title: The acute phase inflammatory response to maximal exercise testing in children and young adults with sickle cell anaemia.
abstract: Although individuals with sickle cell anaemia (SCA) have elevated baseline inflammation and endothelial activation, the acute phase response to maximal exercise has not been evaluated among children with SCA. We measured the acute phase response to maximal exercise testing for soluble vascular cell adhesion molecule (sVCAM) as well as interleukin 6 (IL6), total white blood cell (WBC) count, C-reactive protein (CRP) and D-dimer in a cohort of children with SCA and matched controls at baseline, immediately after, and 30, 60 and 120 min following exercise. Despite higher baseline levels of all biomarkers except CRP, the acute phase response from baseline to immediately after exercise was significantly greater in subjects versus controls for CRP (2·1 vs. 0·2 mg/l, P = 0·02) and D-dimer (160 vs. 10 μg/l, P < 0·01) only. Similar between-group trends were observed over time for all biomarkers, including sVCAM, IL6, total WBC, CRP and D-dimer. Lower fitness, defined by peak oxygen consumption (VO2 ), was independently associated with greater acute phase responses to exercise for sVCAM. Our results suggest maximal exercise may not be associated with any greater escalation of endothelial activation or inflammation in SCA and provide preliminary biomarker evidence for the safety of brief, high-intensity physical exertion in children with SCA.
authors.affiliation: Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.|Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Robert I
authors.initials: RI
authors.lastname: Liem
authors.affiliation: Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.|Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Kasiemobi
authors.initials: K
authors.lastname: Onyejekwe
authors.affiliation: Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.|Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Olszewski
authors.affiliation: Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.|Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Chisalu
authors.initials: C
authors.lastname: Nchekwube
authors.affiliation: Pediatric Exercise Research Center, University of California Irvine, Irvine, CA, USA.
authors.forename: Frank P
authors.initials: FP
authors.lastname: Zaldivar
authors.affiliation: Pediatric Exercise Research Center, University of California Irvine, Irvine, CA, USA.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Radom-Aizik
authors.affiliation: Rodeghier Consultants, Inc., Chicago, IL, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Rodeghier
authors.affiliation: Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.|Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Thompson
mesh_terms: D000210:Acute-Phase Reaction / Q000209:etiology* / Q000378:metabolism; D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D015850:Interleukin-6 / Q000378:metabolism; D007958:Leukocyte Count; D010809:Physical Fitness / Q000502:physiology; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D019010:Vascular Cell Adhesion Molecule-1; C036309:fibrin fragment D; D002097:C-Reactive Protein
keywords: biomarkers; exercise testing; fitness; inflammation; sickle cell disease