Asthma and the outcome of sickle cell disease

Alan Lunt, Sarah S. Sturrock, Anne Greenough

    Research output: Contribution to journalArticlepeer-review

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    Abstract

    Introduction: Sickle cell disease (SCD) is one of the commonest monogenetic diseases. Worldwide, there are 300,000 infants with SCD born every year. Affected patients can die prematurely in their fifth decade as they suffer multi-organ damage, including pulmonary complications.

    Areas covered: This review describes the pathophysiology of SCD and its pulmonary complications and discusses the relationship between asthma and the outcomes of SCD. Patients with SCD and asthma, but importantly recurrent episodes of wheeze (which may not be due to asthma) have an increased risk of acute chest syndrome (ACS), painful crisis, stroke, and all-cause mortality. In SCD, there is an increased pulmonary vascular volume, which is a response to their chronic anemia. Data from adult and pediatric cohorts show such hemodynamic changes result in airflow obstruction and hence wheezing.

    Expert commentary: The wheezing and lung function abnormalities which occur in SCD patients can be due to asthma, but in others reflects the vascular airway interaction occurring because of chronic anemia. It is important to differentiate whether a SCD patient is wheezing due to asthma or SCD per se as it will affect the choice of appropriate treatment.
    Original languageEnglish
    Pages (from-to)733-740
    JournalExpert opinion on orphan drugs
    Early online date16 Nov 2018
    DOIs
    Publication statusE-pub ahead of print - 16 Nov 2018

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