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Sickle Cell Disease - A New Vision for an Old Problem (Hardcover)
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Sickle Cell Disease - A New Vision for an Old Problem (Hardcover)
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Sickle cell hemoglobin (HbS) is the result of a single nucleotide
change (GAG GTG) in the beta-globin gene, where valine replaces
glutamic acid at the sixth amino acid position in the beta-globin
chain. Sickle cell disease is a growing global health problem. The
World Health Organization has estimated that 7% of the world
population has the mutation and 300,000400,000 affected children
are born every year. The disease progresses towards a severe
chronic hemolytic anemia, and it shows a heterogeneous clinical
course, related with different genetic factors. Despite the fact
that all subjects with sickle cell disease (SCD) have the same
single base pair mutation in the DNA, we further confirmed here
that the severity of the clinical and hematological manifestations
is extremely variable. Increasing evidence has indicated a role of
oxidative stress in the vascular pathophysiology of SCD. 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.In addition, recent studies support the
existence of a hyperoxidative status in SCD patients that may
account, at least in part, for the clinical manifestations of these
patients. Moreover, SCD patients with mild clinical outcomes were
associated with low oxidative status, whereas high oxidative stress
was related to severe phenotypes. Thus, the use of oxidative stress
biomarkers may be important in the evaluation of the clinical
condition of SCD patients, whereas the use of therapies to improve
their redox status and increase NO bioavailability would be
beneficial to reduce the severity of sickle disease. The global
burden of SCD is now significantly increased and, thus, it is
currently a public health problem around the world. This disease
has passed from being a problem of the developing countries to
affect many people in developed countries. This book summarizes the
current epidemiology status and the latest discoveries in the
pathophysiology of SCD, and the potential therapies that may
improve the clinical course of this disease.
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