Increased levels of the inflammatory biomarker C‐reactive protein at baseline are associated with childhood sickle cell vasocclusive crises |
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Authors: | Suba Krishnan Yamaja Setty Suhita G. Betal Vaidyula Vijender Koneti Rao Carlton Dampier Marie Stuart |
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Affiliation: | 1. Marian Anderson Comprehensive Sickle Cell Anemia Care and Research Center, Department of Pediatrics, Division of Research Hematology, Jefferson Medical College, Thomas Jefferson University;2. Thrombosis Research Center, Temple University School of Medicine, Philadelphia, PA;3. Office of Clinical Research, Emory University School of Medicine, Atlanta, GA, USA |
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Abstract: | Several lines of evidence suggest that sickle cell disease (SCD) is associated with a chronic inflammatory state. In this study of 70 children with SCD at steady state evaluated by a broad panel of biomarkers representing previously examined mechanisms of pathogenicity in SCD, high sensitivity C‐reactive protein (hs‐CRP), a marker of low‐grade, systemic inflammation, emerged as the most significant laboratory correlate of hospitalizations for pain or vaso‐occlusive (VOC) events. While markers of increased haemolytic status, endothelial activation and coagulation activation all correlated positively with VOC events by univariate analysis, baseline hs‐CRP levels provided the most significant contribution to the association in multiple regression models (22%), and, hs‐CRP, along with age, provided the best fit in negative binomial models. These data highlight the clinical relevance of the role of inflammation in paediatric VOC, providing both a rationale for future therapeutic strategies targeting inflammation in microvessel occlusive complications of SCD, and the potential clinical use of hs‐CRP as a biomarker in childhood SCD. |
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Keywords: | sickle cell disease inflammation paediatric haematology vascular biology |
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