title: Anti-annexin V IgG and IgM antibodies in sickle cell disease patients with vaso-occlusive crisis.
abstract: Vaso-occlusive crisis (VOC) is a significant cause of morbidity and mortality in sickle cell anemia (SCA) patients; however, its mechanisms are poorly understood. In view of their prothrombotic nature, we hypothesized that SCA-associated VOC may be due to the presence of anti-annexin V antibodies. Anti-annexin V antibodies were measured with ELISA in 177 VOC and 81 steady-state SCA patients. Anti-annexin V IgM and IgG concentrations were significantly higher in VOC patients than in steady-state patients and were associated with elevated VOC risk. After categorizing anti-annexin V antibodies, the adjusted odds ratio increased as the percentile value increased. Monovariate logistic regression analysis demonstrated a positive dose-effect relationship for anti-annexin V IgM with VOC, with increased VOC risk seen with increased antibody titers. Multivariate logistic regression analyses confirmed the association of anti-annexin V IgM, more so than IgG, as an independent VOC risk factor. Anti-annexin V IgG antibodies correlated positively with VOC type and negatively with HbF and age of VOC onset, while anti-annexin V IgM correlated positively with VOC type, duration, frequency, site, pain severity, hospitalization, and medication, and negatively with age of VOC onset and HbS levels. High levels of anti-annexin V IgM antibodies constitute a risk factor for VOC in SCA patients.
authors.affiliation: Department of Medical Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
authors.forename: Mai S
authors.initials: MS
authors.lastname: Sater
authors.forename: Najat
authors.initials: N
authors.lastname: Mahdi
authors.forename: Iman K
authors.initials: IK
authors.lastname: Al-Absi
authors.forename: Abeer M
authors.initials: AM
authors.lastname: Al-Subaie
authors.forename: Khadija
authors.initials: K
authors.lastname: Al-Ola
authors.forename: Fatema A
authors.initials: FA
authors.lastname: Mohammed
authors.forename: Wassim Y
authors.initials: WY
authors.lastname: Almawi
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D017304:Annexin A5 / Q000276:immunology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000302:isolation & purification; D007075:Immunoglobulin M / Q000097:blood* / Q000302:isolation & purification; D008297:Male; D016036:Seroepidemiologic Studies; D013927:Thrombosis / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000276:immunology*
chemical_list: D017304:Annexin A5; D007074:Immunoglobulin G; D007075:Immunoglobulin M