Priapism in sickle cell disease: Associations between NOS3 and EDN1 genetic polymorphisms and laboratory biomarkers

PLoS One. 2021 Feb 4;16(2):e0246067. doi: 10.1371/journal.pone.0246067. eCollection 2021.

Abstract

Priapism is a urologic emergency characterized by an uncontrolled, persistent and painful erection in the absence of sexual stimulation, which can lead to penile fibrosis and impotence. It is highly frequent in sickle cell disease (SCD) associated with hemolytic episodes. Our aim was to investigate molecules that may participate in the regulation of vascular tone. Eighty eight individuals with SCD were included, of whom thirty-seven reported a history of priapism. Priapism was found to be associated with alterations in laboratory biomarkers, as well as lower levels of HbF. Patients with sickle cell anemia using hydroxyurea and those who received blood products seemed to be less affected by priapism. Multivariate analysis suggested that low HbF and NOm were independently associated with priapism. The frequency of polymorphisms in genes NOS3 and EDN1 was not statistically significant between the studied groups, and the presence of the variant allele was not associated with alterations in NOm and ET-1 levels in patients with SCD. The presence of the variant allele in the polymorphisms investigated did not reveal any influence on the occurrence priapism. Future studies involving larger samples, as well as investigations including patients in priapism crisis, could contribute to an enhanced understanding of the development of priapism in SCD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell / blood
  • Anemia, Sickle Cell / complications*
  • Anemia, Sickle Cell / genetics
  • Case-Control Studies
  • Child
  • Endothelin-1 / blood
  • Endothelin-1 / genetics*
  • Fetal Hemoglobin / metabolism
  • Genetic Association Studies
  • Humans
  • Male
  • Multivariate Analysis
  • Nitric Oxide / blood
  • Nitric Oxide Synthase Type III / blood
  • Nitric Oxide Synthase Type III / genetics*
  • Polymorphism, Single Nucleotide*
  • Priapism / blood
  • Priapism / etiology
  • Priapism / genetics*

Substances

  • Endothelin-1
  • Nitric Oxide
  • Fetal Hemoglobin
  • NOS3 protein, human
  • Nitric Oxide Synthase Type III

Grants and funding

The work from MSG was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq 470959/2014-2 and 405595/2016-6). SCMAY, RPS, and SPC received scholarship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES), Finance Code 001. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.