Elevated Plasma sVCAM-1 Levels in Children With Sickle Cell Disease: Impact of Chronic Transfusion Therapy

Vishwas S. Sakhalkar, Sreedhar P. Rao, Jeremy Weedon, Scott T. Miller

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Vascular cell adhesion molecule-1 (VCAM-1) has been implicated as being important in the pathophysiology of acute pain episodes (APE) and acute chest syndrome (ACS) of sickle cell disease (SCD). The frequency of these episodes is reduced by chronic transfusion therapy. The Impact of chronic transfusion therapy on VCAM-1 expression is unknown. Soluble VCAM-1 (sVCAM-1) levels were measured in plasma using an ELISA assay (R&D Systems) in 61 patients with SCD (age range 1.5-20 years) and 12 normal controls (2.5-14 years). SCD patients included 20 with ACS, 14 with APE, 12 at well-child visits, and 15 receiving chronic transfusion therapy. Asymptomatic SCD patients had higher sVCAM-1 levels compared to normal subjects (P < 0.001). Levels of sVCAM-1 were further elevated during ACS (P < 0.001) and APE (P = 0.072) and returned to the asymptomatic range on resolution. Levels wore significantly lower in transfused patients (P = 0.003) compared to asymptomatic SCD patients. Our findings of Increased VCAM-1 expression during ACS and perhaps APE offer a rationale for therapeutic use of cytokine and other VCAM-1 modulators. The reduction of sVCAM-1 levels observed in our transfused SCD patients offers insight into the mechanism of the protective effect of transfusion against ACS and APE and possibly stroke.

Original languageEnglish (US)
Pages (from-to)57-60
Number of pages4
JournalAmerican Journal of Hematology
Issue number1
StatePublished - May 2004
Externally publishedYes


  • Acute chest syndrome
  • Acute pain episode
  • Chronic transfusion therapy
  • Sickle cell anemia
  • Vascular cell adhesion molecule-1
  • White blood cell count

ASJC Scopus subject areas

  • Hematology


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