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From Virchow to red cells (the unended quest).

G A Marcel, C George, D Weill

    La Ricerca in Clinica E in Laboratorio
    |January 1, 1983
    PubMed
    Summary
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    Thrombogenesis, the formation of blood clots, involves vessel wall issues, coagulability, and blood flow. Recent research now focuses on red blood cell deformability as a key factor in microvessel flow, advancing clot prevention therapies.

    Area of Science:

    • Biomedical Science
    • Hematology
    • Vascular Biology

    Background:

    • Thrombogenesis, the process of blood clot formation, is traditionally attributed to three main factors: Virchow's triad of vessel wall abnormalities, blood coagulability, and blood flow dynamics.
    • Pharmacological advancements targeting these factors have progressed unevenly, with therapies for vessel wall and coagulability preceding those for flow dynamics.

    Purpose of the Study:

    • To highlight the historical progression of understanding and therapeutic development in thrombogenesis.
    • To emphasize the recent emergence of red blood cell deformability as a critical determinant of microvessel flow and a target for antithrombotic strategies.

    Main Methods:

    • Review of historical and contemporary research in thrombogenesis.
    • Analysis of the chronological development of pharmacological interventions for each component of Virchow's triad.

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  • Discussion of novel investigative methods enabling the assessment of red blood cell deformability.

    • Main Results:

    • Therapeutic strategies for thrombogenesis have historically addressed the vessel wall (e.g., vasodilators) and coagulability (e.g., anticoagulants, antiplatelets) before focusing on flow dynamics.
    • Red blood cell deformability has been identified as a primary determinant of blood flow in microcirculation.
    • New investigation techniques facilitate the evaluation and pharmacological manipulation of red blood cell deformability.

    Conclusions:

    • The understanding and treatment of thrombogenesis have evolved, with a growing appreciation for the role of red blood cell properties.
    • Targeting red blood cell deformability represents a newer frontier in developing effective antithrombotic therapies, particularly for microvascular conditions.