Heme-induced cell adhesion in the pathogenesis of sickle-cell disease and inflammation

Vascular occlusion is a major cause of the morbidity associated with sickle-cell disease. Although such obstruction is generally attributed to the clumping of sickle-shaped erythrocytes within vessels, other factors might be involved. Heme, which is released into the circulation during the active phase of sickle-cell disease, causes increased expression of endothelial adhesion molecules and adherence of leukocytes and reticulocytes to endothelial cells. Counteracting heme-mediated adhesion could form the basis for novel therapies to prevent the complications associated with this disabling disease.