S125: THE ROLE OF THE MICROBIOME AS A SICKLE CELL DISEASE MODIFIER: AN EXPERT REVIEW
Authors: C Oosterwyk, A Nguweneza, K Mnika, V Nembaware, A Wonkam
Journal: HemaSphere (2022)

Background: There is evidence that the microbiome is involved in numerous human systems’ pathobiology, however, its role in sickle cell disease (SCD) remains elusive. Methodology: An extensive systematic search was conducted by applying the PRISMA guidelines (2009) and using three databases (Pubmed, Web of Science, and Scopus). The keywords were used separately and a combination of the following: “Microbiota” AND “Anemia” OR “Sickle Cell”. Articles included were confined to full-length articles written in English and focused on research and review articles on the contribution of the microbiome in the development of sickle cell disease (SCD) severity. The main search was conducted, separately, by a MSc Student and a PhD student, both in Human Genetics and reviewed by a medical and human geneticist with expertise in SCD and a clinician-scientist with expertise in molecular biology and microbiology. A total of 229 articles was compared and screened for duplications. The abstracts of the remaining articles were screened for suitability to the study. Articles were excluded based on its relevance to the scope of the review. Results: This systematic review examines available data on the role of the microbiome in SCD clinical events. A total of 13 published articles were selected; most were observational human studies (n =10), and five included SCD mouse models. Few studies performed microbiome 16S rRNA analysis, to identify/classify uncultured microbes (n = 8/13). Results showed that the microbiome influences inflammation, and vaso-occlusive crises (VOC) in SCD, and is disrupted by medication and diet. This review was able to provide insight on how immunity can be maintained by the microbiome through TLRs and Myd88 mechanisms. The exploration of bacterial translocation may be regulated by an altering intestinal permeability and the microbial density, which is managed by the damage-associated molecular pattern (DAMPs). 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