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Salkar M, Rosenthal M, Bhattacharya K, Ramachandran S, Barnard M, Young J, Bentley JP. An assessment of the psychometric properties of the Coping Strategies Questionnaire - Sickle Cell Disease (CSQ-SCD) among adults in the United States. Health Qual Life Outcomes 2024; 22:35. [PMID: 38644478 PMCID: PMC11034024 DOI: 10.1186/s12955-024-02251-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/05/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Previous studies have reported conflicting factor structures of the Coping Strategies Questionnaire - Sickle Cell Disease (CSQ-SCD). This study examined the psychometric properties of the CSQ-SCD among adults with SCD in the United States. METHODS This study implemented a cross-sectional study design with web-based self-administered surveys. Individuals with SCD were recruited via an online panel. Psychometric properties, including factorial and construct validity, and internal consistency reliability, of the CSQ-SCD were assessed. RESULTS A total of 196 adults with SCD completed the survey. Confirmatory factor analysis (CFA), using maximum likelihood estimation and the 13 subscale scores as factor indicators, supported a three-factor model for the CSQ-SCD compared to a two-factor model. Model fit statistics for the three-factor model were: Chi-square [df] = 227.084 [62]; CFI = 0.817; TLI = 0.770; RMSEA [90% CI] = 0.117 [0.101-0.133]; SRMR = 0.096. All standardized factor loadings (except for the subscales isolation, resting, taking fluids, and praying and hoping) were > 0.5 and statistically significant, indicating evidence of convergent validity. Correlations between all subscales (except praying and hoping) were lower than hypothesized; however, model testing revealed that the three latent factors, active coping, affective coping, and passive adherence coping were not perfectly correlated, suggesting discriminant validity. Internal consistency reliabilities for the active coping factor (α = 0.803) and affective coping factor (α = 0.787) were satisfactory, however, reliability was inadequate for the passive adherence coping factor (α = 0.531). Given this overall pattern of results, a follow-up exploratory factor analysis (EFA) was also conducted. The new factor structure extracted by EFA supported a three-factor structure (based on the results of a parallel analysis), wherein the subscale of praying and hoping loaded on the active coping factor. CONCLUSIONS Overall, the CSQ-SCD was found to have less than adequate psychometric validity in our sample of adults with SCD. These results provide clarification around the conflicting factor structure results reported in the literature and demonstrate a need for the future development of a SCD specific coping instrument.
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Affiliation(s)
- Monika Salkar
- AbbVie Inc. Headquarters, 1 N. Waukegan Road, North Chicago, IL, 60064, USA.
| | - Meagen Rosenthal
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
| | - Kaustuv Bhattacharya
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
| | - Sujith Ramachandran
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
| | - Marie Barnard
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
| | - John Young
- Department of Psychology, University of Mississippi, University, MS, USA
| | - John P Bentley
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
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Chonat S, Fields E, Baratz H, Watt A, Pochron M, Dixon S, Tonda M, Brown C, Archer D. Voxelotor improves red blood cell functionality in children with sickle cell anaemia: An ancillary study of the HOPE-KIDS 1 trial. EJHAEM 2024; 5:125-130. [PMID: 38406531 PMCID: PMC10887232 DOI: 10.1002/jha2.831] [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: 03/27/2023] [Revised: 11/07/2023] [Accepted: 11/17/2023] [Indexed: 02/27/2024]
Abstract
INTRODUCTION Sickle haemoglobin (HbS) polymerisation perturbs red blood cell (RBC) rheology and drives sickle cell disease (SCD) pathophysiology. Voxelotor is an HbS polymerisation inhibitor that increases haemoglobin (Hb)-oxygen affinity. METHODS/RESULTS In this 48-week, prospective, single-centre translational study, 10 children aged 4-11 years with SCD were treated with voxelotor. Improvements in RBC deformability were observed using osmotic/oxygen gradient ektacytometry, with increases in minimal and maximal elongation index and reductions in point of sickling. Increased Hb and reduced markers of haemolysis were also observed. CONCLUSION These findings suggest that voxelotor treatment is associated with reduced RBC sickling and haemolysis in children with SCD.
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Affiliation(s)
- Satheesh Chonat
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Emory University Department of PediatricsAtlantaGeorgiaUSA
| | - Earl Fields
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Emory University Department of PediatricsAtlantaGeorgiaUSA
| | - Hannah Baratz
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Emory University Department of PediatricsAtlantaGeorgiaUSA
| | - Amanda Watt
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Emory University Department of PediatricsAtlantaGeorgiaUSA
| | | | | | | | - Clark Brown
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Emory University Department of PediatricsAtlantaGeorgiaUSA
- Present address:
Pfizer IncNew YorkNew YorkUSA
| | - David Archer
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Emory University Department of PediatricsAtlantaGeorgiaUSA
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Hoyek S, Lemire C, Halawa O, Altamirano-Lamarque F, Gonzalez E, Patel NA. Longitudinal Assessment of Macular Thickness and Microvascular Changes in Children with Sickle Cell Disease. Ophthalmol Retina 2024; 8:184-194. [PMID: 37696394 DOI: 10.1016/j.oret.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To longitudinally assess macular thickness and microvascular changes in children with sickle cell disease (SCD). DESIGN A retrospective consecutive series. SUBJECTS Children with SCD aged ≤ 18 years who had an ophthalmic examination at Boston Children's Hospital between January 1998 and August 2022. METHODS Qualitative and quantitative analyses of both OCT and OCT angiography (OCTA) images were performed. MAIN OUTCOME MEASURES Total retinal thickness measured on macular OCT, superficial capillary plexus and deep capillary plexus (DCP) vessel density (VD), and foveal avascular zone (FAZ) area measured on 6- × 6-mm OCTA scans. RESULTS International Classification of Diseases, 10th Revision, code search identified 303 pediatric SCD patients who underwent ophthalmic examination during the study period. OCT and OCTA images were acquired on 104 (17.2%) and 60 (9.9%) eyes at presentation and on 159 (26.2%) and 100 (16.5%) eyes at final visit, respectively. Overall, temporal retinal thinning was noted qualitatively in 35.6% of SCD patients at presentation and 39.6% at final visit. Of those patients with macular thinning, 94.6% and 90.5% had peripheral sickle cell retinopathy (SCR) at presentation and final visit. On quantitative OCT analysis, HbSS eyes had a lower retinal thickness in the fovea and temporal parafovea compared with HbSC (P < 0.05). Eyes with peripheral SCR had a larger FAZ at presentation compared with eyes without peripheral SCR (P = 0.004), a lower DCP VD at final visit in the inferior temporal macula (P = 0.03), and a higher DCP VD at final visit in the superior nasal macula (P = 0.01). Eighty eyes of 40 patients had OCT, and 34 eyes of 20 patients had both OCT and OCTA images acquired at both initial and final visits. At final visit, retinal thickness decreased at the fovea, inferior perifovea, and temporal perifovea compared with presentation (P < 0.05). In parallel, VD DCP in the superonasal quadrant increased at final visit (P = 0.03). CONCLUSIONS Macular retinal thinning was progressive and observed in eyes with and without peripheral SCR. Over time, there was a compensatory increase in DCP VD in the nasal macula on OCTA. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Sandra Hoyek
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Colin Lemire
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Omar Halawa
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland
| | | | - Efren Gonzalez
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nimesh A Patel
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
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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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Pilgaard Kristiansen H, Winther-Larsen A. Influence of age and sex on osmoscan indies for next-generation osmotic gradient ektacytometry. Clin Chim Acta 2023; 548:117532. [PMID: 37659465 DOI: 10.1016/j.cca.2023.117532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND AND AIMS Osmotic gradient ektacytometry is an important method for diagnosis of red blood cell membrane disorders. For interpretation of the osmoscan parameters on the ektacytomety, an age-matched control sample drawn at the same time is recommended for direct comparison. However, this can be challenging for laboratories to fulfil, especially when ektacytometry is performed in children. Therefore, the aim of this study was to evaluate the influence of age and sex on the osmoscan parameters. MATERIALS AND METHODS Blood samples from 231 subjects were analyses on a LoRRca MaxSIS. Data were investigated for need of partitioning by age and sex. After outlier detection, reference intervals (RIs) for osmoscan parameters were estimated. RESULTS For all parameters except EImin, lower values were observed in infants < 3 month (N = 50) than in all other age group. Hence, RIs were calculated separately for this age group. For EImin, a unified RI was calculated. No difference between sexes was observed for any of the parameters. CONCLUSION Lower RIs and a left shift in the osmoscan curves were observed in infants < 3 months compared with older subjects. Hence, age-matched controls are necessary when evaluating ektacytometry in newborns, but can be ignored in older children and adults. This will ease the laboratory workflow when performing ektacytometry.
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Affiliation(s)
| | - Anne Winther-Larsen
- Department of Clinical Biochemistry, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
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Merlo A, Losserand S, Yaya F, Connes P, Faivre M, Lorthois S, Minetti C, Nader E, Podgorski T, Renoux C, Coupier G, Franceschini E. Influence of storage and buffer composition on the mechanical behavior of flowing red blood cells. Biophys J 2023; 122:360-373. [PMID: 36476993 PMCID: PMC9892622 DOI: 10.1016/j.bpj.2022.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/17/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
On-chip study of blood flow has emerged as a powerful tool to assess the contribution of each component of blood to its overall function. Blood has indeed many functions, from gas and nutrient transport to immune response and thermal regulation. Red blood cells play a central role therein, in particular through their specific mechanical properties, which directly influence pressure regulation, oxygen perfusion, or platelet and white cell segregation toward endothelial walls. As the bloom of in-vitro studies has led to the apparition of various storage and sample preparation protocols, we address the question of the robustness of the results involving cell mechanical behavior against this diversity. The effects of three conservation media (EDTA, citrate, and glucose-albumin-sodium-phosphate) and storage time on the red blood cell mechanical behavior are assessed under different flow conditions: cell deformability by ektacytometry, shape recovery of cells flowing out of a microfluidic constriction, and cell-flipping dynamics under shear flow. The impact of buffer solutions (phosphate-buffered saline and density-matched suspension using iodixanol/Optiprep) are also studied by investigating individual cell-flipping dynamics, relative viscosity of cell suspensions, and cell structuration under Poiseuille flow. Our results reveal that storing blood samples up to 7 days after withdrawal and suspending them in adequate density-matched buffer solutions has, in most experiments, a moderate effect on the overall mechanical response, with a possible rapid evolution in the first 3 days after sample collection.
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Affiliation(s)
- Adlan Merlo
- GDR MECABIO, France; Institut de Mécanique des Fluides de Toulouse (IMFT), Université de Toulouse, CNRS, Toulouse, France; Biomechanics and Bioengineering Laboratory (UMR 7338), Université de Technologie de Compiègne - CNRS, Compiègne, France
| | - Sylvain Losserand
- GDR MECABIO, France; Université Grenoble Alpes, CNRS, LIPhy, Grenoble, France
| | - François Yaya
- GDR MECABIO, France; Université Grenoble Alpes, CNRS, LIPhy, Grenoble, France
| | - Philippe Connes
- GDR MECABIO, France; Team 'Vascular Biology and Red Blood Cell', Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Magalie Faivre
- GDR MECABIO, France; University Lyon, CNRS, INSA Lyon, Ecole Centrale de Lyon, Université Claude Bernard Lyon 1, CPE Lyon, INL, UMR5270, Villeurbanne, France
| | - Sylvie Lorthois
- GDR MECABIO, France; Institut de Mécanique des Fluides de Toulouse (IMFT), Université de Toulouse, CNRS, Toulouse, France
| | - Christophe Minetti
- Aero Thermo Mechanics CP 165/43, Université libre de Bruxelles, Brussels, Belgium
| | - Elie Nader
- GDR MECABIO, France; Team 'Vascular Biology and Red Blood Cell', Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Thomas Podgorski
- GDR MECABIO, France; Université Grenoble Alpes, CNRS, LIPhy, Grenoble, France; Université Grenoble Alpes, CNRS, Grenoble INP, LRP, Grenoble, France
| | - Céline Renoux
- GDR MECABIO, France; Team 'Vascular Biology and Red Blood Cell', Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France; Service de biochimie et biologie moléculaire, Hospices Civils de Lyon, Lyon, France
| | - Gwennou Coupier
- GDR MECABIO, France; Université Grenoble Alpes, CNRS, LIPhy, Grenoble, France.
| | - Emilie Franceschini
- GDR MECABIO, France; Aix-Marseille University, CNRS, Centrale Marseille, LMA, Turing Center for Living Systems, Marseille, France.
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Arlet J, Lionnet F, Khimoud D, Joseph L, Montalembert M, Morisset S, Garou A, Cannas G, Cougoul P, Guitton C, Holvoet L, Odièvre M, Cheminet G, Bartolucci P, Santin A, Bernit E, Luna G. Risk factors for severe COVID-19 in hospitalized sickle cell disease patients: A study of 319 patients in France. Am J Hematol 2022; 97:E86-E91. [PMID: 34882837 PMCID: PMC9011445 DOI: 10.1002/ajh.26432] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 01/28/2023]
Affiliation(s)
- Jean‐Benoît Arlet
- French Sickle Cell Referral Center France
- Internal Medicine Department, Georges Pompidou European Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
| | - François Lionnet
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
- Internal Medicine Department, Tenon Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Djamal Khimoud
- French Sickle Cell Referral Center France
- Internal Medicine Department, Georges Pompidou European Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
| | - Laure Joseph
- French Sickle Cell Referral Center France
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
- Service de Biothérapie, Necker‐Enfants malades Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Mariane Montalembert
- French Sickle Cell Referral Center France
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker‐Enfants Malades Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | | | - Alain Garou
- French Sickle Cell Referral Center France
- Pediatric Department, Centre Hospitalier de Mayotte Rue de l'hôpital Mayotte France
| | - Giovanna Cannas
- French Sickle Cell Referral Center France
- Internal Medicine Department Hospices Civils Lyon France
| | - Pierre Cougoul
- French Sickle Cell Referral Center France
- Internal Medicine Department IUCT Oncopole, CHU de Toulouse France
| | - Corinne Guitton
- French Sickle Cell Referral Center France
- Pediatric Department, Bicetre Hospital, Bicêtre Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Laurent Holvoet
- French Sickle Cell Referral Center France
- Internal Medicine Department, Georges Pompidou European Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
- Pediatric Department, Robert Debré Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Marie‐Hélène Odièvre
- French Sickle Cell Referral Center France
- Internal Medicine Department, Georges Pompidou European Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
- Pediatric Department, Hôpital Armand Trousseau Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Geoffrey Cheminet
- French Sickle Cell Referral Center France
- Internal Medicine Department, Georges Pompidou European Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
| | - Pablo Bartolucci
- French Sickle Cell Referral Center France
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
- Department of Internal Medicine, Mondor Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Aline Santin
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
- Internal Medicine Department, Tenon Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Emmanuelle Bernit
- French Sickle Cell Referral Center France
- Unité Transversale de la Drépanocytose CHU de Guadeloupe Pointe à Pitre France
| | - Gonzalo Luna
- French Sickle Cell Referral Center France
- AP‐HP/Universities/Inserm COVID‐19 Research Collaboration Paris France
- Department of Internal Medicine, Mondor Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
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Manna S, Biswas P, Haldar R, Naskar TK, Law S. Cord and peripheral blood erythrocyte analysis by scanning electron microscopy and flow cytometry. Int J Lab Hematol 2022; 44:679-687. [PMID: 35150189 DOI: 10.1111/ijlh.13810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Human umbilical cord blood is rich in hematopoietic cells. We aimed to focus on the morphological, biochemical, membrane protein profile and surface protein expression differences of erythrocytes, isolated from cord and adult peripheral blood using techniques such as high-resolution scanning electron microscopy (SEM), gel electrophoresis (SDS-PAGE) and flow cytometry. METHODS Adult peripheral blood was collected from consenting adults, and umbilical cord blood was procured from consenting mothers, post-delivery at Medical College, Kolkata. We emphasized on cord and adult peripheral blood erythrocytes' morphological variations using SEM images and protein expression by flow cytometric analysis. Some conventional biochemical analyses such as osmotic fragility of the cell membrane, haemoglobin co-oxidation study and lipid peroxidation assay were done for supporting evidence along with membrane protein content using gel electrophoresis. RESULTS Our SEM images indicated clear morphological variations in cord erythrocyte with a higher degree of cellular deformities and difference in membrane texture. Flow cytometric analysis of cord erythrocyte showed a significant difference in CD235a expression than adults. We observed an overexpression of GLUT1 and decreased expression of Band 3 in cord erythrocyte membrane. Our results also showed cord erythrocytes have low osmotic fragility, a slower rate of co-oxidation of cord haemoglobin and a lesser lipid peroxidation level than that of adults. CONCLUSION Cord blood erythrocytes have deeper indentations leading to higher flexibility, more oxygen-carrying capacity and less osmotic fragility in comparison with adult erythrocytes. The expression of CD235a and Band 4.5 (GLUT 1) was significantly higher in cord erythrocytes than peripheral adult erythrocytes.
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Affiliation(s)
- Sayak Manna
- Stem Cell Research and Application Unit, Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, Kolkata, India
| | - Payel Biswas
- Biophysics and Electrophysiology Unit, Department of Physiology, University of Calcutta, Kolkata, India
| | - Rajen Haldar
- Biophysics and Electrophysiology Unit, Department of Physiology, University of Calcutta, Kolkata, India
| | - Tapan Kumar Naskar
- Department of Obstetrics and Gynaecology, Medical College Kolkata, Kolkata, India
| | - Sujata Law
- Stem Cell Research and Application Unit, Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, Kolkata, India
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Boisson C, Rab MAE, Nader E, Renoux C, Kanne C, Bos J, van Oirschot BA, Joly P, Fort R, Gauthier A, Stauffer E, Poutrel S, Kebaili K, Cannas G, Garnier N, Renard C, Hequet O, Hot A, Bertrand Y, van Wijk R, Sheehan VA, van Beers EJ, Connes P. Effects of Genotypes and Treatment on Oxygenscan Parameters in Sickle Cell Disease. Cells 2021; 10:cells10040811. [PMID: 33916502 PMCID: PMC8067408 DOI: 10.3390/cells10040811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 02/08/2023] Open
Abstract
(1) Background: The aim of the present study was to compare oxygen gradient ektacytometry parameters between sickle cell patients of different genotypes (SS, SC, and S/β+) or under different treatments (hydroxyurea or chronic red blood cell exchange). (2) Methods: Oxygen gradient ektacytometry was performed in 167 adults and children at steady state. In addition, five SS patients had oxygenscan measurements at steady state and during an acute complication requiring hospitalization. (3) Results: Red blood cell (RBC) deformability upon deoxygenation (EImin) and in normoxia (EImax) was increased, and the susceptibility of RBC to sickle upon deoxygenation was decreased in SC patients when compared to untreated SS patients older than 5 years old. SS patients under chronic red blood cell exchange had higher EImin and EImax and lower susceptibility of RBC to sickle upon deoxygenation compared to untreated SS patients, SS patients younger than 5 years old, and hydroxyurea-treated SS and SC patients. The susceptibility of RBC to sickle upon deoxygenation was increased in the five SS patients during acute complication compared to steady state, although the difference between steady state and acute complication was variable from one patient to another. (4) Conclusions: The present study demonstrates that oxygen gradient ektacytometry parameters are affected by sickle cell disease (SCD) genotype and treatment.
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Affiliation(s)
- 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, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Érythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69500 Bron, France
| | - Minke A. E. Rab
- Central Diagnostic Laboratory—Research, University Medical Center Utrecht, Utrecht University, 85500, 3508 GA Utrecht, The Netherlands; (M.A.E.R.); (J.B.); (B.A.v.O.); (R.v.W.)
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, 85500, 3508 GA Utrecht, The Netherlands;
| | - 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, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
| | - 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, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Érythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69500 Bron, France
| | - Celeste Kanne
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX 77030, USA; (C.K.); (V.A.S.)
| | - Jennifer Bos
- Central Diagnostic Laboratory—Research, University Medical Center Utrecht, Utrecht University, 85500, 3508 GA Utrecht, The Netherlands; (M.A.E.R.); (J.B.); (B.A.v.O.); (R.v.W.)
| | - Brigitte A. van Oirschot
- Central Diagnostic Laboratory—Research, University Medical Center Utrecht, Utrecht University, 85500, 3508 GA Utrecht, The Netherlands; (M.A.E.R.); (J.B.); (B.A.v.O.); (R.v.W.)
| | - 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, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Érythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69500 Bron, France
| | - Romain Fort
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008 Lyon, France; (G.C.); (A.H.)
| | - 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, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Institut d’Hématologie et d’Oncologie Pédiatrique, Hospices Civils de Lyon, 69008 Lyon, France; (N.G.); (C.R.); (Y.B.)
| | - Emeric Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Centre de Médecine du Sommeil et des Maladies Respiratoires, Hôpital Croix Rousse, Hospices Civils de Lyon, 69004 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, Université de Lyon, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008 Lyon, France; (G.C.); (A.H.)
| | - Kamila Kebaili
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Institut d’Hématologie et d’Oncologie Pédiatrique, Hospices Civils de Lyon, 69008 Lyon, France; (N.G.); (C.R.); (Y.B.)
| | - Giovanna Cannas
- Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008 Lyon, France; (G.C.); (A.H.)
| | - Nathalie Garnier
- Institut d’Hématologie et d’Oncologie Pédiatrique, Hospices Civils de Lyon, 69008 Lyon, France; (N.G.); (C.R.); (Y.B.)
| | - Cécile Renard
- Institut d’Hématologie et d’Oncologie Pédiatrique, Hospices Civils de Lyon, 69008 Lyon, France; (N.G.); (C.R.); (Y.B.)
| | - Olivier Hequet
- Apheresis Unit, Etablissement Français du Sang Rhône Alpes, Centre Hospitalier Lyon Sud Pierre Bénite, 69310 Pierre Bénite, France;
| | - Arnaud Hot
- Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008 Lyon, France; (G.C.); (A.H.)
| | - Yves Bertrand
- Institut d’Hématologie et d’Oncologie Pédiatrique, Hospices Civils de Lyon, 69008 Lyon, France; (N.G.); (C.R.); (Y.B.)
| | - Richard van Wijk
- Central Diagnostic Laboratory—Research, University Medical Center Utrecht, Utrecht University, 85500, 3508 GA Utrecht, The Netherlands; (M.A.E.R.); (J.B.); (B.A.v.O.); (R.v.W.)
| | - Vivien A. Sheehan
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX 77030, USA; (C.K.); (V.A.S.)
| | - Eduard J. van Beers
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, 85500, 3508 GA Utrecht, The Netherlands;
| | - 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, 69008 Lyon, France; (C.B.); (E.N.); (C.R.); (P.J.); (R.F.); (A.G.); (E.S.); (S.P.); (K.K.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75006 Paris, France
- Correspondence:
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10
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Rab MAE, Kanne CK, Bos J, Oirschot BA, Boisson C, Houwing ME, Gerritsma J, Teske E, Renoux C, Riedl J, Schutgens REG, Bartels M, Nur E, Joly P, Fort R, Cnossen MH, Wijk R, Connes P, Beers EJ, Sheehan VA. Oxygen gradient ektacytometry-derived biomarkers are associated with vaso-occlusive crises and correlate with treatment response in sickle cell disease. Am J Hematol 2021; 96:E29-E32. [PMID: 33095451 PMCID: PMC7756395 DOI: 10.1002/ajh.26031] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Minke A. E. Rab
- Central Diagnostic Laboratory‐Research University Medical Center Utrecht, Utrecht University Utrecht The Netherlands
- Van Creveldkliniek, University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Celeste K. Kanne
- Department of Pediatrics Emory University School of Medicine Childrenʼs Healthcare of Atlanta Atlanta Georgia USA
| | - Jennifer Bos
- Central Diagnostic Laboratory‐Research University Medical Center Utrecht, Utrecht University Utrecht The Netherlands
| | - Brigitte A. Oirschot
- Central Diagnostic Laboratory‐Research University Medical Center Utrecht, Utrecht University Utrecht The Netherlands
| | - 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
| | - Maite E. Houwing
- Department of Pediatric Hematology Erasmus Medical Center Rotterdam The Netherlands
| | - Jorn Gerritsma
- Emma Childrenʼs Hospital, Pediatric Hematology Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Erik Teske
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | - Celine 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
| | - Jurgen Riedl
- Result Laboratory Albert Schweitzer Hospital Dordrecht The Netherlands
| | - Roger E. G. Schutgens
- Van Creveldkliniek, University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Marije Bartels
- Van Creveldkliniek, University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Erfan Nur
- Department of Hematology Amsterdam University Medical Centers Amsterdam 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
| | - Romain Fort
- Department of Internal Medicine Hospices Civils de Lyon Lyon France
| | - Marjon H. Cnossen
- Department of Pediatric Hematology Erasmus Medical Center Rotterdam The Netherlands
| | - Richard Wijk
- Central Diagnostic Laboratory‐Research University Medical Center Utrecht, Utrecht University Utrecht The Netherlands
| | - 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
| | - Eduard J. Beers
- Van Creveldkliniek, University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Vivien A. Sheehan
- Department of Pediatrics Emory University School of Medicine Childrenʼs Healthcare of Atlanta Atlanta Georgia USA
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11
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Kucukal E, Man Y, Hill A, Liu S, Bode A, An R, Kadambi J, Little JA, Gurkan UA. Whole blood viscosity and red blood cell adhesion: Potential biomarkers for targeted and curative therapies in sickle cell disease. Am J Hematol 2020; 95:1246-1256. [PMID: 32656816 PMCID: PMC7689825 DOI: 10.1002/ajh.25933] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022]
Abstract
Sickle cell disease (SCD) is a recessive genetic blood disorder exhibiting abnormal blood rheology. Polymerization of sickle hemoglobin, due to a point mutation in the β‐globin gene of hemoglobin, results in aberrantly adhesive and stiff red blood cells (RBCs). Hemolysis, abnormal RBC adhesion, and abnormal blood rheology together impair endothelial health in people with SCD, which leads to cumulative systemic complications. Here, we describe a microfluidic assay combined with a micro particle image velocimetry technique for the integrated in vitro assessment of whole blood viscosity (WBV) and RBC adhesion. We examined WBV and RBC adhesion to laminin (LN) in microscale flow in whole blood samples from 53 individuals with no hemoglobinopathies (HbAA, N = 10), hemoglobin SC disease (HbSC, N = 14), or homozygous SCD (HbSS, N = 29) with mean WBV of 4.50 cP, 4.08 cP, and 3.73 cP, respectively. We found that WBV correlated with RBC count and hematocrit in subjects with HbSC or HbSS. There was a significant inverse association between WBV and RBC adhesion under both normoxic and physiologically hypoxic (SpO2 of 83%) tests, in which lower WBV associated with higher RBC adhesion to LN in subjects with HbSS. Low WBV has been found by others to associate with endothelial activation. Altered WBV and abnormal RBC adhesion may synergistically contribute to the endothelial damage and cumulative pathophysiology of SCD. These findings suggest that WBV and RBC adhesion may serve as clinically relevant biomarkers and endpoints in assessing emerging targeted and curative therapies in SCD.
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Affiliation(s)
- Erdem Kucukal
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Yuncheng Man
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Ailis Hill
- Division of Hematology and Oncology, School of Medicine Case Western Reserve University Cleveland Ohio
| | - Shichen Liu
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Allison Bode
- Division of Hematology and Oncology, School of Medicine Case Western Reserve University Cleveland Ohio
| | - Ran An
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Jaikrishnan Kadambi
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Jane A. Little
- Division of Hematology and Blood Research Center, Department of Medicine University of North Carolina Chapel Hill North Carolina
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
- Department of Biomedical Engineering Case Western Reserve University Cleveland Ohio
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12
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Reversal of a rheologic cardiomyopathy following hematopoietic stem cell transplantation for sickle cell disease. Blood Adv 2020; 3:2816-2824. [PMID: 31578191 DOI: 10.1182/bloodadvances.2019000387] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/29/2019] [Indexed: 02/01/2023] Open
Abstract
Cardiac complications have been well-described in sickle cell disease; however, it has been rare to see improvements in cardiac abnormalities following any interventions. Previous work has shown no significant structural changes after treatment with hydroxyurea. The cardiac effects of red blood cell exchange transfusion (RBCx) and hematopoietic stem cell transplantation (HSCT) have not been well described. We studied 56 patients undergoing HSCT (41 HLA-matched, 15 haploidentical), of whom 32 had RBCx within 3 months before HSCT. Echocardiograms and laboratory parameters were obtained at baseline, and at 3, 6, and 12 months following HSCT. Although hemolytic parameters and anemia improved following RBCx, there was a small increase in left ventricular volume index. Following successful HSCT, however, there were significant improvements in cardiac size, function, and diastolic filling parameters at 3 months followed by continued smaller improvements up to 1 year. There was a significant improvement in N-terminal pro B-type natriuretic peptide levels and a trend toward improvement in 6-minute walk time 1 year after HSCT. The magnitude of cardiac improvement seen following HSCT was comparable to that observed following correction of a volume overload state as seen in pregnancy or after repair of chronic valvular regurgitation. Further studies in sickle cell disease patients will help delineate which cardiac complications and what level of severity should be considered indications for HSCT.
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13
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Thielen FW, Houwing ME, Cnossen MH, Al Hadithy-Irgiztseva IA, Hazelzet JA, Groot CAUD, de Pagter APJ, Blommestein HM. Cost of health care for paediatric patients with sickle cell disease: An analysis of resource use and costs in a European country. Pediatr Blood Cancer 2020; 67:e28588. [PMID: 32672889 DOI: 10.1002/pbc.28588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/28/2020] [Accepted: 06/23/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND While multiple studies have examined the cost of health care for one aspect of sickle cell disease care, few have focussed on the overall cost of comprehensive care for sickle cell disease. METHODS We conducted a retrospective cohort study of children with sickle cell disease treated in a comprehensive care centre from 1 January 2015 to 31 December 2016. Health care utilisation of included patients was based upon data from two main sources. The clinical practice guideline was used to determine the expected resource use of routine comprehensive care (planned elective care), and the financial claims database was used to estimate real-world resource use associated with acute and inpatient care (additional care). RESULTS A total of 125 children with sickle cell disease were analysed. Expenditures for these patients averaged €5049 [standard deviation (SD) €1634] per child per year. Total yearly costs per patient varied considerably, ranging from €669 to €84 010, and less than 15% of patients were responsible for 50% of the health care costs. The majority (37%) of costs was associated with inpatient hospital care, which increased by age group, 27% with diagnostics, 19% with treatment, 11% with outpatients' visits and 6% with emergency care. CONCLUSION We have described real-world resource use and expenditures for children with sickle cell disease in a European comprehensive care centre. It seems that costs of a comprehensive approach with effective management in the outpatient setting is favourable when compared to episodic health care.
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Affiliation(s)
- Frederick W Thielen
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
| | - Maite E Houwing
- Department of Paediatric Haematology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marjon H Cnossen
- Department of Paediatric Haematology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ilona A Al Hadithy-Irgiztseva
- Department of Control and Compliance, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jan A Hazelzet
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Carin A Uyl-de Groot
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.,Institute for Medical Technology Assessment, Rotterdam, The Netherlands
| | - Anne P J de Pagter
- Department of Paediatric Haematology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.,Leiden University Medical Center-Willem Alexander Children's Hospital, Leiden, The Netherlands
| | - Hedwig M Blommestein
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
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14
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Valadão Cardoso A. An experimental erythrocyte rigidity index (Ri) and its correlations with Transcranial Doppler velocities (TAMMV), Gosling Pulsatility Index PI, hematocrit, hemoglobin concentration and red cell distribution width (RDW). PLoS One 2020; 15:e0229105. [PMID: 32084188 PMCID: PMC7034921 DOI: 10.1371/journal.pone.0229105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/29/2020] [Indexed: 12/17/2022] Open
Abstract
Brain artery velocities (Time-Averaged Maximum Mean Velocity, TAMMV) by Transcranial Doppler (TCD), hematocrit, hemoglobin, Red blood cell (RBC) Distribution Width (RDW) and RBC rigidity index (Ri), when reported together with their correlations, provide a accurate and useful diagnostic picture than blood viscosity measurements alone. Additionally, our study included a sixth parameter provided by TCD, the Gosling Pulsatility Index PI, which is an indicator of CBF (Cerebral Blood Flow) resistance. All these parameters are routine in Hematology except for values of Ri. The rigidity (Ri) of the RBC is the main rheological characteristic of the blood of Sickle Cell Anemia (SCA) patients and several pathologies. However, its quantification depends on many commercial and experimental techniques, none disseminated and predominant around the World. The difference in absorbance values of the blood, during the process of sedimentation in a microwell of a Microplate Reader, is a straightforward way of semi-quantifying the RBC rigidity Ri, since the fraction of irreversibly sickled red blood cells does not form rouleaux. Erythrocyte Rigidity Index (Ri) was calculated using initial absorbance Ainitial (6 s) and final Afinal (540 s), Ri = 1 / (Ai-Af). The Ri of 119 patients (2–17 y / o, M & F) SCA, SCC (Sickle Cell/hemoglobin C), SCD (Sickle Cell/hemoglobin D), Sβ0thal (Sickle Cell/hemoglobin Beta Zero Thalassemia) and 71 blood donors (20–65 y / o, M & F) were measured in our laboratory while the five parameters (TAMMV and PI by TCD, Hct, Hb and RDW) were obtained from medical records. The in vitro addition of hydroxyurea (HU, 50mg /dl, n = 51 patients, and n = 8 healthy donors) in the samples decreased the rouleaux adhesion strength of both donor and patients’ blood samples, leading to extraordinarily high Ri values. The correlation between the studied parameters was especially significant for the direct relationships between Ri, TAMMV, and PI.
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Affiliation(s)
- Antonio Valadão Cardoso
- Rheology Laboratory, Materials Engineering Post-Graduation Program REDEMAT-UEMG/DESP-ED, State University of Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- * E-mail:
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15
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Schlemmer F, Gellen-Dautremer J, Carette MF, de Prost N, Spagnolo S, Deux JF, Fartoukh M, Naccache JM, Habibi A, Mahevas M, Bartolucci P, Mekontso Dessap A, Maitre B. Systemo-pulmonary shunting and acute chest syndrome in a patient with SC sickle-cell disease. Respir Med Res 2020; 77:21-23. [PMID: 32036282 DOI: 10.1016/j.resmer.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
Affiliation(s)
- F Schlemmer
- Pneumology, DHU A-TVB, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Université Paris Est Créteil, 94010 Créteil, France.
| | - J Gellen-Dautremer
- Unité des maladies génétiques du globule rouge, Sickle cell center, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - M F Carette
- Radiology, hôpital Tenon, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France; Université Pierre et Marie Curie Paris, 75252 Paris, France
| | - N de Prost
- Université Paris Est Créteil, 94010 Créteil, France; Intensive Care Unit, DHU A-TVB, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - S Spagnolo
- Intensive Care Unit, DHU A-TVB, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - J F Deux
- Université Paris Est Créteil, 94010 Créteil, France; Radiology, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France
| | - M Fartoukh
- Intensive Care Unit, hôpital Tenon, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France; Université Pierre et Marie Curie Paris, 75252 Paris, France
| | - J M Naccache
- Université Pierre et Marie Curie Paris, 75252 Paris, France; Pneumology, hôpital Tenon, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France
| | - A Habibi
- Unité des maladies génétiques du globule rouge, Sickle cell center, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - M Mahevas
- Université Paris Est Créteil, 94010 Créteil, France; Centre de référence des cytopénies auto-immunes de l'adulte, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - P Bartolucci
- Université Paris Est Créteil, 94010 Créteil, France; Unité des maladies génétiques du globule rouge, Sickle cell center, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - A Mekontso Dessap
- Université Paris Est Créteil, 94010 Créteil, France; Intensive Care Unit, DHU A-TVB, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - B Maitre
- Pneumology, DHU A-TVB, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Université Paris Est Créteil, 94010 Créteil, France
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16
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Lu M, Rab MA, Shevkoplyas SS, Sheehan VA. Blood rheology biomarkers in sickle cell disease. Exp Biol Med (Maywood) 2020; 245:155-165. [PMID: 31948290 DOI: 10.1177/1535370219900494] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Sickle cell disease (SCD) is the most common inherited blood disorder, affecting approximately 100,000 patients in the U.S. and millions more worldwide. Patients with SCD experience a wide range of clinical complications, including frequent pain crises, stroke, and early mortality, all originating from a single-point mutation in the β-globin subunit. The RBC changes resulting from the sickle mutation lead to a host of rheological abnormalities that diminish microvascular blood flow, and produce severe anemia due to RBC hemolysis, and ischemia from vaso-occlusion initiated by sticky, rigid sickle RBCs. While the pathophysiology and mechanisms of SCD have been investigated for many years, therapies to treat the disease are limited. In addition to RBC transfusion, there are only two US Food and Drug Administration (FDA)-approved drugs to ameliorate SCD complications: hydroxyurea (HU) and L-glutamine (Endari™). The only curative therapy currently available is allogeneic hematopoietic stem cell transplantation (HSCT), which is generally reserved for individuals with a matched related donor, comprising only 10–15% of the total SCD population. Potentially curative advanced gene therapy approaches for SCD are under investigation in ongoing clinical trials. The ultimate goal of any curative treatment should be to repair the hemorheological abnormalities caused by SCD, and thus normalize blood flow and prevent clinical complications. Our mini-review highlights a set of key hemorheological biomarkers (and the current and emerging technologies used to measure them) that may be used to guide the development of novel curative and palliative therapies for SCD, and functionally assess outcomes. Impact statement Severe impairment of blood rheology is the hallmark of SCD pathophysiology, and one of the key factors predisposing SCD patients to pain crises, organ damage, and early mortality. As novel therapies emerge to treat or cure SCD, it is crucial that these treatments are functionally evaluated for their effect on blood rheology. This review describes a comprehensive panel of rheological biomarkers, their clinical uses, and the technologies used to obtain them. The described technologies can produce highly sensitive measurements of the ability of current treatments to improve blood rheology of SCD patients. The goal of curative therapies should be to achieve blood rheology biomarkers measurements in the range of sickle cell trait individuals (HbAS). The use of the panel of rheological biomarkers proposed in this review could significantly accelerate the development, optimization, and clinical translation of novel therapies for SCD.
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Affiliation(s)
- Madeleine Lu
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA
| | - Minke Ae Rab
- Laboratory of Clinical Chemistry & Hematology, University Medical Center Utrecht, Utrecht University, Utrecht 3584, The Netherlands
| | - Sergey S Shevkoplyas
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA
| | - Vivien A Sheehan
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX 77030, USA
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17
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Brousse V, Pondarre C, Arnaud C, Kamden A, de Montalembert M, Boutonnat-Faucher B, Bourdeau H, Charlot K, Grévent D, Verlhac S, da Costa L, Connes P. One-Fifth of Children with Sickle Cell Anemia Show Exercise-Induced Hemoglobin Desaturation: Rate of Perceived Exertion and Role of Blood Rheology. J Clin Med 2020; 9:jcm9010133. [PMID: 31947773 PMCID: PMC7019952 DOI: 10.3390/jcm9010133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/18/2019] [Accepted: 12/28/2019] [Indexed: 01/08/2023] Open
Abstract
Perceived exertion is an important self-limiting factor influencing functional capacity in patients with sickle cell anemia (SCA). Exercise-related hemoglobin desaturation (EHD) may occur during a six-minute walking test (6MWT) and could influence the perceived rate of exertion. The aims of this study were (1) to compare the 6MWT responses (heart rate, perceived rate of exertion, and distance covered) between SCA children with and without EHD, and (2) to test the associations between EHD and several biological/physiological parameters. Nine of 51 SCA children (18%) at steady state (mean age 11.9 ± 3.8 years) exhibited EHD at the end of the 6MWT. The rate of perceived exertion increased with exercise in the two groups, but reached higher values in the EHD group. Heart rate and performance during the 6MWT did not differ between the two groups. The magnitude of change in SpO2 during the 6MWT was independently associated with the red blood cell (RBC) deformability and RBC aggregates strength. This study demonstrates that SCA children with EHD during a 6MWT have a higher rate of perceived exertion than non-EHD children despite a similar physiological demand, and that abnormal RBC rheology determinants appear to be significant contributors.
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Affiliation(s)
- Valentine Brousse
- Service de Pédiatrie Générale et Maladies infectieuses, Hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France (B.B.-F.)
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
- UMR_S1134, Inserm, Institut National de la transfusion sanguine, 75015 Paris, France
- Correspondence:
| | - Corinne Pondarre
- Service de Pédiatrie, Centre Intercommunal de Créteil, 94000 Créteil, France; (C.P.); (C.A.)
| | - Cecile Arnaud
- Service de Pédiatrie, Centre Intercommunal de Créteil, 94000 Créteil, France; (C.P.); (C.A.)
| | - Annie Kamden
- Service de Pédiatrie, Centre Intercommunal de Créteil, 94000 Créteil, France; (C.P.); (C.A.)
| | - Mariane de Montalembert
- Service de Pédiatrie Générale et Maladies infectieuses, Hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France (B.B.-F.)
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
| | - Benedicte Boutonnat-Faucher
- Service de Pédiatrie Générale et Maladies infectieuses, Hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France (B.B.-F.)
| | - Hélène Bourdeau
- Service d’Hématologie Biologique, Hôpital Robert Debré, AP-HP, 75019 Paris, France;
| | - Keyne Charlot
- Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels Institut de Recherche Biomédicale des Armées, 91220 Brétigny-sur-Orge, France;
| | - David Grévent
- Service d’Imagerie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, F-75015 Paris, France;
| | - Suzanne Verlhac
- Service de Radiologie, Centre Intercommunal de Créteil, 94000 Créteil, France;
| | - Lydie da Costa
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
- UMR_S1134, Inserm, Institut National de la transfusion sanguine, 75015 Paris, France
- Service d’Hématologie Biologique, Hôpital Robert Debré, AP-HP, 75019 Paris, France;
- Paris University, F-75010 Paris, France
| | - Philippe Connes
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
- Equipe «Biologie Vasculaire et du Globule Rouge», Laboratoire LIBM EA7424, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Institut Universitaire de France, 75015 Paris, France
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18
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Ong SS, Linz MO, Li X, Liu TA, Han IC, Scott AW. Retinal Thickness and Microvascular Changes in Children With Sickle Cell Disease Evaluated by Optical Coherence Tomography (OCT) and OCT Angiography. Am J Ophthalmol 2020; 209:88-98. [PMID: 31473216 DOI: 10.1016/j.ajo.2019.08.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE To compare the severity of macular vascular changes in children with sickle cell disease (SCD) vs age- and race-matched controls. DESIGN Cross-sectional study. METHODS Children (<18 years old) with HbSS and HbS variant (HbSC and HbS thalassemia) genotypes, and their age- and race-matched controls, were recruited between January 2017 and December 2018. All subjects underwent optical coherence tomography angiography (OCTA) scans centered on the fovea and temporal macula. Retinal thickness, superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density (VD), and foveal avascular zone (FAZ) size were measured and compared between HbSS and HbS variant vs controls. RESULTS Thirty-four HbSS, 34 HbS variant (Goldberg staging 0-3 for SCD eyes), and 24 control eyes (total 48 children, aged 5-17 years) were included. Total VD (3-mm ETDRS circle) was lower in HbS variant eyes than in controls for both the SCP (42.9% vs 47.7%, P = .02) and DCP (47.4% vs 52.6%, P = .01). In HbSS eyes, VD was lower in the DCP (47.7%, P = .008) but not in the SCP (45.5%, P = .5), compared to controls. A higher proportion of HbSS (n = 18, 55%) than HbS variant eyes (n = 9, 26%) had pathologic areas of retinal thinning associated with SCP and DCP flow loss (P = .03). However, retinal thickness measurements and FAZ size did not differ between either HbSS or HbS variant group vs controls. CONCLUSIONS Children with SCD have similar retinal thickness but less dense vasculature on OCTA compared to age and race-matched controls, suggesting that microvascular insult may precede structural thinning.
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19
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Kanter J, Lanzkron S. Innovations in Targeted Anti-Adhesion Treatment for Sickle Cell Disease. Clin Pharmacol Ther 2019; 107:140-146. [PMID: 31617585 DOI: 10.1002/cpt.1682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/13/2019] [Indexed: 02/02/2023]
Abstract
Sickle cell disease (SCD) is an inherited hemoglobinopathy that leads to significant lifetime morbidity and early mortality. An enhanced understanding of the complex pathophysiology of the disease has elucidated novel therapeutic targets for which new therapies are in development. In order to increase the therapeutic landscape, it has been important to identify the blood vessel and more specifically the endothelium as the target organ in this complex disease. Through this lens, we present a review of new anti-adhesion therapies for SCD in development. The long-term promise of multimodal therapies for SCD is finally on the horizon.
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Affiliation(s)
- Julie Kanter
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sophie Lanzkron
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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20
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Nader E, Skinner S, Romana M, Fort R, Lemonne N, Guillot N, Gauthier A, Antoine-Jonville S, Renoux C, Hardy-Dessources MD, Stauffer E, Joly P, Bertrand Y, Connes P. Blood Rheology: Key Parameters, Impact on Blood Flow, Role in Sickle Cell Disease and Effects of Exercise. Front Physiol 2019; 10:1329. [PMID: 31749708 PMCID: PMC6842957 DOI: 10.3389/fphys.2019.01329] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/04/2019] [Indexed: 01/07/2023] Open
Abstract
Blood viscosity is an important determinant of local flow characteristics, which exhibits shear thinning behavior: it decreases exponentially with increasing shear rates. Both hematocrit and plasma viscosity influence blood viscosity. The shear thinning property of blood is mainly attributed to red blood cell (RBC) rheological properties. RBC aggregation occurs at low shear rates, and increases blood viscosity and depends on both cellular (RBC aggregability) and plasma factors. Blood flow in the microcirculation is highly dependent on the ability of RBC to deform, but RBC deformability also affects blood flow in the macrocirculation since a loss of deformability causes a rise in blood viscosity. Indeed, any changes in one or several of these parameters may affect blood viscosity differently. Poiseuille's Law predicts that any increase in blood viscosity should cause a rise in vascular resistance. However, blood viscosity, through its effects on wall shear stress, is a key modulator of nitric oxide (NO) production by the endothelial NO-synthase. Indeed, any increase in blood viscosity should promote vasodilation. This is the case in healthy individuals when vascular function is intact and able to adapt to blood rheological strains. However, in sickle cell disease (SCD) vascular function is impaired. In this context, any increase in blood viscosity can promote vaso-occlusive like events. We previously showed that sickle cell patients with high blood viscosity usually have more frequent vaso-occlusive crises than those with low blood viscosity. However, while the deformability of RBC decreases during acute vaso-occlusive events in SCD, patients with the highest RBC deformability at steady-state have a higher risk of developing frequent painful vaso-occlusive crises. This paradox seems to be due to the fact that in SCD RBC with the highest deformability are also the most adherent, which would trigger vaso-occlusion. While acute, intense exercise may increase blood viscosity in healthy individuals, recent works conducted in sickle cell patients have shown that light cycling exercise did not cause dramatic changes in blood rheology. Moreover, regular physical exercise has been shown to decrease blood viscosity in sickle cell mice, which could be beneficial for adequate blood flow and tissue perfusion.
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Affiliation(s)
- Elie Nader
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Sarah Skinner
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Marc Romana
- Laboratory of Excellence GR-Ex, Paris, France.,Biologie Intégrée du Globule Rouge, Université de Paris, UMR_S1134, BIGR, INSERM, F-75015, Paris, France.,Biologie Intégrée du Globule Rouge, The Université des Antilles, UMR_S1134, BIGR, F- 97157, Pointe-a-Pitre, France
| | - Romain Fort
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Département de Médecine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Nathalie Lemonne
- Unité Transversale de la Drépanocytose, Hôpital de Pointe-a-Pitre, Hôpital Ricou, Pointe-a-Pitre, France
| | - Nicolas Guillot
- Laboratoire Carmen INSERM 1060, INSA Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France
| | - Alexandra Gauthier
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | | | - Céline Renoux
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Laboratoire de Biochimie et de Biologie Moleìculaire, UF de Biochimie des Pathologies Eìrythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Marie-Dominique Hardy-Dessources
- Laboratory of Excellence GR-Ex, Paris, France.,Biologie Intégrée du Globule Rouge, Université de Paris, UMR_S1134, BIGR, INSERM, F-75015, Paris, France.,Biologie Intégrée du Globule Rouge, The Université des Antilles, UMR_S1134, BIGR, F- 97157, Pointe-a-Pitre, France
| | - Emeric Stauffer
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Philippe Joly
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Laboratoire de Biochimie et de Biologie Moleìculaire, UF de Biochimie des Pathologies Eìrythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Yves Bertrand
- d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Philippe Connes
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
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21
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Beral L, Romana M, Lemonne N, Garnier Y, Billaud M, Acomat M, Zorobabel C, Etienne-Julan M, David T, Connes P. Multifocal electroretinogram findings in sickle cell maculopathy. Eye (Lond) 2019; 33:1939-1945. [PMID: 31289356 DOI: 10.1038/s41433-019-0499-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 04/04/2019] [Accepted: 04/30/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of the present work was to describe and compare multifocal electroretinogram findings (mfERG) between patients with sickle cell disease (SCD) without clinical sign of maculopathy and controls (HbAA). METHODS Both HbSS (homozygous SCD) and HbSC (compound heterozygous SCD) patients, the two most frequent SCD genotypes, were included. All individuals underwent a full ophthalmologic examination (with a fundoscopy), a spectral domain ocular coherence tomography (SD-OCT) and a mfERG. RESULTS A total of 86 subjects were included: 54 SCD patients (107 eyes) with 32 HbSS (63 eyes) and 22 HbSC (44 eyes) and 32 controls (64 eyes). None of the eyes showed retinal clinical abnormalities. SD-OCT analysis showed that macular thickness was statistically lower in SCD eyes than in controls. mfERG analysis demonstrated a significant reduction of N1 (initial-negative deflection), and P1 (positive peak) response amplitude densities of HbSS eyes compared to HbAA eyes from the centre (<2°) and to the periphery (>15°). Implicit time response was also reduced in the centre (<2°). N1 and P1 response amplitude densities of HbSC eyes were significantly lower than those of HbAA eyes from the centre (<2°) to the periphery (>15°). N1 implicit time was statistically reduced in HbSS compared to HbSC eyes. CONCLUSION Our study is the first one to describe macular electrophysiological dysfunction in SCD patients. Moreover, we confirm that SCD maculopathy is equally frequent in HbSS and HbSC.
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Affiliation(s)
- Laurence Beral
- Service d'ophtalmologie, CHU de Pointe-à-Pitre/ Abymes, r de Chauvel, Pointe-à-Pitre, Guadeloupe, France.,UMR Inserm 1134, Biologie Intégrée du Globule Rouge, INSERM/Université Paris Diderot-Université Sorbonne Paris Cité/INTS/Université des Antilles, Guadeloupe, France
| | - Marc Romana
- UMR Inserm 1134, Biologie Intégrée du Globule Rouge, INSERM/Université Paris Diderot-Université Sorbonne Paris Cité/INTS/Université des Antilles, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France
| | - Nathalie Lemonne
- Unité transversale de la Drépanocytose, CHU de Pointe-à-Pitre/ Abymes, r de Chauvel, Pointe-à-Pitre, Guadeloupe, France
| | - Yoann Garnier
- UMR Inserm 1134, Biologie Intégrée du Globule Rouge, INSERM/Université Paris Diderot-Université Sorbonne Paris Cité/INTS/Université des Antilles, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France
| | - Marie Billaud
- Unité transversale de la Drépanocytose, CHU de Pointe-à-Pitre/ Abymes, r de Chauvel, Pointe-à-Pitre, Guadeloupe, France
| | - Malik Acomat
- Service d'ophtalmologie, CHU de Pointe-à-Pitre/ Abymes, r de Chauvel, Pointe-à-Pitre, Guadeloupe, France
| | - Coralie Zorobabel
- Service d'ophtalmologie, CHU de Pointe-à-Pitre/ Abymes, r de Chauvel, Pointe-à-Pitre, Guadeloupe, France
| | - Maryse Etienne-Julan
- Unité transversale de la Drépanocytose, CHU de Pointe-à-Pitre/ Abymes, r de Chauvel, Pointe-à-Pitre, Guadeloupe, France
| | - Thierry David
- Service d'ophtalmologie, CHU de Pointe-à-Pitre/ Abymes, r de Chauvel, Pointe-à-Pitre, Guadeloupe, France.,Université des Antilles, Guadeloupe (FWI), France
| | - Philippe Connes
- UMR Inserm 1134, Biologie Intégrée du Globule Rouge, INSERM/Université Paris Diderot-Université Sorbonne Paris Cité/INTS/Université des Antilles, Guadeloupe, France. .,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France. .,Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Université Claude Bernard Lyon 1, COMUE Lyon, Villeurbanne, France. .,Institut Universitaire de France, Paris, France.
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22
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Tsikouras P, Niesigk B, von Tempelhoff GF, Rath W, Schelkunov O, Daragó P, Csorba R. Blood rheology during normal pregnancy. Clin Hemorheol Microcirc 2018; 69:101-114. [PMID: 29758932 DOI: 10.3233/ch-189104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Recent studies have shown increased RBC aggregation and no difference in plasma viscosity in the presence of markedly lower hematocrit in women at term compared to non-pregnant women. Little is known about the outcome of blood rheological parameters and red blood cell (RBC) deformability particularly in the course of normal pregnancy. METHODS During a 36 months interval 1.913 blood samples were randomly collected from a total of 945 pregnant women in the course of their pregnancy (n = 1.259) and during puerperium (upto 1 week; n = 654). Next to the blood count, hemorheological parameters including red blood cell (RBC) -aggregation (stasis E0; low shear E1), -deformability (low, moderate and high shear conditions) and plasma viscosity (pv) were assessed. Plasma viscosity (pv) was examined using KSPV 1 Fresenius, RBC aggregation (stasis: E0 and low shear: E1) using MA1-Aggregometer; Myrenne and RBC deformability (def) was determined by Rheodyn SSD Diffractometer, Myrenne, Roetgen, Germany were tested. In some of these women laboratory results prior to pregnancy (n = 145) were available which were compared with those during pregnancy. RESULTS Mean maternal pv remained unchanged within each trimester and compared to the values before pregnancy and during early puerperium (Range of means: 1.18-1.20 mPa S). In contrast, RBC agg (E0 and E1) was markedly higher in the 2nd (21.8 ± 7.0 and 28.9 ± 9.4; p < 0.001) and 3rd trimester (18.74 ± 8.4 and 28.2 ± 9.4; p < 0.01) compared to the values before pregnancy (16.4 ± 6.4 and 20 ± 7.5) and during 1st trimester (17.49 ± 6.5 and 22.4 ± 7.4). There was a stat. significant temporary reduction in RBC def. under all shear rate conditions during 2nd trimester compared to the values before pregnancy which remained significantly lower during 3rd trimester only under high shear rates.An increase RBC agg was stat. significantly inversely correlated with reduced RBC def being most pronounced under low shear rate conditions. While RBC rigidity was stat. significantly correlated with higher hematocrit values there was only a weak correlation between RBC agg and haematocrit (E0: r = -0.084; p = 0.03; E1: r = -0.06; p = 0.1). Pv was not correlated with haematocrit or RBC def but stat. significantly correlated with RBC agg. CONCLUSIONS Blood rheological changes manifest during 1st trimester, and fairly remain unchanged during 2nd trimester until term. Physiologic hemodilution and increasing hypercoagulability is accompanied by high RBC -aggregation and - rigidity during 2nd trimester while plasma viscosity remains nearly unaffected throughout normal pregnancy.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Barbara Niesigk
- Department of Obstetrics and Gynecology, City Hospital of Aschaffenburg, Aschaffenburg, Germany
| | | | - Werner Rath
- Department of Obstetrics and Gynecology, University of Schleswig-Holstein Kiel, Germany
| | - Olga Schelkunov
- Department of Obstetrics and Gynecology, Vinzenz Hospital of Hanau, Germany
| | - Peter Daragó
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Hungary
| | - Roland Csorba
- Department of Obstetrics and Gynecology, City Hospital of Aschaffenburg, Aschaffenburg, Germany.,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Hungary
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23
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Renoux C, Joly P, Gauthier A, Pialoux V, Romanet-Faes C, Bertrand Y, Garnier N, Cuzzubbo D, Cannas G, Connes P. Blood rheology in children with the S/β+-thalassemia syndrome. Clin Hemorheol Microcirc 2018; 69:207-214. [PMID: 29630544 DOI: 10.3233/ch-189119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aim of the present study was to compare blood rheological parameters between children with homozygous sickle cell disease (SS), sickle cell SC disease or S/β+-thalassemia syndrome, and healthy children (AA) and to test the associations between blood rheology and the clinical severity in S/β+-thalassemia. Sixty-two SS, 14 SC, 11 S/β+-thalassemia and 12 healthy children participated in this study. Blood viscosity was measured with a cone-plate viscometer at 225 s-1. Red blood cell (RBC) deformability was measured by ektacytometry and RBC aggregation, by syllectometry. Nitric oxide and nitrotyrosine levels were determined for each child. While most of the hematological parameters were not different between SC and S/β+-thalassemia children, we demonstrated that SC patients had lower RBC deformability and aggregation than S/β+ individuals. Nitrotyrosine level, which indicates peroxynitrite production, was similar and lower in both healthy and S/β+ compared to SS children. However, S/β+-thalassemia children who experienced vaso-occlusive crises (VOC) in the 2 previous years had lower NOx and higher nitrotyrosine levels than those who never had VOC within the same period. These findings suggest that vascular function could be impaired in the most severe S/β+-thalassemia children compared to the less severe one.
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Affiliation(s)
- Céline Renoux
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Laboratoire de biochimie des pathologies érythrocytaires, Centre de Biologie Est, Hospices Civils de Lyon, France
| | - Philippe Joly
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Laboratoire de biochimie des pathologies érythrocytaires, Centre de Biologie Est, Hospices Civils de Lyon, France
| | - Alexandra Gauthier
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut d'Hématologie et d'Oncologie Pédiatrique (IHOPe), Hospices Civils de Lyon, France
| | - Vincent Pialoux
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France (IUF), Paris, France
| | - Camille Romanet-Faes
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique (IHOPe), Hospices Civils de Lyon, France
| | - Nathalie Garnier
- Institut d'Hématologie et d'Oncologie Pédiatrique (IHOPe), Hospices Civils de Lyon, France
| | - Daniela Cuzzubbo
- Institut d'Hématologie et d'Oncologie Pédiatrique (IHOPe), Hospices Civils de Lyon, France
| | - Giovanna Cannas
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Clinique de Médecine Ambulatoire/Hématologie Hôpital Edouard Herriot, Lyon, France
| | - Philippe Connes
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France (IUF), Paris, France
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24
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Tzounakas VL, Valsami SI, Kriebardis AG, Papassideri IS, Seghatchian J, Antonelou MH. Red cell transfusion in paediatric patients with thalassaemia and sickle cell disease: Current status, challenges and perspectives. Transfus Apher Sci 2018; 57:347-357. [PMID: 29880248 DOI: 10.1016/j.transci.2018.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Notwithstanding the high safety level of the currently available blood for transfusion and the decreasing frequency of transfusion-related complications, administration of labile blood products to paediatric patients still poses unique challenges and considerations. The incidence of thalassaemia and sickle cell disease in the paediatric population may be high enough under specific racial and geographical contexts. Red cell transfusion is the cornerstone of β-thalassaemia treatment and one of the most effective ways to prevent or correct specific acute and chronic complications of sickle cell disease. However, this life-saving strategy comes with its own complications, such as additional iron overload, alloimmunization and haemolytic reactions, among others. In paediatrics, the dependency of the transfusion outcome upon disease and other recipient characteristics is more prominent compared with the adults, owing to differences in developmental maturity and physiology that render them more susceptible to common risks, exacerbate the host response to transfused cells, and modify the type or the clinical severity of the transfusion-related morbidity. The adverse branch of red cell transfusion is likely the overall effect of several factors acting synergistically to shape the clinical phenotype of this therapy, including inherent donor/blood unit variables, like antigenicity, red cell deformability and extracellular vesicles, as well as recipient variables, such as history of alloimmunization and inflammation level at time of transfusion. This review focuses on paediatric patients with β-thalassaemia and sickle cell disease as a recipient group with distinct transfusion-related characteristics, and introduces new concepts for consideration, not adequately studied and elucidated so far.
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Affiliation(s)
- Vassilis L Tzounakas
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Serena I Valsami
- Department of Blood Transfusion, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios G Kriebardis
- Department of Medical Laboratories, Technological and Educational Institute of Athens, Athens, Greece
| | - Issidora S Papassideri
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Jerard Seghatchian
- International Consultancy in Blood Component Quality/Safety Improvement, Audit/Inspection and DDR Strategy, London, UK.
| | - Marianna H Antonelou
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece.
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25
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Chang AK, Ginter Summarell CC, Birdie PT, Sheehan VA. Genetic modifiers of severity in sickle cell disease. Clin Hemorheol Microcirc 2018; 68:147-164. [PMID: 29614629 DOI: 10.3233/ch-189004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Sickle cell disease (SCD) is one of the most common single disease disorders world-wide. It is remarkable for its clinical heterogeneity, even among individuals with identical genotypes. Some individuals experience morbidity and mortality in early childhood, while others have a relatively mild course, and normal or near normal life expectancy. Many clinical complications are associated with SCD; most notably frequent pain episodes, stroke, acute chest syndrome, avascular necrosis, nephropathy, retinopathy and pulmonary hypertension. While the effects of higher fetal hemoglobin (HbF) levels, UGTA1A polymorphisms, alpha-thalassemia and G6PD deficiency on SCD has been extensively studied, these variables do not explain all of the clinical heterogeneity of SCD. It is not known why some patients develop certain complications, and it is difficult to predict which complications a particular patient will experience. Much work has been done to identify genetic variants associated with these disease complications; many associations remain unvalidated. As the field continues to move beyond small sample collections and candidate gene approaches into whole genome sequencing and merging of samples from all over the world, we will identify more genetic variants associated with development of specific SCD related complications, and hopefully leverage this knowledge into targeted therapies.
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Affiliation(s)
- Alicia K Chang
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Carly C Ginter Summarell
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Parendi T Birdie
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Vivien A Sheehan
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
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26
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Connes P, Renoux C, Romana M, Abkarian M, Joly P, Martin C, Hardy-Dessources MD, Ballas SK. Blood rheological abnormalities in sickle cell anemia. Clin Hemorheol Microcirc 2018; 68:165-172. [PMID: 29614630 DOI: 10.3233/ch-189005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This review focuses on the contribution of abnormal blood rheology in the pathophysiology of sickle cell anemia (SCA). SCA is characterized by a reduction of red blood cell (RBC) deformability but this reduction is very heterogeneous among patients. Recent works have shown that patients with the lowest RBC deformability (measured by ektacytometry) have enhanced hemolysis and would be more prone to develop several complications such as priapism, leg ulcers and glomerulopathy. In contrast, patients with the highest deformability, and not under hydroxyurea therapy, seem to develop more frequently vaso-occlusive like events. Although less studied, RBC aggregation properties are very different between SCA and healthy individuals and it was demonstrated that increased RBC aggregates strength could be involved in some complications. Finally, several studies have established that the vascular system of SCA patients could not fully compensate any increase in blood viscosity because of the loss of vascular reactivity, which may result in vaso-occlusive crises.
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Affiliation(s)
- Philippe Connes
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Institut Universitaire de France, Paris, France
| | - Céline Renoux
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Laboratoire de biochimie des pathologies érythrocytaires, Centre de Biologie Est, Hospices Civils de Lyon, France
| | - Marc Romana
- Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-à-Pitre, 97157 Pointe-à-Pitre, Guadeloupe
| | - Manouk Abkarian
- CNRS UMR 5048, Université de Montpellier, Centre de Biochimie Structurale, 34090 Montpellier, France
| | - Philippe Joly
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Laboratoire de biochimie des pathologies érythrocytaires, Centre de Biologie Est, Hospices Civils de Lyon, France
| | - Cyril Martin
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France
| | - Marie-Dominique Hardy-Dessources
- Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-à-Pitre, 97157 Pointe-à-Pitre, Guadeloupe
| | - Samir K Ballas
- Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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27
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Renoux C, Joly P, Faes C, Mury P, Eglenen B, Turkay M, Yavas G, Yalcin O, Bertrand Y, Garnier N, Cuzzubbo D, Gauthier A, Romana M, Möckesch B, Cannas G, Antoine-Jonville S, Pialoux V, Connes P. Association between Oxidative Stress, Genetic Factors, and Clinical Severity in Children with Sickle Cell Anemia. J Pediatr 2018; 195:228-235. [PMID: 29449005 DOI: 10.1016/j.jpeds.2017.12.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/13/2017] [Accepted: 12/08/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To investigate the associations between several sickle cell disease genetic modifiers (beta-globin haplotypes, alpha-thalassemia, and glucose-6-phosphate dehydrogenase deficiency) and the level of oxidative stress and to evaluate the association between oxidative stress and the rates of vaso-occlusive events. STUDY DESIGN Steady-state oxidative and nitrosative stress markers, biological variables, genetic modulators, and vaso-occlusive crisis events requiring emergency admissions were measured during a 2-year period in 62 children with sickle cell anemia (58 SS and 4 Sβ0). Twelve ethnic-matched children without sickle cell anemia also participated as healthy controls (AA) for oxidative and nitrosative stress level measurement. RESULTS Oxidative and nitrosative stress were greater in patients with sickle cell anemia compared with control patients, but the rate of vaso-occlusive crisis events in sickle cell anemia was not associated with the level of oxidative stress. The presence of alpha-thalassemia, but not glucose-6-phosphate dehydrogenase deficiency or beta-globin haplotype, modulated the level of oxidative stress in children with sickle cell anemia. CONCLUSION Mild hemolysis in children with alpha-thalassemia may limit oxidative stress and could explain the protective role of alpha-thalassemia in hemolysis-related sickle cell complications.
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Affiliation(s)
- Céline Renoux
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Department of Biochemistry on Red Blood Cell Disease, Biologie Est Center, Hospices Civils de Lyon, Lyon, France
| | - Philippe Joly
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Department of Biochemistry on Red Blood Cell Disease, Biologie Est Center, Hospices Civils de Lyon, Lyon, France
| | - Camille Faes
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Pauline Mury
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Buse Eglenen
- School of Medicine, Koç University, Istanbul, Turkey
| | - Mine Turkay
- School of Medicine, Koç University, Istanbul, Turkey
| | - Gokce Yavas
- School of Medicine, Koç University, Istanbul, Turkey
| | - Ozlem Yalcin
- School of Medicine, Koç University, Istanbul, Turkey
| | - Yves Bertrand
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Nathalie Garnier
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Daniela Cuzzubbo
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Alexandra Gauthier
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Marc Romana
- Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; UMR Inserm 1134, Ricou Hospital, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe
| | - Berenike Möckesch
- Laboratory ACTES EA3596, University of French West Indies, Pointe-à-Pitre, Guadeloupe
| | - Giovanna Cannas
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Internal Medicine, Hématology, Edouard Herriot Hospital, Lyon, France
| | | | - Vincent Pialoux
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; French University Institute (IUF), Paris, France
| | - Philippe Connes
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; French University Institute (IUF), Paris, France.
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28
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Lemonne N, Möckesch B, Charlot K, Garnier Y, Waltz X, Lamarre Y, Antoine-Jonville S, Etienne-Julan M, Hardy-Dessources MD, Romana M, Connes P. Effects of hydroxyurea on blood rheology in sickle cell anemia: A two-years follow-up study. Clin Hemorheol Microcirc 2018; 67:141-148. [PMID: 28759962 DOI: 10.3233/ch-170280] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The aim of the present study was to test the effects of hydroxyurea (HU) therapy on clinical, hematological and hemorheological parameters in adult patients with sickle cell anemia (SCA). Hematological and hemorheological parameters were measured in 28 SCA patients before HU therapy (i.e., baseline) and at 6, 12 and 24 months of treatment. RBC deformability was determined by ektacytometry at 30 Pa. RBC aggregation properties were investigated by light-backscatter method. Blood viscosity was measured at 225 s-1 by a cone-plate viscometer. The rates of vaso-occlusive crises and acute chest syndrome were lower at 1 and 2 years of HU therapy compared to baseline. The proportion of patients with leg ulcers tended to decrease after 2 years of treatment. Hemoglobin oxygen saturation improved with HU therapy. HU therapy induced a decrease of platelet and white blood cell counts and a rise in fetal hemoglobin level and mean cell volume. While hemoglobin concentrations increased under HU, blood viscosity remained unchanged all along the study. RBC deformability increased over baseline values at 6 months of HU therapy and continued to rise until the end of the follow-up period. In conclusion, the improvement in RBC deformability probably compensates the increase of hemoglobin on blood viscosity and participates to the improvement of the clinical status of patients.
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Affiliation(s)
- Nathalie Lemonne
- Unité Transversale de la Drépanocytose, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France
| | - Berenike Möckesch
- Laboratoire ACTES, EA3596, Université des Antilles, Pointe-á-Pitre, Guadeloupe, France
| | - Keyne Charlot
- Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France.,Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Yohann Garnier
- Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France
| | - Xavier Waltz
- Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France
| | - Yann Lamarre
- Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France
| | | | - Maryse Etienne-Julan
- Unité Transversale de la Drépanocytose, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France
| | - Marie-Dominique Hardy-Dessources
- Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France
| | - Marc Romana
- Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France
| | - Philippe Connes
- Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-á-Pitre, Guadeloupe, France.,Laboratoire d'Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, Paris, France.,Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Université Claude Bernard Lyon 1, COMUE Lyon, Villeurbanne, France.,Institut Universitaire de France, Paris, France
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29
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Renoux C, Connes P, Nader E, Skinner S, Faes C, Petras M, Bertrand Y, Garnier N, Cuzzubbo D, Divialle-Doumdo L, Kebaïli K, Renard C, Gauthier A, Etienne-Julan M, Cannas G, Martin C, Hardy-Dessources MD, Pialoux V, Romana M, Joly P. Alpha-thalassaemia promotes frequent vaso-occlusive crises in children with sickle cell anaemia through haemorheological changes. Pediatr Blood Cancer 2017; 64. [PMID: 28097791 DOI: 10.1002/pbc.26455] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/15/2016] [Accepted: 12/21/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sickle cell anaemia (SCA) is a severe hereditary haemoglobinopathy characterised by haemorheological abnormalities, which play a role in the occurrence of several acute and chronic clinical complications. While βS -haplotypes and alpha-thalassaemia modulate SCA clinical severity, their effects on blood rheology have been incompletely described. The aim of this study was to test the effects of these genetic modifiers on the haemorheological properties and clinical complication of children with SCA. PROCEDURE Steady-state haemorheological profile, biological parameters, βS -haplotypes, alpha-globin status, vaso-occlusive crisis (VOC) and acute chest syndrome frequencies were analysed in 128 children (aged 5 to 18 years) with SCA. RESULTS Patients with alpha-thalassaemia showed increased red blood cell (RBC) deformability and aggregation compared to those without. Median VOC rate was higher in patients with homozygous alpha-thalassaemia compared to those with a normal alpha genotype. Conversely, the haemorheological profile and clinical complications were not influenced by the βS -haplotypes in our study. CONCLUSION Our results demonstrate that alpha-thalassaemia is associated with higher risk for VOC events in children with SCA, which may be due in part to its effects on RBC deformability and aggregation.
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Affiliation(s)
- Céline Renoux
- 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 sur le globule rouge (Labex GR-Ex), Paris, France.,UF Pathologie moléculaire du globule rouge, Hôpital Edouard Herriot, 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, COMUE, Lyon, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,Institut Universitaire de France, Paris, 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 sur le globule rouge (Labex GR-Ex), Paris, France
| | - Sarah Skinner
- 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 sur le globule rouge (Labex GR-Ex), Paris, France
| | - Camille Faes
- 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 sur le globule rouge (Labex GR-Ex), Paris, France
| | - Marie Petras
- Unité Transversale de la Drépanocytose, Centre Hospitalier Universitaire, Pointe-à-Pitre, Guadeloupe, France
| | - Yves Bertrand
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Nathalie Garnier
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Daniela Cuzzubbo
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Lydia Divialle-Doumdo
- Unité Transversale de la Drépanocytose, Centre Hospitalier Universitaire, Pointe-à-Pitre, Guadeloupe, France
| | - Kamila Kebaïli
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Cécile Renard
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), 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, COMUE, Lyon, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,Institut d'hématologie et d'oncologie pédiatrique (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Maryse Etienne-Julan
- Unité Transversale de la Drépanocytose, Centre Hospitalier Universitaire, Pointe-à-Pitre, Guadeloupe, France
| | - Giovanna Cannas
- 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 sur le globule rouge (Labex GR-Ex), Paris, France.,Clinique de Médecine Ambulatoire/Hématologie Hôpital Edouard Herriot, Lyon, France
| | - Cyril Martin
- 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 sur le globule rouge (Labex GR-Ex), Paris, France
| | - Marie-Dominique Hardy-Dessources
- Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,UMR Inserm 1134, Hôpital Ricou, Centre Hospitalier Universitaire, Pointe-à-Pitre, Guadeloupe, France
| | - Vincent Pialoux
- 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 sur le globule rouge (Labex GR-Ex), Paris, France.,Institut Universitaire de France, Paris, France
| | - Marc Romana
- Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,UMR Inserm 1134, Hôpital Ricou, Centre Hospitalier Universitaire, Pointe-à-Pitre, Guadeloupe, France
| | - Philippe Joly
- 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 sur le globule rouge (Labex GR-Ex), Paris, France.,UF Pathologie moléculaire du globule rouge, Hôpital Edouard Herriot, Lyon, France
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Naessens V, Ward R, Kuo KHM. A proposed treatment algorithm for adults with Haemoglobin SC disease. Br J Haematol 2017; 182:607-609. [PMID: 28699645 DOI: 10.1111/bjh.14852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Veronique Naessens
- Division of Haematology, McGill University Health Centre, Montreal, QC, Canada
| | - Richard Ward
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kevin H M Kuo
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Möckesch B, Charlot K, Jumet S, Romana M, Divialle-Doumdo L, Hardy-Dessources MD, Petras M, Tressieres B, Tarer V, Hue O, Etienne-Julan M, Connes P, Antoine-Jonville S. Micro- and macrovascular function in children with sickle cell anaemia and sickle cell haemoglobin C disease. Blood Cells Mol Dis 2017; 64:23-29. [DOI: 10.1016/j.bcmd.2017.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/02/2017] [Accepted: 02/03/2017] [Indexed: 01/25/2023]
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Charlot K, Antoine-Jonville S, Moeckesch B, Jumet S, Romana M, Waltz X, Divialle-Doumdo L, Hardy-Dessources MD, Petras M, Tressières B, Tarer V, Hue O, Etienne-Julan M, Connes P. Cerebral and muscle microvascular oxygenation in children with sickle cell disease: Influence of hematology, hemorheology and vasomotion. Blood Cells Mol Dis 2017; 65:23-28. [PMID: 28411485 DOI: 10.1016/j.bcmd.2017.03.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/03/2017] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
Abstract
The present study investigated cerebral and muscle hemoglobin oxygen saturation (tissue oxygen index, TOI) in children with sickle cell anemia (SS), sickle cell hemoglobin C disease (SC) and healthy children (AA). TOI was measured by near-infrared spectroscopy (NIRS) and spectral analysis of the TOI variability was used to assess flowmotion and vasomotion. Arterial oxyhemoglobin saturation (SpO2), hemorheological and hematological parameters were also measured in SS and SC children. Both TOI were lower in SS compared to both AA and SC children, with SC exhibiting lower values than AA children. Cerebral vasomotion expressed in absolute values was enhanced in SS compared to AA and SC children. Muscle vasomotion did not differ between the three groups. Hematocrit, SpO2 and red blood cell deformability were positively associated with cerebral TOI in SS children. We demonstrated that 1) cerebral and muscle TOI were markedly decreased in SS children while the decrease of TOI was milder in SC children, 2) cerebral TOI level was associated with several biological markers in SS children only and 3) cerebral vasomotion was enhanced in SS, possibly to counterbalance the effects of chronic cerebral hypoxia.
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Affiliation(s)
- Keyne Charlot
- Université des Antilles, Inserm, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence du Globule Rouge GR-Ex, Paris, France; Université des Antilles, Laboratoire ACTES (EA 3596), Pointe-à-Pitre, Guadeloupe; Département Institut de Recherche Biomédicale des Armées, Environnements Opérationnels, Brétigny-sur-Orge, France
| | | | - Berenike Moeckesch
- Université des Antilles, Inserm, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence du Globule Rouge GR-Ex, Paris, France; Université des Antilles, Laboratoire ACTES (EA 3596), Pointe-à-Pitre, Guadeloupe.
| | - Stéphane Jumet
- Université des Antilles, Laboratoire ACTES (EA 3596), Pointe-à-Pitre, Guadeloupe
| | - Marc Romana
- Université des Antilles, Inserm, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence du Globule Rouge GR-Ex, Paris, France.
| | - Xavier Waltz
- Université des Antilles, Inserm, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence du Globule Rouge GR-Ex, Paris, France; Université des Antilles, Laboratoire ACTES (EA 3596), Pointe-à-Pitre, Guadeloupe.
| | - Lydia Divialle-Doumdo
- CHU de Pointe-à-Pitre, Unité transversale de la Drépanocytose, Pointe-à-Pitre, Guadeloupe.
| | - Marie-Dominique Hardy-Dessources
- Université des Antilles, Inserm, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence du Globule Rouge GR-Ex, Paris, France.
| | - Marie Petras
- CHU de Pointe-à-Pitre, Unité transversale de la Drépanocytose, Pointe-à-Pitre, Guadeloupe.
| | - Benoît Tressières
- Centre Investigation Clinique Antilles Guyane, Inserm/DGOS CIC 1424, Pointe-à-Pitre, Guadeloupe
| | - Vanessa Tarer
- CHU de Pointe-à-Pitre, Unité transversale de la Drépanocytose, Pointe-à-Pitre, Guadeloupe.
| | - Olivier Hue
- Université des Antilles, Laboratoire ACTES (EA 3596), Pointe-à-Pitre, Guadeloupe.
| | - Maryse Etienne-Julan
- CHU de Pointe-à-Pitre, Unité transversale de la Drépanocytose, Pointe-à-Pitre, Guadeloupe.
| | - Philippe Connes
- Université des Antilles, Inserm, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence du Globule Rouge GR-Ex, Paris, France; Institut Universitaire de France (IUF), Paris, France; Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Villeurbanne, France.
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