Red Blood Cells: Tethering, Vesiculation, and Disease in Micro-Vascular Flow.

Area of Science:

• Hematology
• Pathophysiology
• Vascular Biology

Background:

• Red blood cells (RBCs) are increasingly recognized for their role in disease progression.
• RBC-derived vesicles are implicated in transporting inflammatory species.
• This involvement spans diseases like diabetes mellitus, sickle cell anemia, and atherosclerosis.

Purpose of the Study:

• To review the role of RBCs and their vesicles in various disease pathologies.
• To propose a novel paradigm for RBC vesiculation induced by vascular flow and adhesion.
• To elucidate the mechanistic basis of membrane loss and RBC turnover.

Main Methods:

• Review of existing literature on RBCs, vesiculation, and adhesion in disease.
• Analysis of physiological conditions favoring RBC adhesion and vesiculation.
• Examination of splenic flow as a model for RBC vesiculation and membrane loss.

Main Results:

• RBCs contribute to disease through inflammatory species transported via cell-derived vesicles.
• A unifying hypothesis suggests vascular flow and adhesion to endothelium or spleen induce RBC vesiculation.
• Splenic flow provides a specific example demonstrating RBC membrane loss and turnover mechanisms.

Conclusions:

• RBC vesiculation, driven by flow-induced adhesion, is a key mechanism in disease.
• Understanding RBC deformability is crucial for quantifying vesiculation.
• This paradigm offers a new perspective on RBC turnover and its pathological implications.