Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002895 (sickle cell disease)
 11,747 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Decreased deformability and increased internal viscosity of the sickle red blood cell (SRBC) contribute to abnormal flow in the microcirculation. Since the lungs are commonly affected in sickle cell disease, we compared the hemodynamics of the normal human red blood cell (NRBC) with the SRBC in the pulmonary circulation. The SRBC has decreased antioxidant enzyme activities compared with the NRBC. Thus, using the capillary filtration coefficient (Kfc), we determined the ability of the NRBC and the SRBC to attenuate the increased permeability and resulting edema seen in the oxidant stress of reperfusion lung injury (RLI). We found that lungs perfused with a 5% SRBC perfusate had higher pulmonary arterial pressures (Ppa) and resistances than lungs perfused with a 5% NRBC perfusate. Lungs made ischemic and reperfused with a physiologic cell-free perfusate resulted in a significant increase (P less than .05) in Kfc compared with the preischemic Kfc (.45 +/- .06 to 1.4 +/- 22 mL.min-1.cm H2O.100 g-1). In lungs reperfused with 5% RBC-containing perfusates, the Kfc did not change from preischemic Kfc with NRBCs and decreased from the preischemic Kfc with SRBCs. These findings suggest that the SRBC causes physiologically significant increases in Ppa and resistances and the SRBC, like the NRBC, offers apparent protection in RLI.
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PMID:Normal versus sickle red blood cells: hemodynamic and permeability characteristics in reperfusion lung injury. 213 18

Magnetic resonance imaging (MRI) has value in characterizing normal and abnormal bone marrow because of its ability to distinguish fat from other tissues. Due to this advantage, hematologic disorders resulting in alterations of the normal cellular and fatty marrow distribution can be appreciated. In this article, the role of MRI in diffuse hematologic disorders is emphasized. At birth, almost all marrow is cellular, but by age 25, cellular marrow is restricted to the axial skeleton and proximal femoral and humeral metaphysis. The remainder is fatty, consisting of 80% fat, 15% water, and 5% protein. With increased need for hematopoiesis, reconversion from fatty to cellular marrow occurs in many diffuse disease states. Diffuse diseases that affect bone marrow production are divided into four categories representing conditions that affect the pluripotent hematopoietic stem cell. These include stem cell failure resulting in aplastic anemia, uncontrolled stem cell proliferation as exemplified by polycythemia vera, stem cell dysplasia such as sickle cell anemia, and malignant transformations or replacement. The MRI appearance of these disorders is discussed in this article. The use of spin-echo (SE) sequences is the most common approach to bone marrow imaging. With T1-weighted SE images, fatty marrow will appear bright and cellular marrow, with lower fat content, will exhibit a lower density signal. With T2-weighted SE pulse sequences, contrast between fatty marrow and cellular marrow decreases. Contrast between fatty and cellular marrow is enhanced with chemical shift imaging, including Dixon out-of-phase imaging, as emphasized in this article. MRI presents a more global view of the bone marrow than biopsy material and should provide a better understanding of diffuse hematologic disease progression and resolution.
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PMID:Magnetic resonance imaging of bone marrow: diagnostic value in diffuse hematologic disorders. 220 May

Because peroxidative damage to red cell membranes may contribute to the pathophysiology of sickle cell disease, deficiency of fat- and water-soluble antioxidants could be a determinant in the pathogenesis of this disease. We have previously reported a deficiency of vitamin E in sickle cell disease. The present study was undertaken to see if a deficiency in vitamin C might also be detected. Leukocyte vitamin C, which reflects total body vitamin C reserve, was measured by a modified 2,4-dinitrophenylhydrazine method. Sickle cell patients (N = 18) had lower leukocyte vitamin C levels (18.3 +/- 9.4 micrograms/10(8) cells) than normal controls (N = 12; 30.3 +/- 7.5 micrograms/10(8) cells; p less than 0.01). Furthermore, 50% of the patients had vitamin C levels below 15 micrograms/10(8) cells, a value consistent with vitamin C deficiency. A statistically significant correlation (r = -0.62 with 0.01 less than p less than or equal to 0.025) was found between leukocyte vitamin C levels and serum ferritin concentration. Because dietary vitamin C intake appeared to be adequate, increased vitamin C utilization may account for this deficiency. However, the mechanisms for this deficiency as well as its pathophysiologic consequences remain to be established.
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PMID:Vitamin C deficiency in patients with sickle cell anemia. 224 Apr 72

The variable levels of HbF in sickle cell anemia reflect the heterogeneous genetic mix of the beta s-gene-cluster haplotypes and coinheritance of alpha-thalassemia-2 in American SS patients. Clinical severity is less when the level of HbF reaches 20% or 1.2 g/dl or more. The coinheritance of alpha-thalassemia-2 not only increases the intracellular red cell water but modifies the HbF level in accordance with the beta-cluster haplotype. In general, the SS patient with at least one Senegalese haplotype who does not have a CAR haplotype in trans, has a significantly greater probability of maintaining HbF above 20%. This is in part related to the genetic control of the G gamma HbF locus. Such a patient is protected from arteriolar vasculopathy and subsequent major organ destruction. Much of this but perhaps not all of the better health of patients with a Senegalese haplotype can be attributed to the elevation of G gamma HbF. The coinheritance of alpha-thalassemia-2 further decreases the risk of major morbidity of the soft tissues but increases the risk of avascular necrosis of the bony skeleton. Although these heterozygous Senegal patients are healthier, eventually most, in time, will show the deleterious effect of HbS as retinopathy and avascular necrosis usually beginning after age 30 and sickle nephropathy after age 40. Because of the age-specific effect, the onset of the sickle vasculopathy is delayed by nearly 20 years in the Sen/Ben patient with increased G gamma HbF as compared to those with a CAR haplotype or the homozygous Benin. Lifetime elevation of HbF above 20% modifies the severity of disease expression and provides relative protection to the patient with sickle cell anemia.
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PMID:The influence of fetal hemoglobin on the clinical expression of sickle cell anemia. 247 64

The extent of intracellular polymerization of hemoglobin S, leading to loss of erythrocyte deformability and eventual morphological sickling, is primarily determined by oxygen saturation and intracellular hemoglobin concentration and composition. Epidemiological analysis of sickle cell disease severity among the sickle syndromes and studies of the biophysics of intracellular polymerization were used to estimate the potential clinical benefit of various therapeutic strategies. These strategies include those designed to increase deoxyhemoglobin S solubility; to increase erythrocyte volume or water content, thereby reducing the intracellular hemoglobin concentration; or, most recently, to decrease the proportion of hemoglobin S by increasing the amount of non-S hemoglobin. Increasing levels of hemoglobin F is of particular interest due to its "sparing" effect in inhibiting polymerization, the well-characterized epidemiological associations of high levels of hemoglobin F with reduced disease severity, and recent studies of drug-induced increases in hemoglobin F. Our analyses of equilibrium polymer formation at physiological oxygen saturation values suggest that small decreases in polymer formation at intermediate levels of hemoglobin F may give rise to a small decrease in anemia (as associated with homozygous alpha-thalassemia coexistent with sickle cell anemia), but that greater reductions in polymer formation may be necessary to effect a significant improvement in disease severity. Current studies of hydroxyurea-induced increases of hemoglobin F give cautious optimism that therapeutically useful levels may be attainable.
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PMID:Intracellular polymerization. Disease severity and therapeutic predictions. 247 66

High-performance liquid chromatography (HPLC) has been successfully used in the quantitation of the relatively minute amounts of hemoglobin types recovered from in vitro cultures of hemoglobin-synthesizing erythroid progenitor (BFU-E) cells. This reversed-phase HPLC method uses the Vydac C4 column and water-acetonitrile-trifluoroacetic acid as mobile phases; it has been applied to the study of fetal hemoglobin synthesis patterns in ten homozygous sickle cell anemia patients and a similar number of their heterozygous relatives along with a few normal control subjects. A significant increase in the total gamma chain level was observed in the BFU-E lysate samples corresponding to the whole blood lysates of all the patients and their heterozygous relatives, except in one patient with the beta S haplotype Mor. On the other hand, the relative level of the G gamma chains appeared to be decreased in the BFU-E lysate samples of all except the individuals carrying the Mor haplotype, where it is reversed. The method has considerable advantages over other chromatographic and electrophoretic procedures; it is extremely sensitive and allows quantitation of all different globin chains in one single chromatogram.
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PMID:Application of high-performance liquid chromatographic methodology to the analysis of hemoglobins synthesized in erythroid progenitor cells. 248 Mar 57

Calcium influx into sickle cells, with consequential activation of the Ca2(+)-activated K+ efflux (Gardos) channel, is a potential cause of cellular dehydration and loss of deformability. Bepridil, a recently described inhibitor of the Gardos channel, was found at pharmacological concentration (1 mumol/l) to inhibit significantly (P less than 0.01) the loss of deformability when sickle cells were subjected to cycles of oxygenation-deoxygenation for 15 h at 37 degrees C. Bepridil also inhibited significantly (P less than 0.005) the formation of irreversibly sickled cells. Drugs that preserve the K+ and therefore water content of erythrocytes are of potential value for hydrotherapy of sickle cell disease.
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PMID:Bepridil protects sickle cells against the adverse rheological effects of cyclical deoxygenation. 261 Nov 38

We have measured the diffusional water permeability of sickle cell anemia red blood cells under isotonic conditions using pulsed nuclear magnetic resonance (NMR) techniques. We have found that the equilibrium diffusional permeability for sickle cells is about 1.61.10(-3) cm/s, or about 60% of the value measured for normal cells. This abnormality is not related to the heterogeneity generally found in cell populations in sickle red cells with different mean corpuscular hemoglobin concentrations. We speculate that the abnormality of water exchange under isotonic conditions in sickle cells reflects an alteration of membrane proteins responsible for water exchange, possibly caused by oxidation of Band 3 proteins.
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PMID:Reduced water exchange in sickle cell anemia red cells: a membrane abnormality. 274 85

Small angle neutron scattering (SANS) was used to investigate interaction forces between hemoglobin (Hb) molecules contained within human red cells. The scattering separately attributable to cell membranes and intracellular Hb was identified. A series of D2O-H2O contrast variation measurements were made in order to establish conditions for which scattering from the cell membrane is minimized (approximately 15% D2O). Measurements then were performed to examine changes in intermolecular Hb interactions occurring when the cells are contracted or swollen by varying the ionic strength of the suspension buffer. The scattering cross-sections were fitted to structure factors computed by a mean spherical approximation, and molecular parameters thereby extracted. Oxygenation studies on normal cells were performed, and results contrasted with those of similar studies of erythrocytes obtained from sickle cell disease patients.
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PMID:SANS studies of interacting hemoglobin in intact erythrocytes. 282 85

1. With the development of techniques of gene transfer, human genetic defects such as sickle cell anaemia, phenylketonurea, cystic fibrosis, haemophilia, Huntington's chorea, etc. will be eliminated. Ninety nine percent of humans in the year 2500 will be much the same as at present, but healthier. 2. Studies of Comparative Biochemistry and Physiology show that many strategies have been developed in the Animal Kingdom that could be advantageous in furthering human survival. Some of these strategies are discussed in the present article. 3. Commensal algae that will live in the epidermis of domestic animals (pigs, goats, cattle) will be developed enabling these animals to live in dry environments with minimal demands for food and water. Once successful in domestic animals, the algae could be adapted to live in some humans, i.e. the "Green Man". 4. Commensal protozoa and bacteria that digest cellulose and lignin will be developed so that they can live in the human gut and convert the material to sugars, volatile fatty acids and amino acids that can be absorbed and metabolized by Man, thus making many inexpensive vegetable food resources available. 5. Mammalian embryos will be able to develop through to full term in vitro in a cleidoic egg; and the in vitro fertilized egg will have to depend on finding a surrogate mother. 6. Some people will have an altered pattern of sexual activity. Many patterns will be available; one suggested here is of protogynous hermaphroditism, i.e. the individuals would be female for the first 30 years of life and male for the remaining years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Possible evolutionary futures for mankind. 290 Jan 6


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