In vivo studies of sickle red blood cells
In vivo studies of sickle red blood cells
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DOI：
10.1080/10739680490278457
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发表时间：
2004-03-01
期刊：
影响因子：
2.4
通讯作者：
Fabry, ME
中科院分区：
文献类型：
--
作者：
Kaul, DK;Fabry, ME
镰状细胞性贫血的明确临床特征是周期性发生疼痛性血管闭塞危象。促进微循环中红细胞捕获和镰状化的因素可能触发血管闭塞。镰状血中明显的红细胞异质性和镰状红细胞与血管内皮的异常粘附将是主要的破坏性影响。使用离体和体内模型，作者展示了如何剖析异质性镰状红细胞类别对粘附和阻塞事件的相对贡献。这些研究表明，（1）流变学异常和镰状红细胞的粘附都有助于其异常的血液动力学行为，（2）小静脉是镰状红细胞粘附的部位，（3）镰状红细胞变形性在粘附和阻塞事件中起重要作用。变形镰状红细胞优先粘附在毛细血管后微静脉，然后选择性捕获致密镰状红细胞，可导致血管闭塞。提出了这两步模型的更新版本。镰状红细胞粘附的多因素性质需要考虑在体内设计抗粘附治疗。
The defining clinical feature of sickle cell anemia is periodic occurrence of painful vasoocclusive crisis. Factors that promote trapping and sickling of red cells in the microcirculation are likely to trigger vasoocclusion. The marked red cell heterogeneity in sickle blood and abnormal adhesion of sickle red cells to vascular endothelium would be major disruptive influences. Using ex vivo and in vivo models, the authors show how to dissect the relative contribution of heterogeneous sickle red cell classes to adhesive and obstructive events. These studies revealed that (1) both rheological abnormalities and adhesion of sickle red cells contribute to their abnormal hemodynamic behavior, ( 2) venules are the sites of sickle cell adhesion, and (3) sickle red cell deformability plays an important role in adhesive and obstructive events. Preferential adhesion of deformable sickle red cells in postcapillary venules followed by selective trapping of dense sickle red cells could result in vasoocclusion. An updated version of this 2-step model is presented. The multifactorial nature of sickle red cell adhesion needs to be considered in designing antiadhesive therapy in vivo.