Erythrophagocytosis in sickle cell anemia: statistical evidence for a biological phenomenon.

Abstract:

:The precise role of erythrophagocytosis in sickle cell disease is not known. Using hematological data from three studies and 791 subjects comprising of eight epidemiological groups, we found a strong statistical support for the hypothesis that erythrophagocytosis is increased in sickle cell trait, that neutrophils and lymphocytes are the most likely cells involved in erythrophagocytosis in these subjects and that increased erythrophagocytosis may for a mechanistic explanation for an increased risk of vaso-occlusive crisis in sickle cell trait. Statistically, erythrophagocytosis was not increased in subjects with homozygous sickle cell disease. Our findings offer an interesting mechanistic implication about the presence of a strong autoimmune component of sickle cell trait that can be explained by the well recognized interplay between the receptor molecule signal regulatory protein-alpha (SIRP-alpha) on the phagocyte and its ligand, CD47, on the red blood cell. Our findings also support further and closer evaluation of the other hypothesized mechanisms by which neutrophils and lymphocytes partake in differential degree of erythrophagocytosis in subjects heterozygous for the sickle hemoglobin. Finally, translation of these findings into a clinical realm suggests that the extent of erythrophagocytosis, as measured by peripheral blood hematological indicators, can serve as an important indicator of the likelihood of future vaso-occlusive crisis events in subjects of sickle cell trait.

journal_name

Med Hypotheses

journal_title

Medical hypotheses

authors

Mamtani M,Sharma M,Amin M,Amin A,Jawahirani A,Kulkarni H

doi

10.1016/j.mehy.2006.09.044

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

1065-70

issue

5

eissn

0306-9877

issn

1532-2777

pii

S0306-9877(06)00709-2

journal_volume

68

pub_type

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