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Serum levels of substance P are elevated in patients with sickle cell disease and increase further during vaso-occlusive crisis.

Abstract

As a mediator of neurogenic inflammation and pain, we hypothesized that levels of the neuropeptide Substance P (SP) would be elevated in patients with sickle cell disease (SCD) with vaso-occlusive pain crisis. SP is a known stimulator of tumor necrosis factor-alpha (TNF-alpha) release and a promoter of interleukin-8 (IL-8), which are reported to be increased in SCD. These cytokines enhance adhesion of leukocytes to endothelium and may play a role in vaso-occlusive events. Serum levels of IL-8, TNFalpha, and SP were studied in three groups of children aged 2 to 18 years: 30 well children with SCD, 21 with SCD in pain crisis, and 20 healthy age-matched controls. Serum levels of SP were elevated in all SCD patients and were highest in patients in pain crisis. The percentage of sera with detectable levels of IL-8 (>5.0 pmol/L) was increased in SCD patients as compared with the control group. IL-8 levels were similar for well SCD patients and those with pain. TNFalpha levels were not significantly different among the three groups. In three children with SCD, SP was measured at baseline and again during pain crisis. In each case, serum levels during pain crisis were higher than they were when the patient was well. We conclude that levels of SP are high in patients with SCD and increase during pain crisis. These results imply that SP plays a prominent role in the pain and inflammation of SCD and may be a measurable laboratory marker of vaso-occlusive crisis. We speculate that neurokinin receptor antagonists may have a therapeutic potential in the treatment of crisis pain.

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  • Authors+Show Affiliations

    ,

    Divisions of Hematology, Immunologic and Infectious Diseases, The Children's Hospital of Philadelphia, Department of Pediatrics, PA, USA.

    , ,

    Source

    Blood 92:9 1998 Nov 01 pg 3148-51

    MeSH

    Acute Disease
    Adolescent
    Anemia, Sickle Cell
    Child
    Child, Preschool
    Female
    Humans
    Interleukin-8
    Ischemia
    Male
    Pain
    Substance P
    Tumor Necrosis Factor-alpha

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9787150

    Citation

    Michaels, L A., et al. "Serum Levels of Substance P Are Elevated in Patients With Sickle Cell Disease and Increase Further During Vaso-occlusive Crisis." Blood, vol. 92, no. 9, 1998, pp. 3148-51.
    Michaels LA, Ohene-Frempong K, Zhao H, et al. Serum levels of substance P are elevated in patients with sickle cell disease and increase further during vaso-occlusive crisis. Blood. 1998;92(9):3148-51.
    Michaels, L. A., Ohene-Frempong, K., Zhao, H., & Douglas, S. D. (1998). Serum levels of substance P are elevated in patients with sickle cell disease and increase further during vaso-occlusive crisis. Blood, 92(9), pp. 3148-51.
    Michaels LA, et al. Serum Levels of Substance P Are Elevated in Patients With Sickle Cell Disease and Increase Further During Vaso-occlusive Crisis. Blood. 1998 Nov 1;92(9):3148-51. PubMed PMID: 9787150.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Serum levels of substance P are elevated in patients with sickle cell disease and increase further during vaso-occlusive crisis. AU - Michaels,L A, AU - Ohene-Frempong,K, AU - Zhao,H, AU - Douglas,S D, PY - 1998/10/27/pubmed PY - 1998/10/27/medline PY - 1998/10/27/entrez SP - 3148 EP - 51 JF - Blood JO - Blood VL - 92 IS - 9 N2 - As a mediator of neurogenic inflammation and pain, we hypothesized that levels of the neuropeptide Substance P (SP) would be elevated in patients with sickle cell disease (SCD) with vaso-occlusive pain crisis. SP is a known stimulator of tumor necrosis factor-alpha (TNF-alpha) release and a promoter of interleukin-8 (IL-8), which are reported to be increased in SCD. These cytokines enhance adhesion of leukocytes to endothelium and may play a role in vaso-occlusive events. Serum levels of IL-8, TNFalpha, and SP were studied in three groups of children aged 2 to 18 years: 30 well children with SCD, 21 with SCD in pain crisis, and 20 healthy age-matched controls. Serum levels of SP were elevated in all SCD patients and were highest in patients in pain crisis. The percentage of sera with detectable levels of IL-8 (>5.0 pmol/L) was increased in SCD patients as compared with the control group. IL-8 levels were similar for well SCD patients and those with pain. TNFalpha levels were not significantly different among the three groups. In three children with SCD, SP was measured at baseline and again during pain crisis. In each case, serum levels during pain crisis were higher than they were when the patient was well. We conclude that levels of SP are high in patients with SCD and increase during pain crisis. These results imply that SP plays a prominent role in the pain and inflammation of SCD and may be a measurable laboratory marker of vaso-occlusive crisis. We speculate that neurokinin receptor antagonists may have a therapeutic potential in the treatment of crisis pain. SN - 0006-4971 UR - https://www.unboundmedicine.com/medline/citation/9787150/Serum_levels_of_substance_P_are_elevated_in_patients_with_sickle_cell_disease_and_increase_further_during_vaso_occlusive_crisis_ L2 - http://www.bloodjournal.org/cgi/pmidlookup?view=long&pmid=9787150 DB - PRIME DP - Unbound Medicine ER -