Effects of Rifaximin on Circulating Aged Neutrophils in Sickle Cell Disease

There is a large therapeutic gap in sickle cell disease (SCD). Hydroxy-urea reduces acute sickle cell-related events, but does not appear to protect patients from cardiopulmonary complications, which are the major causes of death in SCD patients. The long-term effects of newer agents such as crizanlizumab and L-glutamine on the disease course remain to be determined. The only cure currently available for SCD is allogeneic stem cell transplant (allo-SCT); however, many barriers prevent allo-SCT from being readily offered to these patients. Investigations into other therapeutic approaches are, therefore, appropriate. Activated and circulating aged neutrophils (CANs) adhere to vascular endothelium and are pivotal for the pathogenesis of sickle cell vaso-occlusive crisis (VOC). CANs in mice are regulated by intestinal micro biota. Treatment of SCD mice with a cocktail of ampicillin, neomycin, metronidazole, and vancomycin (ANMV) induced reduction in CANs and protected the mice from fatal tumor necrosis factor-α-induced VOC. Therefore, antibiotic therapy might be a potential therapeutic approach for SCD. Abstract source Full text