Although polymorphonuclear neutrophils (PMN) are well recognized for playing important roles in infl ammation in sickle cell disease (SCD), direct evidence linking myeloperoxidase (MPO) to impaired vascular endothelial cell (EC) function in SCD remains lacking. Over the last 25 years, only a handful of studies have been published suggesting that MPO may be involved. One of the fi rst reports, published in 1986, showed that vaso-occlusive crises increased PMN stickiness, an index of activation, in SCD patients ( 1 ). In 1993, plasma levels of MPO and C3d were reported to be higher in SCD patients than in controls, and these biomarkers inversely correlated with red cell hemoglobin ( 2 ). In 1996, PMN were shown to interact directly with the sickle red blood cell (RBC), and this interaction notably enhanced PMN activation ( 3 ). Later in 2002, it was reported that activated PMN increased sickle RBC retention in isolated rat lungs ( 4 ) and that MPO and 3-nitrotyrosine colocalized in sections of lungs from patients who died from complications associated with SCD ( 5 ). Evidence that stress increases MPO in SCD comes from studies showing that exercise induced a dual increase in plasma MPO and percentage of sickled cells in SCD patients ( 6 ). Finally, evidence linking the coagulation pathway to infl ammation in sickle cell anemia comes from studies showing that inhibiting tissue factor decreased MPO in the lungs of SCD mice ( 7 ). Although these reports and others ( 8-10 ) provide strong support for the idea that PMN activation and MPO play important roles in SCD,
Abstract Activated leukocytes and polymorphonuclear neutrophils (PMN) release myeloperoxidase (MPO), which binds to endothelial cells (EC), is translocated, and generates oxidants that scavenge nitric oxide (NO) and impair EC function. To determine whether MPO impairs EC function in sickle cell disease (SCD), control (AA) and SCD mice were treated with N-acetyl-lysyltyrosylcysteine-amide (KYC). SCD humans and mice have high plasma MPO and soluble L-selectin (sL-selectin). KYC had no effect on MPO but de-