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Strenuous exercise in warm environment is associated with improved microvascular function in sickle cell trait



Sickle cell trait is characterized by the presence of both normal and abnormal haemoglobin in red blood cells. The rate of exertional collapse is increased in athletes and military recruits who carry the trait, particularly in stressful environmental conditions. The aim of the present study was to investigate microvascular function and its determinants in response to intense exercise at control and warm environmental temperatures in carriers (AS) and non-carriers (AA) of sickle cell trait.


Nine AS and 11 AA, all healthy physically active young men, randomly participated in four experimental sessions (rest at 21 °C and 31 °C and cycling at 21 °C and 31 °C). All participants performed three exercises bouts as follows: 18-min submaximal exercise; an incremental test to exhaustion; and three 30-s sprints spaced with 20-s resting intervals.


Skin Blood Flow (SkBF) was similar at rest between AA and AS. SkBF for all participants was higher at 31 °C than 21 °C. It was significantly higher in the AS group compared to the AA group immediately after exercise, regardless of the environmental conditions. No significant differences in hemorheological parameters, muscle damage or cardiac injury biomarkers were observed between the two groups. Our data also suggest higher oxidative stress for the AS group, with high superoxide dismutase (P = 0.044 main group effect).


A specific profile is identified in the AS population, with increased microvascular reactivity after maximal exercise in stressful environment and slight pro-/antioxidant imbalance.

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Fig. 1
Fig. 2
Fig. 3
Fig. 4 



Aggregation index


Advanced oxidation protein products



CL :



Creatine phosphokinase


Creatine phosphokinase –myoglobin


Reduced glutathione


Oxidized glutathione


Heat shock protein 70


Lactate dehydrogenase

K+ :







Oxide nitric


N-terminal pro-brain natriuretic peptide


Red blood cell


Sickle cell trait


Skin blood flow


Superoxide dismutase


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We thank the participants, nurses (coordinated by Franceline Falla), and physicians (Patrick Chérubin, Nicolas Benoit) for their great involvement.


Funding for this work was provided by European Regional Development Fund & Région Guadeloupe 2015-FED-213.

Author information




KR: formal analysis, investigation, methodology, writing– original draft, writing review & editing. ETNS: data curation, formal analysis, investigation, review & editing. MR: investigation, resources, writing-review & editing. PC: conceptualization, formal analysis, resources, writing – review & editing. SR: investigation, methodology. SH: investigation, methodology. OH: original draft, review & editing. MHD: investigation, methodology, writing – review & editing. SAJ: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, supervision, writing – original draft, writing – review & editing.

Corresponding author

Correspondence to S. Antoine-Jonville.

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The author declares no financial or other conflict of interest that might bias this article.

Ethical approval

The participants were informed of the procedures and purposes of the study, which were in accordance with the institutional guidelines and the Helsinki Declaration of 2013 and was approved by the National Ethics Committee (CPP 17.10.10). This protocol described in this article is part of a larger project registered in EudraCT (TDEX: 2017-A02226-47) and Clinical Trials (NCT04028791).

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Reminy, K., Ngo Sock, E.T., Romana, M. et al. Strenuous exercise in warm environment is associated with improved microvascular function in sickle cell trait. Eur J Appl Physiol (2021).

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  • Sickle cell trait
  • Cutaneous thermal hyperemia
  • Physical exercise