Preprint
Heme-mediated cell activation: the inflammatory puzzle of sickle cell anemia
Registro en:
10.1080/17474086.2017.1327809
GUARDA, C. C. et al. Heme-mediated cell activation: the inflammatory puzzle of sickle cell anemia. Expert Review Hematology, v. 10, n. 6, p. 533-541, 2017.
Autor
Guarda, Caroline Conceição da
Santiago, Rayra Pereira
Fiuza, Luciana Magalhães
Aleluia, Milena Magalhães
Ferreira, Júnia Raquel Dutra
Figueiredo, Camylla Vilas Boas
Yahouedehou, Setondji Cocou Modeste Alexandre
Oliveira, Rodrigo Mota de
Lyra, Isa Menezes
Gonçalves, Marilda de Souza
Resumen
Introduction: Hemolysis triggers the onset of several clinical manifestations of sickle cell anemia (SCA). During hemolysis, heme, which is derived from hemoglobin (Hb), accumulates due to the inability of detoxification systems to scavenge sufficiently. Heme exerts multiple harmful effects, including leukocyte activation and migration, enhanced adhesion molecule expression by endothelial cells and the production of prooxidant molecules.
Area covered: In this review, we describe the effects of heme on leukocytes and endothelial cells, as well as the features of vascular endothelial cells related to vasoocclusion in SCA. Expert commentary: Free Hb, heme and iron, potent cytotoxic intravascular molecules released during hemolysis, can exacerbate, modulate and maintain the inflammatory response, a main feature of SCA. Endothelial cells in the vascular environment, as well
as leukocytes, can become activated via the molecular signaling effects of heme. Due to the hemolytic nature of SCA, hemolysis represents an interesting therapeutic target for heme-scavenging purposes.