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Editor's Correspondence |

C-Reactive Protein and Vascular Cell Adhesion Molecule-1 as Markers of Severity in Sickle Cell Disease

Alexandros C. Makis, MD, PhD; Eleftheria C. Hatzimichael, MD; Justin Stebbing, MD, MRCP, PhD; Konstantinos L. Bourantas, MD, PhD
Arch Intern Med. 2006;166(3):366-368. doi:10.1001/archinte.166.3.366.
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Acute and chronic inflammatory processes and concomitant disturbances in cell adhesion characterize the pathogenesis of sickle cell disease. To investigate these processes further, we analyzed serum levels of highly sensitive C-reactive protein (CRP), vascular cell adhesion molecule-1 (VCAM-1), intracellular cell adhesion molecule-1 (ICAM-1), and interleukin (IL)-1β, IL-2, IL-6, IL-8, and IL-12 in a homogenous cohort of individuals with double heterozygous sickle cell/β-thalassemia. We found that steady-state serum levels of CRP and VCAM-1 demonstrated statistically significant correlations with the clinical severity index in this cohort (P = .01), while other markers showed no associations. Although the mechanisms underlying observed associations between serum CRP and VCAM-1 levels and adverse outcomes have yet to be elucidated, their measurement during the course of sickle cell/β-thalassemia may guide and predict disease evolution and outcome. Furthermore, therapies that reduce these levels in the steady state of sickle cell disease may be clinically useful.

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Figure 1.

Correlation between C-reactive protein (CRP) levels and the sickle cell severity index in 35 patients with sickle cell/β-thalassemia. Significant correlations between CRP level and individual components of the sickle cell severity index were not observed (cutoff points were not used).

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Figure 2.

Correlation between serum vascular cell adhesion molecule-1 (VCAM-1) levels and the sickle cell severity index.

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