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Impact of splenectomy on circulating microparticles in patients with sickle cell anemia
Mohamed-Rachid Boulassel1,2, Khoula Al-Rubkhi1, Jamal Al-Qasabi2
1Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman.
Introduction:
Circulating microparticles (MP) are being described as potential biomarkers for disease activity in a variety of conditions including sickle cell anemia (SCA). However, relatively little is known about the influence of spleen status on MP levels in patients with SCA.
Methods:
Using a prospective study design we characterize circulating MP in 144 patients with SCA in steady state by assessing their cellular origin and their relationships to spleen status defined by clinical and imaging findings. In addition, MP levels were studied according to demographic characteristics, clinical status, treatment modalities, and other hematological and biochemical parameters. Absolute plasma concentrations of MP were determined by flow cytometry.
Results:
Patients with SCA displayed a 10-fold increase in levels of MP derived from red blood cell (RBC) and platelets (PLT) when compared to their healthy counterparts (p < 0.0001). Splenectomized patients with SCA have more pronounced levels of MPRBC and MPPLT, and remained elevated after several weeks of follow-up. Levels of MP were not significantly associated with spleen removal procedures, age, gender, clinical severity score, hydroxyurea therapy, hemoglobin F, and co-existence of glucose-6-phosphate dehydrogenase deficiency.
Conclusion:
Collectively, these results suggest that splenectomy affects circulating levels of MP regardless of the known SCA modifiers and correlates.
Insights
Splenectomy significantly increases circulating microparticles (MPs) in sickle cell anemia (SCA) patients. These elevated levels of red blood cell (RBC) and platelet (PLT) MPs persist post-surgery, irrespective of other SCA factors.
Area of Science:
- Hematology
- Vascular Biology
- Biomarker Discovery
Background:
- Circulating microparticles (MPs) are emerging biomarkers for disease activity in conditions like sickle cell anemia (SCA).
- The impact of spleen status on MP levels in SCA patients remains largely uncharacterized.
Purpose of the Study:
- To investigate the relationship between spleen status and circulating MP levels in SCA patients.
- To characterize the cellular origin of MPs and their association with clinical and demographic factors in SCA.
Main Methods:
- Prospective study of 144 steady-state SCA patients.
- Flow cytometry used to quantify absolute plasma concentrations of MPs.
- MP cellular origin assessed, alongside relationships to spleen status (clinical/imaging), demographics, clinical status, and treatments.
Main Results:
- SCA patients exhibited a 10-fold increase in RBC-derived and PLT-derived MPs compared to healthy individuals.
- Splenectomized SCA patients showed significantly higher levels of MPRBC and MPPLT, which remained elevated.
- MP levels were not significantly associated with spleen removal, age, gender, clinical severity, hydroxyurea therapy, HbF, or G6PD deficiency.
Conclusions:
- Splenectomy demonstrably impacts circulating MP levels in SCA patients.
- Elevated MP levels post-splenectomy are independent of known SCA modifiers and correlates.
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