Elevated endothelial progenitor cells during painful sickle cell crisis

van Beem, Rachel T.; Nur, Erfan; Zwaginga, Jaap Jan; Landburg, Precious P.; van Beers, Eduard J.; Duits, Ashley J.; Brandjes, Dees P.; Lommerse, Ingrid; de Boer, Hetty C.; van der Schoot, C. Ellen; Schnog, John-John B.; Biemond, Bart J.; CURAMA Study Group,

doi:10.1016/j.exphem.2009.06.003

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Volume 37, Issue 9 , Pages 1054-1059, September 2009

Elevated endothelial progenitor cells during painful sickle cell crisis

Rachel T. van Beem
- Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
- Rachel T. van Beem and Erfan Nur contributed equally to this study.
Erfan Nur
- Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
- Department of Haematology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- The CURAMA Study Group, The Netherlands
- Rachel T. van Beem and Erfan Nur contributed equally to this study.
Jaap Jan Zwaginga
- Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, Leiden, The Netherlands
Precious P. Landburg
- The CURAMA Study Group, The Netherlands
- Immunology Laboratory Department, Red Cross Blood Bank Foundation, Curaçao, The Netherlands Antilles
Eduard J. van Beers
- Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
- Department of Haematology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- The CURAMA Study Group, The Netherlands
Ashley J. Duits
- The CURAMA Study Group, The Netherlands
- Immunology Laboratory Department, Red Cross Blood Bank Foundation, Curaçao, The Netherlands Antilles
Dees P. Brandjes
- Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
- The CURAMA Study Group, The Netherlands
Ingrid Lommerse
- Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
Hetty C. de Boer
- Department of Nephrology, Leiden University Medical Centre, Leiden, The Netherlands
C. Ellen van der Schoot
- Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
John-John B. Schnog
- The CURAMA Study Group, The Netherlands
Bart J. Biemond
- Department of Haematology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- The CURAMA Study Group, The Netherlands
- Offprint requests to: Bart J. Biemond, M.D., Ph.D., Department of Haematology, F4-224, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
CURAMA Study Group

Received 5 March 2009; received in revised form 6 May 2009; accepted 9 June 2009. published online 18 June 2009.

Objective

Circulating endothelial progenitor cells (EPCs) counts were determined in patients with sickle cell disease (SCD) to elucidate their role in SCD-related ischemia-induced angiogenesis and reendothelialization.

Materials and Methods

Circulating EPC counts (KDR⁺/CD34⁺/Cd45^dim cells) and their relation to serum levels of EPC mobilizing growth factors erythropoietin, vascular endothelial growth factor, and interleukin-8 were investigated in SCD patients during asymptomatic state (n=66) and painful crisis (n=36) and compared to healthy controls (n=13).

Results

EPC counts were comparable between controls (0; range, 0–1.1 cells/mL) and patients (0; range, 0–0 cells/mL) in asymptomatic state, but were significantly higher during painful crisis (41.7; range, 0–186 cells/mL; p<0.05). Also in a paired analysis of 12 patients who were included both during asymptomatic state and painful crisis, EPC counts increased significantly during painful crisis (from 0 [range, 0–0] to 26 [range, 0–149 cell/mL; p<0.05). EPC counts were not related to any of the measured growth factors.

Conclusion

The higher EPC counts during painful crisis might indicate a role for EPC mobilization in reendothelialization. As a relationship of EPCs with the established mobilizing growth factors, measured in this study was not observed, the mechanism of EPC mobilization in SCD remains to be elucidated.