Dr David Rees, Consultant Paediatrician /Senior Lecturer, King’ College Hospital NHS Foundation Trust / King’s College London, UK
Almost every measurable biological parameter is abnormal in sickle cell disease, and as a consequence a very wide range of biomarkers have been identified. Most studies in SCD involve the measurement in blood or urine of a novel molecule and the correlation of this with another parameter or clinical complication; few of these biomarkers have been validated either prospectively or in different populations. These biomarkers are often primarily affected by damage to particular organs or systems, such as abnormalities in blood coagulation or bone disease, with few assessments more directly related to the fundamental pathophysiology, of haemoglobin polymerisation or vaso-occlusion. The predominance of this phenomenological approach has resulted in many potential biomarkers but very few clinically useful ones. There is a need to establish a panel of useful, prospectively validated blood and urine biomarkers.