Changes in Heme Levels During Acute Vaso-occlusive Crisis in Sickle Cell Anemia.

Q1 Medicine

Hematology/ Oncology and Stem Cell Therapy Pub Date : 2023-01-17 DOI:10.1016/j.hemonc.2021.08.002

Evilazio Cunha Cardoso, Pedro Vieira Silva-Neto, Bidossessi Wilfried Hounkpe, Francine Chenou, Cintia Cristina Mateus Xerez Albuquerque, Nadja Pinto Garcia, Alexander Leonardo Silva-Junior, Adriana Malheiro, Purim Cesar, Franciele de Lima, Erich V De Paula, Nelson Abrahim Fraiji

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引用次数: 2

Abstract

Objective/background: Sickle cell anemia (SCA) is associated with increased levels of extracellular heme, which is a key mediator of inflammation in this condition. Despite abundant evidence supporting this concept in cell and animal models, few studies addressed the association between heme levels and the development and severity of acute vasoocclusive crises (VOC) in humans.

Methods: A cross-sectional study was conducted in patients with acute VOC. Total extracellular heme levels were measured in both plasma and serum at admission and after convalescence, and correlated with other clinical and laboratory markers of SCA severity.

Results: A total of 28 episodes of VOC in 25 patients were included. Heme levels were similar between admission and convalescence, and correlated with the difference between pre and post hemoglobin, and SCA severity estimated by a composite score of clinical and laboratory markers. Heme levels were neither associated with VOC severity nor with markers of hemostasis activation, and were similar to those reported in an independent population of SCA patients at steady state.

Discussion: Acute VOC are not characterized by significant increases in total extracellular heme levels. Studies measuring the fraction of free extracellular heme unbound to proteins are warranted to further refine our understanding of the role of heme in acute VOC.

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镰状细胞性贫血急性血管闭塞危象期间血红素水平的变化。

目的/背景:镰状细胞性贫血(SCA)与细胞外血红素水平升高有关，而细胞外血红素是这种情况下炎症的关键介质。尽管在细胞和动物模型中有大量证据支持这一概念，但很少有研究涉及血红素水平与人类急性血管闭塞性危象(VOC)的发展和严重程度之间的关系。方法:对急性VOC患者进行横断面研究。在入院时和康复后测量血浆和血清中的总细胞外血红素水平，并与SCA严重程度的其他临床和实验室标志物相关。结果:共纳入25例患者的28次VOC发作。入院和康复期间血红素水平相似，并与前后血红蛋白差异以及临床和实验室标记物综合评分估计的SCA严重程度相关。血红素水平与VOC严重程度和止血激活标志物无关，并且与稳定状态下SCA患者独立人群的报告相似。讨论:急性挥发性有机化合物的特征不在于总细胞外血红素水平显著增加。研究测量游离细胞外血红素与蛋白质不结合的比例，有必要进一步完善我们对血红素在急性VOC中的作用的理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hematology/ Oncology and Stem Cell Therapy Medicine-Hematology

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

27 weeks

期刊介绍： Hematology Oncology and Stem Cell Therapy is an international, peer-reviewed, open access journal that provides a vehicle for publications of high-quality clinical as well as basic science research reports in hematology and oncology. The contents of the journal also emphasize the growing importance of hematopoietic stem cell therapy for treatment of various benign and malignant hematologic disorders and certain solid tumors.The journal prioritizes publication of original research articles but also would give consideration for brief reports, review articles, special communications, and unique case reports. It also offers a special section for clinically relevant images that provide an important educational value.