Singhal, Atul; Doherty, Justin F.; Raynes, John G.; McAdam, Keith P. W. J.; Thomas, Peter W.; Serjeant, Beryl E.; Serjeant, Graham R.
Author Affiliation, Ana.
Medical Research Council Laboratories (Sickle Cell)
Is there an acute-phase response in steady-state sickle cell disease?
Date of Publication
Determines whether metabolic and serum changes during steady-state homozygous sicle cell (SS) disease are consistent with an acute-phase response and if this raises the possibility that inflammation occurs in SS disease even during the steady state. Measured concentrations of acute phase reactants in patients with SS disease, in patients with sickle cell haemoglobin C (SC) disease, and in normal (AA) control subjects. The concentrations of C-reactive protein and serum amyloid A were increased above 10 mg/L and 5mg/L, respectively (our definition of an acute-phase response) in 18 percent (26/143) of subjects with SS disease even when they were symptom free, in 17 percent (6/35) of subjects with SC disease, and in 1 percent (1/80) of AA controls (p0.001). Suggests that subclinical vaso-occlusion may generate a covert inflammatory response and that the cytokine mediators of this response may contribute to the metabolic abnormalities and growth failure in sickle cell disease.....