Sickle Cell Anemia Info Box

· Prenatal diagnoses allow families to find out early on whether their child will have sickle cell disease.

· All newborns in Virginia are screened for sickle cell disease. Newborn Screening is offered to families who do not have the option of prenatal diagnoses. They will find out very soon after birth.

· Genetic Counseling Services will help couples and families carrying the sickle cell trait better understand their risk when they do decide to have children.

· Professional Education and Training teaches parents about the disease and what serious complications to look for with their children.

Research

Dr. Lloyd says that everyone has the adult gene, Hemoglobin A or S, but everyone’s cell also produces Hb F at the embryo or fetus stage. Hb F is shut off two months after birth and the adult hemoglobin becomes active. This is the time when babies are treated with penicillin. Recent research has found that if Hb F can be reactivated it can serve as a possible treatment. If both Hb F and Hb S are present then cells won’t sickle and there will be no need for treatment.

Sicke Cell Anemia

Blue eyes, brown curly hair, cleft-chin, and hemoglobin A/S are traits that make a person normal and a carrier of the sickle cell trait. Blues eyes, brown curly hair, cleft-chin, and hemoglobin S/S means a person has sickle cell Anemia.

What is sickle cell anemia? Dr. Joyce Lloyd, a research professor in the VCU Human and Molecular Genetics Department says sickle cell disease is a genetic mutation of the red blood cells. It occurs when hemoglobin within the red blood cells fail to function normally. Hemoglobin (Hb) is what makes the red blood cells red. It is made up of protein and iron.

In a normal red blood cell the hemoglobin flows freely in a circular motion forming the round shape. Abnormal hemoglobin sticks together and stretches the cell out. The cells become rigid and curves into sickle-like shape. This shape makes it difficult for cells to pass through small blood vessels. They become clogged preventing oxygen and nutrients in the blood from reaching organs and tissues.

Dr. Joyce Lloyd says that a child is diagnosed with sickle cell disease when they inherit the hemoglobin S trait from both parents. When a mother and father both have the sickle cell trait there is a 25 percent chance that their child will have sickle cell disease.

The parents of a child with sickle cell anemia do not have the disease. They are healthy and would just be considered carriers of the trait because there is only a small dose of sickle cell, not enough to change the shape of the cell. Dr. Lloyd explains that their genotype would be made up of hemoglobin A, the normal adult hemoglobin, and hemoglobin S or C, which are sickle cell traits.

Health officials say people who carry the sickle cell trait are said to be at an advantage because their immune system can resist diseases such as Malaria.

“In a country where Malaria is rampant, it is better to be hemoglobin A/S than hemoglobin A/A,” says Dr. Lloyd.

According to the Virginia Department of Health’s Sickle Cell Disease Awareness Program sickle cell is one of the most common genetic disorders in the United States affecting mostly African Americans. It is also found in people from South and Central America, the Middle East, India, Italy, Greece and Turkey.

In Virginia, one in 325 babies born to African-American parents is affected by Sickle Cell Disease. That is 13 percent higher than the national average. It is estimated that more than 155,000 Virginian's have sickle cell trait. It is estimated that more than 4,000 Virginian's are living with Sickle Cell Disease.

People with Sickle cell anemia can suffer from many severe complications. Because the crescent shaped cells can block the flow of blood and oxygen anywhere in the body. Jean Shipman, Program Manager for the Sickle Cell Anemia Awareness Program says that people can suffer from extreme pain from where ever the blood is not flowing. In the circulatory system, if blood stops flowing to the brain, strokes are likely to happen.

“We have young people before there’re four years of age that have had strokes, sickle related strokes,” says Shipman.

Some people experience a breakdown of their major joints, tissue damage and organ damage.

A young woman, Jane, shares her personal story about living with sickle cell anemia on Revolution Health, a website dedicated to different diseases and conditions.

“I was born with sickle cell anemia…Sometimes it can be just downright hard growing up wanting play with your friends and go outside but didn't understand why you just couldn’t, but as you get older you know that you had a lot of hospital visits, stayed in pain then you do research for yourself and discover that sickle cell anemia is your problem.”

It is debatable whether there is a cure for Sickle Cell Anemia. Shipman says yes there is a cure. Bone marrow transplants are the cure for sickle cell disease. But there are consequences to this procedure and because of it Dr. Lloyd says it is a risk.

“If I had to give a short answer, no, not now. It is treatable, but it is not curable.”

Bone marrow transplants are difficult because donors and matches are rare. Also side effects can cause the immune system to react negatively, says Dr. Lloyd.

There are a number of treatments and services provided to help improve the life expectancy of people with sickle cell disease. By two months of age Newborns are treated with Penicillin. Penicillin is one of the key treatments to help fight off infections, says Shipman.

White blood cells, antibodies for infections, are not able to pass once arteries become blocked, so when people with sickle cells get sick their bodies have a difficult time fighting infections. Shipman also mentions Hydroxyurea, an anti-sickling drug that helps the body maintain fetal hemoglobin. It reduces red blood cells from sickling as much. Hydroxyurea is only used on adults.

The sickle cell disease may seem rare to many people, but it is very common, especially in the African American community. A cure is in the works, treatment is saving lives, but the best thing you can do is educate yourself on this disease and become aware.

To find out more information about Sickle Cell Anemia visit the Sickle Cell Disease Awareness Program on the Virginia Department of Health website.

ART ON CAMPUS

Truth About Acne

Richmond, Va. - Pinocchio’s nose grows bigger each time he lies. You grow a pimple each time you up in size.

What is the difference? Pinocchio, a cartoon character, can prevent his lies and his nose from growing so big. However, humans aren’t so lucky, especially when fighting facial acne.

Kyoni Thomas, a VCU student has had acne for years. She thinks beverages and foods triggered her acne.

“I stopped drinking soda and acidic stuff,” said Thomas.

Students such as Thomas may be surprised to learn there is no real or specific cause to acne.

Brenda King, a registered nurse at the MCV Department of Dermatology, says hormonal imbalances in the body are leading factors in acne. She explained that most adolescents experience acne for the first time during puberty when their bodies encounter estrogen and testosterone surges.

Nicole Gordon, 22, a senior at VCU, says she first experienced acne when she was about 12 years old.

“It started off as just a few breakouts on my cheeks and around my chin area,” said Gordon.

Rather than seek a dermatologist, Gordon instead tried Clinique, Proactive and over-the-counter products but none of them helped. As she matured, she started to see her acne fade away.

“Over time they just stopped coming, I was getting fewer breakouts…it gradually got better over time,” said Gordon.

Although acne is common in adolescents and teenagers, adults are not immune from blackheads and pimples. Adults get acne, too. Older women can flare up during menopause because of the change in estrogen levels, says King.

There are multiple types of acne. For example, rosacea is found mostly in adults. Rosacea acne can be caused by certain foods, alcohol and sunlight. Former president Bill Clinton had rosacea at one point, but the general acne that most young adults get is Comedonal acne, which is whiteheads and blackheads, and inflammatory acne, red pimples.

Acne can attack any kind type, but it is easier to treat oily skin because most medications can dry out the skin. King recommends that people with oily skin wash their face in the morning and at night. Washing once a day is sufficient for people with dry or normal skin, but they should use a mild soap and wash gently, she adds.

Almost every day there seems to be commercial about a new acne treatment that claims to eliminate acne. Some ads claim acne can be cleared in three to 10 days. Acne is not curable and it will never disappear completely, but it is controllable, experts say. Acne takes about two months to begin clearing up. It all depends on the severity of the acne, the medication used and the consistency of the treatment, says King.

Thomas sought dermatology help, but said it was too expensive. Products like Noxzema helped to a certain extent, she said. It took Thomas several months to find the right treatment for her skin and to see results.

The most important thing to remember is that there are all types of acne, King says. Different acnes are caused by different things. Acne is not caused from being dirty. The best results will occur with consistent care. Create a routine and keep up with it. Always use a moisturizer after using medication. Give back to your skin what the medication takes away. It has to be a balance, says King.

“Right now I’m just doing the wash your face every morning regimen. I don’t use any special products, most of the time it’s just moisturizer,” Gordon explained.

Recommended Acne Treatments

Benzyl peroxide washes can help reduce acne, along with salicylic acid for milder cases.
King says face creams with retinol, an ingredient used in anti-wrinkle products, can also help clear acne.