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.

项目摘要 小儿镰状细胞病（SCD）的慢性疼痛是一个主要的临床挑战，由于复杂的相互作用， 生物学、心理学和社会因素的影响。因此，目前的药理学和非- 药物治疗具有可变的和有限的有效性 从青春期到成年期。慢性SCD疼痛的最佳治疗需要个体化， 跨学科护理方法，针对维持慢性疼痛的多方面生物心理社会因素， 例如慢性炎症、神经系统敏感化、压力和情绪困扰。的目标 拟议的研究是确定是否有可测量的升高的促炎生物标志物， 患有慢性SCD疼痛的青年，由压力、抑郁和焦虑驱动，可以有针对性地治疗， 通过非药物治疗方法，如认知行为疗法进行修改。目标 1）确定是否存在与慢性炎症相关的关键炎症生物标志物， SCD疼痛和压力，以及2）确定慢性SCD疼痛青年的炎症生物标志物是否发生变化 在一个适应性的，以家庭为中心的，文化上知情的认知行为干预，称为Back 2Life 这是专为解决儿童SCD慢性疼痛的独特需求。24个月回顾 纵向研究将评估储存的血液样本，从青年与慢性SCD疼痛，以确定率 促炎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 参与一项证明性研究的患有慢性SCD疼痛的年轻人中促炎生物标志物的轨迹， Back 2Life的概念临床试验，看看这些标志物是否随治疗而变化，并告知初步效果 为更大规模的临床试验做准备。我们的长期目标是开发新的综合性 治疗儿童SCD慢性疼痛和改善生活质量的治疗方法。