The Effects of Pain on Leukocyte CAM Expression

疼痛是一种对护理具有重要意义的现象；提供疼痛缓解和减轻痛苦已经在护理实践领域的核心活动，因为这个行业的成立。护士们明白，未缓解的疼痛会带来一系列有害的健康影响，但仍有待探索的是，疼痛作为一种肾上腺素能和伤害性应激源，如何通过其对细胞粘附分子（CAM）水平的直接和间接影响炎症过程。已知的交感神经系统对应激和感觉神经系统对伤害性刺激的反应表明，疼痛可能是CAM表达的一个特别有效的诱导剂。提出和修订的申请代表了首席研究员在疼痛生理学方面的专业知识的扩展，通过与国家公认的免疫学家的多学科合作，包括疼痛对免疫和炎症参数的影响，并完成了一项探索健康对照中实验性疼痛对CAM水平影响的试点研究。情感应激、肾上腺素、去甲肾上腺素和白细胞介素-6在疼痛诱导的CAM表达中的作用将在一个小样本的实验设计中进行描述，该实验设计采用重复测量和随机排序的实验（低应激疼痛、高应激疼痛）和控制（无疼痛）条件。将疼痛作为一种强大而独特的应激源，其对伴随炎症过程的影响显然是一个值得护理研究的领域，对许多患者，特别是那些患有慢性炎症性疾病（如动脉粥样硬化、炎症性肠病和类风湿性关节炎）的患者具有重要的健康意义。

Pain is a phenomenon of seminal interest to nursing; providing pain relief and easing suffering have been central activities within the domain of nursing practice since the profession's inception. Nurses understand that unrelieved pain brings with it a range of detrimental health effects, yet still to be explored is how pain, as an adrenergic and nociceptive stressor, might impact on inflammatory processes via its direct and indirect effects on cellular adhesion molecule (CAM) levels. Known responses of both the sympathetic nervous system to stress and the sensory nervous system to nociceptive stimuli suggest that pain could be an especially potent inducer of CAM expression. The proposed and revised application represents an expansion of the principal investigator's expertise in pain physiology to include the effects of pain on immune and inflammatory parameters via multidisciplinary collaboration with nationally-recognized immunologists, and completion of a pilot study exploring the effects of experimental pain on CAM levels in healthy controls. The roles of affective stress, epinephrine, norepinephrine, and interleukin-6 in pain-induced CAM expression will be described in a small sample using an experimental design with repeated measures and randomly ordered experimental (low-stress pain, high-stress pain) and control (no pain) conditions. Conceptualizing pain as a potent and unique stressor, its effects on concomitant inflammatory processes is clearly an area worthy of nursing investigation, with important health implications for many patients, particularly those suffering from chronic inflammatory diseases such as atherosclerosis, inflammatory bowel disease, and rheumatoid arthritis.