SCD is a genetic disease caused by a single point mutation in the β‐globin gene of hemoglobin, which leads to sickling of RBCs under deoxygenated condition. Sickle RBCs (sRBCs) are not only less deformable, but also express enhanced levels of major adhesion molecules compared to normal discoid shaped RBCs of healthy patients. In addition to RBC sickling, SCD is also associated with a hyper‐inflammatory state, which accounts for enhanced adherence of leukocytes to vascular endothelium. Leukocyte‐endothelium adhesion starts with leukocyte rolling mediated by P‐selectin‐glycoprotein‐ligand (PSGL)‐1 on leukocytes binding to P‐selectin on endothelium. Rolling is followed by firm arrest, which is medicated by activated β¬2‐integrins (LFA‐1 and Mac‐1) on the leukocytes binding to inter‐cellular‐adhesion‐molecule (ICAM)‐1 on endothelium. Although neutrophils have been shown to play a role in the onset of vaso‐occlusion by interacting with sRBCs in systemic venules of SCD mice, the cellular and molecular mechanism that enables systemic vaso‐occlusion in human patients is not completely understood. Heparinized blood from SCD patients and race matched control subjects is perfused through a microfluidic flow chamber with a glass bottom coated with either human microvascular endothelial cells or a cocktail of P‐selection, ICAM‐1 and CXCL‐8 at a physiological shear stress (2‐10 dyn cm‐2). Fluorescent Abs against CD16 and glycophorin‐A are added to the blood to stain neutrophils and sRBCs, respectively and cellular interactions recorded using multi‐color Quantitative Dynamic Footprinting or epifluorescence microscopy. Preliminary results reveal that neutrophil arrest is facilitated by the formation of a thick trunk like structure at the rear, which also enables capturing of free flowing sRBCs by arrested neutrophils. Understanding the molecular mechanism behind vaso‐occlusion will be useful in designing prophylactic interventions for SCD patients.Grant Funding Source: This study is supported by 11SDG7340005 from the American Heart Association (P.S.), VMI start‐up funds (P.S.) and CBTP‐T32 fellowship (M.J).
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