1. UGT1A1 (TA) n genotype is not the major risk factor of cholelithiasis in sickle cell disease children
- Author
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Vincent Pialoux, Daniella Cuzzubbo, Philippe Connes, Yves Bertrand, Nathalie Garnier, Kamila Kebaili, Philippe Joly, Céline Renoux, Cyril Martin, Giovanna Cannas, Philippe Lacan, Alexandra Gauthier, Marc Romana, Cecile Renard, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Institut d'hématologie et d'oncologie pédiatrique [CHU - HCL] (IHOPe), Hospices Civils de Lyon (HCL), Hôpital Edouard Herriot [CHU - HCL], Service d'hématologie : Immuno-Hématologie pédiatrique et transplantation de moelle osseuse, Hôpital Debrousse, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), and Université des Antilles et de la Guyane (UAG)
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Cell ,Disease ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,Internal medicine ,Genotype ,medicine ,ComputingMilieux_MISCELLANEOUS ,business.industry ,Proportional hazards model ,Hematology ,General Medicine ,University hospital ,medicine.disease ,Acute chest syndrome ,3. Good health ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Immunology ,Complication ,business ,Vaso-occlusive crisis ,030215 immunology - Abstract
OBJECTIVES Because of the increased hemolytic rate, a significant proportion of patients with sickle cell disease (SCD) are prone to develop cholelithiasis. The present study investigated the role of several genetic factors (UGT1A1 promoter (TA)n repeat polymorphism, alpha-globin status), hematological parameters, clinical severity, and hydroxyurea (HU) therapy on the occurrence of cholelithiasis in SCD. METHODS One hundred and fifty-eight children (2-18 yr old) regularly followed at the University Hospital of Lyon (France) were included. A multivariate Cox model was used to test the associations between cholelithiasis and the different parameters analyzed. RESULTS We confirmed that alpha-thalassemia and low basal reticulocyte (RET) count were independent protective factors for cholelithiasis while 7/7, 8/8 and 7/8 UGT1A1 (TA)n genotypes were independent predisposing factors for this complication. We also showed for the first time that HU treatment decreased the risk for cholelithiasis while frequent vaso-occlusive crises and acute chest syndrome events increased that risk. CONCLUSIONS Our findings demonstrate that UGT1A1 (TA)n polymorphism is not the only factor triggering gallstone formation in SCD. Cholelithiasis is also modulated by RET count, the number of deleted alpha-genes, HU therapy and the frequency of vaso-occlusive events.
- Published
- 2017
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