Serum P-Selectin levels and disease severity in sickle cell anaemia patients in Lagos State, Nigeria

Abstract

Background: Vaso-occlusion is one of the pathophysiological mechanisms in sickle cell anaemia (SCA) that leads to a myriad of clinical manifestations including the acute pain crisis. Various mechanisms have been identified in the pathophysiology of acute pain and this includes an over-expression of adhesion molecules like Pselectin.
Objective: This study aimed to determine serum Pselectin levels among SCA patients and to determine if there is any association between P-selectin levels and disease severity in Sickle cell anaemia patients. The burden of Sickle Cell Anaemia (SCA) is particularly high in Nigeria. Vaso-occlusive painful crises is the hallmark of SCA responsible for the significant morbidity and mortality associated with the disease. This study is aimed to determine if there is any association between levels of P-Selectin and vaso-occlusive painful crisis in SCA subjects. It was an analytical, prospective study using Enzyme Linked Immunosorbent Assay (ELISA) to identify serum Lu / BCAM glycoprotein. Lu/BCAM was evaluated in SCA subjects during crisis, the same set of subjects were invited three months after during steady-state and haemoglobin AA (HbAA) blood donors were also used as controls. Data were analyzed using statistical package for social science (SPSS) version 23.
Materials and Methods: This was a cross sectional study involving 96 participants (49 HbSS and 47 HbAA controls) attending the Haematology Clinic of the Lagos State University Teaching Hospital. Apparently healthy HbAA controls were also recruited into the study. All participants had serum PSelectin level assayed using the Enzyme Linked Immunosorbent Assay method. All SCA participants had disease severity score (based on clinical and laboratory parameters) calculated. Data were analysed using statistical package for social welfare (SPSS) version 23.
Results: The mean P-selectin level in the SCA group  was 14.19 + 1.22 ng/ml whilst that of the control group was 6.32 + 2.45 ng/ml. The difference in the means between the two groups was statistically significant with p=0.001. Most of the patients (98%) had mild to moderate disease and only 1 (2%) had severe disease. There was no significant correlation between P-Selectin levels and disease severity scores with p= 0.29.
Conclusion: Serum P-Selectin levels were significantly higher in HbSS patients compared with HbAA controls but failed to show a significant positive correlation between P-Selectin levels and disease severity score.