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; 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 由于复杂的相互作用，小儿镰状细胞病（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，当前的药理和非 - 药理学治疗具有可变且有限的有效性，导致慢性疼痛的持久性 在青春期到成年期。慢性SCD疼痛的最佳治疗需要个性化的， 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，神经系统的敏感性，压力和情绪困扰。目的 拟议的研究是确定在 患有慢性SCD疼痛的年轻人受压力，抑郁和焦虑驱动的青年 通过非药物治疗方法（例如认知行为疗法）进行了修改。目的 拟议的研究是1）确定是否存在与慢性有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改变 遵循自适应，以家庭为中心的，文化的认知行为干预，称为Back2life 这是针对儿科SCD中慢性疼痛的独特需求而定制的。 24个月的回顾展 纵向研究将评估慢性SCD疼痛青年的储存血样，以确定速率 促炎细胞因子及其与疼痛和压力的关系。我们将预先评估 慢性SCD疼痛青年中促炎生物标志物的轨迹参与了证明 Back2life的概念临床试验，以查看这些标记是否随治疗而变化并为初步效果提供信息 大小以准备大型临床试验。我们的长期目标是发展新颖的综合 治疗小儿SCD慢性疼痛并改善生活质量的治疗方法。