The acute phase inflammatory response to maximal exercise testing in children and young adults with sickle cell anaemia
The acute phase inflammatory response to maximal exercise testing in children and young adults with sickle cell anaemia
复制标题
DOI：
10.1111/bjh.13782
复制
发表时间：
2015-12-01
影响因子：
6.5
通讯作者：
Thompson, Alexis A.
中科院分区：
文献类型：
--
作者：
Liem, Robert I.;Onyejekwe, Kasiemobi;Thompson, Alexis A.
尽管镰状细胞性贫血 (SCA) 患者的基线炎症和内皮活化水平较高，但尚未评估 SCA 儿童对最大运动量的急性期反应。我们测量了一组 SCA 儿童和匹配对照组在基线、运动后立即以及运动后 30、60 和 120 分钟对可溶性血管细胞粘附分子 (sVCAM) 以及白细胞介素 6 (IL6)、白细胞总数 (WBC) 计数、C 反应蛋白 (CRP) 和 D-二聚体的最大运动测试的急性期反应。尽管除 CRP 之外的所有生物标志物的基线水平较高，但受试者从基线到运动后立即的急性期反应显着高于对照组，仅 CRP（2.1 与 0.2 mg/I，P = 0.02）和 D-二聚体（160 与 10 μg/L，P < 0.01）。随着时间的推移，所有生物标志物（包括 sVCAM、IL6、总 WBC、CRP 和 D-二聚体）都观察到类似的组间趋势。由峰值耗氧量 (VO2) 定义的较低健康水平与 sVCAM 运动急性期反应较大独立相关。我们的研究结果表明，最大程度的运动可能与 SCA 中内皮激活或炎症的任何更大升级无关，并为 SCA 儿童短暂、高强度体力活动的安全性提供了初步的生物标志物证据。
Although individuals with sickle cell anaemia (SCA) have elevated baseline inflammation and endothelial activation, the acute phase response to maximal exercise has not been evaluated among children with SCA. We measured the acute phase response to maximal exercise testing for soluble vascular cell adhesion molecule (sVCAM) as well as interleukin 6 (IL6), total white blood cell (WBC) count, C-reactive protein (CRP) and D-dimer in a cohort of children with SCA and matched controls at baseline, immediately after, and 30, 60 and 120 min following exercise. Despite higher baseline levels of all biomarkers except CRP, the acute phase response from baseline to immediately after exercise was significantly greater in subjects versus controls for CRP (2.1 vs. 0.2 mg/I, P = 0.02) and D-dimer (160 vs. 10 mu g/l, P < 0.01) only. Similar between-group trends were observed over time for all biomarkers, including sVCAM, IL6, total WBC, CRP and D-dimer. Lower fitness, defined by peak oxygen consumption (VO2), was independently associated with greater acute phase responses to exercise for sVCAM. Our results suggest maximal exercise may not be associated with any greater escalation of endothelial activation or inflammation in SCA and provide preliminary biomarker evidence for the safety of brief, high-intensity physical exertion in children with SCA.