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Association of alpha-thalassemia, TNF-alpha (-308G>A) and VCAM-1 (c.1238G>C) gene polymorphisms with cerebrovascular disease in a newborn cohort of 411 children with sickle cell anemia.
[alpha-thalassemia]
Cerebrovascular
disease
(
CVD
)
is
a
severe
complication
associated
with
sickle
cell
anemia
.
Abnormal
transcranial
Doppler
(
TCD
)
identifies
some
children
at
high
risk
,
but
other
markers
would
be
helpful
.
This
cohort
study
was
aimed
at
evaluating
the
effects
of
genetic
biomarkers
on
the
risk
of
developing
CVD
in
children
from
Minas
Gerais
,
Brazil
.
Clinical
and
hematological
data
were
retrieved
from
children
's
records
.
Outcomes
studied
were
overt
ischemic
stroke
and
CVD
(
overt
ischemic
stroke
,
transient
ischemic
attack
,
abnormal
TCD
,
or
abnormal
cerebral
angiography
)
.
Out
of
411
children
,
386
(
93
.
9
%
)
had
SS
genotype
,
23
(
5
.
6
%
)
had
Sβ
(
0
)
-
thal
and
two
had
severe
Sβ
(
+
)
-
thal
(
0
.
5
%
)
.
Frequency
of
CVD
was
lower
in
Sβ-thal
group
(
p
=
0
.
05
)
.
No
effect
of
VCAM-
1
polymorphism
on
stroke
or
CVD
risks
was
detected
.
Cumulative
incidence
of
stroke
was
significantly
higher
for
children
with
TNF
-α
A
allele
(
p
=
0
.
02
)
and
lower
for
children
with
HBA
deletion
(
p
=
0
.
02
)
.
However
,
no
association
between
CVD
and
TNF
-α
-
308
G
>
A
was
found
.
CVD
cumulative
incidence
was
significantly
lower
for
children
with
HBA
deletion
(
p
=
0
.
004
)
.
This
study
found
no
association
between
VCAM
1
c
.
1238
G
>
C
and
stroke
.
An
association
between
stroke
and
TNF
-α
-
308
A
allele
has
been
suggested
.
Our
results
have
confirmed
the
protective
role
of
HBA
deletion
against
stroke
and
CVD
.
Diseases
Validation
Diseases presenting
"cvd"
symptom
alpha-thalassemia
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