Disaggregating shear stress: The roles of cell deformability and fibrinogen concentration

Red blood cell (RBC) aggregation is greatly affected by cell deformability and reduced deformability and increased RBC aggregation are frequently observed in hypertension, diabetes mellitus, and sepsis, thus measurement of both these parameters is essential. In this study, we investigated the effects of cell deformability and fibrinogen concentration on disaggregating shear stress (DSS). The DSS was measured with varying cell deformability and geometry. The deformability of cells was gradually decreased with increasing concentration of glutaraldehyde (0.001~0.005%) or heat treatment at 49.0°C for increasing time intervals (0~7 min), which resulted in a progressive increase in the DSS. However, RBC rigidification by either glutaraldehyde or heat treatment did not cause the same effect on RBC aggregation as deformability did. The effect of cell deformability on DSS was significantly increased with an increase in fibrinogen concentration (2~6 g/L). These results imply that reduced cell deformability and increased fibrinogen levels play a synergistic role in increasing DSS, which could be used as a novel independent hemorheological index to characterize microcirculatory diseases, such as diabetic complications with high sensitivity.