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Modulation of erythrocyte-endothelial interactions and the vasocclusive
severity of sickling disorders
RP Hebbel, CF Moldow and MH Steinberg
The abnormal adherence of sickle erythrocytes to cultured human vascular
endothelium varies among patients and correlates with vasocclusive severity
within and among the different sickling disorders. For individual patients,
the development of an acute vasocclusive event is not accompanied by an
increase in the inherent propensity for their erythrocytes to adhere to
endothelium. However, the onset of vasocclusion appears to be associated
with the appearance of plasma factors, such as fibrinogen, which enhance
the adherence of sickle erythrocytes to endothelium. In addition, sickle
erythrocytes adhere even more avidly to injured endothelium and under
hyperosmolar conditions. Thus, the overall clinical severity of the
sickling disorders appears to correlate with the inherent propensity for
sickle erythrocytes to adhere to endothelium, and changes in the red cells'
environment may help precipitate crises by the sudden facilitation of
erythrocyte/endothelial interactions.
Volume 58,
Issue 5,
pp. 947-952,
11/01/1981
Copyright © 1981 by The American Society of Hematology

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