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Editor's Correspondence
February 13, 2006

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

Arch Intern Med. 2006;166(3):366-368. doi:10.1001/archinte.166.3.366

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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