title: Kinetics of sickle cell biorheology and implications for painful vasoocclusive crisis.
abstract: We developed a microfluidics-based model to quantify cell-level processes modulating the pathophysiology of sickle cell disease (SCD). This in vitro model enabled quantitative investigations of the kinetics of cell sickling, unsickling, and cell rheology. We created short-term and long-term hypoxic conditions to simulate normal and retarded transit scenarios in microvasculature. Using blood samples from 25 SCD patients with sickle hemoglobin (HbS) levels varying from 64 to 90.1%, we investigated how cell biophysical alterations during blood flow correlated with hematological parameters, HbS level, and hydroxyurea (HU) therapy. From these measurements, we identified two severe cases of SCD that were also independently validated as severe from a genotype-based disease severity classification. These results point to the potential of this method as a diagnostic indicator of disease severity. In addition, we investigated the role of cell density in the kinetics of cell sickling. We observed an effect of HU therapy mainly in relatively dense cell populations, and that the sickled fraction increased with cell density. These results lend support to the possibility that the microfluidic platform developed here offers a unique and quantitative approach to assess the kinetic, rheological, and hematological factors involved in vasoocclusive events associated with SCD and to develop alternative diagnostic tools for disease severity to supplement other methods. Such insights may also lead to a better understanding of the pathogenic basis and mechanism of drug response in SCD.
authors.affiliation: Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139;
authors.forename: E
authors.initials: E
authors.lastname: Du
authors.affiliation: Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139;
authors.forename: Monica
authors.initials: M
authors.lastname: Diez-Silva
authors.affiliation: Department of Medicine, Division of Hematology-Oncology, University of Pittsburgh, Pittsburgh, PA 15261; and.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Kato
authors.affiliation: Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139; mingdao@mit.edu suresh@cmu.edu.
authors.forename: Ming
authors.initials: M
authors.lastname: Dao
authors.affiliation: Departments of Biomedical Engineering and Materials Science and Engineering, Carnegie Mellon University, Pittsburgh, PA 15213 mingdao@mit.edu suresh@cmu.edu.
authors.forename: Subra
authors.initials: S
authors.lastname: Suresh
mesh_terms: D000755:Anemia, Sickle Cell / Q000235:genetics / Q000503:physiopathology*; D004913:Erythrocytes, Abnormal / Q000502:physiology*; D005838:Genotype; D006801:Humans; D007700:Kinetics; D012212:Rheology
keywords: Aes-103; capillary obstruction ratio; cell deformability; sickle cell anemia; vasoocclusion