Bandeira Izabel C J, Rocha Lillianne B S, Barbosa Maritza C, Elias Darcielle B D, Querioz José A N, Freitas Max Vitor Carioca, Gonçalves Romélia P
Post-Graduate Program in Pathology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Post-Graduate Program in Development and Technological Innovation in Drugs, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Cytokine. 2014 Feb;65(2):217-21. doi: 10.1016/j.cyto.2013.10.009. Epub 2013 Nov 27.
The chronic inflammatory state in sickle cell anemia (SCA) is associated with several factors such as the following: endothelial damage; increased production of reactive oxygen species; hemolysis; increased expression of adhesion molecules by leukocytes, erythrocytes, and platelets; and increased production of proinflammatory cytokines. Genetic characteristics affecting the clinical severity of SCA include variations in the hemoglobin F (HbF) level, coexistence of alpha-thalassemia, and the haplotype associated with the HbS gene. The different haplotypes of SCA are Bantu, Benin, Senegal, Cameroon, and Arab-Indian. These haplotypes are associated with ethnic groups and also based on the geographical origin. Studies have shown that the Bantu haplotype is associated with higher incidence of clinical complications than the other haplotypes and is therefore considered to have the worst prognosis. This study aimed to evaluate the profile of the proinflammatory cytokines interleukin-6, tumor necrosis factor-α, and interleukin-17 in patients with SCA and also to assess the haplotypes associated with beta globin cluster S (HBB(*)S). We analyzed a total of 62 patients who had SCA and had been treated with hydroxyurea; they had received a dose ranging between 15 and 25 (20.0±0.6)mg/kg/day for 6-60 (18±3.4)months; their data were compared with those for 30 normal individuals. The presence of HbS was detected and the haplotypes of the beta S gene cluster were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Our study demonstrated that SCA patients have increased inflammatory profile when compared to the healthy individuals. Further, analysis of the association between the haplotypes and inflammatory profile showed that the levels of IL-6 and TNF-α were greater in subjects with the Bantu/Bantu haplotype than in subjects with the Benin/Benin haplotype. The Bantu/Benin haplotype individuals had lower levels of cytokines than those with the Bantu/Bantu haplotype and greater levels than those of subjects with the Benin/Benin haplotype. For IL-17, a slight trend toward decreased levels was observed in the subjects with the Benin/Benin haplotype, when compared to those with the Bantu/Bantu and Bantu/Benin haplotypes; however, this difference was not statistically significant. Our results show that genetic polymorphisms in sickle cell anemia are associated with the inflammatory profile.
镰状细胞贫血(SCA)中的慢性炎症状态与以下几个因素相关:内皮损伤;活性氧物质生成增加;溶血;白细胞、红细胞和血小板上黏附分子表达增加;以及促炎细胞因子生成增加。影响SCA临床严重程度的遗传特征包括血红蛋白F(HbF)水平的变化、α地中海贫血的共存以及与HbS基因相关的单倍型。SCA的不同单倍型有班图型、贝宁型、塞内加尔型、喀麦隆型和阿拉伯 - 印度型。这些单倍型与种族群体相关,也基于地理起源。研究表明,班图型单倍型与其他单倍型相比,临床并发症发生率更高,因此被认为预后最差。本研究旨在评估SCA患者中促炎细胞因子白细胞介素 - 6、肿瘤坏死因子 - α和白细胞介素 - 17的情况,并评估与β珠蛋白基因簇S(HBB(*)S)相关的单倍型。我们共分析了62例接受羟基脲治疗的SCA患者;他们接受的剂量为15至25(20.0±0.6)mg/kg/天,治疗时间为6至60(18±3.4)个月;将他们的数据与30名正常个体的数据进行比较。通过聚合酶链反应 - 限制性片段长度多态性(PCR - RFLP)检测HbS的存在并分析βS基因簇的单倍型。我们的研究表明,与健康个体相比,SCA患者的炎症指标升高。此外,对单倍型与炎症指标之间关联的分析表明,班图/班图型单倍型个体的IL - 6和TNF - α水平高于贝宁/贝宁型单倍型个体。班图/贝宁型单倍型个体的细胞因子水平低于班图/班图型个体,高于贝宁/贝宁型单倍型个体。对于IL - 17,与班图/班图型和班图/贝宁型单倍型个体相比,贝宁/贝宁型单倍型个体的水平有轻微下降趋势;然而,这种差异无统计学意义。我们的结果表明,镰状细胞贫血中的基因多态性与炎症指标相关。