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Reducing Adhesion Molecule Expression In Leukocytes May Improve Sickle Cell Symptoms
A DGReview of :"Relationship between the clinical manifestations of sickle cell disease and the expression of adhesion molecules on white blood cells."
European Journal of Haematology
11/27/2002
By James Adams
Leukocytes of sickle cell disease patients express greater amounts of adhesion molecules compared with healthy controls.
Therapy that reduces adhesion molecule expression in leukocytes may have clinical benefits for these patients, according to investigators.
Severity of sickle cell disease is known to increase with leukocyte count, the investigators explain. Adherence of leukocytes to vascular epithelium is mediated by adhesion molecules and could lead to vaso-occlusion.
The investigators, from St. Thomas's Hospital and Hammersmith Hospital in London, England, used flow cytometry to study leukocyte adhesion molecule expression in 100 patients homozygous for sickle cell haemoglobin and 34 controls homozygous for haemoglobin A.
Results showed that those patients with complications of sickle cell disease had high alphaMbeta integrin expression by neutrophils and high 1-selectin expression by neutrophils and lymphocytes.
Patients with sickle nephropathy had high expression of CD18 in neutrophils and patients with stroke had high expression of 1-selectin in lymphocytes.
Expression of 1-selectin in monocytes was increased from steady state levels in patients experiencing sickle cell crisis.
Hydroxyurea therapy reduced expression of integrin in neutrophils, monocytes and lymphocytes within one month. This coincided with symptomatic improvement in the patients.
Corresponding increases in hemoglobin F were no more than 3.3 per cent, suggesting that the improvement in symptoms is independent of increased haemoglobin F and may be related to decreased adhesion molecule expression, according to the investigators.
They suggest that other treatments that reduce leukocyte adhesion molecule expression may also provide clinical benefits for sickle cell patients.
Eur J Haematol 2002; 69(3): 135-144.
"Relationship between the clinical manifestations of sickle cell disease and the expression of adhesion molecules on white blood cells."
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