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BioMed Research International
Volume 2013 (2013), Article ID 604140, 12 pages
http://dx.doi.org/10.1155/2013/604140
Review Article

Asthma Management in Sickle Cell Disease

1Department of Hematology-Oncology, Children’s Hospital & Research Center Oakland, Oakland, CA 94609, USA
2Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory University School of Medicine, 1645 Tullie Circle, NE, Atlanta, GA 30329, USA

Received 24 May 2013; Revised 5 September 2013; Accepted 13 September 2013

Academic Editor: Susanne Saussele

Copyright © 2013 Esteban Gomez and Claudia R. Morris. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Asthma is a common comorbid factor in sickle cell disease (SCD). However, the incidence of asthma in SCD is much higher than expected compared to rates in the general population. Whether “asthma” in SCD is purely related to genetic and environmental factors or rather is the consequence of the underlying hemolytic and inflammatory state is a topic of recent debate. Regardless of the etiology, hypoxemia induced by bronchoconstriction and inflammation associated with asthma exacerbations will contribute to a cycle of sickling and subsequent complications of SCD. Recent studies confirm that asthma predisposes to complications of SCD such as pain crises, acute chest syndrome, and stroke and is associated with increased mortality. Early recognition and aggressive standard of care management of asthma may prevent serious pulmonary complications and reduce mortality. However, data regarding the management of asthma in SCD is very limited. Clinical trials are needed to evaluate the effectiveness of current asthma therapy in patients with SCD and coincident asthma, while mechanistic studies are needed to delineate the underlying pathophysiology.