Introduction: Sickle cell disease is a recessive hereditary disorder manifested by vaso-occlusive crises (VOCs), associated with intense pain and inflammation. Although biomarkers such as IL-6, CRP, COX-1/2 and VCAM-1 are involved in these processes. Their relationship with pain intensity remains poorly elucidated. This study aims to assess this correlation in homozygous sickle cell patients in Brazzaville. Methodology: A prospective observational study was carried out on 85 patients (2 - 62 years). Biomarkers (CRP, IL-6, COX-1/2, VCAM-1) were measured by turbidimetry and ELISA. Pain intensity was assessed using a validated scale, and data were statistically analyzed. Results: 45.88% of patients were in CVO, while intense pain was reported in 84.62% of patients in crisis. CRP, COX-2 and VCAM-1 showed significantly higher concentrations during CVO (p < 0.05, for CRP; p < 0.0001, for COX-2 p = 0.0035 and p = 0.0165 for VCAM-1), in contrast to IL-6 and COX-1, which showed no statistically significant difference (p = 0.06 for IL-6 and p = 0.02 for COX-1). A significant positive correlation was observed between COX-2 and pain intensity (r = 0.65; p < 0.0001), while the other biomarkers showed no significant relationship. Conclusion: These results suggest that COX-2 may be considered a promising biomarker for assessing inflammatory pain during CVO and its potential usefulness in therapeutic pain monitoring in sickle cell crisis patients, although further studies are needed to confirm its clinical role.
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