No effect of acenocoumarol therapy on levels of endothelial activation markers in sickle cell disease.
Sickle cell patients are characterized by a chronic inflammatory and hypercoagulable state, depicted by elevated levels of pro-inflammatory cytokines, endothelial adhesion molecules, and elevated markers of thrombin generation. We set out to determine whether anticoagulation with a coumadin derivative reduces inflammation in sickle cell disease. Therefore, serum levels of NFkappaB-regulated endothelial adhesion molecule soluble vascular cell adhesion molecule-1 and serum levels of non-NFkappaB-dependent markers of endothelial activation (soluble cellular fibronectin and von Willebrand factor antigen) were compared during treatment with acenocoumarol (INR 1.6-2.0) and placebo. No effect on circulating levels of the measured parameters was observed during treatment with acenocoumarol as compared to placebo. In the targeted INR range, anticoagulation of sickle cell patients with acenocoumarol does not seem to reduce endothelial activation.
Schnog
J B
JB
Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. jschnog@hotmail.com
Mac Gillavry
M R
MR
Rojer
R A
RA
Meijers
J C M
JC
Fijnheer
R
R
ten Cate
H
H
Brandjes
D P M
DP
Duits
A J
AJ
D000074:Acenocoumarol / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000188:drug therapy*; D000925:Anticoagulants / Q000494:pharmacology* / Q000627:therapeutic use; D015415:Biomarkers; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D005353:Fibronectins / Q000097:blood*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism; D010446:Peptide Fragments / Q000032:analysis; D011516:Prothrombin / Q000032:analysis; D012995:Solubility; D019851:Thrombophilia / Q000209:etiology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*; D014841:von Willebrand Factor / Q000032:analysis*
D000925:Anticoagulants; D015415:Biomarkers; D005353:Fibronectins; D016328:NF-kappa B; D010446:Peptide Fragments; D019010:Vascular Cell Adhesion Molecule-1; C045879:prothrombin fragment 1.2; D014841:von Willebrand Factor; D011516:Prothrombin; D000074:Acenocoumarol