Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease

Frontiers in Physiology

卷:11

Houmam El Jurdi¹  Isabelle Denjoy¹  Noria Medjahdi¹  Claudine Peiffer¹  Laurent Holvoet²  Malika Benkerrou²  Christophe Delclaux³  Plamen Bokov³ 

[1] Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France;

[2] Service d’Hématologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France;

[3] UMR 1141, Equipe NeoPhen, INSERM co-tutelle, Université de Paris, Paris, France;

关键词: sickle cell disease;    asthma;    salbutamol;    heart rate variability;    sympathetic activity;    vagal activity;   

DOI  :  10.3389/fphys.2020.00031

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown