Influence of Oxidative Stress Biomarkers and Genetic Polymorphisms on the Clinical Severity of Hydroxyurea-Free Senegalese Children with Sickle Cell Anemia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Recruitment of the Cohort and Clinical Data Recording
2.2. Biochemical and Hematological Parameters
2.3. Measurement of Plasma Oxidative Stress Markers
2.4. Genotyping of SCA Modifiers and SNPs of Anti/Pro-Oxidant Enzymes Genes
2.5. Statistical Analyses
3. Results
3.1. Description of the SCA Population
3.2. Comparison of Oxidative Stress Biomarkers between SCA and AA Patients
3.3. Effects of SCA Genetic Modifiers on Oxidative Stress Parameters and Hemolytic Index
3.4. Associations between Oxidative Stress Biomarkers and Indicators of Clinical Severity
3.5. Influence of SOD2, MPO, and XO Genetic Polymorphisms on SCA Complications and Oxidative Stress Parameters
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Assays | Intra-Assay CV | Limit of Detection |
---|---|---|
AOPP | 5.20% | 2 µmol/L |
MDA | 4.23% | 1 µmol/L |
GPX | 6.30% | 2 mmol/L/min |
Catalase | 5.49% | 0.1 mmol/L/min |
SOD | 6.35% | 0.2 mmol/L/min |
MPO | 8.12% | 0.02 mmol/L/min |
XO | 3.41% | 0.01 mmol/L/min |
Clinical and Biological Parameters | Mean (±SD) or N | Range (min–max) |
---|---|---|
Epidemiological parameters | ||
Inclusion age (years) | 9.7 ± 4.6 | 2.0–22.9 |
Sex ratio (M/F) | 170/131 | / |
Age of first SCA complication | ||
<3 years | 146 | / |
>3 years | 155 | / |
Hospitalized VOC in last 2 years | ||
None | 176 | / |
At least one | 125 | / |
Other complications in last 2 years (No/Yes) | ||
Osteomyelitis | 286/15 | / |
Osteonecrosis | 292/9 | / |
Stroke | 289/12 | / |
Acute splenic sequestration | 293/8 | / |
Sepsis | 295/6 | / |
Acute chest syndrome | 290/11 | / |
Biological parameters | ||
WBC count (103/L) | 14.3 ± 4.3 | 4.2–28.5 |
Hb (g/dL) | 7.8 ± 1.1 | 5.5–12.0 |
Reticulocytes count (103/L) | 330 ± 166 | 28–1117 |
Reticulocytes (%) | 12.0 ± 5.6 | 0.6–36.5 |
Platelets count (103/L) | 449 ± 136 | 135–945 |
HbF (%) | 9.5 ± 5.1 | 1.1–26.8 |
ASAT (UI/L) | 61 ± 34 | 20–341 |
Total bilirubin (mg/dL) | 44 ± 24 | 7–107 |
Direct bilirubin (mg/dL) | 23 ± 15 | 2–68 |
LDH (UI/ L) | 940 ± 499 | 148–3318 |
CRP (mg/L) | 4.6 ± 5.4 | 0.1–34.6 |
HbF QTLs (0–6) | p * | HbF Level (%) | p | G6PD Genotype | p | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
(0–1) n = 51 | (2–3) n = 195 | (4–6) n = 55 | <5 n = 68 | 5–15 n = 185 | ≥15 n = 48 | Wild n = 249 | Het n = 25 | Mute n = 27 | ||||
Oxidative stress products | ||||||||||||
AOPP (µmol/L) | 48 ± 16 | 51 ± 17 | 49 ± 14 | 0.58 | 51 ± 17 | 50 ± 16 | 48 ± 15 | 0.68 | 50 ± 16 | 49 ± 17 | 50 ± 16 | 0.89 |
MDA (µmol/L) | 37 ± 8 | 38 ± 10 | 38 ± 23 | 0.82 | 37 ± 11 | 38 ± 14 | 39 ± 13 | 0.63 | 38 ± 14 | 37 ± 7 | 37 ± 7 | 0.90 |
Pro-oxidant enzymes | ||||||||||||
XO (mmol/L/min) | 0.84 ± 0.16 | 0.86 ± 0.16 | 0.84 ± 0.16 | 0.87 | 0.85 ± 0.18 | 0.84 ± 0.15 | 0.87 ± 0.17 | 0.56 | 0.84 ± 0.16 | 0.86 ± 0.16 | 0.84 ± 0.10 | 0.83 |
MPO (mmol/L/min) | 0.6 ± 0.7 | 0.6 ± 0.9 | 0.5 ± 0.5 | 0.76 | 0.62 ± 0.86 | 0.64 ± 0.73 | 0.50 ± 0.50 | 0.47 | 0.6 ± 0.7 | 0.5 ± 0.5 | 0.6 ± 0.5 | 0.50 |
Antioxidant enzymes | ||||||||||||
Catalase (mmol/L/min) | 4.2 ± 1.2 | 4.7 ± 2.3 | 4.3 ± 2.0 | 0.22 | 4.7 ± 1.8 | 4.6 ± 2.4 | 4.2 ± 1.7 | 0.51 | 4.6 ± 2.2 | 3.8 ± 1.7 | 4.6 ± 1.8 | 0.24 |
GPX (mmol/L/min) | 46.6 ± 34.4 | 49.3 ± 38.0 | 45.5 ± 35.5 | 0.75 | 49.4 ± 41.4 | 47.5 ± 36.0 | 48.8 ± 33.2 | 0.93 | 48.3 ± 37.0 | 53.9 ± 38.3 | 40.8 ± 32.0 | 0.42 |
SOD (mmol/L/min) | 11.1 ± 2.6 | 11.1 ± 3.3 | 11.3 ± 3.4 | 0.73 | 10.9 ± 2.7 | 11.5 ± 3.4 | 10.4 ± 2.8 | 0.07 | 10.3 ± 3.26 | 10.8 ± 3.1 | 11.5 ± 3.4 | 0.31 |
Hemolytic index | 0.07 ± 1.06 | −0.02 ± 0.97 | 0.01 ± 1.05 | 0.84 | 0.03 ± 0.86 | 0.05 ± 1.09 | −0.24 ± 0.81 | 0.19 | −0.01 ± 1.02 | 0.10 ± 0.90 | 0.02 ± 0.92 | 0.87 |
Age of First Complication | Hospitalized VOC in Last 2 Years | Acute Chest Syndrome in Last 2 Years | |||||||
---|---|---|---|---|---|---|---|---|---|
<3 years n = 146 | >3 years n = 155 | p | None n = 176 | At Least 1 n = 125 | p | None n = 290 | At Least 1 n = 11 | p | |
Oxidative stress products | |||||||||
AOPP (µmol/L) | 49 ± 16 | 51 ± 16 | 0.15 | 50 ± 16 | 51 ± 16 | 0.48 | 50 ± 16 | 54 ± 20 | 0.46 |
MDA (µmol/L) | 38 ± 16 | 37 ± 10 | 0.53 | 38 ± 14 | 37 ± 11 | 0.51 | 38 ± 13 | 42 ± 10 | 0.28 |
Pro-oxidant enzymes | |||||||||
XO (mmol/L/min) | 0.84 ± 0.15 | 0.85 ± 0.16 | 0.88 | 0.84 ± 0.16 | 0.84 ± 0.16 | 0.85 | 0.85 ± 0.16 | 0.85 ± 0.18 | 0.89 |
MPO (mmol/L/min) | 0.6 ± 0.7 | 0.6 ± 0.7 | 0.98 | 0.6 ± 0.7 | 0.6 ± 0.7 | 0.75 | 0.62 ± 0.74 | 0.50 ± 0.51 | 0.60 |
Antioxidant enzymes | |||||||||
MnSOD (mmol/L/min) | 11.0 ± 3.2 | 9.7 ± 3.3 | 0.001 | 10.6 ± 3.3 | 10.0 ± 3.2 | 0.19 | 11.1 ± 3.2 | 12.5 ± 1.8 | 0.14 |
CAT (mmol/L/min) | 5.0 ± 2.5 | 4.1 ± 1.8 | 0.002 | 4.6 ± 2.4 | 4.4 ± 1.7 | 0.46 | 4.5 ± 2.2 | 5.2 ± 2.4 | 0.36 |
GPX (mmol/L/min) | 49.0 ± 38.9 | 47.3 ± 34.7 | 0.67 | 52.4 ± 35.2 | 42.0 ± 38.1 | 0.01 | 48.1 ± 37.0 | 47.7 ± 32.5 | 0.97 |
SOD2 (rs4880) | MPO (rs2333227) | XO (rs207454) | |||||||
---|---|---|---|---|---|---|---|---|---|
Wild n = 132 | Het + Mute n = 169 | p | Wild n = 163 | Het + Mute n = 138 | p | Wild n = 142 | Het + Mute n = 159 | p | |
Quantitative clinical parameters * | |||||||||
Age first complication (years) | 4.4 ± 3.4 | 3.8 ± 3.2 | 0.12 | 3.7 ± 3.0 | 4.5 ± 3.5 | 0.04 | 4.0 ± 3.2 | 4.0 ± 3.2 | 0.86 |
Number of hospitalized VOC (last 2 years) | 0.80 ± 1.3 | 0.69 ± 1.1 | 0.43 | 0.77 ± 1.3 | 0.71 ± 1.1 | 0.69 | 0.85 ± 1.4 | 0.65 ± 1.1 | 0.16 |
Other clinical parameters (No/Yes) ** | |||||||||
Osteomyelitis | 124/8 | 162/7 | 0.75 | 153/10 | 133/5 | 0.31 | 133/9 | 153/6 | 0.30 |
Osteonecrosis | 129/3 | 163/6 | 0.51 | 157/6 | 135/3 | 0.44 | 137/5 | 158/1 | 0.07 |
Stroke | 124/8 | 165/4 | 0.10 | 156/7 | 133/5 | 0.76 | 137/5 | 152/7 | 0.42 |
Acute splenic sequestration | 128/4 | 165/4 | 0.72 | 157/6 | 136/2 | 0.23 | 137/5 | 156/3 | 0.37 |
Sepsis | 129/3 | 166/3 | 0.75 | 160/3 | 135/3 | 0.83 | 137/5 | 158/1 | 0.07 |
Acute chest syndrome | 126/6 | 164/5 | 0.53 | 156/7 | 134/4 | 0.52 | 134/8 | 156/3 | 0.08 |
Oxidative stress parameters | |||||||||
AOPP (µmol/L) | 51.2 ± 16.4 | 49.4 ± 16.1 | 0.33 | 48.1 ± 15.5 | 52.6 ± 16.8 | 0.02 | 49.9 ± 15.1 | 50.3 ± 17.2 | 0.83 |
MDA (µmol/L) | 37.6 ± 10.7 | 37.9 ± 14.7 | 0.87 | 38.1 ± 14.9 | 37.2 ± 10.5 | 0.54 | 37.9 ± 9.8 | 37.6 ± 15.4 | 0.85 |
XO (mmol/L/min) | Not calculated | Not calculated | 0.57 ± 0.65 | 0.67 ± 0.79 | 0.38 | ||||
MPO (mmol/L/min) | Not calculated | 0.84 ± 0.15 | 0.84 ± 0.16 | 0.93 | Not calculated | ||||
MnSOD (mmol/L/min) | 10.9 ± 2.9 | 11.1 ± 3.4 | 0.22 | Not calculated | Not calculated |
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Gueye Tall, F.; Martin, C.; Ndour, E.h.M.; Faes, C.; Déme Ly, I.; Pialoux, V.; Connes, P.; Gueye, P.M.; Ndiaye Diallo, R.; Renoux, C.; et al. Influence of Oxidative Stress Biomarkers and Genetic Polymorphisms on the Clinical Severity of Hydroxyurea-Free Senegalese Children with Sickle Cell Anemia. Antioxidants 2020, 9, 863. https://doi.org/10.3390/antiox9090863
Gueye Tall F, Martin C, Ndour EhM, Faes C, Déme Ly I, Pialoux V, Connes P, Gueye PM, Ndiaye Diallo R, Renoux C, et al. Influence of Oxidative Stress Biomarkers and Genetic Polymorphisms on the Clinical Severity of Hydroxyurea-Free Senegalese Children with Sickle Cell Anemia. Antioxidants. 2020; 9(9):863. https://doi.org/10.3390/antiox9090863
Chicago/Turabian StyleGueye Tall, Fatou, Cyril Martin, El hadji Malick Ndour, Camille Faes, Indou Déme Ly, Vincent Pialoux, Philippe Connes, Papa Madieye Gueye, Rokhaya Ndiaye Diallo, Céline Renoux, and et al. 2020. "Influence of Oxidative Stress Biomarkers and Genetic Polymorphisms on the Clinical Severity of Hydroxyurea-Free Senegalese Children with Sickle Cell Anemia" Antioxidants 9, no. 9: 863. https://doi.org/10.3390/antiox9090863