# Studying Intra-Individual Pain Variability in Sickle Cell Disease and Resolution of Pain after Hematopoietic Cell Transplant: A Novel Model System to Elucidate Mechanisms of Transition to Chronic Pain

> **NIH NIH K23** · YALE UNIVERSITY · 2022 · $58,005

## Abstract

PROJECT SUMMARY/ABSTRACT
Chronic pain (CP) is a major cause of morbidity and poor quality of life in sickle cell disease (SCD). CP,
defined as the presence of 'pain on most days of the past 6 months', is a major cause of morbidity and poor
Health Related Quality of Life (HRQoL) in SCD. The impact of CP is variable, with some individuals
experiencing severe, disabling pain and pain interference with daily activities, while others experience CP
without activity limitations. High-Impact Chronic Pain (HICP), defined as chronic pain with disability, represents
a severely-impacted sub-group with CP that has not been characterized in SCD, which represents a critical
knowledge gap. In the candidate's K23 award, she found compelling evidence for the presence of a severelyaffected
subgroup of CP in the Pain in Sickle Cell Epidemiology Study (PiSCES), the largest natural history
study of pain in SCD. To better study HICP in SCD in the clinical setting, patients seeking consultation for
curative hematopoietic cell transplant (HCT) were formally screened for HICP, as HICP had been added as an
inclusion criteria for clinical trials of HCT in SCD in 2019. By identifying the clinical correlates of HICP in this
existing cohort (Aim 1 ), the candidate will develop a draft prototype for an electronic health record (EHR)derived
"computational phenotype", which is a defined and reproducible set of data elements that can be used
for automated identification of HICP from the EHR in future studies. This unique cohort with SCD and HICP will
be studied in conjunction with existing longitudinal EHR data allowing the candidate to explore longitudinal
trajectories of pain episode frequency in HICP over several years. To compliment the study of HICP in children
with SCD, the candidate will also perform a secondary analyses of the PiSCES data to characterize outcomes
in adults with CP analogous to HICP, i.e. those with severe or frequent pain interference, and identify
predictors of severe or frequent pain interference (Aim 2). The completion of these aims will characterize the
phenotype of HICP in SCD, its impact on outcomes, and develop a draft prototype of a computational
phenotype to identify individuals with HICP from the EHR. The candidate's preliminary findings and access to
unique existing cohorts provide unprecedented opportunities to investigate HICP in SCD, addressing a major
knowledge gap. This proposal is a new but related extension of the candidate's K23 award, and these key
preliminary data will directly inform the candidate's R01 proposal, allowing her to becoming a successful,
independent investigator in chronic pain in SCD.

## Key facts

- **NIH application ID:** 10990829
- **Project number:** 7K23HL140142-06
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Nitya Bakshi
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $58,005
- **Award type:** 7
- **Project period:** 2018-08-15 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10990829

## Citation

> US National Institutes of Health, RePORTER application 10990829, Studying Intra-Individual Pain Variability in Sickle Cell Disease and Resolution of Pain after Hematopoietic Cell Transplant: A Novel Model System to Elucidate Mechanisms of Transition to Chronic Pain (7K23HL140142-06). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10990829. Licensed CC0.

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