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Blood, 1 December 2004, Vol. 104, No. 12, pp. 3774-3781.
Prepublished online as a Blood First Edition Paper on August 12, 2004; DOI 10.1182/blood-2004-01-0042.


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RED CELLS

Epinephrine acts through erythroid signaling pathways to activate sickle cell adhesion to endothelium via LW-{alpha}v{beta}3 interactions

Rahima Zennadi, Patrick C. Hines, Laura M. De Castro, Jean-Pierre Cartron, Leslie V. Parise, and Marilyn J. Telen

From the Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC; the Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC; and the Institut National de la Santé et de la Recherche Médicale Unité 76, Institut National de la Transfusion Sanguine, Paris, France.

The possible role of physiologic stress hormones in enhancing adhesion of sickle erythrocytes (SS RBCs) to endothelial cells (ECs) in sickle cell disease (SCD) has not been previously explored. We have now found that up-regulation of intracellular cyclic adenosine monophosphate (cAMP)–dependent protein kinase A (PKA) by epinephrine significantly increased sickle but not normal erythrocyte adhesion to both primary and immortalized ECs. Inhibition of serine/threonine phosphatases also enhanced sickle erythrocyte adhesion at least partially through a PKA-dependent mechanism. Adhesion was mediated through LW (intercellular adhesion molecule-4 [ICAM-4], CD242) blood group glycoprotein, and immunoprecipitation studies showed that LW on sickle but not on normal erythrocytes undergoes increased PKA-dependent serine phosphorylation as a result of activation. The major counter receptor for LW was identified as the {alpha}v{beta}3 integrin on ECs. These data suggest that adrenergic hormones such as epinephrine may initiate or exacerbate vaso-occlusion and thus contribute to the association of vaso-occlusive events with physiologic stress.


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