Duke University School of Nursing, Durham, NC, USA.
Duke University School of Medicine, Durham, NC, USA.
Biol Res Nurs. 2022 Jan;24(1):24-30. doi: 10.1177/10998004211027220. Epub 2021 Jun 30.
Severe pain is among the most common and deleterious symptoms experienced by individuals with sickle cell disease (SCD), of whom more than 50% report chronic pain. Despite this, the understanding of the biological contributors to persistent severe SCD pain is limited. This exploratory study sought to describe pain phenotypes based on frequency of severe pain experienced over 6 months and identify inflammatory biomarkers associated with pain phenotypes among individuals with SCD.
This study used self-report and electronic health record data collected from 74 individuals enrolled in the Duke Sickle Cell Disease Implementation Consortium Registry. Plasma from previously collected blood specimens was used to generate inflammatory biomarker data using the Inflammation 20-plex ProcartaPlex panel. Descriptive statistics were used to describe the occurrence of severe pain over the past 6 months, and bi-variate analyses were used to evaluate the relationship between inflammatory biomarkers and pain phenotypes.
Among the 74 participants included in this study, 33.8% reported severe pain occurring never or rarely, 40.5% reported severe pain occurring sometimes, and 25.7% reported severe pain occurring often or always. Soluble E-selectin (sE-selectin) was the only inflammatory biomarker significantly associated with the pain phenotype groups ( = 0.049). Post hoc comparisons identified that participants in the often/always severe pain group had significantly higher plasma concentrations of sE-selectin compared to those in the sometimes severe pain group ( = 0.040).
Our findings provide preliminary evidence of the frequent occurrence of severe pain and that sE-selectin may be an objective biomarker for the frequent occurrence of severe pain in this population.
严重疼痛是镰状细胞病（SCD）患者最常见和最有害的症状之一，其中超过 50%的患者报告有慢性疼痛。尽管如此，对于导致持续性严重 SCD 疼痛的生物学因素的理解仍然有限。这项探索性研究旨在根据过去 6 个月内经历严重疼痛的频率描述疼痛表型，并确定与 SCD 患者疼痛表型相关的炎症生物标志物。
本研究使用了来自参加杜克镰状细胞病实施联盟登记处的 74 名个体的自我报告和电子健康记录数据。使用先前收集的血液标本生成炎症生物标志物数据，使用 Inflammation 20-plex ProcartaPlex 面板。描述性统计用于描述过去 6 个月内严重疼痛的发生情况，双变量分析用于评估炎症生物标志物与疼痛表型之间的关系。
在这项研究的 74 名参与者中，33.8%报告严重疼痛从未或很少发生，40.5%报告严重疼痛有时发生，25.7%报告严重疼痛经常或总是发生。可溶性 E-选择素（sE-选择素）是唯一与疼痛表型组显著相关的炎症生物标志物（=0.049）。事后比较确定，经常/总是发生严重疼痛的参与者的血浆 sE-选择素浓度明显高于有时发生严重疼痛的参与者（=0.040）。
我们的研究结果初步证明了严重疼痛的频繁发生，并且 sE-选择素可能是该人群中频繁发生严重疼痛的客观生物标志物。
