title: Clinical significance of assessment of thrombospondin and placenta growth factor levels in patients with sickle cell anemia: two centers egyptian studies.
abstract: BACKGROUND
  Sickle cell disease has a worldwide distribution. Vaso-occlusive crisis (VOC) is one of the most important clinical features of the disease. Thrombospondin (TSP1) and Placenta growth factor (PlGF) have been reported to be involved in sickle cell diseases (SCD).
  
  
  OBJECTIVE
  The aim of this study was to assess the clinical significance of Thrombospondin and Placenta growth factor profiles in patients with sickle cell disease.
  
  
  METHODS
  This study was carried out in sixty patients with sickle cell anemia who were attendants to Hematology units, Pediatric Departments, Tanta and Elmenofia University Hospitals in the period between December 2011 and May 2014 including thirty patients during vaso-occlusive crisis and thirty patients out of crisis. Also this study included twenty healthy children of matched age and sex as a control group. Serum TSP1 and PlGF levels were analyzed by ELISA.
  
  
  RESULTS
  In SCA patients with crisis the mean serum Thrombospondin level was 902.5±280.89 ng/mL; in SCA patients out of crisis the mean serum Thrombospondin level was 462.5 ± 190.2 ng/mL and in controls the mean value was 236.66±58.29 ng/mL. In SCA patients with crisis the mean serum Placenta growth factor level was 19.97±1.28 pg/ml; in SCA patients out of crisis the mean serum Placenta growth factor level was 13.12 ± 1.82 pg/ml and in controls the mean value was 9.89 ± 1.20 pg/ml. All paired comparisons for Thrombospondin and Placenta growth factor reached statistical significance (P< 0.001). There was significant positive correlation between serum Thrombospondin and Placenta growth factor levels in sickle cell anemia patients during crisis (r=0.848, p=<0.001).
  
  
  CONCLUSIONS
  This is the first study to show TSP1and PlGF concentration changes in patients with SCD in a large cohort study from Middle East, and to show correlation between both markers; therefore TSP1and PlGF may be useful VOC markers in SCD patients.
  
  
  CONCLUSIONS
  To further assess TSP1 and PlGF as a marker of VOC in patients with SCD, further studies should be conducted to determine the exact point before VOC, when serum TSP1 and PIGF levels begin to increase. This requires monitoring of the TSP1 and PIGF levels in sickle cell patients out of crisis, showing how rapidly these levels increase just before VOC development.
authors.affiliation: Pediatrics Department, Faculty of Medicine, Tanta University, Egypt.
authors.forename: Adel A
authors.initials: AA
authors.lastname: Hagag
authors.affiliation: Pediatric Department, Faculty of Medicine, Elmenofia University, Egypt.
authors.forename: Ghada
authors.initials: G
authors.lastname: Elmashad
authors.affiliation: Clinical Pathology Department, Faculty of Medicine, Tanta University, Egypt.
authors.forename: Aml Ezzat
authors.initials: AE
authors.lastname: Abd El-Lateef