Higher plasma levels of E-selectin, but not other markers of endothelial disruption, were associated with vasculopathy and retinopathy among patients with sickle cell disease (SCD), according to the results of study published in the European Journal of Haematology.

Vasculopathy occurs as a result of a complex pathophysiologic process that is induced by vascular endothelial disruption. The aim of this study was to evaluate whether markers of endothelial disruption was associated with SCD vascular complications.

The study included 50 adult patients with SCD. Of these patients, 16 had vasculopathy. The median age of the cohort was 28, and 50% of patients had homozygous hemoglobin S, 34% had sickle β0-thalassemia, and16% had sickle hemoglobin C disease. Hydroxyurea treatment was used in 20% of patients. There were 26% of patients with thromboembolic complications.

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Patients with vasculopathy demonstrated higher E-selectin levels compared with patients without vascular complications (P =.015). Retinopathy as also associated with higher levels of E-selection, with 58.9% with retinopathy presenting with high E-selectin counts compared with 39.1% of patients without retinopathy (P <.001).

E-selectin levels were not associated with nephropathy or chronic active leg ulcers. Other markers of endothelial damage, including circulating endothelial cells, progenitor endothelial cells, and circulating extracellular vesicles, were not associated with vasculopathy.

The authors concluded that “further studies will be required to determine whether E-selectin could be used as an early biomarker of retinopathy sickle cell development.”


Agouti I, Masson E, Loundou A, et al. Plasma levels of E-selectin are associated with retinopathy in sickle cell disease. Eur J Haematol. Published online November 21, 2022. doi: 10.1111/ejh.13902