The burden of pain varies among patients with sickle cell disease (SCD). Chronic pain, resulting from multiple aetiologies, is common in SCD. The Analgesic, Anaesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy (ACTTION-AAPT) criteria have recently described subcategories of chronic SCD pain (Dampier et al, 2017). Haematopoietic stem cell transplant (HSCT) is the most accessible curative therapy for SCD resulting in disease-free survival in over 85% (Hsieh et al, 2014; Gluckman et al, 2017). After successful HSCT (as defined by haematological parameters), most patients are weaned off opioids; however, a subgroup of patients continues to experience pain that requires opioid treatment.
We determined the prevalence and correlates of pain requiring continued opioid treatment at 12 months after successful non-myeloablative human leucocyte antigen-matched sibling allogeneic HSCT in a cohort of SCD patients (Fig 1) (Hsieh et al, 2014). The Institutional Review Board of the National Institutes of Health approved the protocol. All participants provided informed consent. Detailed data on the clinical course, pain, opioid use and laboratory values were prospectively collected within 3 months prior to HSCT and at 12 months post-HSCT (n = 35). Patient Reported Outcomes Measurement Information System (PROMIS) measures were also prospectively collected at the same time points in a subgroup of these patients (n = 20). The PROMIS domains assessed included pain intensity, pain impact, anxiety, depression, satisfaction with social role, physical function, fatigue and sleep disturbance (Cella et al, 2007; Keller et al, 2017). All PROMIS raw data were converted to T-scores.
*Always Remember: Physical Activity can reduce pain and improve physical function by about 40%
Arthritis is very common but not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis (see Appendix) and related conditions. People of all ages, genders and races have arthritis, the leading cause of disability in the United States. We don’t know the true number of people with arthritis because many people don’t seek treatment until their symptoms become severe. Conservative estimates only include those who report they have doctor diagnosed arthritis, indicating that about 54 million adults and almost 300,000 children “officially” have arthritis or another type of rheumatic disease. A recent study says as many as 91 million Americans may really have arthritis – when you add together those who are officially diagnosed plus those who report obvious symptoms but haven’t been diagnosed.
While researchers try to find more accurate ways to estimate the prevalence of this disease and the burdens it causes, we do know that it is more common among women and that the number of people of all ages with arthritis is increasing.
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Stem cells are cells with the potential to develop into many different types of cells in the body. They serve as a repair system for the body. There are two main types of stem cells: embryonic stem cells and adult stem cells.
Stem cells are different from other cells in the body in three ways:
They can divide and renew themselves over a long time
They are unspecialized, so they cannot do specific functions in the body
They have the potential to become specialized cells, such as muscle cells, blood cells, and brain cells
Doctors and scientists are excited about stem cells because they could help in many different areas of health and medical research. Studying stem cells may help explain how serious conditions such as birth defects and cancer come about. Stem cells may one day be used to make cells and tissues for therapy of many diseases. Examples include Parkinson’s disease, Alzheimer’s disease, spinal cord injury, heart disease, diabetes, and arthritis.
Stem cell research is moving ever more deliberately toward the clinic with increasing momentum and is recognized as one of the most promising approaches for developing new kinds of medicines.
