title: Tapered oral dexamethasone for the acute chest syndrome of sickle cell disease.
abstract: Tapered oral dexamethasone for acute chest syndrome (ACS) in sickle cell anaemia was studied using a novel ACS assessment tool and investigational biomarkers. Twelve participants were randomized (mean age 17·3 years) before early study termination. Dexamethasone decreased duration of hospitalization for ACS by 20·8 h compared to placebo (P = 0·024). Rebound pain occurred in both groups (3 dexamethasone versus 1 placebo). Overall, dexamethasone decreased the leucocyte activation biomarker, sL-selectin; however, participants with rebound pain had higher sL-selectin within 24 h of treatment (dexamethasone or placebo). This ACS assessment tool was feasibly applied, and sL-selectin is a promising biomarker of ACS therapy.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Hematology/Oncology, Cincinnati, OH 45220, USA. charles.quinn@cchmc.org
authors.forename: Charles T
authors.initials: CT
authors.lastname: Quinn
authors.forename: Marie J
authors.initials: MJ
authors.lastname: Stuart
authors.forename: Karen
authors.initials: K
authors.lastname: Kesler
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Ataga
authors.forename: Winfred C
authors.initials: WC
authors.lastname: Wang
authors.forename: Lori
authors.initials: L
authors.lastname: Styles
authors.forename: Kim
authors.initials: K
authors.lastname: Smith-Whitley
authors.forename: Ted
authors.initials: T
authors.lastname: Wun
authors.forename: Ashok
authors.initials: A
authors.lastname: Raj
authors.forename: Lewis L
authors.initials: LL
authors.lastname: Hsu
authors.forename: Suba
authors.initials: S
authors.lastname: Krishnan
authors.forename: Frans A
authors.initials: FA
authors.lastname: Kuypers
authors.forename: Yamaja
authors.initials: Y
authors.lastname: Setty
authors.forename: Seungshin
authors.initials: S
authors.lastname: Rhee
authors.forename: Nigel S
authors.initials: NS
authors.lastname: Key
authors.forename: George R
authors.initials: GR
authors.lastname: Buchanan
mesh_terms: D056586:Acute Chest Syndrome / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D002097:C-Reactive Protein / Q000032:analysis; D015815:Cell Adhesion Molecules / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D010102:Oxygen Inhalation Therapy; D012805:Sickle Cell Trait / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult; D017086:beta-Thalassemia / Q000150:complications
chemical_list: D015815:Cell Adhesion Molecules; D009569:Nitric Oxide; D003907:Dexamethasone; D002097:C-Reactive Protein