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Targeting pain at its source in sickle cell disease.
- Source :
-
American journal of physiology. Regulatory, integrative and comparative physiology [Am J Physiol Regul Integr Comp Physiol] 2018 Jul 01; Vol. 315 (1), pp. R104-R112. Date of Electronic Publication: 2018 Mar 28. - Publication Year :
- 2018
-
Abstract
- Sickle cell disease (SCD) is a genetic disorder associated with hemolytic anemia, end-organ damage, reduced survival, and pain. One of the unique features of SCD is recurrent and unpredictable episodes of acute pain due to vasoocclusive crisis requiring hospitalization. Additionally, patients with SCD often develop chronic persistent pain. Currently, sickle cell pain is treated with opioids, an approach limited by adverse effects. Because pain can start at infancy and continue throughout life, preventing the genesis of pain may be relatively better than treating the pain once it has been evoked. Therefore, we provide insights into the cellular and molecular mechanisms of sickle cell pain that contribute to the activation of the somatosensory system in the peripheral and central nervous systems. These mechanisms include mast cell activation and neurogenic inflammation, peripheral nociceptor sensitization, maladaptation of spinal signals, central sensitization, and modulation of neural circuits in the brain. In this review, we describe potential preventive/therapeutic targets and their targeting with novel pharmacologic and/or integrative approaches to ameliorate sickle cell pain.
- Subjects :
- Acute Pain etiology
Acute Pain metabolism
Acute Pain physiopathology
Analgesics adverse effects
Anemia, Sickle Cell complications
Anemia, Sickle Cell metabolism
Anemia, Sickle Cell physiopathology
Animals
Chronic Pain etiology
Chronic Pain metabolism
Chronic Pain physiopathology
Disease Models, Animal
Humans
Molecular Targeted Therapy
Pain Management adverse effects
Pain Perception
Pain Threshold
Risk Factors
Signal Transduction drug effects
Treatment Outcome
Acute Pain prevention & control
Analgesics therapeutic use
Anemia, Sickle Cell drug therapy
Chronic Pain prevention & control
Pain Management methods
Subjects
Details
- Language :
- English
- ISSN :
- 1522-1490
- Volume :
- 315
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of physiology. Regulatory, integrative and comparative physiology
- Publication Type :
- Academic Journal
- Accession number :
- 29590553
- Full Text :
- https://doi.org/10.1152/ajpregu.00021.2018