Increased blood viscosity and red blood cell aggregation in a patient with sickle cell anemia and smoldering myeloma

Lemonne, Nathalie; Connes, Philippe; Romana, Marc; Vent-Schmidt, Jens; Bourhis, Véronique M; Lamarre, Yann; Etienne‐Julan, Maryse

doi:10.1002/ajh.23312

Cited by 14 publications

(8 citation statements)

References 3 publications

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“…In this study, we modelled a healthy RBC using the MS-RBC model with the following parameters: [23], the effective shear modulus of the sickle RBC was first chosen to be 2000 times larger than the value of the healthy RBC in the current study. Recent studies suggest that RBC aggregation properties are likely to be involved in the pathophysiology of SCA [32], and the force required to disrupt aggregates of RBCs in case of SCA is around four times greater than that in the healthy RBC [33]. The RBC aggregation interactions are modelled by the Morse potential with the following properties [24,27] With the parameters defined as shown above, we first consider the healthy blood.…”

Section: Resultsmentioning

confidence: 99%

Patient-specific blood rheology in sickle-cell anaemia

Lei

et al. 2016

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Sickle-cell anaemia (SCA) is an inherited blood disorder exhibiting heterogeneous cell morphology and abnormal rheology, especially under hypoxic conditions. By using a multiscale red blood cell (RBC) model with parameters derived from patient-specific data, we present a mesoscopic computational study of the haemodynamic and rheological characteristics of blood from SCA patients with hydroxyurea (HU) treatment (on-HU) and those without HU treatment (off-HU). We determine the shear viscosity of blood in health as well as in different states of disease. Our results suggest that treatment with HU improves or worsens the rheological characteristics of blood in SCA depending on the degree of hypoxia. However, on-HU groups always have higher levels of haematocrit-to-viscosity ratio (HVR) than off-HU groups, indicating that HU can indeed improve the oxygen transport potential of blood. Our patient-specific computational simulations suggest that the HVR level, rather than the shear viscosity of sickle RBC suspensions, may be a more reliable indicator in assessing the response to HU treatment.

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Section: Resultsmentioning

confidence: 99%

Patient-specific blood rheology in sickle-cell anaemia

Lei

et al. 2016

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“…However, when endothelial/vascular dysfunction is present, like in SCA (Kato et al, 2007; Ataga et al, 2016; Charlot et al, 2016), vasodilation is impaired. Therefore, a rise in blood viscosity cannot be fully compensated for, and could increase the risk of frequent vaso-occlusive crises (Lemonne et al, 2012; Charlot et al, 2016).…”

Section: Sickle Cell Disease Blood Rheology and Vascular Dysfunctionmentioning

confidence: 99%

Blood Rheology: Key Parameters, Impact on Blood Flow, Role in Sickle Cell Disease and Effects of Exercise

et al. 2019

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Blood viscosity is an important determinant of local flow characteristics, which exhibits shear thinning behavior: it decreases exponentially with increasing shear rates. Both hematocrit and plasma viscosity influence blood viscosity. The shear thinning property of blood is mainly attributed to red blood cell (RBC) rheological properties. RBC aggregation occurs at low shear rates, and increases blood viscosity and depends on both cellular (RBC aggregability) and plasma factors. Blood flow in the microcirculation is highly dependent on the ability of RBC to deform, but RBC deformability also affects blood flow in the macrocirculation since a loss of deformability causes a rise in blood viscosity. Indeed, any changes in one or several of these parameters may affect blood viscosity differently. Poiseuille’s Law predicts that any increase in blood viscosity should cause a rise in vascular resistance. However, blood viscosity, through its effects on wall shear stress, is a key modulator of nitric oxide (NO) production by the endothelial NO-synthase. Indeed, any increase in blood viscosity should promote vasodilation. This is the case in healthy individuals when vascular function is intact and able to adapt to blood rheological strains. However, in sickle cell disease (SCD) vascular function is impaired. In this context, any increase in blood viscosity can promote vaso-occlusive like events. We previously showed that sickle cell patients with high blood viscosity usually have more frequent vaso-occlusive crises than those with low blood viscosity. However, while the deformability of RBC decreases during acute vaso-occlusive events in SCD, patients with the highest RBC deformability at steady-state have a higher risk of developing frequent painful vaso-occlusive crises. This paradox seems to be due to the fact that in SCD RBC with the highest deformability are also the most adherent, which would trigger vaso-occlusion. While acute, intense exercise may increase blood viscosity in healthy individuals, recent works conducted in sickle cell patients have shown that light cycling exercise did not cause dramatic changes in blood rheology. Moreover, regular physical exercise has been shown to decrease blood viscosity in sickle cell mice, which could be beneficial for adequate blood flow and tissue perfusion.

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“…40%) and, sometimes, slightly elevated plasma viscosity (Ballas & Mohandas, 2004;Tripette et al, 2009;Nebor et al, 2011). These factors may play a role in the occurrence of acute vaso-occlusive complications, such as painful vaso-occlusive crises or ACS (Ballas & Mohandas, 2004;Nebor et al, 2011;Lamarre et al, 2012;Lemonne et al, 2012).…”

Section: Blood Rheologymentioning

confidence: 99%

Advances in understanding the pathogenesis of cerebrovascular vasculopathy in sickle cell anaemia

2013

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SummaryCerebral vasculopathy is the most severe complication to affect children with sickle cell anaemia and its pathophysiology is complex. Traditionally, small-vessel occlusion by intravascular sickling and sludging was considered to underlie the strokes but, in the last 20 years, progressive major cerebral vessel involvement has become recognized as the principal responsible factor. Macrovasculopathy is well detected by abnormally high velocities on transcranial Doppler and with magnetic resonance angiography (MRA), and is responsible for the majority of overt strokes. Silent infarcts are ischaemic lesions detected by magnetic resonance imaging (MRI) in patients without history of stroke. They are associated with compromised cognitive functioning. The present review discusses the pathophysiologal mechanisms that could be involved in the development of cerebral vasculopathy, such as inflammation and hypoxia, anaemia, haemolysis and the resulting decreased nitric oxide bioavailability, genetic factors, impaired blood rheology and particular local haemodynamic profiles.

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Increased blood viscosity and red blood cell aggregation in a patient with sickle cell anemia and smoldering myeloma

Cited by 14 publications

References 3 publications

Patient-specific blood rheology in sickle-cell anaemia

Patient-specific blood rheology in sickle-cell anaemia

Blood Rheology: Key Parameters, Impact on Blood Flow, Role in Sickle Cell Disease and Effects of Exercise

Advances in understanding the pathogenesis of cerebrovascular vasculopathy in sickle cell anaemia

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