Improved Mitochondrial Function: A Novel Mechanism of Action for Arginine Therapy in Children with Sickle Cell Disease and Pain

Introduction: Vaso-occlusive pain episodes (VOE) are the leading cause of emergency department visits and hospitalization in patients with sickle cell disease (SCD). Our prior work has demonstrated that patients in VOE are arginine deficient and that Arginine therapy significantly decreases total intravenous (IV) opioid use and improves pain scores during hospitalization. Mechanisms remain unclear, but may be due to stimulation of nitric oxide production. The Shiva lab has reported altered mitochondrial function in SCD patients vs healthy controls; decrease in mitochondrial electron transport Complex V …