title: Increased levels of the inflammatory biomarker C-reactive protein at baseline are associated with childhood sickle cell vasocclusive crises.
abstract: Several lines of evidence suggest that sickle cell disease (SCD) is associated with a chronic inflammatory state. In this study of 70 children with SCD at steady state evaluated by a broad panel of biomarkers representing previously examined mechanisms of pathogenicity in SCD, high sensitivity C-reactive protein (hs-CRP), a marker of low-grade, systemic inflammation, emerged as the most significant laboratory correlate of hospitalizations for pain or vaso-occlusive (VOC) events. While markers of increased haemolytic status, endothelial activation and coagulation activation all correlated positively with VOC events by univariate analysis, baseline hs-CRP levels provided the most significant contribution to the association in multiple regression models (22%), and, hs-CRP, along with age, provided the best fit in negative binomial models. These data highlight the clinical relevance of the role of inflammation in paediatric VOC, providing both a rationale for future therapeutic strategies targeting inflammation in microvessel occlusive complications of SCD, and the potential clinical use of hs-CRP as a biomarker in childhood SCD.
authors.affiliation: Marian Anderson Comprehensive Sickle Cell Anemia Care and Research Center, Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA 19107, USA. suba.krishnan@jefferson.edu <suba.krishnan@jefferson.edu>
authors.forename: Suba
authors.initials: S
authors.lastname: Krishnan
authors.forename: Yamaja
authors.initials: Y
authors.lastname: Setty
authors.forename: Suhita G
authors.initials: SG
authors.lastname: Betal
authors.forename: Vaidyula
authors.initials: V
authors.lastname: Vijender
authors.forename: Koneti
authors.initials: K
authors.lastname: Rao
authors.forename: Carlton
authors.initials: C
authors.lastname: Dampier
authors.forename: Marie
authors.initials: M
authors.lastname: Stuart
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood* / Q000150:complications; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D014652:Vascular Diseases / Q000209:etiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein