Which side of the balance determines the frequency of vaso-occlusive crises in children with sickle cell anemia: Blood viscosity or microvascular dysfunction?

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• 作者：Keyne Charlot^a ; ^b ; ^c ; ^{keynecharlot@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Marc Romana^a ; ^c ; ^{marc.romana@inserm.fr" class="auth_mail" title="E-mail the corresponding author} ; Berenike Moeckesch^a ; ^b ; ^c ; ^{berenike-moeckesch@web.de" class="auth_mail" title="E-mail the corresponding author} ; Sté ; phane Jumet^b ; ^{stephanejumet@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Xavier Waltz^a ; ^b ; ^c ; ^{xavier.waltz@wanadoo.fr" class="auth_mail" title="E-mail the corresponding author} ; Lydia Divialle-Doumdo^d ; ^{ldoumccd@yahoo.fr" class="auth_mail" title="E-mail the corresponding author} ; Marie-Dominique Hardy-Dessources^a ; ^c ; ^{marie-dominique.hardy-dessources@inserm.fr" class="auth_mail" title="E-mail the corresponding author} ; Marie Petras^d ; ^{eleonore.petras@chu-guadeloupe.fr" class="auth_mail" title="E-mail the corresponding author} ; Benoî ; t Tressiè ; res^e ; ^{benoit.tressieres@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Vanessa Tarer^d ; ^{vanessa.tarer@chu-guadeloupe.fr" class="auth_mail" title="E-mail the corresponding author} ; Olivier Hue^b ; ^{ohue@univ-ag.fr" class="auth_mail" title="E-mail the corresponding author} ; Maryse Etienne-Julan^d ; ^{maryse.etienne-julan@chu-guadeloupe.fr" class="auth_mail" title="E-mail the corresponding author} ; Sophie Antoine-Jonville^b ; ¹ ; ^{s_antoine@ymail.com" class="auth_mail" title="E-mail the corresponding author} ; Philippe Connes^a ; ^c ; ^f ; ^g ; ¹ ; ^{pconnes@yahoo.fr" class="auth_mail" title="E-mail the corresponding author} ; ^{philippe.connes@uiv-lyon1.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Sickle cell disease ; Microcirculation ; Microcirculatory oxygenation ; Hemorheology
• 刊名：Blood Cells, Molecules and Diseases
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：56
• 期：1
• 页码：41-45
• 全文大小：394 K

文摘

Vascular resistance and tissue perfusion may be both affected by impaired vascular function and increased blood viscosity. Little is known about the effects of vascular function on the occurrence of painful vaso-occlusive crises (VOC) in children with sickle cell anemia (SCA). The aim of the present study was to determine which side of the balance (blood viscosity or vascular function) is the most deleterious in SCA and increases the risk for frequent hospitalized VOC. Microvascular function, microcirculatory oxygenation and blood viscosity were determined in a group of 22 SCA children/adolescents at steady state and a group of 13 healthy children/adolescents. Univariate analyses demonstrated blunted microvascular reactivity during local thermal heating test and decreased microcirculatory oxygenation in SCA children compared to controls. Multivariate analysis revealed that increased blood viscosity and decreased microcirculatory oxygenation were independent risk factors of frequent VOC in SCA. In contrast, the level of microvascular dysfunction does not predict VOC rate. In conclusion, increased blood viscosity is usually well supported in healthy individuals where vascular function is not impaired. However, in the context of SCA, microvascular function is impaired and any increase of blood viscosity or decrease in microcirculatory oxygenation would increase the risks for frequent VOC.