Soluble P- and E-selectin levels as determinants of vaso-occlusive crises among sickle cell anemia patients in a tertiary hospital Northwestern Nigeria

Abstract

BACKGROUND: Vascular E- and P-selectins play important roles in sickle cell anemia (SCA), vaso-occlusive crises (VOC); however, the extent to which they determine VOC has not been studied. OBJECTIVES: The aims of the study were to assess vascular selectin levels and the extent to which they determine VOC among SCA patients. SUBJECTS AND METHODS: This was a cross-sectional comparative study conducted among patients with SCA in a tertiary hospital, Northwestern Nigeria. Eighty-eight participants were enrolled (44 each in VOC and steady state). Soluble E (sE) and P (sP) selectin levels were assessed using enzyme-linked immunosorbent assay technique. The frequency of blood transfusion and bone pains was collated. RESULTS: Patients with VOC compared to those in steady state had higher levels of sP-selectin (5.5 ± 4.6 ng/ml vs. 3.2 ± 0.8 ng/ml, P = 0.001) and mean rank sE-selectin (53.2 vs. 35.8, P = 0.001). The odds ratio (OR) for sE-selectin levels and VOC was 1.135 (P = 0.009), while that of sP-selectin was 2.693 (P = 0.002). The adjusted ORs for sE-selectin and sP-selectin were 1.184 (95% confidence interval [CI]: 1.021, 1.373) and 3.748 (95% CI: 1.475, 9.524), respectively. CONCLUSIONS: Patients in VOC have elevated sP-and E-selectin levels. sP-selectin level is a better predictor of VOC compared to sE-selectin.

Keywords

• crises
• sickle cell
• vascular selectins