PTX-3 and zinc as potential markers of disease severity during sickle cell painful crisis

This study is a sequel to biomarker studies that have been carried out recently
by our study group. First of all, the dynamics of the acute phase protein
pentraxin-3 (PTX3) will be examined. The relevance of this protein in
predicting disease-severity has been studied particularly in the field of
Cardiology. In our own study we found that the height of PTX-3 levels on
admission for a sickle cell crisis were related to the duration of hospital
stay. However, we were not informed about the onset and duration of complaints.
Therefore, this new study was designed, with a short questionnaire on admission
and serial sampling on the first days of admission to gain a better insight in
the clinical relevance of PTX3 in sickle cell disease.
In addition to the serial measurements of PTX3, we also want to perform serial
measurements of bone-markers and zinc. In another recent article of our group
we described an increase in urinary pyridinoline (PYD) and deoxy-pyridinolin
(DPD) in sickle cell patients in steady state compared with a matched control
group with a further increment in these levels in sickle cell patients admitted
for a painful crisis. However, this was not the case for all patients and no
correlation between bone-markers and duration of hospital stay was found.
However, here too, the samples were only drawn upon admission. Serial sampling
of these markers will reveal if these markers show further increments during
admission for painful crisis. Therefore, this new protocol was designed which
also includes determination of urinary- and serum zinc levels as a potential
biomarker.

- To gain insight in dynamics of PTX3, bonemarkers PYD, DPD and zinc during
admission for sickle cell painful crisis.
- To correlate the above markers with clinical parameters of severity of
painful crisis (pain score, the occurrence of complications, duration of
hospital stay, and time to readmision/next crisis)

Prospective case-control whereby serial blood- and urine measurements during
admission for painful vaso-occlusive crisis will be performed. Obtained values
will be compared with values (within the cases) in steady state. By
documentation of clinical parameters a possible relation between obtained
values and disease severity will be studied.

No extra burden or risk is expected from this study.