Effect Of Hydroxyurea On Thrombospondin-1 And Soluble L-Selectin Levels Among Steady State Patients With Sickle Cell Anaemia
Keywords:
hydroxyurea, soluble L-selectin, thrombospondin-1, steady state, sickle cell anaemiaAbstract
Background: Sickle cell anaemia (SCA) is characterized by unpredictable episodes of vasoocclusion. Adhesion molecules, sickled red blood cells and inflammatory stimuli all contribute to these episodes. Hydroxyurea (HU) has proven to be effective in reducing the frequency of pain episodes in SCA, notably via an Hb F dependent mechanism.
Aims and Objectives: The objectives of this study are to determine the relationship between HU therapy and serum levels of thrombospondin-1 and soluble L-selectin in patients with SCA; and assessed the relationship between the use of HU and clinical severity of the disease.
Materials and Methods: Sixty (60) patients with SCA (30 HU exposed and 30 HU naïve patients respectively), all in steady state, were recruited. They were administered structured questionnaire. Clinical determinants and laboratory tests, which include full blood count, soluble L-selectin and thrombospondin-1 were assessed. Clinical severity scores were also computed. Appropriate statistical tools were utilised for data analysis.
Results: Patients with SCA exposed to HU had lower values of thrombospondin-1 and soluble Lselectin compared to HU naïve controls (P < 0.001; and P = 0.121 respectively). Most patients on HU had mild disease when compared to their HU naïve counterparts based on clinical severity score {29/30 (96.7%) vs 18/30 (60.0%), χ2 = 13.918; df = 2; P = 0.001}. There was a significant correlation between thrombospondin-1 levels and clinical severity score in both HU exposed and HU naïve patients with SCA (rho = 0.545; P < 0.001 and rho = 0.509; P = 0.002 respectively). Soluble Lselectin levels showed no significant correlation with clinical severity score in both groups (rho = 0.256; P = 0.086; and rho = 0.255; P = 0.173 respectively).
Conclusion: The usage of HU may significantly reduce levels of thrombospondin-1, but not those of soluble L-selectin in patients with SCA.
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