Nonpharmacological Treatment Effects on Proinflammatory Biomarkers among Youth with Chronic Sickle Cell Pain

非药物治疗对慢性镰状细胞痛青少年促炎生物标志物的影响

• 批准号: 10686934
• 负责人: Soumitri Sil
• 金额: $ 8.14万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10686934
• 关键词: 18 year old; Abdominal Pain; Acute Pain; Address; Adolescence; Adolescent; Adult; Aftercare; Age; Anxiety; Attenuated; Biological; Biological Factors; Biological Markers; Blood; Blood specimen; C-reactive protein; Cardiovascular Diseases; Caring; Child; Childhood; Chronic; Chronic Headaches; Chronic stress; Clinical; Clinical Trials; Cognitive Therapy; Complex; Data; Disease; Effectiveness; Erythrocytes; Family; Frequencies; Future; Goals; Health Care Costs; Health Personnel; Inflammation; Inflammatory; Interleukin-1 beta; Interleukin-6; Intervention; Long-Term Effects; Longitudinal Studies; Longitudinal, observational study; Malignant Neoplasms; Measurable; Measurable Disease; Measures; Mental Depression; Nervous System; Nonpharmacologic Therapy; Pain; Parents; Patient Self-Report; Patient risk; Patients; Pattern; Plasma; Psychological Factors; Psychological Stress; Quality of life; Reporting; Research; Risk Factors; Sampling; Sickle Cell; Sickle Cell Anemia; Stress; Stroke; TNF gene; Testing; Therapeutic Intervention; Time; Treatment Efficacy; United States; Work; Youth; aged; anxiety symptoms; arm; biological adaptation to stress; biopsychosocial factor; career; chronic pain; chronic pain management; chronic painful condition; coping; cytokine; depressive symptoms; disability; effective therapy; emotional distress; evidence base; follow-up; functional disability; health care service utilization; hypothalamic-pituitary-adrenal axis; improved; inter-individual variation; interdisciplinary treatment approach; intervention effect; ischemic injury; novel; optimal treatments; pain chronification; pharmacologic; prospective; psychologic; psychosocial; randomized, clinical trials; response; risk stratification; sickling; social factors; specific biomarkers; theories; treatment effect; treatment response

PROJECT SUMMARY Chronic pain in pediatric sickle cell disease (SCD) is a major clinical challenge due to the complex interaction of biological, psychological, and social factors. Consequently, current pharmacological and non- pharmacological treatments have variable and limited effectiveness resulting in the persistence of chronic pain during adolescence into adulthood. Optimal treatment of chronic SCD pain requires an individualized, interdisciplinary care approach that targets the multifaceted biopsychosocial factors that maintain chronic pain, such as chronic inflammation, nervous system sensitization, stress, and emotional distress. The objective of the proposed research is to determine if there are measurable elevated proinflammatory biomarkers among youth with chronic SCD pain that are driven by stress, depression, and anxiety that can be targeted and modified through non-pharmacological treatment approaches, such as cognitive-behavioral therapy. The aims of the proposed study are to 1) determine if there are key inflammatory biomarkers associated with chronic SCD pain and stress, and 2) determine if inflammatory biomarkers change for youth with chronic SCD pain following an adaptive, family-focused, culturally-informed cognitive-behavioral intervention termed Back2Life that is tailored to address the unique needs of chronic pain in pediatric SCD. A 24-month retrospective longitudinal study will evaluate stored blood samples from youth with chronic SCD pain to determine the rates of elevated proinflammatory cytokines and their relationship to pain and stress. We will prospectively evaluate the trajectory of proinflammatory biomarkers among youth with chronic SCD pain participating in a proof-of- concept clinical trial of Back2Life to see if these markers change with treatment and inform preliminary effect sizes in order to prepare for a larger clinical trial. Our long-term goal is to develop novel comprehensive treatment approaches to treat chronic pain in pediatric SCD and improve quality of life.

项目总结 由于复杂的相互作用，儿童镰状细胞病(Scd)的慢性疼痛是一个主要的临床挑战。 生物、心理和社会因素。因此，目前的药理和非 药物治疗的效果多变且有限，导致慢性疼痛持续存在。 在青春期到成年期。慢性SCD疼痛的最佳治疗需要个体化、 针对维持慢性疼痛的多方面生物、心理和社会因素的跨学科护理方法， 如慢性炎症、神经系统敏感化、压力和情绪困扰。的目标是 拟议的研究旨在确定在以下人群中是否存在可测量的升高的促炎生物标志物 患有慢性SCD疼痛的年轻人，由压力、抑郁和焦虑驱动，可以有针对性和 通过非药物治疗方法，如认知-行为疗法进行修改。目标 这项拟议的研究的目的是：1)确定是否存在与慢性阻塞性肺疾病相关的关键炎症生物标志物 SCD疼痛和应激，以及2)确定慢性SCD疼痛的青年炎性生物标志物是否发生变化 在经历了名为Back2Life的适应性、以家庭为中心、文化知情的认知行为干预之后 这是为解决儿科SCD慢性疼痛的独特需求而量身定做的。为期24个月的回顾 纵向研究将评估患有慢性SCD疼痛的年轻人的储存血液样本，以确定 促炎症细胞因子升高及其与疼痛和压力的关系。我们将前瞻性地评估 青年慢性SCD疼痛患者中促炎生物标记物的轨迹 Back2Life的概念性临床试验，观察这些标志物是否随着治疗而变化并告知初步效果 大小，以便为更大的临床试验做准备。我们的长期目标是开发新的全面的 治疗儿童SCD慢性疼痛和提高生活质量的治疗方法。