Intestinal pathophysiological and microbial changes in sickle cell disease: Potential targets for therapeutic intervention

Br J Haematol. 2020 Feb;188(4):488-493. doi: 10.1111/bjh.16273. Epub 2019 Nov 6.


There is a large therapeutic gap in the treatment of sickle cell disease (SCD). Recent studies demonstrated the presence of pathophysiological and microbial changes in the intestine of patients with SCD. The intestinal microbes have also been found to regulate neutrophil ageing and possible basal activation of circulating neutrophils. Both aged and activated neutrophils are pivotal for the pathogenesis of vaso-occlusive crisis in SCD. In this paper, we will provide an overview of the intestinal pathophysiological and microbial changes in SCD. Based on these changes, we will propose therapeutic approaches that could be investigated for treating SCD.

Keywords: Sickle cell disease; intestinal injury; intestinal microbial changes; intestinal permeability; vaso-occlusive crisis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anemia, Sickle Cell / blood
  • Anemia, Sickle Cell / complications
  • Anemia, Sickle Cell / microbiology*
  • Anemia, Sickle Cell / therapy
  • Cellular Senescence
  • Gastrointestinal Microbiome*
  • Humans
  • Neutrophils / metabolism
  • Vascular Diseases / blood
  • Vascular Diseases / etiology
  • Vascular Diseases / microbiology*
  • Vascular Diseases / therapy