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Nitric oxide impacts source of sickle cell pain crisis
Date:5/9/2011

AUGUSTA, Ga. - Nitric oxide gas appears to directly impact the source of the classic, disabling pain crises of sickle cell disease, Georgia Health Sciences University researchers report.

The short-acting gas helps unglue hemoglobin molecules that stick together, forming long chains that ultimately deform red blood cells and prompting a cellular pileup in small blood vessels and pain, said Dr. C. Alvin Head, Chairman of GHSU's Department of Anesthesiology.

The findings get scientists closer to understanding why red blood cells sickle and potentially to a easy-to-use, non-addictive treatment that helps avoid it, said Dr. Tohru Ikuta, GHSU molecular hematologist.

Hydroxyurea, which prompts the body to make more fetal hemoglobin which cannot sickle, is currently the only approved therapy for sickle cell. Patients with recurring pain crises typically must take increasingly higher doses of stronger narcotics to deal with the pain.

Head and his colleagues envision instead an inhaler like asthmatics use that enables them to breathe in nitric oxide when they feel a pain crisis coming on. "Drugs just mask the symptoms," Head said. "We have mounting evidence that nitric oxide directly addresses the source of pain crises to help patients avoid them."

They've shown in a small patient sample that inhaling nitric oxide appears safe and effective. The study of 18 patients in Atlanta, Chicago and Detroit published in 2010 in the American Journal of Hematology showed that the half who inhaled nitric oxide for four hours had better pain control than those receiving only the standard self-administered morphine.

The new study examined nitric oxide's impact from many angles and showed that it appears to disperse dense, solid chains of hemoglobin troublemakers. Once a significant number of hemoglobin molecules stick together, it causes red blood cells to distort from their natural round shape that easily maneuvers blood vessels to a s
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Contact: Toni Baker
tbaker@georgiahealth.edu
706-721-4421
Georgia Health Sciences University
Source:Eurekalert  

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