Potential pathophysiologic mechanisms underlying adverse events during high-intensity exercise in SCT and SCA
| Potential factors during exercise . | SCT . | SCA . |
|---|---|---|
| Plasma or whole blood viscosity and dense sickle RBCs | • Higher at baseline compared with controls | • No difference in viscosity at baseline or after exercise compared with controls |
| • Increases with exercise but no difference in increase compared with controls | • Increase in dense cells after exercise | |
| • Remained elevated at end of recovery compared with controls | ||
| • No effect of α-thalassemia trait on results | ||
| RBC rigidity and deformability | • Higher at baseline and during exercise compared with controls | • No data in the literature |
| • Unchanged with exercise | ||
| Oxidative stress markers | • No difference in baseline levels compared with controls | • No difference in response after acute exercise compared with controls |
| • Increased after exercise with postexercise levels higher compared with controls | • May remain elevated after prolonged exercise compared with controls | |
| Inflammatory response markers | • No difference in baseline levels of most cytokines and adhesion molecules | • No difference in response of IL-6 and other inflammatory markers after exercise compared with controls |
| • Variability in sVCAM and sP-selectin response to exercise | • No difference in sVCAM response to exercise compared with controls | |
| • No change in sE- or sP-selectin response to exercise | ||
| Coagulation markers | • No difference in baseline levels of coagulation profile, fibrinogen, and antithrombin activity compared with controls | • No data in the literature |
| • Unchanged with exercise | ||
| Lactate metabolism | • No difference in lactate thresholds or clearance compared with controls | • Increases with exercise with lower lactate thresholds during exercise compared with controls |
| • Variability in lactate levels throughout exercise and recovery compared with controls | ||
| • Faster RBC uptake of lactate in SCT |
| Potential factors during exercise . | SCT . | SCA . |
|---|---|---|
| Plasma or whole blood viscosity and dense sickle RBCs | • Higher at baseline compared with controls | • No difference in viscosity at baseline or after exercise compared with controls |
| • Increases with exercise but no difference in increase compared with controls | • Increase in dense cells after exercise | |
| • Remained elevated at end of recovery compared with controls | ||
| • No effect of α-thalassemia trait on results | ||
| RBC rigidity and deformability | • Higher at baseline and during exercise compared with controls | • No data in the literature |
| • Unchanged with exercise | ||
| Oxidative stress markers | • No difference in baseline levels compared with controls | • No difference in response after acute exercise compared with controls |
| • Increased after exercise with postexercise levels higher compared with controls | • May remain elevated after prolonged exercise compared with controls | |
| Inflammatory response markers | • No difference in baseline levels of most cytokines and adhesion molecules | • No difference in response of IL-6 and other inflammatory markers after exercise compared with controls |
| • Variability in sVCAM and sP-selectin response to exercise | • No difference in sVCAM response to exercise compared with controls | |
| • No change in sE- or sP-selectin response to exercise | ||
| Coagulation markers | • No difference in baseline levels of coagulation profile, fibrinogen, and antithrombin activity compared with controls | • No data in the literature |
| • Unchanged with exercise | ||
| Lactate metabolism | • No difference in lactate thresholds or clearance compared with controls | • Increases with exercise with lower lactate thresholds during exercise compared with controls |
| • Variability in lactate levels throughout exercise and recovery compared with controls | ||
| • Faster RBC uptake of lactate in SCT |
IL-6, interleukin 6; RBC, red blood cell; SCT, stem cell transplantation; sE-selectin, soluble E-selectin; sP-selectin, soluble P-selectin.