Taking the Guesswork out of Sickle Cell

Sickle cell anemia blood test identifies high risk patients

(RxWiki News) For some patients, sickle cell disease is a debilitating disease full of painful complications. Until recently it was tough to identify which patients were at risk for the most serious complications.

A blood test can pinpoint the patients most likely to suffer from painful complications that can cause organ damage as a result of abnormal crescent-shaped red blood cells could help doctors better monitor and treat those affected.

"Reduce sickle cell anemia complications by staying hydrated."

Sangeeta Bhatia, the John and Dorothy Wilson Professor of Health Sciences and Technology and Electrical Engineering and Computer Science at MIT and a co-developer of the test, pointed out that high cholesterol patients can be monitored for their risk of developing heart disease and their response to medication through a simple blood test.

"With sickle cell disease, despite patients having the same underlying genetic change, some suffer tremendously while others don't — and we still don't have a test that can guide physicians in making therapeutic decisions," Bhatia said.

In order to determine patients' risk of serious complications from sickle cell anemia, researchers found a method for measuring how well blood samples flow through a microfluidic device. This is key to identifying high risk patients because abnormally-shaped red blood cells do not last as long in circulation.

Researchers initially began studying how the sickle-shaped cells move through capillaries. As part of the current study, they created a vaso-occlusive crisis, which happens when the stiffer and stickier crescent-shaped cells clog blood vessels and block blood flow. In some patients such occurrences happen more often, or are more severe.

Blood from sickle cell patients, some of which had made an emergency visit to the hospital or had a blood transfusion within the past 12 months and some who had not, was then directed through a microchannel with lowered oxygen concentration, which prompted the cells to block blood flow.

With each blood sample investigators measured how fast the blood would stop flowing after oxygen was restored. They found that blood from sickle cell patients with less severe forms of the disease did not slow as quickly as as those who were more severely affected and tended to have more complications.

As part of the study researchers also tested a drug called 5-hydroxymethyl furfural, which helps hemoglobin bind to oxygen, to demonstrate how the finding could be useful in drug development. They found that when the medication was added to the blood, the flow of the blood improved dramatically.

The investigators already have applied for a patent for the test as a diagnostic and research tool.

The findings were published in journal Science Translational Medicine.

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Review Date: 
March 2, 2012