Aeroallergen sensitization predicts acute chest syndrome in children with sickle cell anaemia
Open accessAbstract
Summary: Asthma is associated with higher rates of acute chest syndrome (ACS) and vaso‐occlusive pain episodes among children with sickle cell anaemia (SCA). Aeroallergen sensitization is a risk factor for asthma. We hypothesized that aeroallergen sensitization is associated with an increased incidence of hospitalizations for ACS and pain. Participants in a multicentre, longitudinal cohort study, aged 4–18 years with SCA, underwent skin prick testing to ten aeroallergens. ACS and pain episodes were collected from birth until the end of the follow‐up period. The number of positive skin tests were tested for associations with prospective rates of ACS and pain. Multivariable models demonstrated additive effects of having positive skin tests on future rates of ACS (incidence rate ratio (IRR) for each positive test 1·23, 95% confidence interval [CI] 1·11–1·36, P < 0·001). Aeroallergen sensitization was not associated with future pain (IRR 1·14, 95%CI 0·97–1·33, P = 0·11). Our study demonstrated that children with SCA and aeroallergen sensitization are at increased risk for future ACS. Future research is needed to determine whether identification of specific sensitizations and allergen avoidance and treatment reduce the risk of ACS for children with SCA.
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Bronchial hyper-reactivity, asthma, and chronic airway inflammation are highly prevalent in children with sickle cell disease and may result in a proinflammatory milieu that amplifies cellular and humoral immunity to airway pathogens, leading to a paroxysmal, detrimental response.
“Bronchial hyper-reactivity, asthma, and chronic airway inflammation (209) are highly prevalent in children with SCD and may result in a proinflammatory milieu that amplifies cellular and humoral immunity to airway pathogens, thus leading to a paroxysmal, detrimental response (210, 211).”
From Pathophysiology of Sickle Cell Disease (2019) · cites this paper as [211]
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- Knight-Madden JM Forrester TS Lewis Na Greenough A 2005 Asthma in children with sickle cell disease and its association with acute chest syndrome Thorax 60 206 210 Available at: http://thorax.bmj.com/cgi/doi/10.1136/thx.2004.029165 Accessed March 15, 2016 15741436 PMC1747351 · DOI
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Pathophysiology of Sickle Cell Disease
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- Authors
- Willen, S. M., Rodeghier, M., Strunk, R. C., Bacharier, L. B., Rosen, C. L., Kirkham, F. J., DeBaun, M. R., & Cohen, R. T.
- Affiliations
- Vanderbilt University Medical Center (US)
- Rodeghier Consultants Chicago IL USA
- Washington University in St. Louis (US)
- University Hospitals of Cleveland (US)
- University College London (GB)
- Boston University (US)
- Corresponding author
- Cohen, Robyn T.
- ORCID
- Venue
- British Journal of Haematology
- Publisher
- Wiley
- Published
- 2018-01-24
- Volume
- 180
- Issue
- 4
- Pages
- 571-577
- ISSN
- 0007-1048 (ISSN-L)
- 1365-2141
- PMC
- PMC5945280
- OpenAlex
- W2792411285
- Cited by
- 20
- References
- 26
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 1 · 2021: 6 · 2020: 1 · 2019: 5 · 2018: 2
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- British Journal of Haematology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (NIH 1R01HL079937, UL1 RR024989)
- Topics
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Hematology › Blood groups and transfusion
- Keywords
- sickle cell disease, aeroallergen sensitization, acute chest syndrome, asthma, vaso-occlusive pain, children, skin prick test, hospitalization risk, allergen avoidance
- MeSH terms
- Adolescent, Aerosols, Allergens, Anemia, Sickle Cell, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Hypersensitivity, Immunization, Male, Morbidity, Pain Measurement, Prognosis, Prospective Studies, Skin Tests, Biomarkers, Acute Chest Syndrome
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