Journal Article Ppublish
PubMed: 39318045 DOI: 10.1111/bjh.19785
Impaired microvascular function in patients with sickle cell anemia and leg ulcers improved with healing.
Br J Haematol 205(6):2459-2469
Authors: Judith Catella, Etienne Turpin, Philippe Connes, Elie Nader, Romain Carin, Marie Martin, Hamdi Rezigue, Christophe Nougier, Yesim Dargaud, Audrey Josset-Lamaugarny, Justine Dugrain, Muriel Marano, Alexandre Leuci, Camille Boisson, Celine Renoux, Philippe Joly, Solène Poutrel, Arnaud Hot, Nicolas Guillot, Berengère Fromy
Affiliations
- Service de Médecine Interne et Vasculaire, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), Sorbonne, Paris, France.
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe «Biologie Vasculaire et du Globule Rouge», Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
- Service d'hématologie-hémostase, Hospices civils de Lyon, Bron, France.
- EA 4609-Hémostase et cancer, UFR Laennec, Université Claude Bernard, Lyon 1, France.
- Unité d'hémostase Clinique, Hôpital Cardiologique Louis Pradel, Lyon, France.
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique (LBTI UMR 5305), CNRS/Université Claude Bernard Lyon 1, Lyon, France.
- Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France.
Abstract
Leg Ulcer (LU) pathophysiology is still not well understood in sickle cell anaemia (SCA). We hypothesised that SCA patients with LU would be characterised by lower microvascular reactivity. The aim of the present study was to compare the microcirculatory function (transcutaneous oxygen pressure (TcPO) on the foot and laser Doppler flowmetry on the arm) and several blood biological parameters between nine SCA patients with active LU (LU+) and 56 SCA patients with no positive history of LU (LU-). We also tested the effects of plasma from LU+ and LU- patients on endothelial cell activation. We observed a reduction of the TcPO in LU+ compared to LU- patients. In addition, LU+ patients exhibited lower cutaneous microvascular vasodilatory capacity in response to acetylcholine, current and local heating compared to LU- patients. Inflammation and endothelial cell activation in response to plasma did not differ between the two groups. Among the nine patients from the LU+ group, eight were followed and six achieved healing in 4.4 ± 2.5 months. Among thus achieving healing, microvascular vasodilatory capacity in response to acetylcholine, current and local heating and TcPO improved after healing. In conclusion, microcirculatory function is impaired in patients with LU, and improves with healing.
MeSH
Cells, Microcirculation, Anemia, Sickle Cell, Anemia, Leg Ulcer, Ulcer, Endothelial Cells, Acetylcholine, Heating, Plasma