Department of Biomedical Sciences and Human Oncology, Pediatric Unit, University "A. Moro", Bari, Italy.
Giovanni XXIII Pediatric Hospital, Bari, Italy.
Eur J Haematol. 2022 Apr;108(4):336-341. doi: 10.1111/ejh.13741. Epub 2022 Jan 10.
Sickle bone disease (SBD) is a chronic complication of sickle cell disease (SCD) whose pathogenesis is not completely understood. Chronic inflammation associated with SCD could alter bone remodeling. Our aim was to analyze the serum levels of bone remodeling markers in a group of SCD children to evaluate their involvement in the SBD.
We enrolled 26 SCD subjects and 26 age-matched controls, who lived in the same geographic area. DKK-1, sclerostin, RANKL, and OPG serum levels were evaluated. Neutrophil-lymphocyte ratio (NLR) was also evaluated as a marker of inflammation.
The analysis of bone remodeling markers did not show any significant difference between the two groups except for DKK-1 levels that were significantly higher in the patients than controls (p < .05). A significant direct correlation between NLR and DKK-1 (p = .004) was found. An inverse correlation between NLR and osteocalcin (p = .01) has also been observed.
The chronic inflammation, which represents a peculiar characteristic in SCD patients, would represent the primary causal agent of the activation of osteoblastogenesis inhibitors responsible of bone impairment in these subjects. Further studies will be needed to better explain the role of these inhibitors in SCD, to prevent or treat bone damage in this population.
镰状骨病（SBD）是镰状细胞病（SCD）的一种慢性并发症，其发病机制尚不完全清楚。与 SCD 相关的慢性炎症可能会改变骨重塑。我们的目的是分析一组 SCD 儿童的血清骨重塑标志物水平，以评估它们在 SBD 中的作用。
我们纳入了 26 名 SCD 患者和 26 名年龄匹配的对照组，他们居住在同一地理区域。评估了 DKK-1、骨硬化蛋白、RANKL 和 OPG 的血清水平。还评估了中性粒细胞-淋巴细胞比值（NLR）作为炎症标志物。
两组之间的骨重塑标志物分析没有显示出任何显著差异，除了 DKK-1 水平，患者组明显高于对照组（p <.05）。NLR 与 DKK-1 之间存在显著的直接相关性（p =.004）。还观察到 NLR 与骨钙素之间存在负相关（p =.01）。
慢性炎症是 SCD 患者的一个特有特征，它可能是导致成骨细胞生成抑制剂激活的主要原因，这些抑制剂负责这些患者的骨损伤。需要进一步的研究来更好地解释这些抑制剂在 SCD 中的作用，以预防或治疗该人群的骨损伤。
