Belisário André Rolim, Mendes-Oliveira Franciane, de Souza Valquíria Reis, Bolina-Santos Eduarda, Mendes Fabíola Gomes, Moreno Elizabeth Castro, Franca Alice Timponi, Sabino Ester Cerdeira, Otta Dayane Andriotti, de Faria Elaine Speziali, Coelho-Dos-Reis Jordana Grazziela Alves, Martins-Filho Olindo Assis, Carneiro-Proietti Anna Bárbara
Centro de Tecidos Biológicos de Minas Gerais, Fundação Hemominas, Lagoa Santa, MG, Brazil.
Serviço de Pesquisa, Fundação Hemominas, Belo Horizonte, MG, Brazil.
Hematol Transfus Cell Ther. 2022 Apr-Jun;44(2):169-176. doi: 10.1016/j.htct.2020.09.152. Epub 2020 Dec 5.
Leg ulcers (LUs) are relatively common in patients with sickle cell anemia (SCA). The role of inflammation and nitric oxide (NO) pathways in the pathophysiology of the LU is not understood.
The aim of this study was to verify the association between inflammatory molecules and nitric oxide metabolites (NOx) and the occurrence of the LU in patients with SCA.
It was a cross-sectional study on adult participants with SCA followed at Fundação Hemominas, a public blood center in Brazil. Eligible participants were recruited and included in one of two groups: Group 1, comprised of cases with SCA (Hb SS) and at least one LU at the time of inclusion in the study and Group 2, comprised of controls with SCA without a history of LU, matched by sex and age to cases. Participants were interviewed to obtain sociodemographic data and blood samples were collected. Clinical and laboratory data were abstracted from medical records. Nitric oxide metabolites (NOx) and inflammatory molecules were quantified using an immunoassay and Multiplex xMAP® technology, respectively. Eighty-seven individuals were included, ranging in age from 17 to 61 years (mean 40 ± 10.7 years); 30 had LU and 57 were controls without LU.
Participants with LU had significantly higher levels of interleukin 8 (IL-8), IL-10, IL-15, NOx and platelet and white blood cell (WBC) counts, when compared to those without LU. Participants with LU had a significantly higher risk of having a history of osteomyelitis and a higher use of antiseptic soap in bathing, when compared to those without LU.
In conclusion, our results showed that NOx, inflammatory molecules and hematological features were associated with LU in Brazilian adults with SCA.
腿部溃疡（LUs）在镰状细胞贫血（SCA）患者中相对常见。炎症和一氧化氮（NO）途径在腿部溃疡病理生理学中的作用尚不清楚。
本研究的目的是验证炎症分子和一氧化氮代谢产物（NOx）与SCA患者腿部溃疡发生之间的关联。
这是一项对巴西公共血液中心Hemominas基金会随访的成年SCA参与者进行的横断面研究。符合条件的参与者被招募并分为两组之一：第1组，由SCA（Hb SS）病例组成，在纳入研究时至少有一处腿部溃疡；第2组，由无腿部溃疡病史的SCA对照组组成，在性别和年龄上与病例匹配。对参与者进行访谈以获取社会人口统计学数据，并采集血样。临床和实验室数据从病历中提取。分别使用免疫测定和多重xMAP®技术对一氧化氮代谢产物（NOx）和炎症分子进行定量。共纳入87名个体，年龄在17至61岁之间（平均40±10.7岁）；30人有腿部溃疡，57人是无腿部溃疡的对照组。
与无腿部溃疡的参与者相比，有腿部溃疡的参与者白细胞介素8（IL-8）、IL-10、IL-15、NOx水平以及血小板和白细胞（WBC）计数显著更高。与无腿部溃疡的参与者相比，有腿部溃疡的参与者有骨髓炎病史的风险显著更高，且洗澡时使用抗菌肥皂的频率更高。
总之，我们的结果表明，在巴西成年SCA患者中，NOx、炎症分子和血液学特征与腿部溃疡有关。
