Biophysical Markers of Autonomic Cardiovascular Function in Sickle Cell Disease
Sickle-cell disease is characterized by the occurrence of extensive obstruction of microvascular flow, which occur on top of a progressive, chronic vascular disease. It is still not known why or how transient regional vaso-occlusion cascades into large-scale painful episodes of vaso-occlusive crisis. However, recent studies suggest that the autonomic nervous system likely plays an important role in mediating these transitions. As part of the NIH-funded Excellence in Hemoglobinopathies Research Award program carried out at CHLA, Dr. Khoo and his team have developed multiple biophysical markers of human cardiorespiratory responses to a variety of autonomic challenges, using minimal modeling techniques.
Representative publications:
- Sangkatumvong S, Khoo MCK, Kato R, Detterich JA, Bush A, Keens TG, Meiselman HJ, Wood JC, Coates TD. Peripheral vasoconstriction and abnormal parasympathetic response to sighs and transient hypoxia in sickle cell disease. American J Respir Crit Care Med, 184(4), 474-481, 2011.
- Chalacheva P, Khaleel M, Sunwoo J, Shah P, Detterich JA, Kato RM, Thuptimdang W, Meiselman HJ, Sposto R, Tsao J, Wood JC, Zeltzer L, Coates TD, Khoo MCK. Biophysical markers of the peripheral vasoconstriction response to pain in sickle cell disease. PLoS One12(5):e0178353. doi: 10.1371/journal.pone.0178353, 2017.
- Khaleel M, Puliyel M, Shah P, Sunwoo J, Kato RM, Chalacheva P, Thuptimdang W, Detterich J, Wood JC, Tsao J, Zeltzer L, Sposto R, Khoo MCK, Coates TD. Individuals with sickle cell disease have a significantly greater vasoconstriction response to thermal pain than controls and have significant vasoconstriction in response to anticipation of pain. Am J Hematol 92(11):1137-1145, 2017.
- Coates TD, Chalacheva P, Zeltzer L, Khoo MCK. Autonomic nervous system involvement in sickle cell disease. Clin Hemorheol Microcirc 68(2-3):251-262, 2018.