Microparticle profile during painful crisis and steady state in children with sickle cell anemia

Year 2024, Volume: 49 Issue: 3, 592 - 599, 30.09.2024

Anıl Atmış , Hatice İlgen Şaşmaz , İlknur Kozanoğlu , Bahriye Atmış , Barbaros Karagün , İbrahım Boğa , Bülent Antmen , Yurdanur Kılınç

https://doi.org/10.17826/cumj.1451532

Abstract

Purpose: Sickle cell anemia is a disease characterized by hemolytic anemia, hypercoagulopathy, and painful crises. Microparticles are 0.1-1 µm sized membrane particles derived during cellular activation or apoptotic phases of the cell cycle. In this study, we investigated the role of microparticles on clinical state and prognosis during painful crisis and steady state in children with sickle cell anemia.
Materials and Methods: Patients with sickle cell anemia who were followed up in Çukurova University Pediatric Hematology Department and presented with a painful crisis were included in the study. Children without any systemic disease were included in the control group. Total microparticle levels, erythrocyte (CD235a), endothelial (CD106), and monocyte (CD14) microparticle levels, and tissue factor expressing (CD142) microparticle levels were analyzed.
Results: A total of 29 patients with sickle cell anemia who presented with a painful crisis were included in the study. In addition, blood samples were collected from 26 of these patients in a steady state. Blood samples were obtained from 18 healthy children as the control group. Total microparticle levels were significantly higher in sickle cell anemia patients in painful crises than in control group. Erythrocyte and monocyte microparticle levels were significantly higher in patients with a painful crisis than in a steady state. Endothelial and tissue factor expressing microparticle levels were higher during a painful crisis than steady state, although not at statistically significant levels. Microparticle levels were lower in patients with hydroxyurea treatment than those without, although it was not a statistically significant difference.
Conclusion: Total microparticles as well as erythrocyte and monocyte microparticles were high in sickle cell anemia patients during a painful crisis. Studies involving larger numbers of patients are needed to better understand the role of microparticles in the pathophysiology of sickle cell anemia and their association with painful crises.

Keywords

child, microparticle, sickle cell anemia

Orak hücreli anemili çocuklarda ağrılı kriz ve kriz dışı dönemde mikropartikül profili

Abstract

Amaç: Orak hücreli anemi, hemolitik anemi, hiperkoagülopati ve ağrılı krizlerle karakterize bir hastalıktır. Mikropartiküller, hücre döngüsünün hücresel aktivasyonu veya apoptotik fazları sırasında hücrelerden dökülen 0.1-1 µm boyutlarında membran parçacıklarıdır. Bu çalışmada, orak hücreli anemisi olan çocuklarda kriz ve kriz dışı durumda mikropartiküllerin klinik durum ve prognoz üzerindeki rolünü araştırdık.
Gereç ve Yöntem: Çukurova Üniversitesi Pediatrik Hematoloji Bölümünde takipli ve ağrılı kriz ile başvuran orak hücreli anemi tanılı hastalar çalışmaya dahil edildi. Herhangi bir sistemik hastalığı olmayan çocuklar kontrol grubuna dahil edildi. Hastaların ve kontrol grubunun total mikropartikül düzeyleri, eritrosit (CD235a), endotel (CD106), monosit (CD14) mikropartikül düzeyleri ve doku faktörü eksprese eden (CD142) mikropartikül düzeyleri analiz edildi.
Bulgular: Orak hücreli anemi tanısı olan ve ağrılı kriz ile başvuran toplam 29 hasta çalışmaya dahil edildi. Ayrıca bu hastaların 26'sının ağrılı kriz dışı durumda kan örnekleri alındı. Kontrol grubu olan 18 sağlıklı çocuktan kan örnekleri alındı. Total mikropartikül düzeyleri ağrılı krizdeki orak hücreli anemi hastalarında kontrol grubuna göre anlamlı olarak yüksek bulundu. Eritrosit ve monosit mikropartikül düzeyleri ağrılı krizde kriz dışı döneme göre anlamlı olarak yüksekti. Endotelyal ve doku faktörü eksprese eden mikropartikül seviyeleri, istatistiksel olarak anlamlı olmasa da ağrılı krizde kriz dışı döneme göre daha yüksekti. Mikropartikül seviyeleri hidroksiüre tedavisi alan hastalarda almayanlara göre daha düşüktü, ancak istatistiksel olarak anlamlı bulunmadı.
Sonuç: Orak hücreli anemi hastalarında ağrılı kriz sırasında total mikropartiküller, eritrosit ve monosit mikropartikülleri yüksek bulunmuştur. Mikropartiküllerin orak hücreli aneminin patofizyolojisindeki rolünü ve ağrılı krizlerle ilişkisini daha iyi anlamak için daha fazla sayıda hastayı içeren çalışmalara ihtiyaç vardır

Keywords

çocuk, mikropartikül, orak hücreli anemi

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