Copper to Zinc Ratio in Pediatric Patients with Sickle Cell Disease (Steady-State and Crises)

Abstract: BACKGROUND: Inflammation has a pivotal role in acquiring acute and chronic complications in sickle cell disease (SCD), therapeutic approaches directed to inflammation pathways may have therapeutic and preventative benefits. OBJECTIVES: The objective of the study was to evaluate the copper to zinc (Cu/Zn) ratio in SCD pediatric patients (in steady state and crises) and compare it with the control group and to look for its association with other inflammatory markers. MATERIALS AND METHODS: Sixty patients known to have SCD and 60 healthy children and adolescents were evaluated, their age ranged from 2 to 14 years. Patients were evaluated while they were in crisis and followed until they were in a steady state. Complete blood count, reticulocyte count, lactate dehydrogenase (LDH), C-reactive protein (CRP), serum Cu, and Zn concentrations were assessed. RESULTS: Patients with SCD during crises demonstrated a significantly reduced mean hemoglobin and serum Zn levels and significantly higher mean reticulocytes, white blood cells, neutrophils and platelet counts, LDH, CRP, and serum Cu compared to those without crises and healthy controls, P < 0.05. Cu/Zn ratio showed a significant increase during crises (1.98 ± 0.52) compared to that during steady state (1.35 ± 0.34) and healthy controls (1.05 ± 0.21), P = 0.001. A significant association between Cu/Zn ratio and CRP (R = 0.335, P = 0.009) was found. CONCLUSION: The Cu/Zn ratio may function as a critical index of the inflammatory process in SCD patients, especially during vaso-occlusive crises, and also as an indicator of Zn status. Continued research is essential to examine the role of Zn intake in maintaining Cu-Zn homeostasis.