The Effects of Pain on Leukocyte CAM Expression

疼痛是一种对护理具有开创性意义的现象；自护理专业诞生以来，提供疼痛缓解和减轻痛苦一直是护理实践领域的中心活动。护士们知道，未缓解的疼痛会带来一系列有害健康的影响，但作为一种肾上腺素能和伤害性应激源，疼痛如何通过直接和间接影响细胞黏附分子(CAM)水平来影响炎症过程，仍有待探讨。已知的交感神经系统对压力的反应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因素。拟议和修订的申请代表着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，并完成了一项初步研究，探索实验性疼痛对健康对照组CAM水平的影响。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中描述，采用重复测量的实验设计和随机排序的实验(低应激疼痛、高应激疼痛)和对照(无疼痛)条件。疼痛是一种强大而独特的压力源，其对伴随的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，特别是患有动脉粥样硬化、炎症性肠病和类风湿性关节炎等慢性炎症性疾病的患者，具有重要的健康影响。

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.