Elevated plasma levels of cytokines such as endothelin-1 (ET-1) have been shown to be associated with sickle cell disease (SCD). However, the role of ET-1 in the pathophysiology of SCD is not entirely clear. I now show that treatment of SAD mice, a transgenic mouse model of SCD, with BQ-788 (0.33 mg ⅐ kg Ϫ1 ⅐ day Ϫ1 intraperitoneally for 14 days), an ET-1 receptor B (ET B) antagonist, induced a significant decrease in Gardos channel activity (1.7 Ϯ 0.1 to 1.0 Ϯ 0.4 mmol ⅐ 10 13 cell Ϫ1 ⅐ h Ϫ1 , n ϭ 3, P ϭ 0.019) and reduced the erythrocyte density profile by decreasing the mean density (D50; n ϭ 4, P ϭ 0.012). These effects were not observed in mice treated with BQ-123, an ET-1 receptor A (ET A) antagonist. A mixture of both antagonists induced a similar change in density profile as with BQ-788 alone that was associated with an increase in mean cellular volume and a decrease in corpuscular hemoglobin concentration mean. I also observed in vitro effects of ET-1 on human sickle erythrocyte dehydration that was blocked by BQ-788 and a mixture of ET B/ETA antagonists but not by ETA antagonist alone. These results show that erythrocyte hydration status in vivo is mediated via activation of the ET B receptor, leading to Gardos channel modulation in SCD. cellular dehydration; Gardos channel; transgenic sickle mice ACUTE CHEST SYNDROME AND STROKE are the leading causes of morbidity and mortality among sickle cell disease (SCD) patients. One major clinical manifestation of this disease is the onset of recurrent episodes of severe pain called vaso-occlusive crises. These crises are caused by the occlusion within blood vessels of dehydrated sickle erythrocytes and the ischemia that follows (18). Epidemiological data indicate that 5% of the patients with SCD experience 3-10 crises a year (24,25). It is believed that crises are initiated by the interaction among the endothelium, sickle cells, and plasma factors (33).Patients with SCD have been shown to have elevated levels of cytokines such as ET-1 (16, 31), transforming growth factor-, stem cell factor, soluble transferrin receptor (7), IL-8 (11), and platelet-activating factor (PAF) (20). These vasoactive molecules control a variety of physiological processes, which are mediated by cell surface receptors, reactive oxygen species, H 2 O 2 , and nitric oxide. However, the mechanisms for their interaction with the vasoactive molecules and their pathophysiological roles in SCD are not completely understood. Nonetheless, it is believed that they play an important role in the adhesion of sickle erythrocytes to the endothelium and in the pathogenesis of vaso-occlusive crises (2, 7).Sickle erythrocytes have been shown to interact with vascular endothelial cells, stimulating the release of ET-1 and regulating the expression of the ET-1 gene in cultured endothelial cells (17). My coworkers and I have recently shown that the Gardos channel is coupled to ET-1, C-X-C (cytokines), and C-C (chemokines) receptors in both human (27) and mouse sickle erythrocytes (28). ET-1 acts via two ma...