Neutrophil Gelantinase Associated Lipocalin (NGAL) as a Biomarker of Painful Vaso-Occlusive Crisis in Sickle Cell Disease (SCD
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Neutrophil Gelantinase Associated Lipocalin (NGAL) as a Biomarker of Painful Vaso-Occlusive Crisis in Sickle Cell Disease (SCD),MOHAMAD T. ELKHOLY and IBRAHIM E. EWEES
Abstract
Chronic inflammation and hypercoagulable state contribute significantly to the occurance of vaso-occlusive complication of sickle cell diseases (SCD). The pathogenesis determines changes in the levels of pro-inflammatory mediators such as cytokines, endothelial adhesion molecules, elevated markers of thrombin generation and group of new biochemical markers including NGAL. The aim of the present study was to evaluate levels of neutrophil gelatinase associated lipocalin (NGAL) in SCD patients during painful crises and steady state of illness. This work included 43 patients with SCD in painful crises that was severe to justify hospital admission. Nineteen samples were collected among the cases when patients came to the clinic for follow up visit in steady state. Control group included fourteen healthy ethnically matched individuals. NGAL levels were quantitated by ELISA. Other haematolog-ical and biochemical parameters such as HG, RBC, WBC, bilirubin, CRP, LDH were also determined.
The results revealed that NGAL concentrations were highly significantly elevated in sickle cell painful crises compared with steady state SCD (p<0.0001) and when com-pared with healthy controls. These results also showed the NGAL levels correlate with WBC, CRP and LDH.
This work represents initial step to determine NGAL role as a biomarker involved in the inflammatory and immune modulatory functions reported in the pathogenesis of painful episodes in SCD and may be a valuable predictor marker in the progress to severe attaches (e.g. acute chest syndrome) or resolution of acute SCD crisis.