期刊
FREE RADICAL BIOLOGY AND MEDICINE
卷 43, 期 11, 页码 1469-1483出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.freeradbiomed.2007.08.014
关键词
sickle cell disease; endothelium; nitric oxide; free radicals
资金
- NHLBI NIH HHS [R01 HL064937-07, R37 HL058115, R01 HL058115-11, HL64937, R01 HL058115, HL58115, R01 HL064937] Funding Source: Medline
The vascular pathophysiology of sickle cell disease (SCD) is influenced by many factors, including adhesiveness of red and white blood cells to endothelium, increased coagulation, and homeostatic perturbation. The vascular endothelium is central to disease pathogenesis because it displays adhesion molecules for blood cells, balances procoagulant and anticoagulant properties of the vessel wall, and regulates vascular homeostasis by synthesizing vasoconstricting and vasodilating substances. The occurrence of intermittent vascular occlusion in SCD leads to reperfusion injury associated with granulocyte accumulation and enhanced production of reactive oxygen species. The participation of nitric oxide (NO) in oxidative reactions causes a reduction in NO bioavailability and contributes to vascular dysfunction in SCD. Therapeutic strategies designed to counteract endothelial, inflammatory, and oxidative abnormalities may reduce the frequency of hospitalization and blood transfusion, the incidence of pain, and the occurrence of acute chest syndrome and pulmonary hypertension in patients with SCD. (C) 2007 Elsevier Inc. All rights reserved.
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