Effects of poloxamer 188 treatment on sickle cell vaso-occlusive crisis: computer-assisted intravital microscopy study.
Nine patients with sickle cell disease (SCD) who were hospitalized at UC Davis Medical Center for vaso-occlusive crisis (VOC) were studied as part of a randomized double-blind phase III clinical trial to investigate the real-time effects of poloxamer 188 on VOC. All patients showed significant microvascular changes from normal (steady-state) values during VOC (diminished venular diameter and red cell velocity). The patients were randomly assigned to be treated with poloxamer 188 or placebo. Poloxamer 188 (n = 4) but not placebo (n = 5) significantly reversed these microvascular changes approximately 2 hours postinitiation of loading infusion (100 mg/kg in 1 hour). Further significant improvement induced by poloxamer 188 but not placebo was observed > or = 7 hours postinfusion, resulting in a significant reversal of the microvascular changes to steady-state values.
Cheung
Anthony T W
AT
Departmentsof Pathology and Laboratory Medicine, UC Davis School of Medicine, Davis, CA, USA. atcheung@ucdavis.edu
Chan
Matthew S
MS
Ramanujam
Sahana
S
Rangaswami
Arun
A
Curl
Kris
K
Franklin
Patricia
P
Wun
Ted
T
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D000986:Antisickling Agents / Q000627:therapeutic use*; D002648:Child; D003228:Conjunctiva / Q000098:blood supply / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D010147:Pain Measurement; D020442:Poloxamer / Q000627:therapeutic use*; D013501:Surface-Active Agents / Q000627:therapeutic use*; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
D000986:Antisickling Agents; D013501:Surface-Active Agents; D020442:Poloxamer