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| ID | Type | Description | Link |
|---|---|---|---|
| 2024-A00950-47 | Other Identifier | ANSM Frech Human Health Organisation |
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Sickle cell disease is a chronic disease characterized by multiple vaso-occlusive complications. The basic treatment for patients with a vaso-occlusive crisis (VOC) is based on adequate hydration, oxygen therapy and pain control. Loco Regional Anesthesia (LRA) is one of the major treatments in resuscitation anesthesia for both anesthesia and analgesia. LRA allows effective and almost immediate pain control by blocking nerve afferents in a given area. LRA could decrease the inflammatory response during crises and accelerate resolution of the crisis.
Regional anesthesia (RA) possesses intrinsic anti-inflammatory properties and can modulate the inflammatory response. For instance, ropivacaine reduces inflammation induced in vitro in rat epithelial cells. At the cellular level, lidocaine decreases free radical production by neutrophils, inhibits leukocyte phagocytic activity, and significantly suppresses cytokine production in response to endotoxemia.
The value of RA no longer lies solely in its ability to block nociceptive input via sodium channel inhibition. A peripheral nerve block with local anesthetics inhibits local neurogenic inflammation, thereby reducing sensitization, hyperalgesia, and the risk of pain chronification. A peripheral nerve block is therefore an anti-inflammatory treatment.
However, no study has yet demonstrated the anti-inflammatory effects of RA at the cellular level in sickle cell disease patients.
The aim of this study is to analyze the evolution of inflammatory markers during vaso-occlusive crises (e.g., MPs, cytokines, NETs, etc.), by comparing patients who received RA to those who did not during hospitalization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| RA-Group | When a sickle cell patient comes to the emergency department with pain such as vaso-occlusive crises, we will offer them the opportunity to participate in the study. Inclusion will therefore occur before the choice of analgesic technique. The patient will receive the treatment they have chosen (with or without regional anesthesia). Depending on their choice and/or any contraindications (e.g., morphine intolerance or allergy to ropivacaine), they will be placed in the "RA group" (if they received regional anesthesia) or the "non-RA group" (if they did not receive it). | ||
| Non-RA group | When a sickle cell patient comes to the emergency department with pain such as vaso-occlusive crises, we will offer them the opportunity to participate in the study. Inclusion will therefore occur before the choice of analgesic technique. The patient will receive the treatment they have chosen (with or without regional anesthesia). Depending on their choice and/or any contraindications (e.g., morphine intolerance or allergy to ropivacaine), they will be placed in the "RA group" (if they received regional anesthesia) or the "non-RA group" (if they did not receive it). |
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| Measure | Description | Time Frame |
|---|---|---|
| Inflammatory process during vaso-occlusive crises | The variation between D0 and D1 in the proportion of endothelial cells expressing ICAM-1 on their surface, following stimulation with microparticles from patients who received or did not receive regional anesthesia. | Baseline and Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Quantification of protein levels | ICAM-1, VCAM-1, P-selectin, Elastase (marker of neutrophil extracellular traps (NET) | Baseline and day 1 |
| Quantification of cytokine levels | Quantification of cytokine levels |
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Inclusion Criteria:
Exclusion Criteria:
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Adult sickle cell patients consulting for vaso-occlusive crisis in CHU de Guadeloupe
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Valérie Hamony Soter | Contact | +590590934677 | valerie.soter@chu-guadeloupe.fr | |
| Mélanie Petapermal | Contact | +590590934667 | melanie.petapermal@chu-guadeloupe.fr |
| Name | Affiliation | Role |
|---|---|---|
| Amelie Rolle, MD | CHU de la Guadeloupe | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chu de La Guadeloupe | Recruiting | Pointe-à-Pitre | 97159 | Guadeloupe |
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| ID | Term |
|---|---|
| D000755 | Anemia, Sickle Cell |
| D000098644 | Vaso-Occlusive Crises |
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D000745 | Anemia, Hemolytic, Congenital |
| D000743 | Anemia, Hemolytic |
| D000740 | Anemia |
| D006402 | Hematologic Diseases |
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Collection of two blood tubes for the quantification of protein and cytokine levels, and for the quantitative and qualitative analysis of circulating blood microparticles.
| Baseline and day 1 |
| Quantitative and qualitative profil of blood microparticles | Quantitative and qualitative profil of blood microparticles | Baseline and day 1 |
| D006425 |
| Hemic and Lymphatic Diseases |
| D006453 | Hemoglobinopathies |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |