Fucosyltransferase VII Activity in Sickle Cell Disease: Implications for Disease Severity and Vaso-occlusive Risk in Nigerian Patients

Fucosyltransferase VII Activity in Sickle Cell Disease: Implications for Disease Severity and Vaso-occlusive Risk in Nigerian Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Fucosyltransferase VII Activity in Sickle Cell Disease: Implications for Disease Severity and Vaso-occlusive Risk in Nigerian Patients Onyinye Ezinne Eze, Ebele Adaobi Muoghalu, Bruno Basil, Chinonye Nnenna Ike, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6480636/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 22 Jul, 2025 Read the published version in SN Comprehensive Clinical Medicine → Version 1 posted 10 You are reading this latest preprint version Abstract Background This study investigated plasma fucosyltransferase VII (FUT7) levels in Nigerian patients with sickle cell disease (SCD) to assess its relationship with disease severity and vaso-occlusive risk. Given FUT7's role in leukocyte-endothelial interactions, we hypothesized that altered FUT7 activity may contribute to the pathogenesis of vaso-occlusive crises (VOCs) in SCD. Method A cross-sectional study was conducted at the University of Nigeria Teaching Hospital, Enugu, involving 38 SCD patients and 40 age- and sex-matched healthy controls. Plasma FUT7 levels were measured using enzyme-linked immunosorbent assay (ELISA), and haematological parameters were assessed. SCD patients were classified based on VOC frequency in the preceding year. Result Plasma FUT7 levels did not differ significantly between SCD patients and healthy controls (p = 0.674). No significant correlations were observed between FUT7 levels and markers of disease severity, including haematocrit, white blood cell count, and platelet count. Although patients with ≥ 2 VOCs had lower median FUT7 levels than those with < 2 VOCs, the difference was not statistically significant (p = 0.108). Conclusion These findings suggest that FUT7 activity may not be a major determinant of disease severity or vaso-occlusive risk in SCD. Further research should explore alternative glycosylation pathways and leukocyte adhesion mechanisms in SCD pathophysiology. Sickle cell disease Fucosyltransferase VII Vaso-occlusive crisis Leukocyte adhesion Glycosylation Nigeria Introduction Sickle cell disease (SCD) is a genetic hemoglobinopathy characterized by chronic hemolysis, vaso-occlusion, and systemic inflammation, leading to significant morbidity and mortality.( 1 ) The disease arises from a single nucleotide mutation in the β-globin gene, resulting in the production of abnormal hemoglobin S (HbS). Under hypoxic conditions, HbS polymerizes, causing red blood cells (RBCs) to adopt a rigid, sickled shape, which contributes to varying degrees of vascular occlusion, ischemia-reperfusion injury, and end-organ damage.( 2 – 4 ) The clinical heterogeneity of SCD, ranging from mild to severe complications, highlights the need for identifying biomarkers that influence disease severity and vaso-occlusive risk. Fucosyltransferase VII (FUT7) is a key enzyme involved in the biosynthesis of selectin ligands, which mediate leukocyte adhesion to the endothelium.( 5 , 6 ) Elevated leukocyte-endothelial interactions have been implicated in the pathogenesis of vaso-occlusive crises (VOCs) and other SCD-related complications.( 7 – 9 ). FUT7 catalyzes the fucosylation of selectin ligands, such as sialyl Lewis X, which enhances cell adhesion and trafficking in inflammatory states.( 10 , 11 ) Dysregulation of FUT7 activity may contribute to increased leukocyte adhesion and endothelial dysfunction, both of which are central to the vaso-occlusive process in SCD. Previous studies have suggested that aberrant glycosylation patterns in SCD may exacerbate vascular inflammation and this may potentially contribute to disease severity.( 12 , 13 ) However, limited data exist on the role of FUT7 activity in modulating these processes, particularly in African populations, where SCD burden is highest. Given that genetic and environmental factors influence disease expression, understanding FUT7 activity in Nigerian patients may provide critical insights into SCD pathophysiology and potential therapeutic targets. This study aims to investigate FUT7 activity in patients with SCD compared to healthy controls, exploring its associations with disease severity and vaso-occlusive risk. By elucidating the role of FUT7 in the inflammatory and adhesive mechanisms of SCD, this study may contribute to the development of novel biomarkers and targeted interventions for better disease management. Methods Study Design and Setting This was a hospital-based, cross-sectional analytical study comprising of adult patients with sickle cell disease (SCD) attending the haematology outpatient clinic at the University of Nigeria Teaching Hospital (UNTH), Enugu, as well as healthy control subjects recruited from voluntary and family replacement blood donors at the UNTH blood bank. Ethical Considerations Ethical approval for this study was obtained from the Health Research Ethics Committee (HREC) of the University of Nigeria Teaching Hospital, Enugu, with ethical clearance number NHREC/05/01/2008B-IRB00000232. Informed consent was obtained from all participants before enrolment, and all procedures were conducted in accordance with the Declaration of Helsinki on human research ethics.(14) Participants were assured of data confidentiality, and no personally identifiable information was linked to the study results. Also, participation was voluntary, with the right to withdraw at any stage of the study. Sample Size Determination and Participant Recruitment A total of 78 participants were recruited for this study, consisting of 38 patients with steady-state SCD and 40 age- and sex-matched healthy control subjects with the HbAA phenotype. The HbSS phenotype of SCD patients was confirmed by high-performance liquid chromatography (HPLC), while HbAA controls were identified through standard blood donor screening procedures. Given that this is an exploratory study, this sample size was considered adequate to detect preliminary differences in FUT7 activity and provide a basis for future research. SCD patients were further categorized based on the frequency of vaso-occlusive crises (VOCs) in the preceding year. Group A included 19 patients with mild disease, defined as having 0-1 VOC and no documented disease complications such as stroke, chronic leg ulcers, nephropathy, or avascular necrosis. Group B comprised 19 patients with moderate to severe disease, characterized by ≥2 VOCs in the previous year, with or without associated complications. Patients who had received a blood transfusion within the preceding four months, were on treatment with hydroxyurea or other medications known to affect VOC frequency, or had a co-existing chronic disorder unrelated to SCD, such as asthma or diabetes mellitus were excluded from the study. Data Collection and Interpretation Demographic and clinical data, including age, sex, and frequency of VOCs, were obtained from participants through structured interviews and medical record reviews. The primary outcomes of the study were to compare plasma FUT7 levels between SCD patients and HbAA controls and to evaluate differences in plasma FUT7 levels between SCD patients with mild and moderate-severe disease in the previous year. Sample Collection and Assays Venous blood samples (10mL) were collected from all participants into ethylenediaminetetraacetic acid (EDTA) anticoagulated tubes. Following collection, blood samples were processed for laboratory analyses. Analysis of full blood count was performed using an automated hematology analyzer, while hemoglobin phenotyping was confirmed using HPLC. FUT7 activity was assessed using an enzyme-linked immunosorbent assay (ELISA) kit (Lot Number 20191129C, MyBiosource Inc., USA) according to the manufacturer’s instructions. Statistical Analysis Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 25.0 for Windows. Descriptive statistics, including means and standard deviations, were used to summarize continuous variables, while categorical variables were presented as frequencies and percentages. Relationship between continuous variables where necessary was done using Pearson’s correlation analysis. Group comparisons were performed using the independent t-test or Mann-Whitney U test for continuous variables and the chi-square test for categorical variables, as appropriate. All tests were two-sided, and statistical significance was set at a p-value of less than 0.05. Results Table 1 presents the sociodemographic, clinical, and haematological characteristics of participants. Significant differences were observed in multiple haematological parameters between the SCD and control groups. Haematocrit levels were markedly lower in SCD patients compared to controls (24.4 ± 4.2% vs. 40.6 ± 4.4%, p < 0.001), as were haemoglobin concentration (7.9 ± 1.3 g/dL vs. 12.6 ± 1.4 g/dL, p < 0.001) and red blood cell (RBC) count (2.9 ± 0.8 ×10¹²/L vs. 4.7 ± 0.6 ×10¹²/L, p < 0.001). Red cell distribution width, both coefficient of variation (RDW-CV) and standard deviation (RDW-SD), was significantly higher in SCD patients compared to controls (p < 0.001 for both), indicating greater variability in erythrocyte size. Total white blood cell (WBC) count was significantly elevated in the SCD group (11.6 ± 3.3 ×10⁹/L vs. 5.9 ± 1.5 ×10⁹/L, p < 0.001), with corresponding increases in neutrophil (6.2 ± 2.2 ×10⁹/L vs. 2.8 ± 1.0 ×10⁹/L, p < 0.001), lymphocyte (4.6 ± 1.8 ×10⁹/L vs. 2.7 ± 0.7 ×10⁹/L, p < 0.001), and monocyte (0.3 ± 0.3 ×10⁹/L vs. 0.1 ± 0.1 ×10⁹/L, p = 0.001) counts. Platelet count was also significantly higher in SCD patients (326.1 ± 117.4 ×10⁹/L vs. 216.9 ± 56.9 ×10⁹/L, p < 0.001), along with platelet count (PCT) (3.0 ± 1.0% vs. 2.3 ± 0.5%, p < 0.001). Mean corpuscular haemoglobin concentration (MCHC) was slightly but significantly increased in SCD patients compared to controls (32.1 ± 1.2 g/L vs. 31.1 ± 1.1 g/L, p < 0.001) while mean platelet volume (MPV) was significantly lower in SCD patients than in controls (9.5 ± 0.7 vs. 10.6 ± 0.9, p < 0.001), suggesting altered platelet morphology and function. Platelet distribution width (PDW), sociodemographic variables (age distribution, sex, educational level, and occupation), mean corpuscular volume (MCV), and mean corpuscular haemoglobin (MCH) showed no significant differences between SCD patients and controls. Table 1 Sociodemographic, Clinical, and Haematological Parameters of SCD Patients and Controls Parameter SCD (n = 38) Controls (n = 40) Statistics P-value Age group (years) χ² = 1.025 0.906 < 25 10 (27.5%) 13 (32.5%) 25–29 11 (27.5%) 10 (25.0%) 30–34 6 (17.5%) 6 (15.0%) 35–39 4 (10.0%) 6 (15.0%) ≥ 40 7 (17.5%) 5 (12.5%) Sex χ² = 0.050 0.823 Male 19 (47.5%) 18 (45.0%) Female 21 (52.5%) 22 (55.0%) Education Fisher’s test 0.217 Primary 1 (2.5%) 0 (0.0%) Secondary 11 (27.5%) 6 (15.0%) Tertiary 28 (70.0%) 34 (85.0%) Occupation Fisher’s test 0.056 Professionals 2 (5.0%) 0 (0.0%) Skilled workers 13 (32.5%) 15 (37.5%) Unskilled workers 3 (7.5%) 4 (10.0%) Students 14 (35.0%) 20 (50.0%) Unemployed 8 (20.0%) 1 (2.5%) Haematological Parameters Haematocrit (%) 24.4 ± 4.2 40.6 ± 4.4 -15.912 < 0.001 Haemoglobin (g/dL) 7.9 ± 1.3 12.6 ± 1.4 -16.090 < 0.001 RBC count (10¹²/L) 2.9 ± 0.8 4.7 ± 0.6 -11.313 < 0.001 MCV (fL) 85.7 ± 10.1 86.3 ± 6.0 -0.319 0.751 MCH (pg) 28.1 ± 3.9 26.8 ± 2.5 1.685 0.096 MCHC (g/L) 32.1 ± 1.2 31.1 ± 1.1 4.028 < 0.001 RDW-CV 0.19 ± 0.02 0.13 ± 0.01 14.099 < 0.001 RDW-SD 75.2 ± 11.2 52.8 ± 4.9 11.590 < 0.001 WBC (×10⁹/L) 11.6 ± 3.3 5.9 ± 1.5 10.077 < 0.001 Neutrophils (×10⁹/L) 6.2 ± 2.2 2.8 ± 1.0 8.710 < 0.001 Lymphocytes (×10⁹/L) 4.6 ± 1.8 2.7 ± 0.7 6.149 < 0.001 Monocytes (×10⁹/L) 0.3 ± 0.3 0.1 ± 0.1 3.460 0.001 Platelets (×10⁹/L) 326.1 ± 117.4 216.9 ± 56.9 5.294 < 0.001 MPV 9.5 ± 0.7 10.6 ± 0.9 -5.834 < 0.001 PDW 15.9 ± 0.7 16.0 ± 0.3 -1.023 0.309 PCT (%) 3.0 ± 1.0 2.3 ± 0.5 4.300 < 0.001 HCT: haematocrit, RBC: red blood cell, MCV: mean corpuscular volume, MCH: Mean corpuscular haemoglobin, MCHC: Mean Corpuscular Haemoglobin Concentration, RDW-CV: Red cell distribution width Coefficient of variation, RDW-SD: Red cell distribution width The median plasma FUT7 level did not differ significantly between SCD patients (2.1 (1.8–2.5)) and HbAA controls (2.2 (1.8–2.8), p = 0.674) (Table 2 ), and there was no significant correlation between plasma FUT7 levels and laboratory measures of severity including haematocrit (r = 0.055, p = 0.744), white cell count (r = -0.076, p = 0.649), lymphocyte count (r = 0.196, p = 0.244), neutrophil count (r = -0.123, p = 0.461), or platelet count (r = 0.101, p = 0.545) (Table 3 ). Additionally, the median plasma FUT7 level was lower in SCD patients with ≥ 2 vaso-occlusive crises 92.0 (1.2–2.4)) compared to those with < 2 crises (2.2 (1.9–2.9)), but the difference was not statistically significant (p = 0.108) (Table 4 ). Table 2 Plasma FUT7 Levels in SCD Patients and HbAA Controls. Group Median FUT7 (IQR) p-value SCD 2.1 (1.8–2.5) 0.674 Controls 2.2 (1.8–2.8) Table 3 Correlation of Plasma FUT7 Levels with Laboratory Measures of Disease Severity. Parameter r p-value Hematocrit (HCT) 0.055 0.744 White Cell Count (WBC) -0.076 0.649 Lymphocyte Count 0.196 0.244 Neutrophil Count -0.123 0.461 Platelet Count 0.101 0.545 Table 4 Plasma FUT7 Levels by Frequency of Vaso-occlusive Crises Frequency of VOC Median FUT7 (IQR) p-value < 2 crises 2.2 (1.9–2.9) 0.108 ≥ 2 crises 2.0 (1.2–2.4) Discussion This study investigated plasma FUT7 levels in Nigerian patients with SCD, assessing its relationship with disease severity and vaso-occlusive risk. Our findings indicate that plasma FUT7 levels did not differ significantly between SCD patients and HbAA controls, nor did they correlate with key laboratory markers of disease severity, including hematocrit, white cell count, and platelet count. Additionally, although SCD patients with more frequent VOCs exhibited lower median FUT7 levels, this difference was not statistically significant. These findings suggest that FUT7 activity may not play a major role in modulating disease severity or vaso-occlusive risk in SCD. The lack of significant differences in plasma FUT7 levels between SCD patients and controls contrasts with prior studies highlighting the role of fucosylation in leukocyte adhesion and vascular inflammation.( 15 – 19 ) FUT7 is a key enzyme responsible for the synthesis of sialyl Lewis X, a crucial ligand for selectin-mediated leukocyte-endothelial interactions, which are central to the pathophysiology of VOCs. Previous reports have suggested that increased selectin-mediated adhesion contributes to endothelial dysfunction and vaso-occlusion in SCD.( 15 – 17 , 19 – 25 ) However, our findings do not support a direct role for plasma FUT7 in these processes, potentially indicating that other factors, such as altered glycosylation pathways or compensatory mechanisms, may regulate leukocyte-endothelial interactions in SCD. One possible explanation for the observed lack of association is that plasma FUT7 levels may not accurately reflect cellular fucosylation activity in SCD. FUT7 activity is primarily localized to the Golgi apparatus, where it catalyzes fucosylation of glycoproteins involved in adhesion and immune responses.( 26 – 28 ) It is plausible that post-translational modifications or differential expression of selectin ligands, rather than circulating FUT7 levels, mediate leukocyte adhesion in SCD. Additionally, the dynamic nature of VOCs, influenced by inflammatory triggers, oxidative stress, and endothelial dysfunction, may overshadow the contribution of a single enzyme in the complex pathogenesis of vaso-occlusion. Furthermore, previous studies have suggested that abnormal glycosylation patterns might contribute to vascular inflammation.( 26 – 27 ) This could be relevant in SCD, while the diversity of fucosylation pathways in different populations may lead to varying results. Genetic and environmental factors influence glycosyltransferase activity, and the expression of FUT7-related adhesion molecules may differ between individuals.( 29 , 30 ) Future studies incorporating genetic analysis of FUT7 polymorphisms and functional assays of fucosylated selectin ligands could provide a more comprehensive understanding of its role in SCD pathophysiology. The study’s limitations should be considered when interpreting these findings. The relatively small sample size may have limited the statistical power to detect subtle differences in FUT7 levels or associations with disease severity. Additionally, the cross-sectional study design precludes assessment of temporal variations in FUT7 activity, particularly during acute VOC episodes. Longitudinal studies evaluating FUT7 expression during steady-state and vaso-occlusive episodes could provide further insights into its potential involvement in disease pathogenesis. Conclusion This study found no significant difference in plasma FUT7 levels between SCD patients and healthy controls and no clear association between FUT7 levels and markers of disease severity or vaso-occlusive risk. These findings suggest that FUT7 activity may not be a major determinant of disease severity in SCD. Future research should explore alternative glycosylation pathways and leukocyte adhesion mechanisms in SCD to identify novel therapeutic targets for reducing vaso-occlusive complications. Abbreviations FUT7 Fucosyltransferase VII SCD Sickle Cell Disease VOC Vaso-occlusive Crisis HbS Hemoglobin S RBC Red Blood Cell HbAA Normal Hemoglobin Phenotype HbSS Sickle Cell Phenotype HPLC High-Performance Liquid Chromatography SPSS Statistical Package for Social Sciences WBC White Blood Cell RDW Red Cell Distribution Width RDW-CV Red Cell Distribution Width Coefficient of Variation RDW-SD Red Cell Distribution Width Standard Deviation EDTA Ethylenediaminetetraacetic Acid ELISA Enzyme-Linked Immunosorbent Assay PCT Plateletcrit MPV Mean Platelet Volume PDW Platelet Distribution Width MCV Mean Corpuscular Volume MCH Mean Corpuscular Hemoglobin MCHC Mean Corpuscular Hemoglobin Concentration. Declarations Consent for publication Not Applicable in this study. Availability of Data and Materials The datasets from this study will be available upon reasonable request to the corresponding author. This is because the dataset includes additional data that are not relevant to this study and may require exclusion. Competing Interests The authors declare that they have no conflict of interest. FundingTop of Form This research did not receive any dedicated funding from a public, commercial, or not-for-profit agency. Authors’ contributions All authors collaborated on this research project. EEO, TN, and SO conceptualized the study. Methodology was developed by EEO, TN, SO, CDN, and MEA. Investigation was conducted by EEO, CDN, MEA, EMN, and ICN. Data curation was carried out by EEO, BB, ECC, CDN, MEA, and ICN. BB, ECC, EMN, and ICN performed the formal analysis. The original draft was written by EEO, BB, ECC, CDN, and MEA, while BB, ECC, EMN, ICN, TN, and SO contributed to the review and editing of the manuscript. TN, and SO supervised the study. All authors read and approved the final manuscript. 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Available from: https://www.nature.com/articles/s41392-024-01886-1 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 22 Jul, 2025 Read the published version in SN Comprehensive Clinical Medicine → Version 1 posted Editorial decision: Revision requested 05 Jun, 2025 Reviews received at journal 05 Jun, 2025 Reviewers agreed at journal 01 Jun, 2025 Reviews received at journal 22 May, 2025 Reviewers agreed at journal 21 May, 2025 Reviewers agreed at journal 03 May, 2025 Reviewers invited by journal 01 May, 2025 Editor assigned by journal 21 Apr, 2025 Submission checks completed at journal 21 Apr, 2025 First submitted to journal 18 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6480636","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":451352502,"identity":"f05ad16a-dffd-41c3-9e08-d62c52cb173d","order_by":0,"name":"Onyinye Ezinne Eze","email":"","orcid":"","institution":"Enugu State University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Onyinye","middleName":"Ezinne","lastName":"Eze","suffix":""},{"id":451352503,"identity":"40d7bedf-4299-4bdd-9ba5-ded1bd2a5b9a","order_by":1,"name":"Ebele Adaobi Muoghalu","email":"","orcid":"","institution":"University of Nigeria Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ebele","middleName":"Adaobi","lastName":"Muoghalu","suffix":""},{"id":451352504,"identity":"74b421bc-bbe4-4f02-89dd-84f1893c57a2","order_by":2,"name":"Bruno Basil","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA50lEQVRIie2PMQrCQBBFJwRis2qrSO4QWEgUxLO4CLGxFsutrIK13mIrsRwIxEa0FSw0WGhhoV06nWhnsSSdyD4YGAYe8z+AwfCDeDSYyq4lbXTygyULKUKGlnT6JRQQMi6hBJV1imK1c1XC/DSDrquwGl91SicaeSg2B05KwBmEXGEtbGuD4Yi6TA9CHSO/BRALhcz3tMruciJlK/JgzQyeBZR9n4JN8a00GH0khZ+0Xea3vMuALxJn3GIeLTHzdQYE9eH5/lj13FliL5vZhJZ1xO9a5ysnjQ1Oo4TywS7zxWAwGP6fF5m4VN0JQjDuAAAAAElFTkSuQmCC","orcid":"","institution":"International Institute of Pathology and Forensic Science Research, David Umahi Federal University of Health Sciences","correspondingAuthor":true,"prefix":"","firstName":"Bruno","middleName":"","lastName":"Basil","suffix":""},{"id":451352505,"identity":"27f9b28e-407b-4fd4-a1ec-654de3dc5dab","order_by":3,"name":"Chinonye Nnenna Ike","email":"","orcid":"","institution":"Ebonyi State University","correspondingAuthor":false,"prefix":"","firstName":"Chinonye","middleName":"Nnenna","lastName":"Ike","suffix":""},{"id":451352506,"identity":"fc507737-73c6-4a98-8693-a21b3ef3f39d","order_by":4,"name":"Chiesonu Dymphna Nzeduba","email":"","orcid":"","institution":"Enugu State University Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Chiesonu","middleName":"Dymphna","lastName":"Nzeduba","suffix":""},{"id":451352507,"identity":"06049d0e-d852-4498-85a6-fe91f6e97577","order_by":5,"name":"Chibuife Chilota Efobi","email":"","orcid":"","institution":"Nnamdi Azikiwe University","correspondingAuthor":false,"prefix":"","firstName":"Chibuife","middleName":"Chilota","lastName":"Efobi","suffix":""},{"id":451352508,"identity":"d3500449-e1c5-4c02-b75f-54e7cea0b662","order_by":6,"name":"Malachy Nwaeze Ezenwaeze","email":"","orcid":"","institution":"Enugu State University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Malachy","middleName":"Nwaeze","lastName":"Ezenwaeze","suffix":""},{"id":451352509,"identity":"1c7c52b6-cfa9-4136-96a1-bdbf958c0ce7","order_by":7,"name":"Theresa Nwagha","email":"","orcid":"","institution":"University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Theresa","middleName":"","lastName":"Nwagha","suffix":""},{"id":451352510,"identity":"c0fab2c6-d181-4eb8-b4b4-68f81f82678d","order_by":8,"name":"Sunday Ocheni","email":"","orcid":"","institution":"University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Sunday","middleName":"","lastName":"Ocheni","suffix":""}],"badges":[],"createdAt":"2025-04-18 17:23:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6480636/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6480636/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s42399-025-01950-z","type":"published","date":"2025-07-22T15:57:37+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":87756716,"identity":"f045a8b6-e55b-418a-8bd6-87a8d22f20ee","added_by":"auto","created_at":"2025-07-28 16:08:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":599874,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6480636/v1/1d16c996-63c4-4568-95b8-d354b8c7fde2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Fucosyltransferase VII Activity in Sickle Cell Disease: Implications for Disease Severity and Vaso-occlusive Risk in Nigerian Patients","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSickle cell disease (SCD) is a genetic hemoglobinopathy characterized by chronic hemolysis, vaso-occlusion, and systemic inflammation, leading to significant morbidity and mortality.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) The disease arises from a single nucleotide mutation in the β-globin gene, resulting in the production of abnormal hemoglobin S (HbS). Under hypoxic conditions, HbS polymerizes, causing red blood cells (RBCs) to adopt a rigid, sickled shape, which contributes to varying degrees of vascular occlusion, ischemia-reperfusion injury, and end-organ damage.(\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) The clinical heterogeneity of SCD, ranging from mild to severe complications, highlights the need for identifying biomarkers that influence disease severity and vaso-occlusive risk.\u003c/p\u003e \u003cp\u003eFucosyltransferase VII (FUT7) is a key enzyme involved in the biosynthesis of selectin ligands, which mediate leukocyte adhesion to the endothelium.(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) Elevated leukocyte-endothelial interactions have been implicated in the pathogenesis of vaso-occlusive crises (VOCs) and other SCD-related complications.(\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). FUT7 catalyzes the fucosylation of selectin ligands, such as sialyl Lewis X, which enhances cell adhesion and trafficking in inflammatory states.(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) Dysregulation of FUT7 activity may contribute to increased leukocyte adhesion and endothelial dysfunction, both of which are central to the vaso-occlusive process in SCD.\u003c/p\u003e \u003cp\u003ePrevious studies have suggested that aberrant glycosylation patterns in SCD may exacerbate vascular inflammation and this may potentially contribute to disease severity.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) However, limited data exist on the role of FUT7 activity in modulating these processes, particularly in African populations, where SCD burden is highest. Given that genetic and environmental factors influence disease expression, understanding FUT7 activity in Nigerian patients may provide critical insights into SCD pathophysiology and potential therapeutic targets.\u003c/p\u003e \u003cp\u003eThis study aims to investigate FUT7 activity in patients with SCD compared to healthy controls, exploring its associations with disease severity and vaso-occlusive risk. By elucidating the role of FUT7 in the inflammatory and adhesive mechanisms of SCD, this study may contribute to the development of novel biomarkers and targeted interventions for better disease management.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eStudy Design and Setting\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis was a hospital-based, cross-sectional analytical study comprising of adult patients with sickle cell disease (SCD) attending the haematology outpatient clinic at the University of Nigeria Teaching Hospital (UNTH), Enugu, as well as healthy control subjects recruited from voluntary and family replacement blood donors at the UNTH blood bank.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEthical Considerations\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Health Research Ethics Committee (HREC) of the University of Nigeria Teaching Hospital, Enugu, with ethical clearance number NHREC/05/01/2008B-IRB00000232. Informed consent was obtained from all participants before enrolment, and all procedures were conducted in accordance with the Declaration of Helsinki on human research ethics.(14) Participants were assured of data confidentiality, and no personally identifiable information was linked to the study results. Also, participation was voluntary, with the right to withdraw at any stage of the study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSample Size Determination and Participant Recruitment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA total of 78 participants were recruited for this study, consisting of 38 patients with steady-state SCD and 40 age- and sex-matched healthy control subjects with the HbAA phenotype. The HbSS phenotype of SCD patients was confirmed by high-performance liquid chromatography (HPLC), while HbAA controls were identified through standard blood donor screening procedures. Given that this is an exploratory study, this sample size was considered adequate to detect preliminary differences in FUT7 activity and provide a basis for future research.\u003c/p\u003e\n\u003cp\u003eSCD patients were further categorized based on the frequency of vaso-occlusive crises (VOCs) in the preceding year. Group A included 19 patients with mild disease, defined as having 0-1 VOC and no documented disease complications such as stroke, chronic leg ulcers, nephropathy, or avascular necrosis. Group B comprised 19 patients with moderate to severe disease, characterized by\u0026nbsp;\u0026ge;2 VOCs in the previous year, with or without associated complications. Patients who had received a blood transfusion within the preceding four months, were on treatment with hydroxyurea or other medications known to affect VOC frequency, or had a co-existing chronic disorder unrelated to SCD, such as asthma or diabetes mellitus were excluded from the study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Collection and Interpretation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eDemographic and clinical data, including age, sex, and frequency of VOCs, were obtained from participants through structured interviews and medical record reviews. The primary outcomes of the study were to compare plasma FUT7 levels between SCD patients and HbAA controls and to evaluate differences in plasma FUT7 levels between SCD patients with mild and moderate-severe disease in the previous year.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSample Collection and Assays\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eVenous blood samples (10mL) were collected from all participants into ethylenediaminetetraacetic acid (EDTA) anticoagulated tubes. Following collection, blood samples were processed for laboratory analyses. Analysis of full blood count was performed using an automated hematology analyzer, while hemoglobin phenotyping was confirmed using HPLC. FUT7 activity was assessed using an enzyme-linked immunosorbent assay (ELISA) kit (Lot Number 20191129C, MyBiosource Inc., USA) according to the manufacturer\u0026rsquo;s instructions.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed using the Statistical Package for Social Sciences (SPSS) version 25.0 for Windows. Descriptive statistics, including means and standard deviations, were used to summarize continuous variables, while categorical variables were presented as frequencies and percentages. Relationship between continuous variables where necessary was done using Pearson\u0026rsquo;s correlation analysis. Group comparisons were performed using the independent t-test or Mann-Whitney U test for continuous variables and the chi-square test for categorical variables, as appropriate. All tests were two-sided, and statistical significance was set at a p-value of less than 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the sociodemographic, clinical, and haematological characteristics of participants. Significant differences were observed in multiple haematological parameters between the SCD and control groups. Haematocrit levels were markedly lower in SCD patients compared to controls (24.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2% vs. 40.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), as were haemoglobin concentration (7.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3 g/dL vs. 12.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4 g/dL, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and red blood cell (RBC) count (2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8 \u0026times;10\u0026sup1;\u0026sup2;/L vs. 4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6 \u0026times;10\u0026sup1;\u0026sup2;/L, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Red cell distribution width, both coefficient of variation (RDW-CV) and standard deviation (RDW-SD), was significantly higher in SCD patients compared to controls (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 for both), indicating greater variability in erythrocyte size.\u003c/p\u003e \u003cp\u003eTotal white blood cell (WBC) count was significantly elevated in the SCD group (11.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3 \u0026times;10⁹/L vs. 5.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 \u0026times;10⁹/L, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with corresponding increases in neutrophil (6.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2 \u0026times;10⁹/L vs. 2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0 \u0026times;10⁹/L, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), lymphocyte (4.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8 \u0026times;10⁹/L vs. 2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7 \u0026times;10⁹/L, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and monocyte (0.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3 \u0026times;10⁹/L vs. 0.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.1 \u0026times;10⁹/L, p\u0026thinsp;=\u0026thinsp;0.001) counts. Platelet count was also significantly higher in SCD patients (326.1\u0026thinsp;\u0026plusmn;\u0026thinsp;117.4 \u0026times;10⁹/L vs. 216.9\u0026thinsp;\u0026plusmn;\u0026thinsp;56.9 \u0026times;10⁹/L, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), along with platelet count (PCT) (3.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0% vs. 2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Mean corpuscular haemoglobin concentration (MCHC) was slightly but significantly increased in SCD patients compared to controls (32.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2 g/L vs. 31.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1 g/L, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) while mean platelet volume (MPV) was significantly lower in SCD patients than in controls (9.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7 vs. 10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), suggesting altered platelet morphology and function.\u003c/p\u003e \u003cp\u003ePlatelet distribution width (PDW), sociodemographic variables (age distribution, sex, educational level, and occupation), mean corpuscular volume (MCV), and mean corpuscular haemoglobin (MCH) showed no significant differences between SCD patients and controls.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic, Clinical, and Haematological Parameters of SCD Patients and Controls\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSCD\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControls\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStatistics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAge group (years)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u0026sup2; = 1.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.906\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (27.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (32.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (27.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (25.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (17.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (15.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (10.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (15.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (17.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSex\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u0026sup2; = 0.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.823\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (47.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (45.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (52.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (55.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFisher\u0026rsquo;s test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.217\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (2.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (27.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (15.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (70.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (85.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOccupation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFisher\u0026rsquo;s test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (32.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (37.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnskilled workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (10.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (35.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (20.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eHaematological Parameters\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaematocrit (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-15.912\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaemoglobin (g/dL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-16.090\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBC count (10\u0026sup1;\u0026sup2;/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-11.313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCV (fL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e85.7\u0026thinsp;\u0026plusmn;\u0026thinsp;10.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.319\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.751\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCH (pg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.685\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.096\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCHC (g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRDW-CV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRDW-SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75.2\u0026thinsp;\u0026plusmn;\u0026thinsp;11.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.590\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC (\u0026times;10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutrophils (\u0026times;10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.710\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocytes (\u0026times;10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonocytes (\u0026times;10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.460\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelets (\u0026times;10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e326.1\u0026thinsp;\u0026plusmn;\u0026thinsp;117.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e216.9\u0026thinsp;\u0026plusmn;\u0026thinsp;56.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-5.834\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePDW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.9\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.309\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCT (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eHCT: haematocrit, RBC: red blood cell, MCV: mean corpuscular volume, MCH: Mean corpuscular haemoglobin, MCHC: Mean Corpuscular Haemoglobin Concentration, RDW-CV: Red cell distribution width Coefficient of variation, RDW-SD: Red cell distribution width\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe median plasma FUT7 level did not differ significantly between SCD patients (2.1 (1.8\u0026ndash;2.5)) and HbAA controls (2.2 (1.8\u0026ndash;2.8), p\u0026thinsp;=\u0026thinsp;0.674) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), and there was no significant correlation between plasma FUT7 levels and laboratory measures of severity including haematocrit (r\u0026thinsp;=\u0026thinsp;0.055, p\u0026thinsp;=\u0026thinsp;0.744), white cell count (r = -0.076, p\u0026thinsp;=\u0026thinsp;0.649), lymphocyte count (r\u0026thinsp;=\u0026thinsp;0.196, p\u0026thinsp;=\u0026thinsp;0.244), neutrophil count (r = -0.123, p\u0026thinsp;=\u0026thinsp;0.461), or platelet count (r\u0026thinsp;=\u0026thinsp;0.101, p\u0026thinsp;=\u0026thinsp;0.545) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Additionally, the median plasma FUT7 level was lower in SCD patients with \u0026ge;\u0026thinsp;2 vaso-occlusive crises 92.0 (1.2\u0026ndash;2.4)) compared to those with \u0026lt;\u0026thinsp;2 crises (2.2 (1.9\u0026ndash;2.9)), but the difference was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.108) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePlasma FUT7 Levels in SCD Patients and HbAA Controls.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian FUT7 (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.1 (1.8\u0026ndash;2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControls\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.2 (1.8\u0026ndash;2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation of Plasma FUT7 Levels with Laboratory Measures of Disease Severity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHematocrit (HCT)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.744\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite Cell Count (WBC)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.649\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocyte Count\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.244\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutrophil Count\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.461\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelet Count\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.545\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePlasma FUT7 Levels by Frequency of Vaso-occlusive Crises\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrequency of VOC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian FUT7 (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2 crises\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.2 (1.9\u0026ndash;2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.108\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;2 crises\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.0 (1.2\u0026ndash;2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study investigated plasma FUT7 levels in Nigerian patients with SCD, assessing its relationship with disease severity and vaso-occlusive risk. Our findings indicate that plasma FUT7 levels did not differ significantly between SCD patients and HbAA controls, nor did they correlate with key laboratory markers of disease severity, including hematocrit, white cell count, and platelet count. Additionally, although SCD patients with more frequent VOCs exhibited lower median FUT7 levels, this difference was not statistically significant. These findings suggest that FUT7 activity may not play a major role in modulating disease severity or vaso-occlusive risk in SCD.\u003c/p\u003e \u003cp\u003eThe lack of significant differences in plasma FUT7 levels between SCD patients and controls contrasts with prior studies highlighting the role of fucosylation in leukocyte adhesion and vascular inflammation.(\u003cspan additionalcitationids=\"CR16 CR17 CR18\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) FUT7 is a key enzyme responsible for the synthesis of sialyl Lewis X, a crucial ligand for selectin-mediated leukocyte-endothelial interactions, which are central to the pathophysiology of VOCs. Previous reports have suggested that increased selectin-mediated adhesion contributes to endothelial dysfunction and vaso-occlusion in SCD.(\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan additionalcitationids=\"CR20 CR21 CR22 CR23 CR24\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) However, our findings do not support a direct role for plasma FUT7 in these processes, potentially indicating that other factors, such as altered glycosylation pathways or compensatory mechanisms, may regulate leukocyte-endothelial interactions in SCD.\u003c/p\u003e \u003cp\u003eOne possible explanation for the observed lack of association is that plasma FUT7 levels may not accurately reflect cellular fucosylation activity in SCD. FUT7 activity is primarily localized to the Golgi apparatus, where it catalyzes fucosylation of glycoproteins involved in adhesion and immune responses.(\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) It is plausible that post-translational modifications or differential expression of selectin ligands, rather than circulating FUT7 levels, mediate leukocyte adhesion in SCD. Additionally, the dynamic nature of VOCs, influenced by inflammatory triggers, oxidative stress, and endothelial dysfunction, may overshadow the contribution of a single enzyme in the complex pathogenesis of vaso-occlusion.\u003c/p\u003e \u003cp\u003eFurthermore, previous studies have suggested that abnormal glycosylation patterns might contribute to vascular inflammation.(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) This could be relevant in SCD, while the diversity of fucosylation pathways in different populations may lead to varying results. Genetic and environmental factors influence glycosyltransferase activity, and the expression of FUT7-related adhesion molecules may differ between individuals.(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) Future studies incorporating genetic analysis of FUT7 polymorphisms and functional assays of fucosylated selectin ligands could provide a more comprehensive understanding of its role in SCD pathophysiology.\u003c/p\u003e \u003cp\u003eThe study\u0026rsquo;s limitations should be considered when interpreting these findings. The relatively small sample size may have limited the statistical power to detect subtle differences in FUT7 levels or associations with disease severity. Additionally, the cross-sectional study design precludes assessment of temporal variations in FUT7 activity, particularly during acute VOC episodes. Longitudinal studies evaluating FUT7 expression during steady-state and vaso-occlusive episodes could provide further insights into its potential involvement in disease pathogenesis.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study found no significant difference in plasma FUT7 levels between SCD patients and healthy controls and no clear association between FUT7 levels and markers of disease severity or vaso-occlusive risk. These findings suggest that FUT7 activity may not be a major determinant of disease severity in SCD. Future research should explore alternative glycosylation pathways and leukocyte adhesion mechanisms in SCD to identify novel therapeutic targets for reducing vaso-occlusive complications.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFUT7\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFucosyltransferase VII\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSCD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSickle Cell Disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eVOC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eVaso-occlusive Crisis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHbS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHemoglobin S\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRBC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRed Blood Cell\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHbAA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNormal Hemoglobin Phenotype\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHbSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSickle Cell Phenotype\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHPLC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHigh-Performance Liquid Chromatography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package for Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWBC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWhite Blood Cell\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRDW\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRed Cell Distribution Width\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRDW-CV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRed Cell Distribution Width Coefficient of Variation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRDW-SD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRed Cell Distribution Width Standard Deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEDTA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEthylenediaminetetraacetic Acid\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eELISA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEnzyme-Linked Immunosorbent Assay\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePlateletcrit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMPV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMean Platelet Volume\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePDW\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePlatelet Distribution Width\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMCV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMean Corpuscular Volume\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMCH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMean Corpuscular Hemoglobin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMCHC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMean Corpuscular Hemoglobin Concentration.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable in this study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAvailability of Data and Materials\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets from this study will be available upon reasonable request to the corresponding author. This is because the dataset includes additional data that are not relevant to this study and may require exclusion.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCompeting Interests\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFundingTop of Form\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any dedicated funding from a public, commercial, or not-for-profit agency.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAuthors\u0026rsquo; contributions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll authors collaborated on this research project. EEO, TN, and SO conceptualized the study. Methodology was developed by EEO, TN, SO, CDN, and MEA. Investigation was conducted by EEO, CDN, MEA, EMN, and ICN. Data curation was carried out by EEO, BB, ECC, CDN, MEA, and ICN. BB, ECC, EMN, and ICN performed the formal analysis. The original draft was written by EEO, BB, ECC, CDN, and MEA, while BB, ECC, EMN, ICN, TN, and SO contributed to the review and editing of the manuscript. TN, and SO supervised the study. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe acknowledge the management of University of Nigeria Teaching Hospital, Enugu and the Department of Haematology for granting access to both patients admitted to the wards and those attending the Haematology Clinic.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNational Academies of Sciences E and MH and MDB on PH and PHPC on ASCDASP and B for A, Martinez RM, Osei-Anto HA, McCormick M. Complications of Sickle Cell Disease and Current Management Approaches. Addressing Sickle Cell Disease [Internet]. 2020 Sep 10 [cited 2025 Feb 22];1\u0026ndash;496. 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Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.nature.com/articles/s41392-024-01886-1\u003c/span\u003e\u003cspan address=\"https://www.nature.com/articles/s41392-024-01886-1\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Sickle cell disease, Fucosyltransferase VII, Vaso-occlusive crisis, Leukocyte adhesion, Glycosylation, Nigeria","lastPublishedDoi":"10.21203/rs.3.rs-6480636/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6480636/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis study investigated plasma fucosyltransferase VII (FUT7) levels in Nigerian patients with sickle cell disease (SCD) to assess its relationship with disease severity and vaso-occlusive risk. Given FUT7's role in leukocyte-endothelial interactions, we hypothesized that altered FUT7 activity may contribute to the pathogenesis of vaso-occlusive crises (VOCs) in SCD.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted at the University of Nigeria Teaching Hospital, Enugu, involving 38 SCD patients and 40 age- and sex-matched healthy controls. Plasma FUT7 levels were measured using enzyme-linked immunosorbent assay (ELISA), and haematological parameters were assessed. SCD patients were classified based on VOC frequency in the preceding year.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003ePlasma FUT7 levels did not differ significantly between SCD patients and healthy controls (p\u0026thinsp;=\u0026thinsp;0.674). No significant correlations were observed between FUT7 levels and markers of disease severity, including haematocrit, white blood cell count, and platelet count. Although patients with \u0026ge;\u0026thinsp;2 VOCs had lower median FUT7 levels than those with \u0026lt;\u0026thinsp;2 VOCs, the difference was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.108).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThese findings suggest that FUT7 activity may not be a major determinant of disease severity or vaso-occlusive risk in SCD. Further research should explore alternative glycosylation pathways and leukocyte adhesion mechanisms in SCD pathophysiology.\u003c/p\u003e","manuscriptTitle":"Fucosyltransferase VII Activity in Sickle Cell Disease: Implications for Disease Severity and Vaso-occlusive Risk in Nigerian Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 13:52:38","doi":"10.21203/rs.3.rs-6480636/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-05T20:05:38+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-05T14:22:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"283420522966646830840879217846413713601","date":"2025-06-01T05:51:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-22T15:24:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"172563318996713345340533894256514882922","date":"2025-05-21T16:03:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"330261156959039076353131653482419539202","date":"2025-05-03T05:39:19+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-01T08:22:18+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-21T16:22:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-21T13:41:55+00:00","index":"","fulltext":""},{"type":"submitted","content":"SN Comprehensive Clinical Medicine","date":"2025-04-18T17:12:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"9685c7cf-3f7d-4912-8e76-f8727330cad3","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-28T16:01:29+00:00","versionOfRecord":{"articleIdentity":"rs-6480636","link":"https://doi.org/10.1007/s42399-025-01950-z","journal":{"identity":"sn-comprehensive-clinical-medicine","isVorOnly":false,"title":"SN Comprehensive Clinical Medicine"},"publishedOn":"2025-07-22 15:57:37","publishedOnDateReadable":"July 22nd, 2025"},"versionCreatedAt":"2025-05-06 13:52:38","video":"","vorDoi":"10.1007/s42399-025-01950-z","vorDoiUrl":"https://doi.org/10.1007/s42399-025-01950-z","workflowStages":[]},"version":"v1","identity":"rs-6480636","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6480636","identity":"rs-6480636","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}