PROJECT SUMMARY/ ABSTRACT
Sickle cell disease (SCD) affects millions worldwide, 100,000 individuals in USA, and nearly 1000
children in UAB. Sickle cell anemia (SCA, HbSS or HbSB0 thalassemia) is the most severe form of SCD
and is associated with morbidity, mortality, and health care burden. Acute pain is the hallmark
complication for SCA, and inflammation is a driver of pain. Opioids are used to treat acute pain but lead
to adverse clinical outcomes. Therefore, non-opioid therapies are desperately needed.
Recent data and my preliminary data suggest gut microbial dysbiosis is present in SCD. My data
also suggests that a different microbiota profile is present in children with SCA pain. Therefore, dietary
interventions manipulating the gut microbiome represent a novel therapy for treating SCA pain. Marine
based ¿3FA (fish oil) decreases pain in children with SCA but its acceptance is limited by its fishy odor
and taste. In contrast, plant-based ¿ 3FA (Flaxseed-FS) has a neutral taste and reduced pain in patients
with rheumatoid arthritis. My preliminary tasting trial identified that children with SCA accept FS added
products with over 80% of participants expressing a willingness to be contacted for this feasibility study.
Therefore, I am proposing a feasibility study of FS trial in children with SCA. My overarching hypothesis
is that FS enriched diet will be acceptable, impact the gut microbiome, decrease inflammation, and
reduce pain in children with SCA. The focus of this study is to recruit, retain and monitor for side
effects of a FS diet in children with SCA (Aim 1) while evaluating changes in gut microbiota profile (Aim
2) and improvement in inflammation driven pain outcomes (Aim 3) on this diet.
The applicant has dedicated her career to becoming a physician scientist investigating
inexpensive, sustainable nutritional interventions that impact the microbiome and improve
inflammation driven outcomes in SCD. To fulfil this long-term goal, she moved to the University of
Alabama at Birmingham (UAB) where she has a supportive research environment in the Department of
Pediatrics and School of Medicine, including the Center for Clinical and Translational Science (CCTS), Life
span sickle cell disease comprehensive research center, UAB microbiome center, the Immunology
Institute and the Nutrition and Obesity Research Center. She has assembled an excellent mentorship
team, and she plans to complement this mentorship in formal course work including advanced statistics,
clinical trials, metagenomics, nutrition, mucosal immunology, and pain psychology. This award will allow
her develop expertise in her identified training needs, acquire the skills to transition into a successful
independent physician scientist and grow into a leader in the field.
