Écoulement de globules rouges sains et drépanocytaires en conditions micro-circulatoires : processus d'agrégation (clustering) et phénomène d'automargination

I experimentally characterized the clustering formation of healthy and sickle red blood cells (RBCs) flowing through straight micro-capillaries. The effect of aggregation was also investigated. I found that cluster formation under physiological conditions is most likely caused by a combination of hydrodynamic and macromolecule-induced interactions. Macromolecule-induced interactions are not fully overcome by shear stresses within the physiological range, and they contribute to cluster stability. Moreover, I found that a pronounced bimodal distribution of the cell-to-cell distances in the hydrodynamic clusters is produced.Additionally, I investigated experimentally the collective behavior of oxygenated sickle RBCs and their distribution along cylindrical micro-capillaries with diameters comparable to a human venule or arteriole. I have shown that there is a heterogeneous distribution of RBCs according to their density: low-density cells tend to stay closer to the center of the channel, while most dense cells (also more rigid) self-marginated under defined conditions. Aggregation seems to inhibit self-margination depending on the aggregative factor and patient: dextran allows self-margination in some patients and inhibits it in others. Plasma inhibits self-margination of cells in all cases, highlighting the importance of the plasma proteins and adhesive molecules in the aggregation phenomena.J'ai caractérisé expérimentalement la formation de clusters au cours du passage de globules rouges (GRs) sains et drépanocytaires dans microcapillaires droites. L'effet de l'agrégation a été également étudié. J'ai montré que la formation des clusters dans des conditions physiologiques est due à la combinaison des interactions hydrodynamiques et des celles causées par les macromolécules du plasma. En effet, les interactions macromoléculaires ne sont pas complètement atténuées sous contraintes de cisaillement physiologiques et au contraire ils contribuent à la stabilité des clusters. En outre, j'ai découvert la présence d’une distribution bimodale en ce qui concerne les distances entre les cellules constituant les clusters hydrodynamiques.En plus, j'ai étudié expérimentalement le comportement collectif des globules rouges drépanocytaires oxygénés et leur distribution radiale le long de microcapillaires cylindriques avec un diamètre comparable à ces des veinules et des artérioles humaines. J'ai trouvé que les GRs montrent une distribution hétérogène en fonction de leur densité: les cellules plus légères ont tendance à rester prés du centre du canal, alors que la plupart des cellules denses (et aussi plus rigides) auto-marginent sous des conditions définies. L'agrégation semble d'inhiber l'auto-margination en fonction des patients et en particuliers des facteurs d’agrégation: le dextrane, par exemple, favorise l'auto-margination dans certains patients et il la diminue dans des autres. Le plasma montre de contraster l'auto-margination des GRs dans tous les sujets, en soulignant l'importance des protéines et des molécules adhésives du plasma dans les phénomènes d'agrégation. Finalement, j'ai observé que l'auto-margination se manifeste naturellement au cours de l’écoulement de globules rouges drépanocytaires

Microfluidic blood vasculature replicas using backside lithography

International audienc

Clusters of red blood cells in microcapillary flow: hydrodynamic versus macromolecule induced interaction

International audienc

A pilot clinical phase II trial MemSID: Acute and durable changes of red blood cells of sickle cell disease patients on memantine treatment

An increase in abundance and activity of N-methyl D-aspartate receptors (NMDAR) was previously reported for red blood cells (RBCs) of sickle cell disease (SCD) patients. Increased Ca2+uptake through the receptor supported dehydration and RBC damage. In a pilot phase IIa-b clinical trial MemSID, memantine, a blocker of NMDAR, was used for treatment of four patients for 12 months. Two more patients that have enrolled into the study did not finish it. One of them had psychotic event following the invol-untary overdose of the drug, whereas the other had vertigo and could not comply to the trial visits schedule. Acute and durable responses of RBCs of SCD patients to daily oral administration of memantine were monitored. Markers of RBC turnover, changes in cell density, and alterations in ion handling and RBC morphology were assessed. Acute transient shifts in intracellular Ca2+, volume and density, and reduction in plasma lactate dehydrogenate activity were observed already within the first month of treatment. Durable effects of memantine included (a) decrease in reticulocyte counts, (b) reduction in reticulocyte hemoglobinization, (c) advanced membrane maturation and its stabilization as follows from reduction in the number of NMDAR per cell and reduction in hemolysis, and (iv) rehydration and decrease in K+leakage from patients’ RBC. Memantine therapy resulted in reduction in number of cells with sickle morphology that was sustained at least over 2 months after therapy was stopped indicating an improvementin RBC longevity

In Vitro Red Blood Cell Segregation in Sickle Cell Anemia

Red blood cells in sickle cell anemia (sRBC) are more heterogeneous in their physical properties than healthy red blood cells, spanning adhesiveness, rigidity, density, size, and shape. sRBC with increased adhesiveness to the vascular wall would trigger vaso-occlusive like complications, a hallmark of sickle cell anemia. We investigated whether segregation occurs among sRBC flowing in micron-sized channels and tested the impact of aggregation on segregation. Two populations of sRBC of different densities were separated, labeled, and mixed again. The mixed suspension was flowed within glass capillary tubes at different pressure-drops, hematocrit, and suspending media that promoted or not cell aggregation. Observations were made at a fixed channel position. The mean flow velocity was obtained by using the cells as tracking particles, and the cell depleted layer (CDL) by measuring the distance from the cell core border to the channel wall. The labeled sRBC were identified by stopping the flow and scanning the cells within the channel section. The tube hematocrit was estimated from the number of fluorescence cells identified in the field of view. In non-aggregating media, our results showed a heterogeneous distribution of sRBC according to their density: low-density sRBC population remained closer to the center of the channel, while the densest cells segregated towards the walls. There was no impact of the mean flow velocity and little impact of hematocrit. This segregation heterogeneity could influence the ability of sRBC to adhere to the vascular wall and slow down blood flow. However, promoting aggregation inhibited segregation while CDL thickness was enhanced by aggregation, highlighting a potential protective role against vaso-occlusion in patients with sickle cell anemia

Red cells' dynamic morphologies govern blood shear thinning under microcirculatory flow conditions

Blood viscosity decreases with shear stress, a property essential for an efficient perfusion of the vascular tree. Shear thinning is intimately related to the dynamics and mutual interactions of RBCs, the major component of blood. Because of the lack of knowledge about the behavior of RBCs under physiological conditions, the link between RBC dynamics and blood rheology remains unsettled. We performed experiments and simulations in microcirculatory flow conditions of viscosity, shear rates, and volume fractions, and our study reveals rich RBC dynamics that govern shear thinning. In contrast to the current paradigm, which assumes that RBCs align steadily around the flow direction while their membranes and cytoplasm circulate, we show that RBCs successively tumble, roll, deform into rolling stomatocytes, and, finally, adopt highly deformed polylobed shapes for increasing shear stresses, even for semidilute volume fractions of the microcirculation. Our results suggest that any pathological change in plasma composition, RBC cytosol viscosity, or membrane mechanical properties will affect the onset of these morphological transitions and should play a central role in pathological blood rheology and flow behavior