title: Adhesion molecules and high-sensitivity C-reactive protein levels in patients with sickle cell beta-thalassaemia.
abstract: OBJECTIVE
  The primary symptoms of sickle cell disease (SCD) arise from vaso-occlusive crises. The pathogenesis of these crises is complex phenomenon where endothelial activation and damage has a major role. Chronic inflammation also plays an important role in the pathophysiology of SCD. We aimed to investigate endothelial activation in Caucasian Greek patients with SCD by means of measuring adhesion molecules and markers of inflammation.
  
  
  METHODS
  Twenty-eight patients with SCD aged 5-63 years were included in the study. Most of the patients (23/28) were double heterozygotes for sickle cell/beta-thalassaemia, while five patients (5/28) were sickle cell homozygotes. Patients were treated with one/or more of hydroxyurea, therapeutic phlebotomies, blood transfusion or splenectomy. Twenty apparently healthy individuals matched for age and sex formed the control group. Measurements of soluble intercellular adhesion molecule-1, (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), P-selectin, E-selectin, soluble thrombomodulin (sTM) and high-sensitivity C-reactive protein (hs-CRP) levels were performed using immunoassays in both patients and healthy individuals.
  
  
  RESULTS
  We found that all endothelial adhesion molecules and hs-CRP were significantly increased (P < 0·001) in patients with SCD compared with controls, while sTM levels did not differ significantly (P > 0·05) and this increase was not influenced by the treatment.
  
  
  CONCLUSIONS
  Our findings demonstrate the high degree of endothelial activation and damage seen in sickle cell patients even in steady-state condition, as well as the important chronic inflammation underlying the pathophysiology of this widespread disease.
authors: Department of Clinical Biochemistry, Aghia Sophia Children's Hospital, Athens, Greece.
authors: Ino
authors: I
authors: Kanavaki
authors: Periklis
authors: P
authors: Makrythanasis
authors: Christina
authors: C
authors: Lazaropoulou
authors: Antonis
authors: A
authors: Kattamis
authors: Revekka
authors: R
authors: Tzanetea
authors: Vassiliki
authors: V
authors: Kalotychou
authors: Ioannis
authors: I
authors: Rombos
authors: Ioannis
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authors: Papassotiriou