Experiments were carried out to test the hypothesis that the differences between the surfaces of erythrocytes from normal and sickle cell patients are reflected in the degree of attachment to the capillary lining. An assay was used that measured the number of 51Cr- labeled erythrocytes (normal or sickle) attaching to a monolayer of endothelium cultured from calf aortas. Under these conditions, erythrocytes from sickle cell patients adhered better to the endothelium than did those from normal patients. The results suggested that the enhanced adhesion of the sickle cells to the endothelium may be partially responsible for the increased blockage of capillaries that produce the symptoms in sickle cell anemia.

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