Morphine for the Treatment of Pain in Sickle Cell Disease

Pain is a hallmark of sickle cell disease (SCD) and its treatment remains challenging. Opioids are the major family of analgesics that are commonly used for treating severe pain. However, these are not always effective and are associated with the liabilities of their own. The pharmacology and multio...

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Main Authors: Mihir Gupta, Lilian Msambichaka, Samir K. Ballas, Kalpna Gupta
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2015/540154
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author Mihir Gupta
Lilian Msambichaka
Samir K. Ballas
Kalpna Gupta
author_facet Mihir Gupta
Lilian Msambichaka
Samir K. Ballas
Kalpna Gupta
author_sort Mihir Gupta
collection DOAJ
description Pain is a hallmark of sickle cell disease (SCD) and its treatment remains challenging. Opioids are the major family of analgesics that are commonly used for treating severe pain. However, these are not always effective and are associated with the liabilities of their own. The pharmacology and multiorgan side effects of opioids are rapidly emerging areas of investigation, but there remains a scarcity of clinical studies. Due to opioid-induced endothelial-, mast cell-, renal mesangial-, and epithelial-cell-specific effects and proinflammatory as well as growth influencing signaling, it is likely that when used for analgesia, opioids may have organ specific pathological effects. Experimental and clinical studies, even though extremely few, suggest that opioids may exacerbate existent organ damage and also stimulate pathologies of their own. Because of the recurrent and/or chronic use of large doses of opioids in SCD, it is critical to evaluate the role and contribution of opioids in many complications of SCD. The aim of this review is to initiate inquiry to develop strategies that may prevent the inadvertent effect of opioids on organ function in SCD, should it occur, without compromising analgesia.
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spelling doaj-art-d1bc4de728324171a95209fdacd4120f2025-02-03T05:59:14ZengWileyThe Scientific World Journal2356-61401537-744X2015-01-01201510.1155/2015/540154540154Morphine for the Treatment of Pain in Sickle Cell DiseaseMihir Gupta0Lilian Msambichaka1Samir K. Ballas2Kalpna Gupta3Stanford University School of Medicine, Stanford, CA 94305, USAVascular Biology Center, Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical School, Mayo Mail Code 480, 420 Delaware Street SE, Minneapolis, MN 55455, USACardeza Foundation for Hematologic Research, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USAVascular Biology Center, Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical School, Mayo Mail Code 480, 420 Delaware Street SE, Minneapolis, MN 55455, USAPain is a hallmark of sickle cell disease (SCD) and its treatment remains challenging. Opioids are the major family of analgesics that are commonly used for treating severe pain. However, these are not always effective and are associated with the liabilities of their own. The pharmacology and multiorgan side effects of opioids are rapidly emerging areas of investigation, but there remains a scarcity of clinical studies. Due to opioid-induced endothelial-, mast cell-, renal mesangial-, and epithelial-cell-specific effects and proinflammatory as well as growth influencing signaling, it is likely that when used for analgesia, opioids may have organ specific pathological effects. Experimental and clinical studies, even though extremely few, suggest that opioids may exacerbate existent organ damage and also stimulate pathologies of their own. Because of the recurrent and/or chronic use of large doses of opioids in SCD, it is critical to evaluate the role and contribution of opioids in many complications of SCD. The aim of this review is to initiate inquiry to develop strategies that may prevent the inadvertent effect of opioids on organ function in SCD, should it occur, without compromising analgesia.http://dx.doi.org/10.1155/2015/540154
spellingShingle Mihir Gupta
Lilian Msambichaka
Samir K. Ballas
Kalpna Gupta
Morphine for the Treatment of Pain in Sickle Cell Disease
The Scientific World Journal
title Morphine for the Treatment of Pain in Sickle Cell Disease
title_full Morphine for the Treatment of Pain in Sickle Cell Disease
title_fullStr Morphine for the Treatment of Pain in Sickle Cell Disease
title_full_unstemmed Morphine for the Treatment of Pain in Sickle Cell Disease
title_short Morphine for the Treatment of Pain in Sickle Cell Disease
title_sort morphine for the treatment of pain in sickle cell disease
url http://dx.doi.org/10.1155/2015/540154
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AT kalpnagupta morphineforthetreatmentofpaininsicklecelldisease