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Abu-Shaheen A, Dahan D, Henaa H, Nofal A, Abdelmoety DA, Riaz M, AlSheef M, Almatary A, AlFayyad I. Sickle cell disease in Gulf Cooperation Council countries: a systematic review. Expert Rev Hematol 2022; 15:893-909. [PMID: 36217841 DOI: 10.1080/17474086.2022.2132225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Evidence related to the national burden of Sickle Cell Disease (SCD) in Gulf Cooperation Council (GCC) largely fragmented. Thus, the aim of this study is to systemically review studies from GCC countries to assess the epidemiological profile of SCD. AREAS COVERED We searched combinations of key terms in MEDLINE/PubMed, CINAHL, and EMBASE. We selected relevant observational studies reporting the frequency, incidence, prevalence, risk factors, mortality rate, and complications of SCD among the GCC population. Studies restricted to laboratory diagnostic tests, experimental and animal studies, review articles, case reports and series, and conference proceedings and editorials were excluded. A total of 1,347 articles were retrieved, out of which 98 articles were found to be eligible and included in the study. The total number of participants from all the included studies was 3496447. The prevalence of SCD ranged from 0.24%-5.8% across the GCC and from 1.02%-45.8% for the sickle cell trait. Consanguineous marriage was a risk factor for likely giving children affected with hemoglobinopathies. EXPERT OPINION The prevalence of SCD and its complications vary among GCC. Because of the high prevalence of SCD and its complications, health authorities should focus on more rigorous prevention and treatment strategies.
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Affiliation(s)
| | - Doaa Dahan
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Humariya Henaa
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdullah Nofal
- Emergency Medicine Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Doaa A Abdelmoety
- Clinical Research Holy Management Department, Executive Administration of Research, King Abdullah Medical City in Capital, Makkah, Saudi Arabia
| | - Muhammad Riaz
- Department of Statistics, University of Malakand, Pakistan
| | - Mohammed AlSheef
- Internal Medicine Consultant, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Almatary
- Neonatal Intensive Care Unit, King Fahad Medical City, Children specialized hospital. Riyadh, Saudi Arabia
| | - Isamme AlFayyad
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Rafikova O, James J, Eccles CA, Kurdyukov S, Niihori M, Varghese MV, Rafikov R. Early progression of pulmonary hypertension in the monocrotaline model in males is associated with increased lung permeability. Biol Sex Differ 2020; 11:11. [PMID: 32188512 PMCID: PMC7079376 DOI: 10.1186/s13293-020-00289-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 03/10/2020] [Indexed: 02/06/2023] Open
Abstract
Background The mechanisms involved in pulmonary hypertension (PH) development in patients and pre-clinical models are poorly understood. PH has a well-established sex dimorphism in patients with increased frequency of PH in females, and more severe disease with poor survival prognosis in males. Previously, we found that heme signaling plays an essential role in the development phase of the Sugen/Hypoxia (SU/Hx) model. This study is focused on the elucidation of sex differences in mechanisms of PH development related to heme action at the early stage of the monocrotaline (MCT) PH model. Methods Rats received MCT injection (60 mg/kg, i.p.) and followed for 14 days to investigate early disease changes. Hemodynamic parameters were recorded at the end of the study; plasma, lung homogenates, and nuclear fractions were used for the evaluation of protein levels. Results Our data indicate that on day 14, rats did not show any significant increase in the Fulton index due to the early disease phase. However, the right ventricular systolic pressure was significantly increased in male rats, while female rats showed only a trend. Interestingly, only males demonstrated an increased lung-to-bodyweight ratio that indicated lung edema. Indeed, lung histology confirmed severe perivascular edema in males. Previously, we have reported that the increased perivascular edema in SU/Hx model correlated with intravascular hemolysis and activated heme signaling. Here, we found that elevated free hemoglobin levels and perivascular edema were increased, specifically in males showing more rapid progress of PH. A high level of heme carrier protein 1 (HCP-1), which is involved in heme uptake from the bloodstream into the cells, was also found elevated in the lungs of males. The upregulation of heme oxygenase in males indicated increased intracellular heme catabolism. Increased heme signaling resulted in the activation of heme-mediated barrier-disruptive mechanisms. Thus, hemolysis in males can be responsible for increased permeability of the lungs and early disease development. Conclusions Our study indicates the importance of barrier-disruptive mechanisms as an earlier event in the induction of pulmonary hypertension. Importantly, males are more susceptible to hemolysis and develop PH earlier than females.
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Affiliation(s)
- Olga Rafikova
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Joel James
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Cody A Eccles
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Sergey Kurdyukov
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Maki Niihori
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | | | - Ruslan Rafikov
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, 85721, USA.
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Liem RI, Lanzkron S, D Coates T, DeCastro L, Desai AA, Ataga KI, Cohen RT, Haynes J, Osunkwo I, Lebensburger JD, Lash JP, Wun T, Verhovsek M, Ontala E, Blaylark R, Alahdab F, Katabi A, Mustafa RA. American Society of Hematology 2019 guidelines for sickle cell disease: cardiopulmonary and kidney disease. Blood Adv 2019; 3:3867-3897. [PMID: 31794601 PMCID: PMC6963257 DOI: 10.1182/bloodadvances.2019000916] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/01/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Prevention and management of end-organ disease represent major challenges facing providers of children and adults with sickle cell disease (SCD). Uncertainty and variability in the screening, diagnosis, and management of cardiopulmonary and renal complications in SCD lead to varying outcomes for affected individuals. OBJECTIVE These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about screening, diagnosis, and management of cardiopulmonary and renal complications of SCD. METHODS ASH formed a multidisciplinary guideline panel that included 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Mayo Evidence-Based Practice Research Program supported the guideline development process, including performing systematic evidence reviews up to September 2017. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations, which were subject to public comment. RESULTS The panel agreed on 10 recommendations for screening, diagnosis, and management of cardiopulmonary and renal complications of SCD. Recommendations related to anticoagulation duration for adults with SCD and venous thromboembolism were also developed. CONCLUSIONS Most recommendations were conditional due to a paucity of direct, high-quality evidence for outcomes of interest. Future research was identified, including the need for prospective studies to better understand the natural history of cardiopulmonary and renal disease, their relationship to patient-important outcomes, and optimal management.
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Affiliation(s)
- Robert I Liem
- Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Sophie Lanzkron
- Division of Adult Hematology, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Thomas D Coates
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital of Los Angeles, Los Angeles, CA
| | - Laura DeCastro
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ankit A Desai
- Krannert Institute of Cardiology, School of Medicine, Indiana University, Indianapolis, IN
| | - Kenneth I Ataga
- Center for Sickle Cell Disease, University of Tennessee Health Science Center, Memphis, TN
| | - Robyn T Cohen
- Division of Pediatric Pulmonary and Allergy, Boston Medical Center, School of Medicine, Boston University, Boston, MA
| | - Johnson Haynes
- Division of Pulmonary Disease, College of Medicine, University of South Alabama, Mobile, AL
| | - Ifeyinwa Osunkwo
- Division of Hematology, The Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Jeffrey D Lebensburger
- Division of Pediatric Hematology/Oncology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - James P Lash
- Division of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Theodore Wun
- Division of Hematology and Oncology, School of Medicine, University of California Davis, Sacramento, CA
| | - Madeleine Verhovsek
- Division of Hematology and Thromboembolism, McMaster University, Hamilton, ON, Canada
| | | | | | - Fares Alahdab
- Division of General Internal Medicine, Mayo Medical School, Rochester, MN; and
| | - Abdulrahman Katabi
- Division of General Internal Medicine, Mayo Medical School, Rochester, MN; and
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, School of Medicine, University of Kansas, Kansas City, KS
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Musa BM, Galadanci NA, Coker M, Bussell S, Aliyu MH. The global burden of pulmonary hypertension in sickle cell disease: a systematic review and meta-analysis. Ann Hematol 2016; 95:1757-64. [PMID: 27181705 DOI: 10.1007/s00277-016-2693-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/09/2016] [Indexed: 01/18/2023]
Abstract
Elevated tricuspid regurgitant jet velocity (TRJV) is a surrogate measure of pulmonary hypertension (PH) in persons with sickle cell disease (SCD). We sought to estimate the burden of PH in people living with sickle cell disease based on TRJV. From 2000 to 2015, we searched electronic databases for eligible publications and included 29 studies (n = 5358 persons). We used random effects modeling to determine the pooled estimate of elevated TRJV. The overall pooled prevalence of elevated TRJV was 23.5 %(95 % CI 19.5-27.4) in persons with SCD. The pooled prevalence of elevated TRJV in children and adults with SCD was 20.7 % (95 % CI 15.7--25.6) and 24.4 % (95 % CI 18.4-30.4), respectively. TRJV is prevalent among adults and children with SCD. Our finding support international recommendations that call for screening for PH in SCD patients.
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Affiliation(s)
- B M Musa
- Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
| | - N A Galadanci
- Department of Hematology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - M Coker
- Institute of Human Virology, University of Maryland, Baltimore, USA
| | - S Bussell
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - M H Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.,Departments of Family and Community Medicine, Meharry Medical College, Nashville, USA
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