Department of Basic Medical Sciences, Physiology Section, University of the West Indies, Mona, Kingston 7, Jamaica.
PLoS One. 2013 Jul 26;8(7):e68929. doi: 10.1371/journal.pone.0068929. Print 2013.
To determine differences in TNF-α, IL-1β, IL-10, sICAM-1 concentrations, leg hypoxia and whole blood viscosity (WBV) at shear rates of 46 sec(-1) and 230 sec(-1) in persons with homozygous S sickle cell disease (SCD) with and without chronic leg ulceration and in AA genotype controls.
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fifty-five age-matched participants were recruited into the study: 31 SS subjects without leg ulcers (SSn), 24 SS subjects with leg ulcers (SSu) and 18 AA controls. Haematological indices were measured using an AC.Tron Coulter Counter. Quantification of inflammatory, anti-inflammatory and adhesion molecules was performed by ELISA. Measurement of whole blood viscosity was done using a Wells Brookfield cone-plate viscometer. Quantification of microvascular tissue oxygenation was done by Visible Lightguide spectrophotometry.
TNF-α and whole blood viscosity at 46 sec(-1) and 230 sec(-1) (1.75, 2.02 vs. 0.83, 1.26, p<0.05) were significantly greater in sickle cell disease subjects than in controls. There were no differences in plasma concentration of sICAM-1, IL-1β and IL-10 between SCD subjects and controls. IL-1β (median, IQR: 0.96, 1.7 vs. 0, 0.87; p<0.01) and sICAM-1 (226.5, 156.48 vs. 107.63, 121.5, p<0.005) were significantly greater in SSu group compared with SSn. However there were no differences in TNF-α (2, 3.98 vs. 0, 2.66) and IL-10 (13.34, 5.95 vs. 11.92, 2.99) concentrations between SSu and SSn. WBV in the SSu group at 46 sec(-1) and at 230 Sec 1 were 1.9 (95%CI; 1.2, 3.1) and 2.3 (1.2, 4.4) times greater than in the SSn group. There were no differences in the degree of tissue hypoxia as determined by lightguide spectrophotometry.
Inflammatory, adhesion markers and WBV may be associated with leg ulceration in sickle cell disease by way of inflammation-mediated vasoocclusion/vasoconstriction. Impaired skin oxygenation does not appear to be associated with chronic ulcers in these subjects with sickle cell disease.
确定 TNF-α、IL-1β、IL-10、sICAM-1 浓度、腿部缺氧和全血粘度（WBV）在剪切率为 46 秒（-1）和 230 秒（-1）时，在纯合子 S 镰状细胞病（SCD）患者中有无慢性腿部溃疡以及 AA 基因型对照组中的差异。
招募了 55 名年龄匹配的参与者进行研究：31 名无腿部溃疡的 SS 受试者（SSn），24 名有腿部溃疡的 SS 受试者（SSu）和 18 名 AA 对照组。使用 AC.Tron Coulter 计数器测量血液学指标。通过 ELISA 定量测定炎症、抗炎和粘附分子。使用 Wells Brookfield 锥板粘度计测量全血粘度。使用可见光导分光光度法定量测量微血管组织氧合。
与对照组相比，镰状细胞病患者的 TNF-α 和 46 秒（-1）和 230 秒（-1）时的全血粘度（1.75、2.02 与 0.83、1.26，p<0.05）显著更高。SCD 患者与对照组之间血浆 sICAM-1、IL-1β 和 IL-10 浓度无差异。与 SSn 组相比，IL-1β（中位数，IQR：0.96、1.7 与 0、0.87；p<0.01）和 sICAM-1（226.5、156.48 与 107.63、121.5，p<0.005）明显更高。然而，SSu 组与 SSn 组之间 TNF-α（2、3.98 与 0、2.66）和 IL-10（13.34、5.95 与 11.92、2.99）浓度无差异。SSu 组在 46 秒（-1）和 230 秒（-1）时的 WBV 分别为 1.9（95%CI；1.2、3.1）和 2.3（1.2、4.4）倍高于 SSn 组。通过导光分光光度法确定的组织缺氧程度没有差异。
炎症、粘附标志物和 WBV 可能通过炎症介导的血管阻塞/血管收缩与镰状细胞病的腿部溃疡有关。在这些镰状细胞病患者中，皮肤氧合受损似乎与慢性溃疡无关。
