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van Dijk MJ, Traets MJM, van Oirschot BA, Ruiter TJJ, de Wilde JRA, Bos J, van Solinge WW, Koziel MJ, Jans JJM, Wani R, van Beers EJ, van Wijk R, Rab MAE. A novel composition of endogenous metabolic modulators improves red blood cell properties in sickle cell disease. EJHAEM 2024; 5:21-32. [PMID: 38406513 PMCID: PMC10887255 DOI: 10.1002/jha2.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/18/2023] [Accepted: 01/08/2024] [Indexed: 02/27/2024]
Abstract
The most common forms of sickle cell disease (SCD) are sickle cell anemia (SCA; HbSS) and HbSC disease. In both, especially the more dense, dehydrated and adherent red blood cells (RBCs) with reduced deformability are prone to hemolysis and sickling, and thereby vaso-occlusion. Based on plasma amino acid profiling in SCD, a composition of 10 amino acids and derivatives (RCitNacQCarLKHVS; Axcella Therapeutics, USA), referred to as endogenous metabolic modulators (EMMs), was designed to target RBC metabolism. The effects of ex vivo treatment with the EMM composition on different RBC properties were studied in SCD (n = 9 SCA, n = 5 HbSC disease). Dose-dependent improvements were observed in RBC hydration assessed by hemocytometry (MCV, MCHC, dense RBCs) and osmotic gradient ektacytometry (Ohyper). Median (interquartile range [IQR]) increase in Ohyper compared to vehicle was 4.9% (4.0%-5.5%), 7.5% (6.9%-9.4%), and 12.8% (11.5%-14.0%) with increasing 20×, 40×, and 80X concentrations, respectively (all p < 0.0001). RBC deformability (EImax using oxygen gradient ektacytometry) increased by 8.1% (2.2%-12.1%; p = 0.0012), 9.6% (2.9%-15.1%; p = 0.0013), and 13.3% (5.7%-25.5%; p = 0.0007), respectively. Besides, RBC adhesion to subendothelial laminin decreased by 43% (6%-68%; p = 0.4324), 58% (48%-72%; p = 0.0185), and 71% (49%-82%; p = 0.0016), respectively. Together, these results provide a rationale for further studies with the EMM composition targeting multiple RBC properties in SCD.
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Affiliation(s)
- Myrthe J. van Dijk
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Marissa J. M. Traets
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Brigitte A. van Oirschot
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Titine J. J. Ruiter
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Section Metabolic Diagnostics, Department of GeneticsUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Jonathan R. A. de Wilde
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Jennifer Bos
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Wouter W. van Solinge
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | | | - Judith J. M. Jans
- Section Metabolic Diagnostics, Department of GeneticsUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Revati Wani
- Axcella TherapeuticsCambridgeMassachusettsUSA
- Boehringer Ingelheim Pharmaceuticals, Inc.CambridgeMassachusettsUSA
| | - Eduard J. van Beers
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Richard van Wijk
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Minke A. E. Rab
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Department of HematologyUniversity Medical Center UtrechtUtrechtThe Netherlands
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2
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Rab MAE, Kanne CK, Boisson C, Bos J, van Oirschot BA, Houwing ME, Renoux C, Bartels M, Rijneveld AW, Nur E, Cnossen MH, Joly P, Nader E, Fort R, Connes P, van Wijk R, Sheehan VA, van Beers EJ. Oxygen gradient ektacytometry-derived biomarkers are associated with acute complications in sickle cell disease. Blood Adv 2024; 8:276-286. [PMID: 37976458 PMCID: PMC10824684 DOI: 10.1182/bloodadvances.2023011013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/26/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023] Open
Abstract
ABSTRACT We investigated the potential of the point of sickling (PoS; the pO2 tension at which red cells start to sickle), determined by oxygen gradient ektacytometry to serve as a biomarker associated with the incidence of acute sickle cell disease-related complications in 177 children and 50 adults. In the pediatric cohort, for every 10 mmHg increase in PoS reflecting a greater likelihood of sickling, the likelihood of an individual experiencing >1 type of acute complication increased; the adjusted odds ratio (aOR) was 1.65. For every 0.1 increase in minimum elongation index (EImin; reflecting improved red blood cell deformability at hypoxia), the aOR was 0.50. In the adult cohort, for every 10 mmHg increase in PoS, we found an aOR of 3.00, although this was not significant after correcting for multiple testing. There was a trend for an association between higher PoS and greater likelihood of vaso-occlusive episodes (VOEs; children aOR, 1.35; adults aOR, 2.22). In children, only EImin was associated with VOEs (aOR, 0.68). When data of both cohorts were pooled, significant associations with PoS and/or EImin were found for all acute complications, independently and when >1 type of acute complication was assessed. These findings indicate that oxygen gradient ektacytometry generates novel biomarkers and provides a rationale for further development of these biomarkers in the assessment of clinical severity, evaluation of novel therapies, and as surrogate clinical trial end points. These biomarkers may be useful in assessing efficacy of novel therapies like pyruvate kinase activators, voxelotor, and L-glutamine.
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Affiliation(s)
- Minke A. E. Rab
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Celeste K. Kanne
- Department of Pediatrics Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Camille Boisson
- Laboratory LIBM EA7424, University of Lyon 1, “Vascular Biology and Red Blood Cell” team, Lyon, France
- Laboratory of Excellence GR-Ex, Paris, France
| | - Jennifer Bos
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Brigitte A. van Oirschot
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Maite E. Houwing
- Department of Pediatric Hematology and Oncology, Erasmus Medical Center Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Céline Renoux
- Laboratory LIBM EA7424, University of Lyon 1, “Vascular Biology and Red Blood Cell” team, Lyon, France
- Laboratory of Excellence GR-Ex, Paris, France
- Laboratory of Biochemistry and Molecular Biology, UF Biochemistry of Red Blood Cell Diseases, Est Center of Biology and Pathology, Hospices Civils de Lyon, Lyon, France
| | - Marije Bartels
- Van Creveldkliniek, Divison of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anita W. Rijneveld
- Department of Hematology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erfan Nur
- Department of Hematology, Amsterdam University Medical Center, The Netherlands
| | - Marjon H. Cnossen
- Department of Pediatric Hematology and Oncology, Erasmus Medical Center Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Philippe Joly
- Laboratory LIBM EA7424, University of Lyon 1, “Vascular Biology and Red Blood Cell” team, Lyon, France
- Laboratory of Excellence GR-Ex, Paris, France
- Laboratory of Biochemistry and Molecular Biology, UF Biochemistry of Red Blood Cell Diseases, Est Center of Biology and Pathology, Hospices Civils de Lyon, Lyon, France
| | - Elie Nader
- Laboratory LIBM EA7424, University of Lyon 1, “Vascular Biology and Red Blood Cell” team, Lyon, France
- Laboratory of Excellence GR-Ex, Paris, France
| | - Romain Fort
- Laboratory LIBM EA7424, University of Lyon 1, “Vascular Biology and Red Blood Cell” team, Lyon, France
- Laboratory of Excellence GR-Ex, Paris, France
- Department of Internal Medicine, Hospices Civils de Lyon, Lyon, France
| | - Philippe Connes
- Laboratory LIBM EA7424, University of Lyon 1, “Vascular Biology and Red Blood Cell” team, Lyon, France
- Laboratory of Excellence GR-Ex, Paris, France
| | - Richard van Wijk
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Vivien A. Sheehan
- Department of Pediatrics Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Eduard J. van Beers
- Van Creveldkliniek, Divison of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Esperti S, Nader E, Stier A, Boisson C, Carin R, Marano M, Robert M, Martin M, Horand F, Cibiel A, Renoux C, Van Bruggen R, Blans C, Dargaud Y, Joly P, Gauthier A, Poutrel S, Romana M, Roussel D, Connes P. Increased retention of functional mitochondria in mature sickle red blood cells is associated with increased sickling tendency, hemolysis and oxidative stress. Haematologica 2023; 108:3086-3094. [PMID: 37259576 PMCID: PMC10620576 DOI: 10.3324/haematol.2023.282684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023] Open
Abstract
Abnormal retention of mitochondria in mature red blood cells (RBC) has been recently reported in sickle cell anemia (SCA) but their functionality and their role in the pathophysiology of SCA remain unknown. The presence of mitochondria within RBC was determined by flow cytometry in 61 SCA patients and ten healthy donors. Patients were classified according to the percentage of mature RBC with mitochondria contained in the whole RBC population: low (0-4%), moderate (>4% and <8%), or high level (>8%). RBC rheological, hematological, senescence and oxidative stress markers were compared between the three groups. RBC senescence and oxidative stress markers were also compared between mature RBC containing mitochondria and those without. The functionality of residual mitochondria in sickle RBC was measured by high-resolution respirometry assay and showed detectable mitochondrial oxygen consumption in sickle mature RBC but not in healthy RBC. Increased levels of mitochondrial reactive oxygen species were observed in mature sickle RBC when incubated with Antimycin A versus without. In addition, mature RBC retaining mitochondria exhibited greater levels of reactive oxygen species compared to RBC without mitochondria, as well as greater Ca2+, lower CD47 and greater phosphatidylserine exposure. Hematocrit and RBC deformability were lower, and the propensity of RBC to sickle under deoxygenation was higher, in the SCA group with a high percentage of mitochondria retention in mature RBC. This study showed the presence of functional mitochondria in mature sickle RBC, which could favor RBC sickling and accelerate RBC senescence, leading to increased cellular fragility and hemolysis.
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Affiliation(s)
- Sofia Esperti
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France; Erytech Pharma, 69008 Lyon
| | - 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris
| | - Antoine Stier
- Laboratoire d'Ecologie des Hydrosystèmes Naturels et Anthropisés, CNRS, ENTPE, UMR 5023 Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France; Université de Strasbourg, CNRS, Institut Pluridisciplinaire Hubert Curien, UMR7178, 67000 Strasbourg
| | - Camille Boisson
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris
| | - Romain Carin
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris
| | - Muriel Marano
- UR4609 Hémostase and Thrombose Université Claude Bernard Lyon 1, Université de Lyon, Lyon
| | - Mélanie Robert
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France; Erytech Pharma, 69008 Lyon
| | - Marie Martin
- 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
| | | | | | - Céline Renoux
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France; Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Erythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69500 Lyon
| | - Robin Van Bruggen
- Department of Molecular Hematology, Sanquin Research and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Colin Blans
- Department of Molecular Hematology, Sanquin Research and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Yesim Dargaud
- UR4609 Hémostase and Thrombose Université Claude Bernard Lyon 1, Université de Lyon, Lyon
| | - Philippe Joly
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France; Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Erythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69500 Lyon
| | - Alexandra Gauthier
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France; Institut d'Hématologique et d'Oncologique Pédiatrique, Hospices Civils de Lyon, 69008 Lyon
| | - Solène Poutrel
- 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France; Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008 Lyon, France. de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008 Lyon
| | - Marc Romana
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France; Université de Paris, Université des Antilles, UMR_S1134, BIGR, INSERM, Paris
| | - Damien Roussel
- Laboratoire d'Ecologie des Hydrosystèmes Naturels et Anthropisés, CNRS, ENTPE, UMR 5023 Université Claude Bernard Lyon 1, Université de Lyon, Lyon
| | - 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; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris.
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4
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Hansen S, Wood DK. Simultaneous quantification of blood rheology and oxygen saturation to evaluate affinity-modifying therapies in sickle cell disease. LAB ON A CHIP 2022; 22:4141-4150. [PMID: 36134535 PMCID: PMC10165883 DOI: 10.1039/d2lc00623e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Sickle cell blood demonstrates oxygen-dependent flow behavior as a result of HbS polymerization during hypoxia, and these rheological changes provide a biophysical metric that can be used to quantify the pathological behavior of the blood. Relating these rheological changes directly to hemoglobin oxygen saturation would improve our understanding of SCD pathogenesis and the potential effects of therapeutic drugs. Towards this end, we have developed a microfluidic platform capable of spectrophotometric quantification of Hb-O2 saturation and simultaneous evaluation of the accompanying rheological changes in SCD blood flow. We demonstrated the ability to measure changes in Hb-O2 affinity and a restoration of oxygen-independent blood flow behavior after incubation with voxelotor, an oxygen affinity modifying drug approved for use in SCD. We also identified regimes in Hb-O2 saturation where the effects of HbS polymerization begin to take effect in contributing to pathological flow behavior, independent of voxelotor treatment. In contrast, incubation with voxelotor recovered oxygen-dependent blood flow over a range of PO2, providing a framework for understanding voxelotor's therapeutic effect in lowering the PO2 at which the requisite Hb-O2 saturation is reached to observe pathological blood flow. These results help explain the mechanistic effects of voxelotor and show the potential of this platform to identify affinity-modifying compounds and evaluate their therapeutic effect on blood flow.
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Affiliation(s)
- Scott Hansen
- Department of Biomedical Engineering, University of Minnesota, Minneapolis 55409, USA.
| | - David K Wood
- Department of Biomedical Engineering, University of Minnesota, Minneapolis 55409, USA.
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Nader E, Nougier C, Boisson C, Poutrel S, Catella J, Martin F, Charvet J, Girard S, Havard‐Guibert S, Martin M, Rezigue H, Desmurs‐Clavel H, Renoux C, Joly P, Guillot N, Bertrand Y, Hot A, Dargaud Y, Connes P. Increased blood viscosity and red blood cell aggregation in patients with COVID-19. Am J Hematol 2022; 97:283-292. [PMID: 34939698 DOI: 10.1002/ajh.26440] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 12/11/2022]
Abstract
The aim of this study was to (1) analyze blood viscosity, red blood cell (RBC) deformability, and aggregation in hospitalized patients with Coronavirus disease 19 (COVID-19); (2) test the associations between impaired blood rheology and blood coagulation; and (3) test the associations between impaired blood rheology and several indicators of clinical severity. A total of 172 patients with COVID-19, hospitalized in COVID-unit of the Internal Medicine Department (Lyon, France) participated in this study between January and May 2021. Clinical parameters were collected for each patient. Routine hematological/biochemical parameters, blood viscosity, RBC deformability and aggregation, and RBC senescence markers were measured on the first day of hospitalization. A control group of 38 healthy individuals was constituted to compare the blood rheological and RBC profile. Rotational thromboelastography was performed in 76 patients to study clot formation dynamics. Our study demonstrated that patients with COVID-19 had increased blood viscosity despite lower hematocrit than healthy individuals, as well as increased RBC aggregation. In-vitro experiments demonstrated a strong contribution of plasma fibrinogen in this RBC hyper-aggregation. RBC aggregation correlated positively with clot firmness, negatively with clot formation time, and positively with the length of hospitalization. Patients with oxygen supplementation had higher RBC aggregation and blood viscosity than those without, and patients with pulmonary lesions had higher RBC aggregation and enhanced coagulation than those without. This study is the first to demonstrate blood hyper-viscosity and RBC hyper-aggregation in a large cohort of patients with COVID-19 and describe associations with enhanced coagulation and clinical outcomes.
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Affiliation(s)
- Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Christophe Nougier
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
| | - Camille Boisson
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est Hospices Civils de Lyon Lyon France
| | - Solene Poutrel
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
| | - Judith Catella
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
| | - Fiona Martin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Juliette Charvet
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Sandrine Girard
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
| | - Salomé Havard‐Guibert
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Marie Martin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Hamdi Rezigue
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
| | - Helene Desmurs‐Clavel
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
- GEMMAT, Groupe d'Etude Multidisciplinaire en Maladies Thrombotiques, Lyon, France 4 Service de Medecine Intensive Reanimation Hopital Edouard Herriot Lyon France
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est Hospices Civils de Lyon Lyon France
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est Hospices Civils de Lyon Lyon France
| | - Nicolas Guillot
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Yves Bertrand
- Institut d'Hématologique et d'Oncologique Pédiatrique Hospices Civils de Lyon Lyon France
| | - Arnaud Hot
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
| | - Yesim Dargaud
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
- GEMMAT, Groupe d'Etude Multidisciplinaire en Maladies Thrombotiques, Lyon, France 4 Service de Medecine Intensive Reanimation Hopital Edouard Herriot Lyon France
- Unite d'Hemostase Clinique Hopital Cardiologique Louis Pradel, Lyon, France 6 UR4609 Hemostase & Thrombose Universite Claude Bernard Lyon 1 Lyon France
- UR4609 Hemostase & Thrombose Universite Claude Bernard Lyon 1 Lyon France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
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6
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Shear-Stress-Gradient and Oxygen-Gradient Ektacytometry in Sickle Cell Patients at Steady State and during Vaso-Occlusive Crises. Cells 2022; 11:cells11030585. [PMID: 35159394 PMCID: PMC8834105 DOI: 10.3390/cells11030585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/24/2022] [Accepted: 02/07/2022] [Indexed: 12/02/2022] Open
Abstract
Oxygen gradient ektacytometry (oxygenscan) measures the changes in red blood cell (RBC) deformability in normoxia and during deoxygenation. We investigated the changes in RBC deformability, measured by both oxygenscan and classical shear-stress-gradient ektacytometry, in 10 patients with sickle cell disease (SCD) during vaso-occlusive crisis (VOC) versus steady state. Oxygenscan and shear-stress-gradient ektacytometry parameters were also measured in 38 SCD patients at steady state on two different occasions. Shear-stress-gradient ektacytometry parameters, maximal RBC deformability at normoxia and the minimum RBC deformability during deoxygenation were lower during VOC compared to steady state. The oxygen partial pressure at which RBCs started to sickle (PoS) was not significantly affected by VOC, but the results were very heterogeneous: the PoS increased in 5 in 10 patients and decreased in 4 in 10 patients. Both oxygenscan and shear-stress-gradient ektacytometry parameters remained unchanged in patients at steady state between two sets of measurements, performed at 17 ± 8 months intervals. In conclusion, the present study showed that both oxygen gradient ektacytometry and shear-stress-gradient ektacytometry are sensitive to disease activity in SCD, and that both techniques give comparable results; however, the oxygen-dependent propensity of RBCs to sickle was highly variable during VOC.
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7
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Joly P, Boisson C, Renoux C, Caillat N, Robert M, Gauthier-Vasserot A, Poutrel S, Cibiel A, Nader E, Connes P. Determinants of the point of sickling measured by oxygen gradient ektacytometry in sickle cell anaemia. Br J Haematol 2022; 197:e56-e58. [PMID: 35106753 DOI: 10.1111/bjh.18043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/09/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Philippe Joly
- UF « Biochimie des pathologies érythrocytaires », Laboratoire de Biochimie et Biologie moléculaire Grand-Est, Groupement hospitalier Est, Hospices Civils de Lyon, Bron, France.,Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Camille Boisson
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Céline Renoux
- UF « Biochimie des pathologies érythrocytaires », Laboratoire de Biochimie et Biologie moléculaire Grand-Est, Groupement hospitalier Est, Hospices Civils de Lyon, Bron, France.,Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Noémie Caillat
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France
| | - Mélanie Robert
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Erytech Pharma, Lyon, France
| | - Alexandra Gauthier-Vasserot
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Solène Poutrel
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | - Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
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8
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Hequet O, Boisson C, Joly P, Revesz D, Kebaili K, Gauthier A, Renoux C, Creppy S, Nader E, Nicolas JF, Berard F, Cognasse F, Vocanson M, Bertrand Y, Connes P. Priming With Red Blood Cells Allows Red Blood Cell Exchange for Sickle Cell Disease in Low-Weight Children. Front Med (Lausanne) 2022; 8:743483. [PMID: 35004720 PMCID: PMC8729904 DOI: 10.3389/fmed.2021.743483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Red blood cell exchanges are frequently used to treat and prevent cerebrovascular complications in patients with sickle cell anemia (SCA). However, the low weight of young children represents serious concerns for this procedure. The Spectra Optia device can perform automatic priming using red blood cells (RBCs) (RCE/RBC-primed) which could allow RBC exchanges (RCE) to be performed in young children without hypovolemic complications, but this method requires evaluation. We prospectively analyzed the clinical safety of the RCE/RBC-primed procedure in 12 SCA low-weight children under either a chronic RCE program or emergency treatment over 65 sessions. We monitored grade 2 adverse events (AEs) such as a decrease in blood pressure, increase in heart rate, fainting sensation, or transfusion reactions and identified the critical times during the sessions in which AEs could occur. Post-apheresis hematocrit (Hct) and a fraction of cell remaining (FCR) values were compared to the expected values. We also compared the impact of automatic RCE (n = 7) vs. RCE/RBC-primed (n = 8) on blood viscosity and RBC rheology. A low incidence of complications was observed in the 65 RCE sessions with only seven episodes of transient grade 2 AEs. Post-apheresis Hct and FCR reached expected values with the RCE/RBC-primed method. Both the automatic and priming procedures improved RBC deformability and decreased the sickling tendency during deoxygenation. Blood rheological features improved in both RCE/RBC-primed and automatic RCE without priming conditions. The RCE/RBC-primed procedure provides blood rheological benefits, and is safe and efficient to treat, notably in young children with SCA in prophylactic programs or curatively when a SCA complication occurs.
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Affiliation(s)
- Olivier Hequet
- Etablissement Français du Sang Rhône Alpes, Apheresis Unit, Centre Hospitalier Lyon Sud, Lyon, France.,CIRI, International Center for Infectiology Research, INSERM U1111, Université de Lyon, Lyon, France
| | - Camille Boisson
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France.,Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France.,Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Daniela Revesz
- Etablissement Français du Sang Rhône Alpes, Apheresis Unit, Centre Hospitalier Lyon Sud, Lyon, France
| | - Kamila Kebaili
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France.,Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Gauthier
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France.,Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Celine Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France.,Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Severine Creppy
- Distribution Unit, Centre Hospitalier Edouard Herriot, Etablissement Français du Sang Auvergne Rhône Alpes, Lyon, France
| | - Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France
| | - Jean François Nicolas
- CIRI, International Center for Infectiology Research, INSERM U1111, Université de Lyon, Lyon, France.,Clinical Immunology and Allergology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Berard
- CIRI, International Center for Infectiology Research, INSERM U1111, Université de Lyon, Lyon, France.,Clinical Immunology and Allergology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Fabrice Cognasse
- Scientific Department, Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France
| | - Marc Vocanson
- CIRI, International Center for Infectiology Research, INSERM U1111, Université de Lyon, Lyon, France
| | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France
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9
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Nardo-Marino A, Petersen J, Brewin JN, Birgens H, Williams TN, Kurtzhals JAL, Rees DC, Glenthøj A. Oxygen gradient ektacytometry does not predict pain in children with sickle cell anaemia. Br J Haematol 2021; 197:609-617. [PMID: 34859420 PMCID: PMC7613550 DOI: 10.1111/bjh.17975] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/15/2021] [Indexed: 01/29/2023]
Abstract
The loss of red blood cell (RBC) deformability in sickle cell anaemia (SCA) is considered the primary factor responsible for episodes of acute pain and downstream progressive organ dysfunction. Oxygen gradient ektacytometry (Oxygenscan) is a recently commercialised functional assay that aims to describe the deformability of RBCs in SCA at differing oxygen tensions. So far, the Oxygenscan has been evaluated only by a small number of research groups and the validity and clinical value of Oxygenscan-derived biomarkers have not yet been fully established. In this study we examined RBC deformability measured with the Oxygenscan in 91 children with SCA at King's College Hospital in London. We found a significant correlation between Oxygenscan-derived biomarkers and well-recognised modifiers of disease severity in SCA: haemoglobin F and co-inherited α-thalassaemia. We failed, however, to find any independent predictive value of the Oxygenscan in the clinical outcome measure of pain, as well as other important parameters such as hydroxycarbamide treatment. Although the Oxygenscan remains an intriguing tool for basic research, our results question whether it provides any additional information in predicting the clinical course in children with SCA, beyond measuring known markers of disease severity.
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Affiliation(s)
- Amina Nardo-Marino
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark.,Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Jesper Petersen
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - John N Brewin
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Henrik Birgens
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Thomas N Williams
- KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Medicine, Imperial College London, London, United Kingdom
| | - Jørgen A L Kurtzhals
- Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - David C Rees
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Andreas Glenthøj
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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10
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Stauffer E, Poutrel S, Cannas G, Gauthier A, Fort R, Bertrand Y, Renoux C, Joly P, Boisson C, Hot A, Peter-Derex L, Pialoux V, PetitJean T, Connes P. Nocturnal Hypoxemia Rather Than Obstructive Sleep Apnea Is Associated With Decreased Red Blood Cell Deformability and Enhanced Hemolysis in Patients With Sickle Cell Disease. Front Physiol 2021; 12:743399. [PMID: 34630163 PMCID: PMC8498610 DOI: 10.3389/fphys.2021.743399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Although obstructive sleep apnea (OSA) could act as a modulator of clinical severity in sickle cell disease (SCD), few studies focused on the associations between the two diseases. Research Question: The aims of this study were: (1) to explore the associations between OSA, nocturnal oxyhemoglobin saturation (SpO2) and the history of several acute/chronic complications, (2) to investigate the impact of OSA and nocturnal SpO2 on several biomarkers (hematological, blood rheological, and coagulation) in patients with SCD. Study Design and Methods: Forty-three homozygous SCD patients underwent a complete polysomnography recording followed by blood sampling. Results: The proportion of patients suffering from nocturnal hypoxemia did not differ between those with and those without OSA. No association between OSA and clinical severity was found. Nocturnal hypoxemia was associated with a higher proportion of patients with hemolytic complications (glomerulopathy, leg ulcer, priapism, or pulmonary hypertension). In addition, nocturnal hypoxemia was accompanied by a decrease in RBC deformability, enhanced hemolysis and more severe anemia. Interpretation: Nocturnal hypoxemia in SCD patients could be responsible for changes in RBC deformability resulting in enhanced hemolysis leading to the development of complications such as leg ulcers, priapism, pulmonary hypertension or glomerulopathy. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03753854.
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Affiliation(s)
- Emeric Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Hôpital Croix Rousse, Lyon, France.,Service d'Explorations Fonctionnelles Respiratoires-Médecine du sport et de l'activité physique, Hospices Civils de Lyon, Lyon, France
| | - Solène Poutrel
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Giovanna Cannas
- Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Gauthier
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut d'Hématologique et d'Oncologique Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Romain Fort
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Service de Réanimation Médicale, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Yves Bertrand
- Service de Réanimation Médicale, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Erythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Erythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Camille Boisson
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Arnaud Hot
- Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Laure Peter-Derex
- Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Hôpital Croix Rousse, Lyon, France.,Centre de recherche en Neurosciences de Lyon, CNRS UMR 5292, INSERM U 1028, Universite Claude Bernard Lyon 1, Lyon, France
| | - Vincent Pialoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France
| | - Thierry PetitJean
- Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Hôpital Croix Rousse, Lyon, France.,Centre de recherche en Neurosciences de Lyon, CNRS UMR 5292, INSERM U 1028, Universite Claude Bernard Lyon 1, Lyon, France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team ≪ Vascular Biology and Red Blood Cell ≫, University Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
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