Lactic Acid Dehydrogenase Activity and Plasma Hemoglobin Elevations in Sickle Cell Disease

Neely, Cherry; Wajima, Takeshi; Kraus, Alfred; Diggs, L. W.; Barreras, Luis

doi:10.1093/ajcp/52.2.167

Cited by 43 publications

(27 citation statements)

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“…15 In our study, we found that standard clinical laboratory markers of hemolytic anemia were more pronounced during acute painful episodes, consistent with previously published data from hyperhemolysing SCD patients undergoing acute painful episodes. 19 In addition to hemolysing erythrocytes, ischemic bone marrow and other organs likely release lactate dehydrogenase during acute painful episodes, 20 and injured muscle tissue releases creatine kinase. 21 To our knowledge, our study is the first application of proteomic screening to the clinical problem of acute painful episodes.…”

Section: Discussionmentioning

confidence: 99%

Apolipoprotein A-I and serum amyloid A plasma levels are biomarkers of acute painful episodes in patients with sickle cell disease

Tumblin¹,

Tailor²,

Hoehn

et al. 2010

Haematologica

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BackgroundAcute painful episodes are the clinical hallmark of sickle cell disease and have been linked to morbidity and mortality in the sickle cell population. Design and MethodsWe undertook exploratory proteomic studies on paired plasma samples collected from a cohort of 26 adult sickle cell patients during steady state and on the first day of an acute painful episode. We screened for changes in abundance of specific protein peaks via surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF MS), and confirmed the identify of candidate protein peaks by specific immunoassays. ResultsThe levels of hemoglobin, hematocrit, total protein, and albumin were lower and the levels of lactate dehydrogenase and absolute reticulocytes higher during acute painful episodes than during the steady state. Surface-enhanced laser desorption/ionization time of flight mass spectrometry spectral analysis consistently showed a mass-to-charge peak at 11.7 kDa with elevated intensities during acute painful episodes, which correlated significantly with the serum amyloid A immunoassay. Serum amyloid A levels were significantly elevated during acute painful episodes, especially in four patients with marked end-organ complications of such episodes. A second, recurring peak, less abundant during acute painful episodes, was present at 28.1 kDa; this peak was correlated significantly with immunoassay measurements of apolipoprotein A1. ConclusionsOn the average, plasma serum amyloid A rises and apolipoprotein AI falls during acute painful episodes. The serum amyloid A/apolipoprotein AI ratio increased in 81% of the patients during acute painful episodes, potentially making it a useful objective marker of such episodes. We propose that these protein alterations, known to contribute to endothelial dysfunction in other settings, might do likewise acutely in acute painful episodes and present a new target for therapeutic intervention in sickle cell disease. (ClincalTrials.gov Identifier: NCT00081523). 2010;95(9):1467-1472. doi:10.3324/haematol.2009 This is an open-access paper.Apolipoprotein A-I and serum amyloid A plasma levels are biomarkers of acute painful episodes in patients with sickle cell disease

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Section: Discussionmentioning

confidence: 99%

Apolipoprotein A-I and serum amyloid A plasma levels are biomarkers of acute painful episodes in patients with sickle cell disease

Tumblin¹,

Tailor²,

Hoehn

et al. 2010

Haematologica

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“…The reaction is based on the peroxidase activity of hemoglobin. Lactate dehydroge-nase (LDH) levels, which have been correlated with intravascular hemolysis, 10 were measured using an enzymatic rate method (oxidation of L-lactate to pyruvate, reduction of NAD-NADH and color substrate formation). Total bilirubin was measured using the Diazo method (Synchron LX automatic system; Beckman Coulter, Inc).…”

Section: Methodsmentioning

confidence: 99%

Regular Transfusion Lowers Plasma Free Hemoglobin in Children With Sickle-Cell Disease at Risk for Stroke

Lezcano

Odo

Kutlar

et al. 2006

Stroke

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Background and Purpose-Intravascular hemolysis releases large amounts of free hemoglobin (PFH) in plasma of sicklecell disease (SCD) patients. PFH has been associated with harmful endothelial actions including scavenging nitric oxide (NO). Whether PFH plays a role in stroke in SCD has not been examined. Methods-Serum levels of PFH, lactate dehydrogenase, and total bilirubin were measured in stored sera from children at risk for stroke treated in a randomized controlled trial of regular red cell transfusion (STOP study). Baseline and post-treatment (Ϸ1 year of transfusion) were compared to determine whether treatment (which reduces stroke risk by 90%) was associated with reduction in markers of hemolysis. 2 The Stroke Prevention in Sickle Cell Anemia (STOP) trial demonstrated that Transcranial Doppler (TCD) can detect children at high risk and that regular red cell transfusion (about every 3 to 4 weeks) reduced risk by 90%. 3,4 Serum frozen at baseline and quarterly visits on STOP patients provides an opportunity to explore mechanisms for stroke in SCD by comparison of control (persistent high risk) and on-treatment (low risk) samples. Results-BaselineSCD patients have high plasma free hemoglobin (PFH) resulting from high intravascular hemolysis. 5 PFH has been associated with pulmonary hypertension in SCD. 6 PFH is a scavenger of nitric oxide (NO) 7 and has other deleterious vascular effects. 8 NO is an important regulator of vascular tone in the cerebral circulation, 9 but a role for NO or PFH in the development of stroke in SCD has not been examined. Our objective was to determine whether regular blood transfusion was associated with significant reduction in PFH. MethodsThe details of the STOP study were previously published. 4 Briefly, children without stroke but at high stroke risk based on TCD, time average mean of the maximum of 200 cm/s or more, were randomized to receive regular red cell transfusions or standard care which allowed episodic transfusion for pain episodes or other events. Venous blood was drawn and allowed to clot at room temperature, and then shipped to the Medical College of Georgia (MCG)-Hemoglobinopathy laboratory in wet-ice within 48 hours where samples were centrifuged, serum removed and frozen (Ϫ70°C). Informed consent was obtained in accordance with the STOP study requirements.All 130 randomized STOP patients were eligible, but subjects with grossly hemolyzed or 1 sample only were excluded. The total number of available cases was 112. Actual treatment rather than treatment assignment at randomization was used. Patients were classified in the Transfusion group if they have at least 9 transfusions/year, and in the Episodic/No Transfusion group (included cases with only episodic transfusion) if they received no more than 4 transfusions/year. Levels of hemoglobin S (HbS) were also used as the criterion for treatment classification as follows: patients with HbS Ͻ40% were included in the transfusion group and those with HbS Ͼ50% were classified in the episodic or not transfusion group. B...

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“…1,2 Some previous data suggested that the increase in serum LDH in these patients was mainly due to tissue damage rather than hemolysis.…”

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confidence: 89%

Lactate dehydrogenase isoenzyme 3 and hemolysis in sickle cell anemia: a possible correlation?

Mecabô

Yamamoto

Biassi

et al. 2015

Blood

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Lactic Acid Dehydrogenase Activity and Plasma Hemoglobin Elevations in Sickle Cell Disease

Cited by 43 publications

References 0 publications

Apolipoprotein A-I and serum amyloid A plasma levels are biomarkers of acute painful episodes in patients with sickle cell disease

Apolipoprotein A-I and serum amyloid A plasma levels are biomarkers of acute painful episodes in patients with sickle cell disease

Regular Transfusion Lowers Plasma Free Hemoglobin in Children With Sickle-Cell Disease at Risk for Stroke

Lactate dehydrogenase isoenzyme 3 and hemolysis in sickle cell anemia: a possible correlation?

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