PB1505 - C-reactive protein across the menstrual cycle in females with sickle cell disease

Tuesday, June 27, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

JW

Jessica Wu

Medical Student
Department of Obstetrics and Gynecology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
Philadelphia, Pennsylvania, United States

Co-Author(s)

Veronica Bochenek

Research Technician
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Anh T. Ngo, PhD

Postdoc
Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA
Philadelphia, Pennsylvania, United States
MR

Marjorie Risman

Senior Research Coordinator & Project Manager
Institute for Translational Medicine and Therapeutics, Perelman School of Medicine
Philadelphia, Pennsylvania, United States
JW

Joellen Weaver

Technical Director
Institute for Translational Medicine and Therapeutics, Perelman School of Medicine
Philadelphia, Pennsylvania, United States

Presenting Author(s)

Kandace Gollomp

Assistant Professor
Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA
Philadelphia, Pennsylvania, United States

Co-Author(s)

AR

Andrea H. Roe

Assistant Professor
Department of Obstetrics and Gynecology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
Philadelphia, Pennsylvania, United States

Background: Females with sickle cell disease (SCD) experience more frequent and severe vaso-occlusive crises (VOC) than males. Additionally, many females with SCD report perimenstrual timing of VOC, suggesting cyclic variation in their pain risk. C-reactive protein (CRP) is a robust inflammatory marker that is elevated at baseline in SCD patients and rises during VOC. Cyclic patterns of inflammatory markers in females with SCD have not been previously examined.

Aims: To describe the relationship between CRP and menstrual cycle phase among females with SCD.

Methods: Frozen plasma samples from reproductive-aged adult patients with SCD were obtained from the Penn Medicine BioBank. Estradiol, progesterone, and luteinizing hormone assays were performed on samples from female patients to estimate the menstrual cycle phase at time of sample collection; we used predefined thresholds to estimate follicular and luteal phase. CRP levels were compared between patients with SS (n=15) and SC (n=13) disease, untreated patients (n=25) and those prescribed hydroxyurea (n=6), female (n=13) and male (n=18) subgroups, and across menstrual cycle phase within the female subgroup.

Results: There were no significant differences in CRP levels between patients with SS and SC disease (4.95 vs. 6.13 mg/ml, p=0.47), untreated patients and those prescribed hydroxyurea (5.40 vs. 4.41 mg/ml, p=0.58), or females and males (5.87 vs. 4.73 mg/L, p=0.48). Females with SCD exhibited significant variation in CRP across the menstrual cycle, with higher levels during the follicular phase than the luteal phase (8.17 vs. 2.20 mg/L, p=0.02).

Conclusion(s): Although there were no differences in CRP levels in SCD patients by genotype or treatment, our results suggest that females have cyclicity in inflammation across the menstrual cycle, which may predispose them to VOC during the follicular phase. Further study is needed to validate these findings prospectively and to correlate biomarker patterns with clinical symptomatology.