Abstract • 76
Recent studies have demonstrated that a chronic inflammation and a persistent endothelial cell activation exist in children with sickle cell disease (SCD) regardless of the clinical expression of vaso-obstructive episodes. In a study of 33 children with SCD we had found significantly elevated levels of serum inflammatory cytokines IL-1β and IL-6 and circulating adhesion molecules sL-selectin, V-CAM 1 and sE- selectin as compared to the controls. All the above parameters were further elevated during crises. These findings led us to investigate whether the administration of drugs with anti-inflammatory properties due to down - regulation of adhesion molecule expression, such as cetirizine, has any effect on the laboratory and clinical profile of children with SCD. For this purpose cetirizine was given (5-10mg/d depending on age) in 11/33 children (5-17 years old, x = 11,8) with SCD who presented with 1-3 crises per year that needed hospitalization. We report our preliminary results regarding the effect of cetirizine on the circulating indicators of persistent inflammation and endothelial cell activation in our patients. Levels of IL-1β, IL-6, sL- selectin, V-CAM1 and sE- selectin were measured in all patients during the steady phase of SCD just before and after 6 month treatment with cetirizine. Measurement were done using a quantitative immunoassay (Quantikine R & D Systems). At the end of the 6 month treatment all patients were found to have significantly decreased levels of IL-1β, IL-6, sL- selectin VCAM-1 and sE- selectin compared with levels found before the cetirizine administration (4.0 vs 4.33pg/mL, 2.4 vs 5.3pg/mL, 1214 vs 1371ng/mL, 600 vs 923ng/mL, 40 vs 72ng/mL respectively). During the 6 month follow-up of the patients, only 2 children were hospitalized for infection. Although the 6 month follow-up is a short time to draw reliable conclusions our results regarding the effect of cetirizine on the laboratory profile of our patients would justify the continuation of treatment for another 6 months and the re-evaluation of these preliminary clinical findings.
