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73/ Spring summer 2010, Vol.4, No. 1 Medical Laboratory Journal Correlation between Nitric oxide (NO) & Asymmetric dimethylargininie (ADMA) Hemoglobin Concentration in sickle cell patients Abstract Background and objectives: The importance of Nitric oxide (NO) and Asymmetric dimethylargininie (ADMA) in pathophysiology of Sickle cell disease (SCD) is being increasingly clarified. Since very few of the studies have been conducted in the word and no study has been carried out in Iran, especially in Khuzestan province where is the main center of Sickle Cell disorder (SCD) in Iran, We decided to conduct the present study. Material and Methods: EDTA anticoagulated plasma samples were obtained from 35 healthy controls (Hb AA), 35 heterozygous (HB AS) and 35 homozygous (HB SS) sickle cell anemia patients. Plasma concentration of NO was measured by Colorimetric and Griess reaction and the concentration of ADMA by employing ELISA method. Then the results were analyzed by tstudent test and OneWay ANOVA. Results: There is a positive significance correlation between Hemoglobin (Hb) and NO in SS (r=0.703) and AS (r=0.366) groups. Also, a negative correlation between Hb and ADMA in SS (r=-0.786) and AS (r=-0.478) groups is seen. No correlation is found between these parameters in AA group. Conclusion: The prevention of Hb concentration decrease and prescription of NO donors and (or) ADMA disintegrators can be helpful for improving clinical signs of sickle cell patients. Key words: Nitric oxide (NO), Asymmetric dimethylargininie (ADMA), Sickle cell disease (SCD). Kadkhodaei ElyaderaniM (PhD) Associateprof. of Biochemistry, Dept of Clinical Biochemistry and Research Center of Thalassemia & Hemoglobinopathy, School of Medicine , Jundishapur University of Medical Sciences, Ahwaz , Iran Rostami M (MSc) MSc of Biochemistry, Dept of Clinical Biochemistry, School of Medicine , Jundishapur University of Medical Sciences, Ahwaz , Iran . Keikhaie B (PhD) Assistant Professor of Pediatric Hematology and Oncology, Shafa Hospital and Research Center of Thalassemia& Hemoglobinopathy, Jundishapur University of Medical Sciences, Ahwaz, Iran. PedramM (PhD) Professor of Pediatric Hematology and Oncology, Shafa Hospital and Research Center of Thalassemia & emoglobinopathy, Jundishapur University of Medical Sciences, Ahwaz, Iran. Corresponding: Kadkhodaei ElyaderaniM Email: Kadkhodaeim@yahoo.com

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Background: Sickle cell disease, a hemoglobinopathy due to a point mutation, has a heterogeneous clinical course. HbF level within erythrocytes is believed to be the most important parameter for the severity of disease.
Purpose: To determine whether HbF level, F cell count, and sickle cell percentage after in vitro induction of sickling can predict the severity of the disease.
Methods: All required data was obtained from clinical history, biochemistry, and pathology lab investigations. Statistical analyses were done by using the correlation coefficient and chi-square test to find a significant difference between two variables. Statistical analysis was done using MedCalc software.
Results: Most of the patients are in the mild severity score category; there is a lack of severe disease phenotypes. The number of painful episodes, hospitalizations, and cumulative disease severity scores were associated with high levels of LDH and indirect bilirubin. However, none of the clinical disease severity parameters or the overall cumulative disease severity score were associated with HbF level, F cell count, or the percentage of sickled cells after in vitro induction of sickling. However, a high percentage of F cells was associated with high MCV, MCH, and MCHC and low RDW, LDH, and indirect bilirubin.
Conclusion: This sickle cell disease severity is related to susceptibility of RBCs to hemolysis as indicated by s. LDH and indirect bilirubin levels. However extent of hemolysis may be dependent on multiple factors rather than F cell count or Hb F level only.