title: Urinary markers of bone resorption, pyridinoline and deoxypyridinoline, are increased in sickle cell patients with further increments during painful crisis.
abstract: The painful crisis is the hallmark of sickle-cell disease (SCD). Bone resorption, as part of physiological bone turnover, results in release into the circulation with subsequent urinary excretion of the collagen cross-links pyridinoline (PYD) and deoxypyridinoline (DPD). Urinary PYD and DPD concentrations could reflect the extent of bone infarction during painful sickle-cell crisis. Urinary concentrations of PYD and DPD, adjusted for urine creatinine, were measured in sickle-cell patients (38 clinically asymptomatics and 27 during painful crisis) and healthy controls (n 5 25) using high-performance liquid chromatography(HPLC). PYD and DPD concentrations were higher in asymptomatic HbSS/HbSb0-thalassemia patients compared to controls (P <0.05) with further increments during painful crisis in both HbSS/HbSb0-thalassemia and HbSC/HbSb1-thalassemia patients (P < 0.05). In the asymptomatic HbSS/HbSb0-thalassemia patients, there was a statistically significant positive correlation between DPD and hemolytic rate.Based on urinary PYD and DPD concentrations, bone degradation is increased in asymptomatic sickle-cell patients, with further increments during painful crisis. Urinary PYD and DPD concentrations are potentially diagnostic and prognostic tools in SCD.
authors.affiliation: Department of Internal Medicine, Slotervaart Hospital, Louwesweg 6, Amsterdam, The Netherlands. e.nur@amc.uva.nl
authors.forename: Erfan
authors.initials: E
authors.lastname: Nur
authors.forename: Willem
authors.initials: W
authors.lastname: Mairuhu
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Biemond
authors.forename: Anton P
authors.initials: AP
authors.lastname: van Zanten
authors.forename: John-John B
authors.initials: JJ
authors.lastname: Schnog
authors.forename: Dees P
authors.initials: DP
authors.lastname: Brandjes
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Otten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000652:urine*; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000175:diagnosis / Q000652:urine; D015415:Biomarkers / Q000652:urine; D001862:Bone Resorption / Q000209:etiology / Q000652:urine*; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D006461:Hemolysis; D006801:Humans; D008875:Middle Aged; D010146:Pain; D055815:Young Adult
chemical_list: D000596:Amino Acids; D015415:Biomarkers; C015484:pyridinoline; C036020:deoxypyridinoline