Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease
BackgroundSickle cell disease (SCD) patients with asthma have an increased rate of vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) episodes when compared to those without asthma. We hypothesized that either asthma diagnosis or bronchodilator treatment might aggravate SCD via their modulat...
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doaj-3c9368948a104d8b965843a099bbec6c2020-11-25T02:05:51ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2020-02-011110.3389/fphys.2020.00031509926Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell DiseasePlamen Bokov0Plamen Bokov1Houmam El Jurdi2Isabelle Denjoy3Claudine Peiffer4Noria Medjahdi5Laurent Holvoet6Malika Benkerrou7Christophe Delclaux8Christophe Delclaux9Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceUMR 1141, Equipe NeoPhen, INSERM co-tutelle, Université de Paris, Paris, FranceService de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceService de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceService de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceService de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceService d’Hématologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceService d’Hématologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceService de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, FranceUMR 1141, Equipe NeoPhen, INSERM co-tutelle, Université de Paris, Paris, FranceBackgroundSickle cell disease (SCD) patients with asthma have an increased rate of vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) episodes when compared to those without asthma. We hypothesized that either asthma diagnosis or bronchodilator treatment might aggravate SCD via their modulating effect on the autonomic nervous system (ANS).MethodsCross-sectional evaluation of heart rate variability (HRV) during pulmonary function tests, including salbutamol administration, in children with SCD receiving asthma treatment or not when compared to asthmatic children without SCD matched for ethnicity.ResultsSCD children with asthma (n = 30, median age of 12.9 years old) were characterized by a reduced FEV1/FVC ratio, an increased bronchodilator response, and a greater incidence of VOC and ACS when compared to SCD children without asthma (n = 30, 12.7 years). Children with asthma without SCD (n = 29, 11.4 years) were characterized by a higher exhaled NO fraction than SCD children. SCD children when compared to non-SCD children showed reduced HRV [total power, low (LF) and high (HF, vagal tone) frequencies], which was further worsened by salbutamol administration in all the groups: reduction in total power and HF with an increase in LF/HF ratio. After salbutamol, the LF/HF ratio of the SCD children was higher than that of the non-SCD children. The two groups of SCD children were similar, suggesting that asthma diagnosis per se did not modify ANS functions.ConclusionSCD children are characterized by impaired parasympathetic control and sympathetic overactivity that is worsened by salbutamol administration.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT04062409.https://www.frontiersin.org/article/10.3389/fphys.2020.00031/fullsickle cell diseaseasthmasalbutamolheart rate variabilitysympathetic activityvagal activity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Plamen Bokov Plamen Bokov Houmam El Jurdi Isabelle Denjoy Claudine Peiffer Noria Medjahdi Laurent Holvoet Malika Benkerrou Christophe Delclaux Christophe Delclaux |
spellingShingle |
Plamen Bokov Plamen Bokov Houmam El Jurdi Isabelle Denjoy Claudine Peiffer Noria Medjahdi Laurent Holvoet Malika Benkerrou Christophe Delclaux Christophe Delclaux Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease Frontiers in Physiology sickle cell disease asthma salbutamol heart rate variability sympathetic activity vagal activity |
author_facet |
Plamen Bokov Plamen Bokov Houmam El Jurdi Isabelle Denjoy Claudine Peiffer Noria Medjahdi Laurent Holvoet Malika Benkerrou Christophe Delclaux Christophe Delclaux |
author_sort |
Plamen Bokov |
title |
Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease |
title_short |
Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease |
title_full |
Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease |
title_fullStr |
Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease |
title_full_unstemmed |
Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease |
title_sort |
salbutamol worsens the autonomic nervous system dysfunction of children with sickle cell disease |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Physiology |
issn |
1664-042X |
publishDate |
2020-02-01 |
description |
BackgroundSickle cell disease (SCD) patients with asthma have an increased rate of vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) episodes when compared to those without asthma. We hypothesized that either asthma diagnosis or bronchodilator treatment might aggravate SCD via their modulating effect on the autonomic nervous system (ANS).MethodsCross-sectional evaluation of heart rate variability (HRV) during pulmonary function tests, including salbutamol administration, in children with SCD receiving asthma treatment or not when compared to asthmatic children without SCD matched for ethnicity.ResultsSCD children with asthma (n = 30, median age of 12.9 years old) were characterized by a reduced FEV1/FVC ratio, an increased bronchodilator response, and a greater incidence of VOC and ACS when compared to SCD children without asthma (n = 30, 12.7 years). Children with asthma without SCD (n = 29, 11.4 years) were characterized by a higher exhaled NO fraction than SCD children. SCD children when compared to non-SCD children showed reduced HRV [total power, low (LF) and high (HF, vagal tone) frequencies], which was further worsened by salbutamol administration in all the groups: reduction in total power and HF with an increase in LF/HF ratio. After salbutamol, the LF/HF ratio of the SCD children was higher than that of the non-SCD children. The two groups of SCD children were similar, suggesting that asthma diagnosis per se did not modify ANS functions.ConclusionSCD children are characterized by impaired parasympathetic control and sympathetic overactivity that is worsened by salbutamol administration.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT04062409. |
topic |
sickle cell disease asthma salbutamol heart rate variability sympathetic activity vagal activity |
url |
https://www.frontiersin.org/article/10.3389/fphys.2020.00031/full |
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