Association of cell adhesion molecules with Vaso-occlusive crisis in sickle cell disease.

OBJECTIVE

The aim of this study is to see the association of P-selectin, E-selectin, Vascular Cell Adhesion Molecule-1 (VCAM-1) and Intercellular Adhesion Molecule-1 (ICAM-1) with Vaso-occlusive crisis (VOC) in sickle cell disease patients.

METHODS

In this longitudinal study, a total of 140 SCD patients admitted into a Government Medical College, Jabalpur, were recruited. Plasma levels of soluble P-selectin, E-Selectin, ICAM-1, and VCAM-1 were measured at three different time points, that is, (i) at the time of admission (n = 140), (ii) at discharge (n = 139), and (iii) during steady state (n = 118).

RESULTS

The most common presenting symptoms at the time of VOC were severe joint pain (65.7%) and back pain (49.3%). All the cell adhesion molecule levels were similar in males and females except sVCAM-1. The plasma P-selectin, E-Selectin, ICAM-1 and VCAM-1 levels were significantly higher during crisis than at the discharge and steady state. No statistically significant association of any of the CAM levels with the severity of pain was observed. High plasma VCAM-1 levels (≥1676 ng/mL) were associated with longer duration of hospital stay.

CONCLUSIONS

Significant association of soluble CAMs with VOC in SCD suggests that soluble CAMs play a crucial role in the pathophysiology of the VOC.