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Elevated plasma sVCAM‐1 levels in children with sickle cell disease: Impact of chronic transfusion therapy
Author(s) -
Sakhalkar Vishwas S.,
Rao Sreedhar P.,
Weedon Jeremy,
Miller Scott T.
Publication year - 2004
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20016
Subject(s) - medicine , asymptomatic , acute chest syndrome , transfusion therapy , pathophysiology , gastroenterology , disease , immunology , sickle cell anemia , blood transfusion
Vascular cell adhesion molecule‐1 (VCAM‐1) has been implicated as being important in the pathophysiology of acute pain episodes (APE) and acute chest syndrome (ACS) of sickle cell disease (SCD). The frequency of these episodes is reduced by chronic transfusion therapy. The impact of chronic transfusion therapy on VCAM‐1 expression is unknown. Soluble VCAM‐1 (sVCAM‐1) levels were measured in plasma using an ELISA assay (R&D Systems) in 61 patients with SCD (age range 1.5–20 years) and 12 normal controls (2.5–14 years). SCD patients included 20 with ACS, 14 with APE, 12 at well‐child visits, and 15 receiving chronic transfusion therapy. Asymptomatic SCD patients had higher sVCAM‐1 levels compared to normal subjects ( P < 0.001). Levels of sVCAM‐1 were further elevated during ACS ( P < 0.001) and APE ( P = 0.072) and returned to the asymptomatic range on resolution. Levels were significantly lower in transfused patients ( P = 0.003) compared to asymptomatic SCD patients. Our findings of increased VCAM‐1 expression during ACS and perhaps APE offer a rationale for therapeutic use of cytokine and other VCAM‐1 modulators. The reduction of sVCAM‐1 levels observed in our transfused SCD patients offers insight into the mechanism of the protective effect of transfusion against ACS and APE and possibly stroke. Am. J. Hematol. 76:57–60, 2004. © 2004 Wiley‐Liss, Inc.

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