Horton Renita E
Agricultural and Biological Engineering Department, College of Agriculture and Life Sciences, James Worth Bagley College of Engineering, Mississippi State University, Starkville, MS, USA.
Microcirculation. 2017 Jul;24(5). doi: 10.1111/micc.12373.
SCD stems from amutation in the beta globin gene. Upon deoxygenation, hemoglobin polymerizes and triggers RBC remodeling. This phenomenon is central to SCD pathogenesis as individuals suffering from the disease are plagued by painful vaso-occlusive crises episodes. These episodes are the result of a combination of processes including inflammation, thrombosis, and blood cell adhesion to the vascular wall which leads to blockages within the vasculature termed vaso-occlusions. Vaso-occlusive episodes deprive tissues of oxygen and are a major contributor to SCD-related complications; unfortunately, the complex mechanisms that contribute to vaso-occlusions are not well understood. Vaso-occlusions can occur in post-capillary venules; hence, the microvasculature is a prime target for SCD therapies. Traditional in vitro systems poorly recapitulate architectural and dynamic flow properties of in vivo systems. However, microfluidic devices can capture features of the native vasculature such as cellular composition, flow, geometry, and ECM presentation. This review, although not comprehensive, highlights microfluidic approaches that aim to improve our current understanding of the pathophysiological mechanisms surrounding SCD. Microfluidic platforms can aid in identifying factors that may contribute to disease severity and can serve as suitable test beds for novel treatment strategies which may improve patient outcomes.
镰状细胞病（SCD）源于β珠蛋白基因突变。在脱氧过程中，血红蛋白会聚合并引发红细胞重塑。这种现象是SCD发病机制的核心，因为患有该疾病的个体饱受疼痛性血管阻塞危机发作的困扰。这些发作是多种过程共同作用的结果，包括炎症、血栓形成以及血细胞与血管壁的黏附，进而导致血管内出现阻塞，即血管阻塞。血管阻塞发作会使组织缺氧，是SCD相关并发症的主要原因；不幸的是，导致血管阻塞的复杂机制尚未得到充分理解。血管阻塞可发生在毛细血管后微静脉；因此，微脉管系统是SCD治疗的主要靶点。传统的体外系统很难重现体内系统的结构和动态流动特性。然而，微流控装置可以捕捉天然脉管系统的特征，如细胞组成、流动、几何形状和细胞外基质呈现。本综述虽不全面，但重点介绍了旨在增进我们对SCD周围病理生理机制当前理解的微流控方法。微流控平台有助于识别可能导致疾病严重程度的因素，并可作为新型治疗策略的合适试验平台，这些策略可能改善患者预后。
