Abstract
Nitric Oxide (NO) and soluble adhesion molecules are promising biomarkers, which predict endothelial dysfunction in sickle cell disease (SCD). Several studies have investigated the relationship between NO (as well as its metabolites) and endothelial adhesion molecules in SCD. However, these studies were done mainly in the developed world, and it is difficult to extrapolate the findings to SCD populations in other geographical regions such as Africa due to significant disparities in the results. The aim of the current study was to determine the correlation between levels of nitric oxide metabolites (NOx) and adhesion molecules in SCD patients in a tertiary hospital in Ghana. A case control cross-sectional study involving 100 SCD (made up of HbSS and HbSC patients) and 60 healthy controls was conducted. Concentrations of NOx and soluble endothelial adhesion molecules (ICAM-1, VCAM-1 and E-selectin) were measured in all the study participants (n = 160) by the Griess reagent system and enzyme-linked immunosorbent assay (ELISA). Correlation analysis was performed to determine a possible link between the variables. Levels of soluble adhesion molecules were higher in the HbSS patients. Correlation of NOx with ICAM-1 almost approached significance (r = 0.565, p = 0.058) in the HbSS patients. There were no correlations between NOx and E-selectin in both HbSS and HbSC patients. There were no significant correlations between NOx and VCAM-1 in all the study participants (p > 0.05). Of the soluble adhesion molecules, ICAM-1 showed a significant positive correlation with VCAM-1 in the HbSC patients. There were no significant differences between the adhesion molecules and the age of participants in the various study groups. Whether or not a significant correlation exists between NOx and soluble adhesion molecules may not depend on the sickle cell genotype. The expression of adhesion molecules may not depend on age.
Highlights
Sickle cell disease (SCD) is a group of inherited disorders characterized by an abnormal structure of one of the globin chains of the haemoglobin molecules, resulting in several clinical presentations [1].The disease is known to be caused by a point mutation in the haemoglobin beta gene, which encodes the beta-globin found on chromosome 11a
We investigated the correlation between nitric oxide metabolites (NOx) and soluble adhesion molecules (ICAM-1, VCAM-1, and E-selectin) in Ghanaian SCD patients and observed that, NOx correlated insignificantly with some of the adhesion molecules in the study participants
Observations from the current study suggest that an elevation of NOx may cause a corresponding rise in VCAM-1 in SCD patients
Summary
Sickle cell disease (SCD) is a group of inherited disorders characterized by an abnormal structure of one of the globin chains of the haemoglobin molecules, resulting in several clinical presentations [1]. The disease is known to be caused by a point mutation in the haemoglobin beta gene, which encodes the beta-globin found on chromosome 11a. The amino acid valine is substituted for glutamic acid as a result of the mutation. This leads to the synthesis of an abnormal form of the haemoglobin molecule, which is the haemoglobin S (HbS) [2]. Among the several types of SCD, HbSS (often described as sickle cell anaemia), and haemoglobin SC disease (HbSC) are common [4]
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