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Blood, 1 April 2007, Vol. 109, No. 7, pp. 3088-3098. Prepublished online as a Blood First Edition Paper on December 7, 2006; DOI 10.1182/blood-2006-08-039438. This Article Full Text Full Text (PDF) Erratum (v111,p1772) All Versions of this Article: blood-2006-08-039438v1 109/7/3088    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Hsu, L. L. Articles by Gladwin, M. T. Search for Related Content PubMed PubMed Citation Articles by Hsu, L. L. Articles by Gladwin, M. T. Related Collections Hemostasis, Thrombosis, and Vascular Biology Red Cells Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  RED CELLS Hemolysis in sickle cell mice causes pulmonary hypertension due to global impairment in nitric oxide bioavailability Lewis L. Hsu1,2, Hunter C. Champion3, Sally A. Campbell-Lee4, Trinity J. Bivalacqua3, Elizabeth A. Manci5, Bhalchandra A. Diwan6, Daniel M. Schimel7, Audrey E. Cochard2, Xunde Wang8, Alan N. Schechter9, Constance T. Noguchi9, and Mark T. Gladwin2,8,9 1 Marian Anderson Sickle Cell Center at St Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA; 2 Critical Care Medicine Department, Clinical Center, National Institutes of Health (NIH), Bethesda, MD; 3 Johns Hopkins University, Baltimore, MD; 4 Transfusion Medicine, Department of Pathology, University of Illinois at Chicago; 5 Sickle Cell Pathology Unit, University of South Alabama, Mobile; 6 Basic Research Program, Science Applications International Corporation (SAIC)–Frederick, National Cancer Institute at Frederick (NCI-Frederick), MD; 7 Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; 8 Vascular Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD; 9 Molecular Medicine Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD Pulmonary hypertension is a highly prevalent complication of sickle cell disease and is a strong risk factor for early mortality. However, the pathophysiologic mechanisms leading to pulmonary vasculopathy remain unclear. Transgenic mice provide opportunities for mechanistic studies of vascular pathophysiology in an animal model. By microcardiac catheterization, all mice expressing exclusively human sickle hemoglobin had pulmonary hypertension, profound pulmonary and systemic endothelial dysfunction, and vascular instability characterized by diminished responses to authentic nitric oxide (NO), NO donors, and endothelium-dependent vasodilators and enhanced responses to vasoconstrictors. However, endothelium-independent vasodilation in sickle mice was normal. Mechanisms of vasculopathy in sickle mice involve global dysregulation of the NO axis: impaired constitutive nitric oxide synthase activity (NOS) with loss of endothelial NOS (eNOS) dimerization, increased NO scavenging by plasma hemoglobin and superoxide, increased arginase activity, and depleted intravascular nitrite reserves. Light microscopy and computed tomography revealed no plexogenic arterial remodeling or thrombi/emboli. Transplanting sickle marrow into wild-type mice conferred the same phenotype, and similar pathobiology was observed in a nonsickle mouse model of acute alloimmune hemolysis. Although the time course is shorter than typical pulmonary hypertension in human sickle cell disease, these results demonstrate that hemolytic anemia is sufficient to produce endothelial dysfunction and global dysregulation of NO. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: The "NO" tipping point Gregory M. Vercellotti Blood 2007 109: 2675. [Full Text] [PDF] This article has been cited by other articles: T.-F. Lou, M. Singh, A. Mackie, W. Li, and B. S. Pace Hydroxyurea Generates Nitric Oxide in Human Erythroid Cells: Mechanisms for {gamma}-Globin Gene Activation Experimental Biology and Medicine, November 1, 2009; 234(11): 1374 - 1382. 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