Erythrocyte adhesion to vascular endothelium: clinical applications.

Introduction. - The objectives of this paper are to review the environmenta l factors, the different erythrocyte ligands and the corresponding endothel ial receptors involved in adhesion. Current knowledge and key points. - Leukocyte adhesion to vascular endothel ium is related to inflammation and has been widely studied. The adhesion of erythrocytes to vascular endothelium has been investigated more recently, mainly in the physiopathology of three diseases: diabetes mellitus, sickle cell disease and malaria. The three diseases are characterized by microvasc ular complications and are deleterious for the red blood cell membrane. The y lead to abnormal erythrocyte adhesion to vascular endothelium. Thus bette r understanding of the mechanisms involved in red blood cell adhesion to th e endothelium is important since it might lead to the development of new th erapeutic targets. Progress in this field might contribute to therapeutic i mprovement in sickle cell disease and to the development of an antimalarial vaccine. Future prospects and projects. - However, additional studies focusing on in vivo endothelium heterogeneity, the different subpopulations of red blood cells and the diversity of Plasmodium falciparum strains are required. The consequences of such erythrocytes/endothelium interactions on the endotheli al functions remain to be established. (C) 2000 Editions scientifiques et m edicales Elsevier SAS.