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Lymphocyte blastogenic responses in sickle cell disease
S Taylor1, S Shacks, S Villicana
1Department of Pediatrics, Charles R. Drew University of Medicine and Science, King/Drew Medical Center, Los Angeles, California 90059.
Immunological Investigations
|December 1, 1991
Summary
Sickle cell disease (SCD) patients in crisis show significantly impaired cell-mediated immunity, with reduced lymphocyte blastogenic responses to mitogens like phytohemagglutinin (PHA) and antigens. This immune dysfunction is particularly pronounced during crisis, especially when infection is present.
Area of Science:
- Immunology
- Hematology
Background:
- Cell-mediated immunity (CMI) in sickle cell disease (SCD) remains under-investigated.
- Understanding immune responses in SCD is crucial for managing complications.
Purpose of the Study:
- To assess lymphocyte blastogenic responses in SCD patients during steady state and crisis.
- To compare immune function in SCD patients with healthy controls and infected individuals.
Main Methods:
- Evaluated lymphocyte blastogenic responses using phytohemagglutinin (PHA) and antigens (Candida albicans, Tetanus Toxoid).
- Studied 62 SCD patients (steady state and crisis), 30 healthy controls, and 10 infected controls.
- Assessed responses via stimulation index and mean counts per minute.
Main Results:
- 86% of steady-state SCD patients and 100% of healthy controls showed normal responses.
- Only 20% of SCD crisis patients exhibited normal blastogenic responses.
- SCD crisis patients displayed significantly depressed proliferation to PHA (70%) and antigens (55% to Candida, 30% to Tetanus).
Conclusions:
- The crisis state in SCD profoundly impairs blastogenic responses, particularly to PHA.
- In vitro antigenic stimulation is also affected, though to a lesser extent than mitogen response.
- Infection exacerbates immune dysfunction in SCD crisis patients.