title: Microvascular oxygen consumption during sickle cell pain crisis.
abstract: Sickle cell disease is an inherited blood disorder characterized by chronic hemolytic anemia and episodic vaso-occlusive pain crises. Vaso-occlusion occurs when deoxygenated hemoglobin S polymerizes and erythrocytes sickle and adhere in the microvasculature, a process dependent on the concentration of hemoglobin S and the rate of deoxygenation, among other factors. We measured oxygen consumption in the thenar eminence during brachial artery occlusion in sickle cell patients and healthy individuals. Microvascular oxygen consumption was greater in sickle cell patients than in healthy individuals (median [interquartile range]; sickle cell: 0.91 [0.75-1.07] vs healthy: 0.75 [0.62-0.94] -ΔHbO2/min, P < .05) and was elevated further during acute pain crisis (crisis: 1.10 [0.78-1.30] vs recovered: 0.88 [0.76-1.03] -ΔHbO2/min, P < .05). Increased microvascular oxygen consumption during pain crisis could affect the local oxygen saturation of hemoglobin when oxygen delivery is limiting. Identifying the mechanisms of elevated oxygen consumption during pain crisis might lead to the development of new therapeutic interventions. This trial was registered at www.clinicaltrials.gov as #NCT01568710.
authors.affiliation: Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, MD;
authors.forename: Carol A
authors.initials: CA
authors.lastname: Rowley
authors.affiliation: Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, MD;
authors.forename: Allison K
authors.initials: AK
authors.lastname: Ikeda
authors.affiliation: Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD; and.
authors.forename: Miles
authors.initials: M
authors.lastname: Seidel
authors.affiliation: Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, MD;
authors.forename: Tiffany C
authors.initials: TC
authors.lastname: Anaebere
authors.affiliation: Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD; and.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Antalek
authors.affiliation: Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD.
authors.forename: Catherine
authors.initials: C
authors.lastname: Seamon
authors.affiliation: Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Conrey
authors.affiliation: Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD.
authors.forename: Laurel
authors.initials: L
authors.lastname: Mendelsohn
authors.affiliation: Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD.
authors.forename: James
authors.initials: J
authors.lastname: Nichols
authors.affiliation: Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD; and.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Gorbach
authors.affiliation: Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Kato
authors.affiliation: Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, MD;
authors.forename: Hans
authors.initials: H
authors.lastname: Ackerman
mesh_terms: D059787:Acute Pain / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D001916:Brachial Artery / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications; D008297:Male; D055806:Microvessels / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption; D010146:Pain
chemical_list: D010100:Oxygen