Adhesion of Immunoglobulins to Band3 Promotes Increased Erythrocyte Sedimentation Rate in Multiple Myeloma

Decreased sialic acid increases the adhesion of RBC membranes to immunoglobulins leading to an increased erythrocyte sedimentation rate (ESR). The increase in reactive oxygen species (ROS) damages the sialic acid glycosyl chains on the surface of RBC membrane proteins, causing the membrane proteins to be overexposed to the plasma environment due to the loss of sialic acid coverage. Immunoglobulins in plasma adhere to RBC membrane Band3 extracellularly exposed peptides through intermolecular interactions. The reduction of sialic acid causes a weakening of the RBC membrane negative charge barrier and the adhesion of immunoglobulins further destabilises the suspension of RBCs, resulting in a rapid addition of ESR to multiple myeloma.