Abstract
Red Blood Cells (RBCs) have been increasingly recognized to play important roles in hemostasis and the mechanisms by which they do so continue to be elucidated. First and foremost, RBC biomechanics are the principal determinant of viscosity and flow dynamics of blood, which strongly influence all features of hemostasis. Of note, morphologic pathology, such as that found in sickle cell disease, leads to increased risk of thrombotic disease. RBC surface interactions govern signaling between platelets and RBCs and also aid in the conversion of prothrombin to thrombin. Additionally, RBCs generate microparticles which have been shown to reduce clotting time. Finally, blood clot structure and maturation are dependent on the inclusion of RBCs in forming thrombi. Here, we review the above mechanisms of RBC contribution to hemostasis.
Highlights
Red blood cells (RBCs) have long been known to influence thrombosis through the visco-elastic properties of flowing blood
Long thought to have no active role in clot formation, RBCs are known to be active in clot formation and contraction and to help regulate clot resolution via fibrinolysis
In a non-Newtonian fluid such as blood, viscosity is defined as the ratio of shear stress to shear rate and as such, the viscosity is lowest and velocity is highest at the vessel center; whereas, viscosity is highest and velocity is lowest at the endothelial surface
Summary
Red Blood Cells (RBCs) have been increasingly recognized to play important roles in hemostasis and the mechanisms by which they do so continue to be elucidated. First and foremost, RBC biomechanics are the principal determinant of viscosity and flow dynamics of blood, which strongly influence all features of hemostasis. Morphologic pathology, such as that found in sickle cell disease, leads to increased risk of thrombotic disease. RBCs generate microparticles which have been shown to reduce clotting time. Blood clot structure and maturation are dependent on the inclusion of RBCs in forming thrombi. We review the above mechanisms of RBC contribution to hemostasis. Reviewed by: Marianne Nellis, Cornell University, United States Gail Mary Annich, Hospital for Sick Children, Canada.
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