Does Repeated and Heavy Exercise Impair Blood Rheology in Carriers of Sickle Cell Trait?

Tripette, Julien; Hardy‐Dessources, Marie‐Dominique; Sara, Fagnété; Mona, Montout-Hedreville; Saint‐Martin, C.; Hue, Olivier; Connes, Philippe

doi:10.1097/jsm.0b013e31815aed23

Cited by 37 publications

(38 citation statements)

References 25 publications

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“…This is a surprising result because AS is usually considered a benign condition, 19 except when these individuals are subject to stressful conditions such as altitude hypoxia or extreme exercise. 20 However, recent reports by Tripette et al 21,22 suggest that, besides abnormal blood rheology, AS subjects are characterized by the specific activation of L and P-selectins during strenuous exercise. Although microvascular complications are rarely observed in AS individuals, abnormal blood viscosity plus activation of certain selectins may contribute to such microcirculatory disturbances.…”

Section: Discussionmentioning

confidence: 99%

Red blood cell aggregation, aggregate strength and oxygen transport potential of blood are abnormal in both homozygous sickle cell anemia and sickle-hemoglobin C disease

Tripette¹,

Alexy²,

et al. 2009

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BackgroundRecent evidence suggests that red blood cell aggregation and the ratio of hematocrit to blood viscosity (HVR), an index of the oxygen transport potential of blood, might considerably modulate blood flow dynamics in the microcirculation. It thus seems likely that these factors could play a role in sickle cell disease. Design and MethodsWe compared red blood cell aggregation characteristics, blood viscosity and HVR at different shear rates between sickle cell anemia and sickle cell hemoglobin C disease (SCC) patients, sickle cell trait carriers (AS) and control individuals (AA). ResultsBlood viscosity determined at high shear rate was lower in sickle cell anemia (n=21) than in AA (n=52), AS (n=33) or SCC (n=21), and was markedly increased in both SCC and AS. Despite differences in blood viscosity, both sickle cell anemia and SCC had similar low HVR values compared to both AA and AS. Sickle cell anemia (n=21) and SCC (n=19) subjects had a lower red blood cell aggregation index and longer time for red blood cell aggregates formation than AA (n=16) and AS (n=15), and a 2 to 3 fold greater shear rate required to disperse red blood cell aggregates. ConclusionsThe low HVR levels found in sickle cell anemia and SCC indicates a comparable low oxygen transport potential of blood in both genotypes. Red blood cell aggregation properties are likely to be involved in the pathophysiology of sickle cell disease: the increased shear forces needed to disperse red blood cell aggregates may disturb blood flow, especially at the microcirculatory level, since red blood cell are only able to pass through narrow capillaries as single cells rather than as aggregates.Key words: sickle cell disease, red blood cell aggregation, viscosity, red blood cell deformability. Citation: Tripette J, Alexy T, Hardy-Dessources M-D, Mougeneld D, Beltan E, Chalabi T, Chout

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Section: Discussionmentioning

confidence: 99%

Red blood cell aggregation, aggregate strength and oxygen transport potential of blood are abnormal in both homozygous sickle cell anemia and sickle-hemoglobin C disease

Tripette¹,

Alexy²,

et al. 2009

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“…Thus, it remains unclear whether anemia, microcytosis and hypochromia are limiting factors for performance, even in endurance disciplines in athletes with benign abnormal Hb. To better understand the role of hematological features in HL athletes with abnormal Hb, studies similar to those focussed on athletes with sickle cell trait (Tripette et al 2007) are needed to further explore the hemorheological properties and O 2 transport system in the context of sport. Another interest concerns the effects of ''sports anemia'' or ''pseudoanemia'' due to training on the ''true anemia'' phenotype in HL athletes with an Hb defect.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of abnormal hemoglobins in Mediterranean high-level athletes

et al. 2009

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The aim of this study was to determine the prevalence and nature of hemoglobin (Hb) defects in a Mediterranean high-level (HL) athlete population. Five hundred and ninety-four HL male and female athletes were recruited during the annual follow-up of the members of Tunisian national teams. Hematological data, Hb electrophoresis, and DNA analysis were assessed using conventional techniques. Sporting discipline, type of sport, and performance levels were assessed using a questionnaire. The results showed that 32 HL athletes had abnormal Hb (5.4%): beta-thalassemia (2.2%), alpha-thalassemia (0.5%), HbAS (1.5%), HbAC (0.5%), and rare Hb variants (0.7%). Of the 32 defect carriers, all but one (a alpha-thalassemia) were heterozygous. All the detected hemoglobinopathies but one (an Hb Hope) had already been reported in the country. The prevalence of Hb defect in the HL athletes was similar to that described in the general Tunisian population (P > 0.05). The percentage of Hb defect in the athletes was not dependent on gender, or performance level (P > 0.05). Within each type of sport the percentages of athletes with normal and abnormal Hb were similar (P > 0.05). The hematological data revealed the diversity of anemia, microcytosis, and hypochromia in thalassemic HL athletes. We concluded that HL athletes in Tunisia were a representative sample of the general Tunisian population regarding the prevalence and nature of benign abnormal Hb. The hematological data of the thalassemia carriers exhibited high variability and raised the question of genetic and sporting counseling, as well as biological follow-up for these carriers.

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“…As such, several investigations have monitored these biological factors in response to exercise. To date, the main findings include the following: 1) SCT carriers at rest have increased blood viscosity (19,86,90), slightly decreased RBC deformability (19,87), somewhat inereased RBC disaggregation threshold (87), and increased plasma eoncentration of the adhesion molecule vascular cell adhesion molecule 1 (4,67,68); 2) exercise results in a greater decrease in RBC deformability in SCT carriers than that in controls during late exercise recovery (89), but adequate hydration normalizes the hemorheological abnormalities of SCT carriers (90); 3) exercise results in a greater activation of leucocytes and platelets in SCT carriers than that in non-SCT controls (88); and 4) SCT carriers and controls exhibit very few differenees in eoagulation processes (7,24,100).…”

Section: Is Sct An Independent Risk Factor For Ecast?mentioning

confidence: 99%

ACSM and CHAMP Summit on Sickle Cell Trait

O’Connor

Bergeron²,

Cantrell

et al. 2012

Medicine &Amp; Science in Sports &Amp; Exercise

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Does Repeated and Heavy Exercise Impair Blood Rheology in Carriers of Sickle Cell Trait?

Abstract: The hemorheologic changes induced by exercise in the SCT carriers could trigger microcirculatory disorders during the recovery.

Cited by 37 publications

References 25 publications

Red blood cell aggregation, aggregate strength and oxygen transport potential of blood are abnormal in both homozygous sickle cell anemia and sickle-hemoglobin C disease

Red blood cell aggregation, aggregate strength and oxygen transport potential of blood are abnormal in both homozygous sickle cell anemia and sickle-hemoglobin C disease

The epidemiology of abnormal hemoglobins in Mediterranean high-level athletes

ACSM and CHAMP Summit on Sickle Cell Trait

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