Low nitric oxide level is implicated in sickle cell disease and its complications in Ghana

Antwi‐Boasiako, Charles; Campbell, Andrew

doi:10.2147/vhrm.s163228

Cited by 20 publications

(18 citation statements)

References 42 publications

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“…Elevated PLT counts recorded could be attributed to the outcome of the interaction between the sickled cells and the endothelial cells as a result of the vasoocclusion during microcirculation [8]. Generally, patients with HbS are known to have a significantly higher mean total WBC count [28] and findings from this study were not an exemption. Out of the 113 participants whose hematological parameters were retrieved, majority of both males and females with HbSS were severely anemic, as reported by Jadhav [29].…”

Section: Discussionmentioning

confidence: 64%

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Awaitey

Akorsu

Allotey

et al. 2020

Advances in Hematology

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Background. It is estimated that one out of every three Ghanaians has hemoglobin genotype mutation. This change in genetic make-up may result in genotypes such as HbAS, HbSS, and HbSC. Many children in low- and middle-income countries die even before they are diagnosed with sickle cell disease (SCD). In Africa, there are limited data on the incidence and prevalence of SCD and the Volta region of Ghana is no exception. Aim. The aim of this study was to determine the prevalence of SCD and to assess the hemoglobin variants among patients attending Ho Teaching Hospital. Methods. A retrospective study design was used to extract information from the Hospital Administration and Management Systems (HAMS) on the hemoglobin electrophoresis results and corresponding full blood count results of the SCD and sickle cell anemia (SCA) patients as well as patients who were asked to do Hb electrophoresis irrespective of their sickling status. Data were collected for the period January 2016 to December 2018. Sickle cell disease status was determined using the Hb genotypes from the Hb electrophoresis results. The full blood count was used to categorize the severity of anemia based on the hemoglobin concentration in the SCA and SCD patients. Results. A total of 1,523 subjects were included in the study of which the prevalence for sickle cell disease was 16.7%. The SCD genotypes included HbS (6.2%), HbSC (7.9%), and HbSF (2.6%). Hemoglobin C disease (HbCC) constituted 0.3% out of the total prevalence of SCD. The prevalence of anemia was 99.2%, with the severest form in HbS. Also, majority of the SCD patients had severe anemia. Difference in the severity of anemia was found to be significant among both male (P=0.006) and female (P=0.004) participants with SCD. Conclusion. Patients receiving health care at the Ho Teaching Hospital had different hemoglobin variants with HbAS recording the highest prevalence. The high incidence of hemoglobin AS implies the possibility of having an increased population of individuals with sickle cell disease in future if measures are not put in place to improve screening, counseling, and education of the public about the health threat SCD poses.

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Section: Discussionmentioning

confidence: 64%

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Awaitey

Akorsu

Allotey

et al. 2020

Advances in Hematology

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“…Findings from the study also suggest in part that the lower levels of SOD and CAT in patients with the SS genotype may be due to significant depletion of antioxidants, such as nitric oxide and vitamins, in these patients. Lower levels of vitamin E [ 39 , 40 ] and nitric oxide [ 41 ] were reported in sickle cell patients with the SS genotype in previous studies. The non-significant differences in levels of SOD and CAT between some of the study participants is partly due to, perhaps, a similar ongoing haemolysis and associated conditions in the patients.…”

Section: Discussionmentioning

confidence: 97%

Oxidative Profile of Patients with Sickle Cell Disease

et al. 2019

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Oxidative stress plays a very significant role in the pathophysiology of sickle cell disease (SCD) and associated complications. Oxidative stress, which is often experienced by SCD patients as a result of continuous production of reactive oxygen species (ROS), may lead to endothelial dysfunction and acute inflammation. Antioxidant enzymes, such as superoxide dismutase (SOD) and catalase (CAT), often play a protective role. The current study aimed at determining the oxidative profile of persons with SCD at a tertiary hospital in Ghana. This was a case-control study involving 90 patients with SCD (34 HbSS patients at steady state, 30 HbSC at steady state, 15 HbSS with vaso-occlusive crisis, 11 HbSC with vaso-occlusive crisis), and 50 HbAA control group. Whole blood samples were collected from the study participants and analyzed for full blood counts. The blood samples were assayed for SOD and CAT as a measure of antioxidant defense, while lipid peroxidation was quantified as malondialdehyde (MDA). The results showed that the levels of SOD and CAT were significantly lower in SCD patients as compared to the control group. Patients with HbSS vaso-occlusive crisis had the lowest levels of SOD and CAT. The difference in SOD levels between HbSS at steady state and HbSC with vaso-occlusive crisis was, however, not significant (p = 0.228). The MDA level was significantly higher in SCD patients compared to the control group. This study concludes that the levels of various antioxidant enzymes (erythrocyte SOD and erythrocyte CAT) and oxidative marker (MDA) and are altered in SCD patients.

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“…Several other studies have reported that levels of VCAM-1 are particularly increased in severe complications of SCD, including HbSS vaso-occlusive crises [7,8,9] and acute chest syndrome [10], and thus, may serve as a promising biomarker of disease severity and associated complications of SCD [9]. Although levels of NO as well as its metabolites and soluble adhesion molecules have been exploited in single cohort studies among SCD patients [7,8,9,17,25], a correlation between the two has not been given a closer look. In another study, a significant correlation was observed between nitrate and endothelial adhesion molecules in patients with systemic sclerosis [26].…”

Section: Discussionmentioning

confidence: 99%

“…In the clinical manifestations of SCD, levels of NO metabolites are particularly reduced during a vaso-occlusive crisis [15,16,17]. NO is involved in the suppression of adhesion molecule expression on endothelial cells [18].…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Soluble Endothelial Adhesion Molecules and Nitric Oxide Metabolites in Sickle Cell Disease

et al. 2018

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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.

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Low nitric oxide level is implicated in sickle cell disease and its complications in Ghana

Cited by 20 publications

References 42 publications

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Oxidative Profile of Patients with Sickle Cell Disease

Correlation Between Soluble Endothelial Adhesion Molecules and Nitric Oxide Metabolites in Sickle Cell Disease

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