Placenta growth factor in sickle cell disease: association with hemolysis and inflammation

• Published in: Blood Vol. 115; no. 10; pp. 2014 - 2020
• Main Authors: Brittain, Julia E., Hulkower, Ben, Jones, Susan K., Strayhorn, Dell, De Castro, Laura, Telen, Marilyn J., Orringer, Eugene P., Hinderliter, Alan, Ataga, Kenneth I.
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 11.03.2010; Americain Society of Hematology; American Society of Hematology
• Series: Red Cells, Iron, and Erythropoiesis
• Subjects: Adult; Anemia, Sickle Cell - blood; Anemia, Sickle Cell - complications; Anemias. Hemoglobinopathies; Biological and medical sciences; Case-Control Studies; Cross-Sectional Studies; Diseases of red blood cells; Endothelin-1 - blood; Female; Hematologic and hematopoietic diseases; Hemolysis - physiology; Humans; Hypertension, Pulmonary - blood; Hypertension, Pulmonary - complications; Hypertension, Pulmonary - diagnosis; Inflammation - blood; Inflammation - complications; Male; Medical sciences; Middle Aged; Placenta Growth Factor; Predictive Value of Tests; Pregnancy Proteins - blood; Prognosis; Red Cells, Iron, and Erythropoiesis; Young Adult; Hemolysis; Hemoglobinopathy; Hemolytic anemia; Sickle cell anemia; Angiogenic factor; Hematology; Hemopathy; Inflammation; Placenta growth factor; Genetic disease
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2009-04-217950

Placenta growth factor (PlGF) is released by immature erythrocytes and is elevated in sickle cell disease (SCD). Previous data generated in vitro suggest that PlGF may play a role in the pathophysiology of SCD-associated pulmonary hypertension (PHT) by inducing the release of the vasoconstrictor, endothelin-1. In this cross-sectional study of 74 patients with SCD, we confirm that PlGF is significantly elevated in SCD compared with healthy control subjects. We found significantly higher levels of PlGF in SCD patients with PHT but observed no association of PlGF with the frequency of acute pain episodes or history of acute chest syndrome. The observed correlation between PlGF and various measures of red cell destruction suggests that hemolysis, and the resultant erythropoietic response, results in the up-regulation of PlGF. Although relatively specific, PlGF, as well as N-terminal pro-brain natriuretic peptide and soluble vascular cell adhesion molecule, has low predictive accuracy for the presence of PHT. Prospective studies are required to conclusively define the contribution of PlGF to the pathogenesis of PHT and other hemolytic complications in SCD.