Stress, Fear of Pain May Be Cause of Painful Sickle Cell Episodes

Newswise — Washington (November 6, 2017)—Mental stress and the anticipation of pain may cause blood vessels to narrow and trigger episodes of severe pain (vaso-occlusive crisis, or VOC) in sickle cell disease (SCD). A team of researchers from California will present their findings today at the American Physiological Society’s Physiological and Pathophysiological Consequences of Sickle Cell Disease conference in Washington, D.C.

SCD is a lifelong genetic condition in which red blood cells (RBC) form in an abnormal crescent (sickle) shape. Sickled RBCs can get caught in the blood vessels, leading to reduced blood flow and severe pain. Emotional stress is a known trigger of VOC, but the reasons for the association have been unclear.

The researchers studied people with SCD and healthy controls while they performed mentally stressful tasks. The volunteers were also told they would be experiencing pain during the trial to elicit a natural fear anticipation response. However, the research team did not expose the participants to pain at any point.

The research team found that, when exposed to stress and anticipating pain, both groups showed areas of decreased blood flow due to narrowing of the blood vessels (vasoconstriction). Although all participants experienced the same physiological response, “the consequences of decreased blood flow can be quite different [for people with SCD] because of the resultant entrapment of sickle cells in the microvasculature,” which are very small blood vessels such as capillaries, explained Payal Shah, MS, CCRP, first author of the study.

Payal Shah, MS, CCRP, will present “Microvascular perfusion is a physiologic biomarker of mental stress and fear of pain in sickle cell subjects and normal controls” in a poster session on Monday, November 6, from 6:45 to 9 p.m. in the Embassy Suites D.C. Convention Center Hotel.

NOTE TO JOURNALISTS: The Physiological and Pathophysiological Consequences of Sickle Cell Disease conference will be held in Washington, D.C., November 6–8, 2017. Read the full program. To schedule an interview with the conference organizers or presenters, contact the APS Communications Office or call 301-634-7209. Find more research highlights in the APS Press Room.

Physiology is the study of how molecules, cells, tissues and organs function in health and disease. Established in 1887, the American Physiological Society (APS) was the first U.S. society in the biomedical sciences field. The Society represents more than 10,500 members and publishes 15 peer-reviewed journals with a worldwide readership.