Dipyridamole/Magnesium To Improve Sickle Cell Hydration
Vaso-occlusive episodes are the most common problem experienced by patients with SCA and the
most frequent reason for hospital admissions as well as visits to the clinic and emergency
department. Many cellular, humoral, and vascular factors influence the initiation and
propagation of vaso-occlusion by sickle cells. Among these is the tendency of sickle cells
(SS RBC) to become dehydrated with accompanying increase in the hemoglobin (Hb)
concentration. Since sickle hemoglobin (Hb S) concentration controls the rate of
polymerization, cellular dehydration plays a key role in sickle cell pathology.
Two separate but interdependent cation transport mechanisms affect sickle cell hydration,
the first involving abnormal KCl cotransport (KCC), and the second a sickle-induced (SI)
passive leak which permits the influx of calcium ions (Ca++) that activates the Gardos
pathway, a Ca++-dependent K channel. Early investigations aimed at inhibiting KCC with
magnesium (Mg) and the Gardos pathway with clotrimazole met with partial success. We have
recently shown in vitro that dipyridamole also inhibits the SI pathway. Strategies designed
to block the formation of these dense, dehydrated cells would offer important therapeutic
options that might decrease the number and severity of the vaso-occlusive episodes in
patients. Drawing on the information gained from two decades of research on cation transport
in SS RBC, including the unique discovery made at this Center that dipyridamole inhibits the
SI cation leak, we now propose a study of combined therapy using two transport inhibitors
aimed at reducing SS RBC dehydration.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double-Blind
To assess effects on red cell hydration.
Karen Kalinyak, MD
Principal Investigator
Children's Hospital Medical Center, Cincinnati
United States: Food and Drug Administration
CCHMC 03-7-41
NCT00276146
May 2005
Name | Location |
---|---|
Cincinnati Children's Hospital Medical Center | Cincinnati, Ohio 45229-3039 |
Karmanos Cancer Institute | Detroit, Michigan 48201 |
University of Cincinnati | Cincinnati, Ohio 45267-0502 |