C-reactive protein and the menstrual cycle in females with sickle cell disease

Blood Vessels, Thrombosis & Hemostasis Pub Date : 2025-04-09 DOI:10.1016/j.bvth.2025.100067

Jessica Wu , Veronica Bochenek , Kandace Gollomp , Andrea H. Roe

{"title":"C-reactive protein and the menstrual cycle in females with sickle cell disease","authors":"Jessica Wu , Veronica Bochenek , Kandace Gollomp , Andrea H. Roe","doi":"10.1016/j.bvth.2025.100067","DOIUrl":null,"url":null,"abstract":"<div><h3>Abstract</h3><div>Females with sickle cell disease (SCD) experience more frequent and severe vaso-occlusive episodes (VOEs) than males. Many also report perimenstrual timing of VOEs, suggesting cyclic variation in pain risk. C-reactive protein (CRP) is a robust inflammatory marker that is elevated at baseline in patients with SCD and rises during VOEs. Cyclic patterns of inflammatory markers in female patients with SCD have not been previously examined. This study examined the relationship between CRP and menstrual cycle phase in female patients with SCD. Frozen plasma samples from reproductive-aged adult patients with SCD were analyzed. Estradiol, progesterone, and luteinizing hormone levels were measured in female patient samples to estimate menstrual cycle phase at time of collection. CRP levels were compared by SCD genotype, hydroxyurea treatment, female vs male sex, and menstrual cycle phase in the female subgroup. CRP levels did not differ significantly by SCD genotype (SS vs SC), hydroxyurea use, or sex. However, in females with SCD, median CRP levels were significantly higher during the follicular phase than the luteal phase (8.80 mg/L [2.7-10.5] vs 0.82 mg/L [0.6-2.1]; <em>P</em> = .03). Although there were no differences in CRP levels in patients with SCD by sex, genotype, or hydroxyurea use, our results suggest that female patients have cyclicity in inflammation across the menstrual cycle that may predispose them to VOEs during the follicular phase. Further study is needed to validate these findings prospectively and to correlate biomarker patterns with clinical symptoms.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 3","pages":"Article 100067"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Vessels, Thrombosis & Hemostasis","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2950327225000245","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Females with sickle cell disease (SCD) experience more frequent and severe vaso-occlusive episodes (VOEs) than males. Many also report perimenstrual timing of VOEs, suggesting cyclic variation in pain risk. C-reactive protein (CRP) is a robust inflammatory marker that is elevated at baseline in patients with SCD and rises during VOEs. Cyclic patterns of inflammatory markers in female patients with SCD have not been previously examined. This study examined the relationship between CRP and menstrual cycle phase in female patients with SCD. Frozen plasma samples from reproductive-aged adult patients with SCD were analyzed. Estradiol, progesterone, and luteinizing hormone levels were measured in female patient samples to estimate menstrual cycle phase at time of collection. CRP levels were compared by SCD genotype, hydroxyurea treatment, female vs male sex, and menstrual cycle phase in the female subgroup. CRP levels did not differ significantly by SCD genotype (SS vs SC), hydroxyurea use, or sex. However, in females with SCD, median CRP levels were significantly higher during the follicular phase than the luteal phase (8.80 mg/L [2.7-10.5] vs 0.82 mg/L [0.6-2.1]; P = .03). Although there were no differences in CRP levels in patients with SCD by sex, genotype, or hydroxyurea use, our results suggest that female patients have cyclicity in inflammation across the menstrual cycle that may predispose them to VOEs during the follicular phase. Further study is needed to validate these findings prospectively and to correlate biomarker patterns with clinical symptoms.

查看原文本刊更多论文

c反应蛋白与女性镰状细胞病的月经周期

摘要镰状细胞病（SCD）女性比男性更频繁和严重的血管闭塞发作（VOEs）。许多人还报告了月经前后VOEs的时间，这表明疼痛风险的周期性变化。c反应蛋白（CRP）是一种强大的炎症标志物，SCD患者在基线时升高，VOEs期间升高。女性SCD患者炎症标志物的循环模式以前没有被检查过。本研究探讨了女性SCD患者CRP与月经周期的关系。对育龄成年SCD患者的冷冻血浆样本进行分析。测量女性患者样本中的雌二醇、黄体酮和黄体生成素水平，以估计收集时的月经周期阶段。通过SCD基因型、羟脲治疗、女性与男性、月经周期来比较女性亚组的CRP水平。CRP水平与SCD基因型（SS vs SC）、羟脲使用或性别没有显著差异。然而，在患有SCD的女性中，CRP水平中位数在卵泡期明显高于黄体期(8.80 mg/L [2.7-10.5] vs 0.82 mg/L [0.6-2.1]；P = .03)。虽然SCD患者的CRP水平没有性别、基因型或羟脲使用的差异，但我们的研究结果表明，女性患者在月经周期中炎症具有周期性，这可能使她们在卵泡期易患VOEs。需要进一步的研究来前瞻性地验证这些发现，并将生物标志物模式与临床症状联系起来。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Blood Vessels, Thrombosis & Hemostasis

自引率

0.00%

发文量