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. 2018 Nov 30;2018(1):493–506. doi: 10.1182/asheducation-2018.1.493

Figure 6.

Figure 6.

Therapeutic targets investigating chronic pain in SCD. Chronic pain in SCD is likely multifactorial and results from various mechanisms, such as mast cell activation and neurogenic inflammation, peripheral nociceptor sensitization, and central sensitization. Nonopioid agents with established benefits in non-SCD chronic pain are being investigated. Cannabinoids decrease chronic pain by their central effects as well as stabilization of mast cells and reduced neurogenic inflammation. Memantine is an NMDA receptor antagonist, and gabapentin binds to voltage-gated calcium channels in neurons. Adapted from Morrone et al48 with permission.