Airway hyperreactivity in children with sickle cell disease☆,☆☆,★
Section snippets
Methods
Forty patients were recruited consecutively from the Marian Anderson Sickle Cell Center in St. Christopher’s Hospital for Children (Table I).
Empty Cell Sickle cell disease Empty Cell Empty Cell Empty Cell RAD ( n = 18) Non-RAD ( n = 22) Control ( n = 10) p * Age (yr) 10.1 ± 3.1 11.3 ± 3.5 10.5 ± 3.1 NS Height (cm) 142.6 ± 18.1 138.0 ± 17.0 143.0 ± 16.5 NS Sex Male 8 12 4 Female 10 10 6 Hemoglobinopathy SS 14 16 NA SC 2 5 NA Sβ + -Thal 2 1 NA Pulmonary
Results
There were no significant differences in age and height between the SCD groups and the control group (Table I).
Discussion
This study documents a 73% prevalence of airway hyperreactivity in the sickle cell population. Common estimates of bronchial reactivity by CACh in the normal population are as high as 6%, 11, 14, 15, 16 whereas those of the asthma population are varied, with values of 57% to 100%. 11, 17, 18, 19, 20 Furthermore, by dividing the subjects with SCD into two groups—those with and those without RAD symptoms—we have shown that, in SCD, a high prevalence of AHR at 64% can occur in the absence of
Acknowledgements
We thank Dr. Marie Stuart for reviewing the manuscript. We also acknowledge the assistance of Raymond Motley, RRT, Nancy Bauer, PhD, and Darcy Reber-Bodecki, BS.
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2017, Blood ReviewsCitation Excerpt :These results correlated with clinical features in SCD patients, including elevated endothelin-1 and tricuspid regurgitant velocity, an echocardiographic marker of risk for high pulmonary artery pressure [61]. An increased incidence of airway hyperresponsiveness has also been described in children and adults with SCD [62–64], and emerging evidence suggests a possible contributing role for PlGF in leukotriene-mediated inflammation [65]. Leukotrienes are known mediators of bronchoconstriction, with a critical role in triggering acute asthma as well as in mediating airway hypersensitivity in chronic asthma [66].
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Supported in part by grant Nos. RO1 HL-51493, RO1 HL-51494, and RO1 HL-51495 from the National Heart, Lung, and Blood Institute.
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Reprint requests: Julian L. Allen, MD, Chief, Section of Pulmonology, St. Christopher’s Hospital for Children, Erie Avenue at Front Street, Philadelphia, PA 19134.
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0022-3476/97/$5.00 + 0 9/21/79358