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Evaluation of Oral Urea in the Management of Sickle Cell Anemia

  • Jeanne M. Lusher
  • Marion I. Barnhart
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 28)

Abstract

The rationale for the use of urea in treating or preventing sickle cell vaso-occlusive episodes is based on Murayama’s hypothesis that hemoglobin S molecules, when deoxygenated, polymerize by means of hydrophobic interaction to form microfilaments and microcables which result in distortion of the red cell (Murayama, 1971). The resulting sickle forms may then occlude the microcirculation with subsequent infarction and necrosis. Almost all of the clinical manifestations, symptomatology, and ultimate progressive disability seen in individuals with sickle cell anemia are the direct result of such vaso-occlusive phenomena. (Diggs, 1965). Nalbandian postulated that any agent or condition which could diminish hydrophobic bond strength should interfere with the mechanism of tetramer polymerization of hemoglobin S, and thus prevent or reverse sickling of hemoglobin S erythrocytes. (Nalbandian, 1971a). In a search for such an agent Nalbandian and co-workers found that urea was not only effective in disrupting hydrophobic bonds, but also possessed other desirable properties for in vivo use. These included molecular dimensions small enough to pass through the membrane of the intact red blood cell (rbc) and the fact that urea is water soluble, metabolically inert and non-toxic.

Keywords

Sickle Cell Anemia Sickle Cell Blood Urea Nitrogen Sickle Cell Anemia Patient Major Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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Copyright information

© Plenum Press, New York 1972

Authors and Affiliations

  • Jeanne M. Lusher
    • 1
    • 2
  • Marion I. Barnhart
    • 3
  1. 1.Department of PediatricsWayne State University School of MedicineDetroitUSA
  2. 2.Children’s Hospital of MichiganDetroitUSA
  3. 3.Department of Physiology and PharmacologyWayne State University School of MedicineDetroitUSA

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