Impact of circulating erythrocyte-derived microparticles on coagulation activation in sickle cell disease

Abstract

Sickle cell disease (SCD) is characterized by a hypercoagulable state as a result of multiple factors, including chronic hemolysis and the presence of circulating cell-derived microparticles (MPs). The aim of this work was to study the impact of erythrocyte-derived circulating microparticles (glycophorin A; CD235 positive) on coagulation activation and their probable role in contribution to painful crisis in SCD patients. Peripheral blood samples of 25 SCD patients during painful crisis and in steady state were studied for the presence of erythrocyte-derived MPs using flow cytometry. Estimation of D-dimer level, as a marker of coagulation activation, was done using semiquantitative assay. Thirty-six healthy individuals, age- and sex-matched, were included as a control group. Erythrocyte-derived MPs level was significantly higher in SCD patients during painful crisis compared to control group (p = 0.02), but no statistically significant difference was found between erythrocyte-derived MPs level in SCD patients in steady state compared to controls or to SCD patients during painful crisis (p = 0.3 and 0.49, respectively). D-dimer level was higher in SCD patients both during crisis and in steady state compared to controls (p < 0.001). SCD during painful crisis is associated with increased levels of erythrocyte-derived MPs and D-dimer which may contribute to the hypercoagulable state observed in such group of patients.