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High levels of proinflammatory cytokines IL-6 and IL-8 are associated with a poor clinical outcome in sickle cell anemia.
Annals of Hematology ( IF 3.5 ) Pub Date : 2020-03-05 , DOI: 10.1007/s00277-020-03978-8
Igor F Domingos 1 , Diego A Pereira-Martins 1, 2 , Marcondes J V C Sobreira 1 , Romulo T D Oliveira 3 , Adekunle E Alagbe 3 , Carolina Lanaro 4 , Dulcineia M Albuquerque 4 , Maria H S L Blotta 3 , Aderson S Araujo 5 , Fernando F Costa 4 , Antonio R Lucena-Araujo 1 , Maria F Sonati 3 , Marcos A C Bezerra 1 , Magnun N N Santos 3
Affiliation  

Sickle cell anemia (SCA) pathophysiology is characterized by the activation of sickle red blood cells, reticulocytes, leukocytes, platelets, and endothelial cells, and with the expression of several inflammatory molecules. Therefore, it is conceivable that variations in levels of proinflammatory cytokines may act as a signaling of differential clinical course in SCA. Here, we evaluated the clinical impact of proinflammatory cytokines interleukin 1-β (IL-1β), interleukin 6 (IL-6), and interleukin 8 (IL-8) in 79 patients with SCA, followed in a single reference center from northeastern Brazil. The main clinical/laboratory data were obtained from patient interview and medical records. The proinflammatory markers IL-1β, IL-6, and IL-8 were evaluated by using commercially available enzyme-linked immunosorbent assay kits. According to levels of the proinflammatory markers, we observed that patients who had a higher frequency of VOC per year (P = 0.0236), acute chest syndrome (P = 0.01), leg ulcers (P = 0.0001), osteonecrosis (P = 0.0006), stroke (P = 0.0486), and priapism (P = 0.0347) had higher IL-6 levels compared with patients without these clinical complications. Furthermore, increased levels of IL-8 were found in patients who presented leg ulcers (P = 0.0184). No significant difference was found for IL-1β levels (P > 0.05). In summary, the present study emphasizes the role of inflammation in SCA pathophysiology, reveals an association of IL-8 levels and leg ulcer occurrence, and indicates that IL-6 levels can be used as a useful predictor for poor outcomes in SCA.

中文翻译:

镰状细胞性贫血中高水平的促炎细胞因子IL-6和IL-8与不良的临床预后相关。

镰状细胞性贫血(SCA)病理生理学的特征在于镰状红细胞,网状细胞,白细胞,血小板和内皮细胞的活化,以及几种炎症分子的表达。因此,可以想象的是,促炎细胞因子水平的变化可能是SCA中不同临床过程的信号。在这里,我们评估了促炎细胞因子白细胞介素1-β(IL-1β),白细胞介素6(IL-6)和白细胞介素8(IL-8)在79例SCA患者中的临床影响,随后在东北的一个参考中心进行了评估巴西。主要的临床/实验室数据来自患者访谈和医疗记录。通过使用可商购的酶联免疫吸附测定试剂盒评估促炎标记物IL-1β,IL-6和IL-8。根据促炎标记物的水平,我们观察到每年VOC发生频率较高的患者(P = 0.0236),急性胸综合症(P = 0.01),腿部溃疡(P = 0.0001),骨坏死(P = 0.0006)与没有这些临床并发症的患者相比,中风(P = 0.0486)和阴茎异常勃勃(P = 0.0347)具有更高的IL-6水平。此外,在出现腿部溃疡的患者中发现IL-8水平升高(P = 0.0184)。IL-1β水平差异无统计学意义(P> 0.05)。总而言之,本研究强调炎症在SCA病理生理中的作用,揭示了IL-8水平与小腿溃疡发生的关系,并表明IL-6水平可以用作SCA不良预后的有用预测指标。我们观察到每年VOC发生频率较高(P = 0.0236),急性胸综合症(P = 0.01),腿溃疡(P = 0.0001),骨坏死(P = 0.0006),中风(P = 0.0486)的患者,与没有这些临床并发症的患者相比,普林斯普林和普林起病(P = 0.0347)的IL-6水平更高。此外,在出现腿部溃疡的患者中发现IL-8水平升高(P = 0.0184)。IL-1β水平差异无统计学意义(P> 0.05)。总而言之,本研究强调炎症在SCA病理生理中的作用,揭示了IL-8水平与小腿溃疡发生的关系,并表明IL-6水平可以用作SCA不良预后的有用预测指标。我们观察到每年VOC发生频率较高(P = 0.0236),急性胸综合症(P = 0.01),腿部溃疡(P = 0.0001),骨坏死(P = 0.0006),中风(P = 0.0486)的患者,与没有这些临床并发症的患者相比,普林斯普林和普林起病(P = 0.0347)的IL-6水平更高。此外,在出现腿部溃疡的患者中发现IL-8水平升高(P = 0.0184)。IL-1β水平差异无统计学意义(P> 0.05)。总而言之,本研究强调炎症在SCA病理生理中的作用,揭示了IL-8水平与小腿溃疡发生的关系,并表明IL-6水平可以用作SCA不良预后的有用预测指标。与没有这些临床并发症的患者相比,0347)的IL-6水平更高。此外,在出现腿部溃疡的患者中发现IL-8水平升高(P = 0.0184)。IL-1β水平差异无统计学意义(P> 0.05)。总而言之,本研究强调炎症在SCA病理生理中的作用,揭示了IL-8水平与小腿溃疡发生的关系,并表明IL-6水平可以用作SCA不良预后的有用预测指标。与没有这些临床并发症的患者相比,0347)的IL-6水平更高。此外,在出现腿部溃疡的患者中发现IL-8水平升高(P = 0.0184)。IL-1β水平差异无统计学意义(P> 0.05)。总而言之,本研究强调炎症在SCA病理生理中的作用,揭示了IL-8水平与小腿溃疡发生的关系,并表明IL-6水平可以用作SCA不良预后的有用预测指标。
更新日期:2020-03-06
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