Analyses of the soluble levels of sCD40L, sCD62P and sCD40 in pediatric sickle cell anemia patients with abnormal transcranial Doppler

Araújo, Cinthya Pereira Leite Costa de; Duarte, Maria do Carmo Menezes Bezerra; Torres, Leuridan Cavalcante

doi:10.1016/j.htct.2023.03.020

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Original article • Hematol., Transfus. Cell Ther. 46 (3) • 2024 • https://doi.org/10.1016/j.htct.2023.03.020 linkcopy

Analyses of the soluble levels of sCD40L, sCD62P and sCD40 in pediatric sickle cell anemia patients with abnormal transcranial Doppler

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction Serum levels of sCD40L, sCD40 and sCD62P were evaluated in sickle cell anemia (SCA) patients aged between 2 and 16 years with normal transcranial Doppler (TCD) and no stroke (G1, n = 24); in SCA patients with abnormal TCD (G2, n = 16); in SCA patients with a previous history of stroke (G3, n = 8), and; in healthy controls (aged 2 to 13 years; n = 26).

Results The levels of sCD40L were significantly higher in the G1, G2 and G3 groups, compared to controls (p = 0.0001, p < 0.0002 and p = 0.004, respectively). Among patients with SCA, higher levels of sCD40L were found in the G3 group, compared to the G2 group (p = 0.03). In the sCD62P analysis, high levels in G3, compared to G1 (p = 0.0001), G2 (p = 0.03) and G4 (p = 0.01), and G2 also had high levels, compared to G1 (p = 0.04). The G1 patients had a higher sCD40L/sCD62P ratio, compared to G2 (p = 0.003) and controls (p < 0.0001). The sCD40L/sCD40 ratios were higher in G1, G2 and G3, compared to controls (p < 0.0001, p = 0.008 and p = 0.002, respectively).

Conclusion It was concluded that the combination of TCD abnormality, associated with levels of sCD40L and sCD62P, may contribute to a better assessment of the risk for stroke in pediatric SCA patients. Favor pedir para os autores corrigirem esta frase, pois NÃO é uma sentença completa em inglês: Our data suggest that decreased values of the s[LSM1] CD40L/sCD62P ratio involving two inflammatory mediators produced in platelet activation, being unprecedented in the literature.

Keywords
Sickle cell anemia; Stroke; Blood platelets; CD40 antigenCD40 ligand inflammation

Inflammatory Parameters	G1 (n = 24)	G2 (n = 16)	G3 (n = 8)	G4 (n = 26)	P-Values*
Inflammatory Parameters	G1 (n = 24)	G2 (n = 16)	G3 (n = 8)	G4 (n = 26)	G1 X G2	G1 X G3	G2 X G3	G1 X G4	G2 X G4	G3 X G4
sCD40L/sCD40a	7.1 (5.5 - 12.5)	6.1 (3.7 - 7.8)	7.7 (2.7 - 13.5)	1.02 (0.9 - 2.6)	0.2	0.9	0.4	< 0.0001	0.008	0.002
sCD40L/sCD62Pa (x 10²)	4.0 (2.8 - 5.9)	2.2 (1.5 - 3.0)	2.7 (1.5 - 3.4)	0.8 (0.2 - 1.2)	0.003	0.3	0.37	< 0.0001	0.0002	0.0002
Hematological Parameters
Leukocytesb x 10³/µL	13.2 (±3.9)	13.9 (±4.2)	12.7 (±3.0)	8.0 (±1.3)	0.6	0.6	0.4	< 0.0001	< 0.0001	0.0004
Neutrophilsa x 10³/µL	5.8 (3.5 - 7)	5.9 (4.6 - 9.9)	5.1 (4.5 - 7.1)	3.5 (2.6 - 4.4)	0.3	0.9	0.2	0.001	< 0.0001	< 0.0007
Lymphocytesa x 10³/µL	4.8 (4.2 - 5.4)	3.8 (2.9 - 5)	3.1 (2.7 - 5.1)	3.3 (2.6 - 3.5)	0.01	0.02	0.5	< 0.0001	0.07	0.5
Hemoglobinb (g/dL)	7.7 (±1.0)	7.8 (±1.4)	8.7 (±1.2)	12.9 (±0.8)	0.8	0.01	0.08	< 0.0001	< 0.0001	< 0.0001
Reticulocytesb (%)	7.2 (±2.6)	6.8 (±2.6)	7.3 (±2.9)	1.2 (±0.3)	0.5	0.7	0.7	<0.0001	<0.0001	<0.0001
Plateletsa x 10³/µL	445 (±187)	377.5 (±99)	423 (360-461)	315 (±57)	0.1	0.6	0.1	0.0003	0.01	0.0002

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[1] SCA: sickle cell anemia; TCD: Transcranial Doppler; G1: SCA, normal TCD and no stroke; G2: SCA, abnormal TCD and no stroke; G3: SCA and stroke; G4: Controls.

[TFN1] ^a
mean and standard deviation;.

[TFN2] ^b
median and interquartile range (IQR); *Kruskal-Wallis test. *P-values < 0.05.