The acute phase inflammatory response to maximal exercise testing in children and young adults with sickle cell anaemia

Robert I. Liem*, Kasiemobi Onyejekwe, Marie Olszewski, Chisalu Nchekwube, Frank P. Zaldivar, Shlomit Radom-Aizik, Mark J. Rodeghier, Alexis A. Thompson

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Although individuals with sickle cell anaemia (SCA) have elevated baseline inflammation and endothelial activation, the acute phase response to maximal exercise has not been evaluated among children with SCA. We measured the acute phase response to maximal exercise testing for soluble vascular cell adhesion molecule (sVCAM) as well as interleukin 6 (IL6), total white blood cell (WBC) count, C-reactive protein (CRP) and D-dimer in a cohort of children with SCA and matched controls at baseline, immediately after, and 30, 60 and 120 min following exercise. Despite higher baseline levels of all biomarkers except CRP, the acute phase response from baseline to immediately after exercise was significantly greater in subjects versus controls for CRP (2·1 vs. 0·2 mg/l, P = 0·02) and D-dimer (160 vs. 10 μg/l, P < 0·01) only. Similar between-group trends were observed over time for all biomarkers, including sVCAM, IL6, total WBC, CRP and D-dimer. Lower fitness, defined by peak oxygen consumption (VO2), was independently associated with greater acute phase responses to exercise for sVCAM. Our results suggest maximal exercise may not be associated with any greater escalation of endothelial activation or inflammation in SCA and provide preliminary biomarker evidence for the safety of brief, high-intensity physical exertion in children with SCA.

Original languageEnglish (US)
Pages (from-to)854-861
Number of pages8
JournalBritish Journal of Haematology
Volume171
Issue number5
DOIs
StatePublished - Dec 1 2015

Keywords

  • Biomarkers
  • Exercise testing
  • Fitness
  • Inflammation
  • Sickle cell disease

ASJC Scopus subject areas

  • Hematology

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