Asthma and lower airway diseaseElevation of IgE in children with sickle cell disease is associated with doctor diagnosis of asthma and increased morbidity
Section snippets
Patient population
The Silent Cerebral Infarct Transfusion (SIT) Trial includes 29 North American (US and Canadian) and European (United Kingdom and French) clinical sites, a clinical coordinating center, and a statistical data coordinating center to test the following hypothesis: prophylactic blood transfusion therapy in children with SCD will result in at least an 86% reduction in the rate of subsequent overt strokes or new or progressive cerebral infarcts as defined by magnetic resonance imaging of the brain.
Demographics
A total of 521 children with SCD had complete clinical data and measured total IgE levels for this analysis (Fig 1; Table II). One hundred forty of 521 (27%) children met the criterion of having a physician diagnosis of asthma, with statistically significantly (P = .01) higher asthma prevalence in boys (32%; 86/271) than in girls (22%; 54/250)—that is, boys accounted for 61% (86/140) of subjects with asthma and 49% (185/381) of subjects without asthma. Hemoglobin SS distribution was not
Discussion
Previously, our group6, 11, 14 and others7, 8, 9, 10, 12, 13 have demonstrated that children with SCD and asthma are at increased risk for ACS6, 7, 8, 9, 10, 11, 12, 13, 14 and pain11 episodes compared with children with SCD alone; however, there has been limited evaluation of asthma risk factors. In the current analysis, we tested 2 hypotheses: first, whether the asthma risk factors of total and allergen-specific IgE levels are associated with a physician diagnosis of asthma, and second,
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Cited by (42)
Pulmonary Manifestations of Hematologic and Oncologic Diseases in Children
2021, Pediatric Clinics of North AmericaCitation Excerpt :The use of antiinflammatory, antipolymerization, and antiadhesive medications offers potential beneficial approaches to treat ACS. Asthma is seen in 15% to 28% of patients with SCD and is associated with increased morbidity and mortality.85 In a cohort of 521 children with SCD, those having asthma had higher incidence rates of ACS episodes (19 vs12 episodes per 100 patient years; P = .02) as well as more vasoocclusive pain episodes than those without asthma.85
Sickle Cell Disease: Monitoring, Current Treatment, and Therapeutics Under Development
2019, Hematology/Oncology Clinics of North AmericaCitation Excerpt :Silent cerebral infarcts occur in up to 39% of children with SCD and 43% of adults,4,29–32 and are associated with neurocognitive deficits33–35 and increased risk for overt strokes (Box 4).36 Asthma is common in SCD40–43 and is associated with a higher incidence of acute chest syndrome,44–46 vasoocclusive episodes (VOE), and mortality (Box 5).47–50 Common underlying pathophysiology includes dysregulation of arginine metabolism and nitric oxide.7,51
Exhaled nitric oxide: Not associated with asthma, symptoms, or spirometry in children with sickle cell anemia
2016, Journal of Allergy and Clinical ImmunologyImproved guideline adherence with integrated sickle cell disease and asthma care
2016, American Journal of Preventive MedicineIschemia-reperfusion injury in sickle cell anemia: Relationship to acute chest syndrome, endothelial dysfunction, arterial vasculopathy, and inflammatory pain
2014, Hematology/Oncology Clinics of North AmericaCitation Excerpt :So, it seems plausible that the adverse effects of smoke exposure on both vessel wall and airways would increase lung susceptibility to ALI/ACS as ROI from an inciting I/R event. Asthma association with ACS is particularly intriguing, because both are associated with increased levels of total and allergen-specific IgE.68 The sickle milieu includes other (allergen-independent) mast cell activators (superoxide, PAF), and one wonders if this total IgE includes hidden cytokinergic IgE.69
Acute pulmonary complications of sickle cell disease
2014, Paediatric Respiratory Reviews
Supported by the National Institute of Neurological Disorders and Stroke (U01 NS042804) and the National Heart, Lung, and Blood Institute (RO1-HL079937).
Disclosure of potential conflict of interest: J. Casella receives research support from the National Institutes of Health. The rest of the authors have declared that they have no conflict of interest.