma, and that whole blood transfusion may be considered as a blood replacement therapy in SCD. Impact statement Our study adds to the growing evidence that the dysfunctional red blood cell (RBC) in sickle cell disease (SCD) affects the plasma environment, which contributes significantly in the vasculopathy that defines the disease. Remodeling of anti-inflammatory high density lipoprotein (HDL) to pro-inflammatory entities can occur during the acute phase response. SCD plasma is depleted of the pre-β particle (HDL3), which is essential for stimulation of reverse cholesterol from macrophages, and the function of the larger HDL2 particle is altered. These dysfunctions are exacerbated during vaso-occlusive episodes. Interaction of lipoproteins with endothelium increases formation of inflammatory mediators, a process counteracted by the heme-scavenger hemopexin. This links hemolysis to lipoprotein-mediated inflammation in SCD, and hemopexin treatment could be considered. The use of RBC concentrates in transfusion therapy of SCD patients underestimates the importance of the dysfunctional plasma compartment, and transfusion of whole blood or plasma may be warranted.
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Affiliation(s)
- Eric Soupene
- Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA
| | - Sandra K Larkin
- Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA
| | - Frans A Kuypers
- Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA
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Aleluia MM, da Guarda CC, Santiago RP, Fonseca TCC, Neves FI, de Souza RQ, Farias LA, Pimenta FA, Fiuza LM, Pitanga TN, Ferreira JRD, Adorno EV, Cerqueira BAV, Gonçalves MDS. Association of classical markers and establishment of the dyslipidemic sub-phenotype of sickle cell anemia. Lipids Health Dis 2017; 16:74. [PMID: 28399852 PMCID: PMC5387254 DOI: 10.1186/s12944-017-0454-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/13/2017] [Indexed: 02/08/2023] Open
Abstract
Background Sickle cell anemia (SCA) patients exhibit sub-phenotypes associated to hemolysis and vaso-occlusion. The disease has a chronic inflammatory nature that has been also associated to alterations in the lipid profile. This study aims to analyze hematological and biochemical parameters to provide knowledge about the SCA sub-phenotypes previously described and suggest a dyslipidemic sub-phenotype. Methods A cross-sectional study was conducted from 2013 to 2014, and 99 SCA patients in steady state were enrolled. We assessed correlations and associations with hematological and biochemical data and investigated the co-inheritance of -α3.7Kb-thalassemia (-α3.7Kb-thal). Correlation analyses were performed using Spearman and Pearson coefficient. The median of quantitative variables between two groups was compared using t-test and Mann-Whitney. P-values <0.05 were considered statistically significant. Results We found significant association of high lactate dehydrogenase levels with decreased red blood cell count and hematocrit as well as high levels of total and indirect bilirubin. SCA patients with low nitric oxide metabolites had high total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol and reduced very low-density cholesterol, triglycerides, direct bilirubin level and reticulocyte counts. In SCA patients with high-density lipoprotein cholesterol greater than 40 mg/dL, we observed increased red blood cell count, hemoglobin, hematocrit, and fetal hemoglobin and decreased nitric oxide metabolites levels. The presence of -α3.7Kb-thal was associated with high red blood cell count and low mean corpuscular volume, mean corpuscular hemoglobin, platelet count and total and indirect bilirubin levels. Conclusions Our results provide additional information about the association between biomarkers and co-inheritance of -α3.7Kb-thal in SCA, and suggest the role of dyslipidemia and nitric oxide metabolites in the characterization of this sub-phenotype.
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Affiliation(s)
- Milena Magalhães Aleluia
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Caroline Conceição da Guarda
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Rayra Pereira Santiago
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Teresa Cristina Cardoso Fonseca
- Centro de Referência a Doença Falciforme de Itabuna, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | - Regiana Quinto de Souza
- Centro de Referência a Doença Falciforme de Itabuna, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | | | - Luciana Magalhães Fiuza
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Thassila Nogueira Pitanga
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil
| | - Júnia Raquel Dutra Ferreira
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | | | | | - Marilda de Souza Gonçalves
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil. .,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.
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Kato GJ, Steinberg MH, Gladwin MT. Intravascular hemolysis and the pathophysiology of sickle cell disease. J Clin Invest 2017; 127:750-760. [PMID: 28248201 DOI: 10.1172/jci89741] [Citation(s) in RCA: 381] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Hemolysis is a fundamental feature of sickle cell anemia that contributes to its pathophysiology and phenotypic variability. Decompartmentalized hemoglobin, arginase 1, asymmetric dimethylarginine, and adenine nucleotides are all products of hemolysis that promote vasomotor dysfunction, proliferative vasculopathy, and a multitude of clinical complications of pulmonary and systemic vasculopathy, including pulmonary hypertension, leg ulcers, priapism, chronic kidney disease, and large-artery ischemic stroke. Nitric oxide (NO) is inactivated by cell-free hemoglobin in a dioxygenation reaction that also oxidizes hemoglobin to methemoglobin, a non-oxygen-binding form of hemoglobin that readily loses heme. Circulating hemoglobin and heme represent erythrocytic danger-associated molecular pattern (eDAMP) molecules, which activate the innate immune system and endothelium to an inflammatory, proadhesive state that promotes sickle vaso-occlusion and acute lung injury in murine models of sickle cell disease. Intravascular hemolysis can impair NO bioavailability and cause oxidative stress, altering redox balance and amplifying physiological processes that govern blood flow, hemostasis, inflammation, and angiogenesis. These pathological responses promote regional vasoconstriction and subsequent blood vessel remodeling. Thus, intravascular hemolysis represents an intrinsic mechanism for human vascular disease that manifests clinical complications in sickle cell disease and other chronic hereditary or acquired hemolytic anemias.
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Soupene E, Borja MS, Borda M, Larkin SK, Kuypers FA. Featured Article: Alterations of lecithin cholesterol acyltransferase activity and apolipoprotein A-I functionality in human sickle blood. Exp Biol Med (Maywood) 2016; 241:1933-1942. [PMID: 27354333 DOI: 10.1177/1535370216657447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/04/2016] [Indexed: 01/25/2023] Open
Abstract
In sickle cell disease (SCD) cholesterol metabolism appears dysfunctional as evidenced by abnormal plasma cholesterol content in a subpopulation of SCD patients. Specific activity of the high density lipoprotein (HDL)-bound lecithin cholesterol acyltransferase (LCAT) enzyme, which catalyzes esterification of cholesterol, and generates lysoPC (LPC) was significantly lower in sickle plasma compared to normal. Inhibitory amounts of LPC were present in sickle plasma, and the red blood cell (RBC) lysophosphatidylcholine acyltransferase (LPCAT), essential for the removal of LPC, displayed a broad range of activity. The functionality of sickle HDL appeared to be altered as evidenced by a decreased HDL-Apolipoprotein A-I exchange in sickle plasma as compared to control. Increased levels of oxidized proteins including ApoA-I were detected in sickle plasma. In vitro incubation of sickle plasma with washed erythrocytes affected the ApoA-I-exchange supporting the view that the RBC blood compartment can affect cholesterol metabolism in plasma. HDL functionality appeared to decrease during acute vaso-occlusive episodes in sickle patients and was associated with an increase of secretory PLA2, a marker for increased inflammation. Simvastatin treatment to improve the anti-inflammatory function of HDL did not ameliorate HDL-ApoA-I exchange in sickle patients. Thus, the cumulative effect of an inflammatory and highly oxidative environment in sickle blood contributes to a decrease in cholesterol esterification and HDL function, related to hypocholesterolemia in SCD.
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Affiliation(s)
- Eric Soupene
- Children's Hospital Oakland Research Institute, Oakland, California 94609, USA
| | - Mark S Borja
- Children's Hospital Oakland Research Institute, Oakland, California 94609, USA
| | - Mauricio Borda
- Children's Hospital Oakland Research Institute, Oakland, California 94609, USA
| | - Sandra K Larkin
- Children's Hospital Oakland Research Institute, Oakland, California 94609, USA
| | - Frans A Kuypers
- Children's Hospital Oakland Research Institute, Oakland, California 94609, USA
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