Comparison of Thrombin Generation, Platelet Activation and Aggregation Profiles in Patients With Sickle Cell Disease Depending on Their SS or SC Genotype (DrepAgreg) (DrepAgreg)
Comparison of Thrombin Generation, Platelet Activation and Aggregation Profiles in Patients With Sickle Cell Disease Depending on Their SS or SC Genotype
Sickle cell disease (SCD) is characterized by chronic hemolytic anemia, painful crises called vaso-occlusive crises (VOC) and chronic inflammation. Activated platelets from SCD patients contribute to both chronic inflammation and painful VOC. Individuals with the HbSC genotype experience anemia and less severe clinical manifestations than those with the HbSS genotype; however, they are at higher risk of venous thromboembolic events, particularly pulmonary embolism.
This study aims to investigate whether sickle cell patients exhibit different thrombin generation profiles as well as distinct platelet activation and aggregation profiles, depending on their SS or SC genotype.
Aperçu de l'étude
Statut
Les conditions
Description détaillée
Sickle cell anemia is the most common genetic disease worldwide. It is due to a homozygous mutation in the beta globin gene leading to the production of abnormal hemoglobin S (HbS). This hemoglobin polymerizes and precipitates in the red blood cells (RBCs) under hypoxic conditions, leading to the rigidification of the red blood cells that obstruct the small vessels and are subsequently destroyed. The disease is thus characterized by chronic hemolytic anemia associated with painful vaso-occlusive crises (VOC) and chronic inflammation. The HbSC genotype is associated with anemia and less severe clinical manifestations than the HbSS genotype. However, the risk of venous thromboembolic events, particularly pulmonary embolism, is paradoxically higher. The pathophysiological mechanisms involved in the occurrence of VOC and venous thromboembolic events (VTE) have not been fully elucidated. They involve phenomena of ischemia-reperfusion and complex interactions between the RBC, the endothelium, the leucocytes and the platelets. The sickle RBCs express phosphatidylserine (PS) on their surface, which facilitates their adhesion to other blood cells and their interaction with the endothelium. The release of hemoglobin and free heme into the circulation, along with oxidative stress, induces endothelial activation and dysfunction, as well as vascular inflammation, platelet activation and clotting. Numerous studies have documented the existence of coagulation activation in sickle cell patients during the stable phase of the disease and during VOCs, decreased levels of physiological inhibitors of coagulation and resistance to activated protein C. One of the main mechanisms of coagulation activation in sickle cell patients is increased tissue factor expression on the surface of activated monocytes and endothelial cells. Free heme promotes NETs (neutrophil extracellular traps) formation, which activates the intrinsic coagulation pathway. Moreover, platelets probably play a pivotal role in the thrombo-inflammatory process, coagulation activation, and the occurrence of VOC and VTE. We hypothesize that sickle cell patients may exhibit a different thrombin generation profile as well as distinct platelet activation and reactivity profiles, depending on their SS or SC genotype.
Type d'étude
Inscription (Estimé)
Contacts et emplacements
Coordonnées de l'étude
- Nom: mélanie petapermal, Master degree
- Numéro de téléphone: +590 0590934667
- E-mail: melanie.petapermal@chu-guadeloupe.fr
Lieux d'étude
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Bobigny, France, 93000
- Hôpital Avicenne
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Contact:
- Sylvain Lejeune, MD PhD
- E-mail: sylvain.le-jeune@aphp.fr
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Chercheur principal:
- sylvain lejeune, MD PhD
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Les Abymes, Guadeloupe, 97159
- CHU de la Guadeloupe
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Contact:
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Contact:
- mélanie petapermal
- Numéro de téléphone: 0590934667
- E-mail: melanie.petapermal@chu-guadeloupe.fr
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Chercheur principal:
- Maryse ETIENNE JULAN, MD
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
Patients with sickle cell disease and the HbSS or HbSC genotype recruited from the participating study centers in Guadeloupe or Bobigny
La description
Inclusion Criteria:
- SCD patients with SS or SC
- diagnosis of SCD performed by electrophoresis or high-performance liquid chromatography (HPLC) in a reference laboratory for hemoglobinopathies
- patients older than 18 years at inclusion
- clinically in a steady state at inclusion (no complication in the last month and no transfusion in the three last months)
- patient followed up for SCD at the sickle cell center of Guadeloupe (University hospital of Guadeloupe, Pointe à Pitre) or at the Adult Rare Diseases Reference Center "Sickle Cell Disease / Major Sickle Cell Syndromes" of the Avicenne hospital in Bobigny.
- patients who will provide written informed consent in accordance with the Declaration of Helsinki
- patients affiliated with national social security
Exclusion Criteria:
- patients younger than 18 years old
- patients with hemoglobinopathy other than SS and SC SCD
- patients who have received transfusion therapy or on bleeding therapy for less than three months
- patients no affiliated with national social security
- pregnant or breastfeeding patients
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: COHORT
- Perspectives temporelles: CROSS_SECTIONAL
Cohortes et interventions
Groupe / Cohorte |
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SS Group
Patients with sickle cell disease and an SS genotype. |
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SC Group
Patients with sickle cell disease and an SC genotype. |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
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Endogenous thrombin potential (ETP)
Délai: At baseline
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Thrombin generation profiles will be assessed in whole blood, plasma, and platelet-rich plasma. Endogenous thrombin potential will be compared between patients with sickle cell disease and an SS genotype and patients with sickle cell disease and an SC genotype |
At baseline
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Lag time of thrombin generation
Délai: At baseline
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Thrombin generation will be assessed in whole blood, plasma, and platelet-rich plasma. Lag time will be compared between patients with sickle cell disease and the HbSS genotype and those with the HbSC genotype. |
At baseline
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Time to peak thrombin generation
Délai: At baseline
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Thrombin generation will be assessed in whole blood, plasma, and platelet-rich plasma. Time to peak will be compared between patients with sickle cell disease and the HbSS genotype and those with the HbSC genotype. |
At baseline
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Peak height of thrombin generation
Délai: At baseline
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Thrombin generation will be assessed in whole blood, plasma, and platelet-rich plasma. Peak height will be compared between patients with sickle cell disease and the HbSS genotype and those with the HbSC genotype. |
At baseline
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Platelet activation profile
Délai: At baseline
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Platelet activation profiles will be assessed and compared between patients with sickle cell disease and the HbSS genotype and those with the HbSC genotype. |
At baseline
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Platelet aggregation profile
Délai: At baseline
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Platelet aggregation profiles will be assessed and compared between patients with sickle cell disease and the HbSS genotype and those with the HbSC genotype. |
At baseline
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Collaborateurs et enquêteurs
Collaborateurs
Les enquêteurs
- Directeur d'études: Véronique Baccini, MD PhD, chu de la guadeloupe
- Chercheur principal: Sylvain Lejeune, MD PhD, Centre de Référence Maladies Rares Adulte de Bobigny " Drépanocytose / syndromes drépanocytaires majeurs " de l'hôpital Avicenne
- Chercheur principal: Maryse ETIENNE JULAN, MD, CHU de la Guadeloupe Coordonnateur, Centre de référence des syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'érythropoïèse
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies vasculaires
- Maladies cardiovasculaires
- Maladies génétiques, innées
- Maladies hématologiques
- Embolie et thrombose
- Anémie, hémolytique, congénitale
- Anémie, hémolytique
- Anémie
- Hémoglobinopathies
- Thromboembolie
- Maladies et anomalies congénitales, héréditaires et néonatales
- Maladies hémiques et lymphatiques
- Anémie, Drépanocytose
- Thromboembolie veineuse
Autres numéros d'identification d'étude
- CHUG_RIPH2_2026/01
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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