Researchers from the Icahn School of Medicine at Mount Sinai will share new discoveries about sickle cell disease and other blood disorders at the 66th Annual Meeting and Exposition of the American Society of Hematology (ASH) in San Diego from Saturday, December 7, to Tuesday, December 10. ASH is the largest meeting in the world for doctors and scientists who focus on blood diseases, bringing together leaders to explore emerging treatments and strategies for improving patient outcomes.
This release highlights four Mount Sinai abstracts focused on sickle cell disease pain management, and the role of gut microbiota in chronic inflammation, demonstrating the institution's commitment to advancing care for communities with complex hematological disorders.
Innovative Metrics to Improve Sickle Cell Pain Management
Karishma Vijay Rupani, MD, MMSc, is a hematology and medical oncology fellow at the Icahn School of Medicine at Mount Sinai. Her abstract will introduce a novel metric to study outcomes for door-to-analgesia time for patients with sickle cell pain episodes. Patients with sickle cell disease experiencing acute pain episodes should receive analgesia within one hour of arrival to the emergency department, with the goal of administering the initial analgesic as quickly as possible. Dr. Rupani's findings validate that a low-burden data retrieval approach offers clinicians a simplified process to retrieve and track this metric to improve outcomes for sickle cell patients in emergency rooms across diverse health care systems nationwide, potentially enhancing timely care and reducing disparities.
"This metric simplifies tracking pain management outcomes, ensuring all health care systems can provide equitable care for patients with sickle cell disease ," said Dr. Rupani. "Many institutions across the country do not have the ability to extract this data from an electronic health record data warehouse system. Validating a low-burden approach means that any emergency room across the country can reliably track outcomes for patients presenting to the ER with sickle cell pain episodes, and ensure that they are administered analgesia in a timely manner."
Buprenorphine as a Novel Option for Sickle Cell Pain Management
Charleen Jacobs-McFarlane, PhD, RN, ANP-BC, a nurse practitioner at The Mount Sinai Hospital and postdoctoral fellow in the T32 Post Doctoral Clinician Scientist Program in Emergency Medicine , explored the use of buprenorphine in reducing hospitalizations and home opioid use among sickle cell disease patients with chronic pain. Buprenorphine is a medication prescribed for people with chronic pain, and also for people with opioid use disorder. This research may help people with sickle cell disease help manage pain and reduce their hospitalizations. The study also demonstrated the feasibility of telemedicine for administering this underutilized treatment.
"Our research highlights buprenorphine's potential to alleviate chronic pain while reducing opioid dependence, improving both patient quality of life and health care system outcomes," Dr. Jacobs-McFarlane said. "I think we can do some good by using this research to inform our practice and how to better care for people with sickle cell disease."
Linking Hemolysis to Organ Injury in Sickle Cell Disease
Angela Liu, MD, is a clinical instructor of hematology at the Icahn School of Medicine at Mount Sinai. She conducts clinical research on the proteomics of sickle cell disease, funded by a T32 grant in Emergency Medicine. For this abstract, Dr. Liu examined the role of tumor necrosis factor (TNF) in the inflammatory pathways that connect hemolysis, a hallmark of sickle cell disease, to organ damage. Her study identified elevated TNF levels in patients, linking it to kidney and cardiac complications.
"By understanding these pathways, we can identify targets like TNF for interventions to reduce organ damage and hospitalizations in sickle cell disease patients," Dr. Liu explained. "This research lays the groundwork for future studies to prevent long-term complications. I focused on these clinical outcomes that we see and that are common in sickle cell disease, such as kidney disease, heart disease, and also hospitalizations. It's important to understand what contributes to these complications, and how to prevent them."
Gut Microbiota's Role in Chronic Inflammation and Organ Damage
Huihui Li, PhD, Assistant Professor of Emergency Medicine, and Pharmacological Sciences, at the Icahn School of Medicine at Mount Sinai, and Althea Agdamag, MD, a pediatric hematology-oncology fellow, are studying the gut microbiota's influence on chronic inflammation and organ damage in hematological disorders, including sickle cell disease and myeloproliferative neoplasms. Their research in mouse models showed that reducing microbial signals alleviates inflammatory complications, offering potential for microbiota-targeted therapies.
"Our findings suggest that modulating the gut microbiota could provide cost-effective strategies to reduce inflammation-triggered complications for patients with hematological disorders," said Dr. Li. Dr. Agdamag added, "This work underscores the microbiome's transformative potential across various hematological conditions, paving the way for novel treatments."
