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Camacho RA, Machado AV, de Oliveira Mendonça F, Teixeira-Alves LR, Guimarães-Nobre CC, Mendonça-Reis E, da Silva PF, Cardim-Pires TR, Miranda-Alves L, Berto-Junior C. Unraveling DEHP influence on hemoglobin S polymerization in sickle cell disease: Ex vivo, in vitro and in silico analysis. Toxicol In Vitro 2024; 98:105832. [PMID: 38653437 DOI: 10.1016/j.tiv.2024.105832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/30/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
Sickle cell disease (SCD) is a hereditary hemoglobinopathy, caused by a mutation at position 6 of the β-globin chain and patients are frequently exposed to several blood transfusions in order to maintain physiological function. Transfusion blood bags are composed of PVC and phthalates (as DEHP) are often introduced to the material in order to confer malleability. In this sense, DEHP can easily elute to the blood and cause harmful effects. This study aimed to unravel DEHP effect on SCD patient's hemoglobin function. We found that HbS polymerization using whole erythrocytes is decreased by DEHP in ex vivo experiments and this effect might be mediated by the DEHP-VAL6 interaction, evaluated in silico. Isolated HbS exhibited less polymerization at low DEHP concentrations and increased polymerization rate at higher concentration. When analyzing the propensity to aggregate, HbS is more inclined to aggregate when compared to HbA due to the residue 6 mutation. Circular dichroism showed characteristic hemoglobin peaks for oxygenated HbS that are lost when oxygen is sequestered, and DEHP at higher concentration mildly recovers a peak close to the second hemoglobin one. Finally, by transmission electron microscopy we demonstrated that high DEHP concentration increased polymer formation with a more organized structure. These findings show for the first-time the beneficial effect of low-dose DEHP on HbS polymerization.
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Affiliation(s)
- Rodrigo Abreu Camacho
- Grupo de Pesquisa em Fisiologia Eritróide - GPFisEri, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil; Programa de Pós-graduação em Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Brazil
| | - Aghata Vitoria Machado
- Grupo de Pesquisa em Fisiologia Eritróide - GPFisEri, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil; Instituto de Ciências Farmacêuticas, Universidade Federal do Rio de Janeiro, Centro Multidisciplinar UFRJ Macaé, Brazil
| | - Fernanda de Oliveira Mendonça
- Grupo de Pesquisa em Fisiologia Eritróide - GPFisEri, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil; Instituto de Ciências Farmacêuticas, Universidade Federal do Rio de Janeiro, Centro Multidisciplinar UFRJ Macaé, Brazil
| | - Lyzes Rosa Teixeira-Alves
- Grupo de Pesquisa em Fisiologia Eritróide - GPFisEri, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil; Programa de Pós-graduação em Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Brazil
| | - Camila Cristina Guimarães-Nobre
- Grupo de Pesquisa em Fisiologia Eritróide - GPFisEri, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil; Programa de Pós-graduação em Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Farmacêuticas, Universidade Federal do Rio de Janeiro, Centro Multidisciplinar UFRJ Macaé, Brazil
| | - Evelyn Mendonça-Reis
- Grupo de Pesquisa em Fisiologia Eritróide - GPFisEri, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil; Programa de Pós-graduação em Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Brazil
| | - Priscila Ferreira da Silva
- Universidade Federal do Rio de Janeiro, Centro Multidisciplinar UFRJ Macaé, Instituto de Ciências Farmacêuticas, Av. Aluizio da Silva Gomes, 50- Novo Cavaleiros, Macaé, 27930-560 Rio de Janeiro, RJ, Brazil
| | | | - Leandro Miranda-Alves
- Laboratório de Endocrinologia Experimental- LEEx, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Programa de Pós-graduação em Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Brazil; Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Clemilson Berto-Junior
- Grupo de Pesquisa em Fisiologia Eritróide - GPFisEri, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil; Programa de Pós-graduação em Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Farmacêuticas, Universidade Federal do Rio de Janeiro, Centro Multidisciplinar UFRJ Macaé, Brazil.
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2
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Ansong-Ansongton YON, Adamson TD. Computing Sickle Erythrocyte Health Index on quantitative phase imaging and machine learning. Exp Hematol 2024; 131:104166. [PMID: 38246310 DOI: 10.1016/j.exphem.2024.104166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 12/30/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
Sickle cell disease (SCD) is a genetic disorder characterized by abnormal hemoglobin and deformation of red blood cells (RBCs), leading to complications and reduced life expectancy. This study developed an in vitro assessment, the Sickle Erythrocyte Health Index, using quantitative phase imaging (QPI) and machine learning to model the health of RBCs in people with SCD. The health index combines assessment of cell deformation, sickle-shaped classification, and membrane flexibility to evaluate erythrocyte health. Using QPI and image processing, the percentage of sickle-shaped cells and membrane flexibility were quantified. Statistically significant differences were observed between individuals with and without SCD, indicating the impact of underlying pathophysiology on erythrocyte health. Additionally, sodium metabisulfite led to an increase in sickle-shaped cells and a decrease in flexibility in the sickle cell blood samples. Based on these findings, two approaches were used to calculate the Sickle Erythrocyte Health Index: one using hand-crafted features and one using learned features from deep learning models. Both indices showed significant differences between non-SCD and SCD groups and sensitivity to changes induced by sodium metabisulfite. The Sickle Erythrocyte Health Index has important clinical implications for SCD management and could be used by providers when making treatment decisions. Further research is warranted to evaluate the clinical utility and applicability of the Sickle Erythrocyte Health Index in diverse patient populations.
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Affiliation(s)
- Yaw Ofosu Nyansa Ansong-Ansongton
- Department of Bioengineering, KovaDx, New Haven, CT; Department of Bioengineering, University of California Berkeley, Bioengineering, Berkeley, CA.
| | - Timothy D Adamson
- Department of Bioengineering, KovaDx, New Haven, CT; Department of Bioengineering, University of California Berkeley, Bioengineering, Berkeley, CA
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3
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Giannaki A, Georgatzakou HΤ, Fortis SP, Anastasiadi AT, Pavlou EG, Nomikou EG, Drandaki MP, Kotsiafti A, Xydaki A, Fountzoula C, Papageorgiou EG, Tzounakas VL, Kriebardis AG. Stratification of β Sβ + Compound Heterozygotes Based on L-Glutamine Administration and RDW: Focusing on Disease Severity. Antioxidants (Basel) 2023; 12:1982. [PMID: 38001835 PMCID: PMC10669421 DOI: 10.3390/antiox12111982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Sickle cell disease (SCD) is heterogeneous in terms of manifestation severity, even more so when in compound heterozygosity with beta-thalassemia. The aim of the present study was to stratify βSβ+ patient blood samples in a severity-dependent manner. Blood from thirty-two patients with HbS/β-thalassemia compound heterozygosity was examined for several parameters (e.g., hemostasis, inflammation, redox equilibrium) against healthy controls. Additionally, SCD patients were a posteriori (a) categorized based on the L-glutamine dose and (b) clustered into high-/low-RDW subgroups. The patient cohort was characterized by anemia, inflammation, and elevated coagulation. Higher-dose administration of L-glutamine was associated with decreased markers of inflammation and oxidation (e.g., intracellular reactive oxygen species) and an altered coagulation profile. The higher-RDW group was characterized by increased hemolysis, elevated markers of inflammation and stress erythropoiesis, and oxidative phenomena (e.g., membrane-bound hemoglobin). Moreover, the levels of hemostasis parameters (e.g., D-Dimers) were greater compared to the lower-RDW subgroup. The administration of higher doses of L-glutamine along with hydroxyurea seems to attenuate several features in SCD patients, probably by enhancing antioxidant power. Moreover, anisocytosis may alter erythrocytes' coagulation processes and hemolytic propensity. This results in the disruption of the redox and pro-/anti-inflammatory equilibria, creating a positive feedback loop by inducing stress erythropoiesis and, thus, the occurrence of a mixed erythrocyte population.
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Affiliation(s)
- Aimilia Giannaki
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Hara Τ. Georgatzakou
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Sotirios P. Fortis
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Alkmini T. Anastasiadi
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
- Department of Biochemistry, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Efthimia G. Pavlou
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
- Blood Bank and Hemophilia Unit, Hippokration Hospital, 11527 Athens, Greece;
| | - Efrosyni G. Nomikou
- Blood Bank and Hemophilia Unit, Hippokration Hospital, 11527 Athens, Greece;
| | - Maria P. Drandaki
- Thalassemia and Sickle Cell Unit, Expertise Center of Hemoglobinopathies and Their Complications, Hippokration General Hospital, 11527 Athens, Greece; (M.P.D.); (A.K.); (A.X.)
| | - Angeliki Kotsiafti
- Thalassemia and Sickle Cell Unit, Expertise Center of Hemoglobinopathies and Their Complications, Hippokration General Hospital, 11527 Athens, Greece; (M.P.D.); (A.K.); (A.X.)
| | - Aikaterini Xydaki
- Thalassemia and Sickle Cell Unit, Expertise Center of Hemoglobinopathies and Their Complications, Hippokration General Hospital, 11527 Athens, Greece; (M.P.D.); (A.K.); (A.X.)
| | - Christina Fountzoula
- Laboratory of Chemistry, Biochemistry and Cosmetic Science (ChemBiochemCosm), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece;
| | - Effie G. Papageorgiou
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Vassilis L. Tzounakas
- Department of Biochemistry, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Anastasios G. Kriebardis
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
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4
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Soteriou D, Kubánková M, Schweitzer C, López-Posadas R, Pradhan R, Thoma OM, Györfi AH, Matei AE, Waldner M, Distler JHW, Scheuermann S, Langejürgen J, Eckstein M, Schneider-Stock R, Atreya R, Neurath MF, Hartmann A, Guck J. Rapid single-cell physical phenotyping of mechanically dissociated tissue biopsies. Nat Biomed Eng 2023; 7:1392-1403. [PMID: 37024677 PMCID: PMC10651479 DOI: 10.1038/s41551-023-01015-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/22/2023] [Indexed: 04/08/2023]
Abstract
During surgery, rapid and accurate histopathological diagnosis is essential for clinical decision making. Yet the prevalent method of intra-operative consultation pathology is intensive in time, labour and costs, and requires the expertise of trained pathologists. Here we show that biopsy samples can be analysed within 30 min by sequentially assessing the physical phenotypes of singularized suspended cells dissociated from the tissues. The diagnostic method combines the enzyme-free mechanical dissociation of tissues, real-time deformability cytometry at rates of 100-1,000 cells s-1 and data analysis by unsupervised dimensionality reduction and logistic regression. Physical phenotype parameters extracted from brightfield images of single cells distinguished cell subpopulations in various tissues, enhancing or even substituting measurements of molecular markers. We used the method to quantify the degree of colon inflammation and to accurately discriminate healthy and tumorous tissue in biopsy samples of mouse and human colons. This fast and label-free approach may aid the intra-operative detection of pathological changes in solid biopsies.
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Affiliation(s)
- Despina Soteriou
- Max Planck Institute for the Science of Light and Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany
| | - Markéta Kubánková
- Max Planck Institute for the Science of Light and Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany
| | - Christine Schweitzer
- Max Planck Institute for the Science of Light and Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany
| | - Rocío López-Posadas
- Department of Medicine 1-Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Rashmita Pradhan
- Department of Medicine 1-Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Oana-Maria Thoma
- Department of Medicine 1-Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Andrea-Hermina Györfi
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Alexandru-Emil Matei
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Maximilian Waldner
- Department of Medicine 1-Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Jörg H W Distler
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | | | | | - Markus Eckstein
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Institute of Pathology, University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Regine Schneider-Stock
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Institute of Pathology, University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Raja Atreya
- Department of Medicine 1-Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Markus F Neurath
- Department of Medicine 1-Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Arndt Hartmann
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Institute of Pathology, University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jochen Guck
- Max Planck Institute for the Science of Light and Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany.
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5
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Sun J, Huang X, Chen J, Xiang R, Ke X, Lin S, Xuan W, Liu S, Cao Z, Sun L. Recent advances in deformation-assisted microfluidic cell sorting technologies. Analyst 2023; 148:4922-4938. [PMID: 37743834 DOI: 10.1039/d3an01150j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Cell sorting is an essential prerequisite for cell research and has great value in life science and clinical studies. Among the many microfluidic cell sorting technologies, label-free methods based on the size of different cell types have been widely studied. However, the heterogeneity in size for cells of the same type and the inevitable size overlap between different types of cells would result in performance degradation in size-based sorting. To tackle such challenges, deformation-assisted technologies are receiving more attention recently. Cell deformability is an inherent biophysical marker of cells that reflects the changes in their internal structures and physiological states. It provides additional dimensional information for cell sorting besides size. Therefore, in this review, we summarize the recent advances in deformation-assisted microfluidic cell sorting technologies. According to how the deformability is characterized and the form in which the force acts, the technologies can be divided into two categories: (1) the indirect category including transit-time-based and image-based methods, and (2) the direct category including microstructure-based and hydrodynamics-based methods. Finally, the separation performance and the application scenarios of each method, the existing challenges and future outlook are discussed. Deformation-assisted microfluidic cell sorting technologies are expected to realize greater potential in the label-free analysis of cells.
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Affiliation(s)
- Jingjing Sun
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
| | - Xiwei Huang
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
| | - Jin Chen
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
| | - Rikui Xiang
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
| | - Xiang Ke
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
| | - Siru Lin
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
| | - Weipeng Xuan
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
| | - Shan Liu
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, China
| | - Zhen Cao
- College of Information Science and Electronic Engineering, Zhejiang University, China
| | - Lingling Sun
- Ministry of Education Key Lab of RF Circuits and Systems, Hangzhou Dianzi University, China.
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6
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Wang L, Gan C, Sun H, Feng L. Magnetic nanoparticle swarm with upstream motility and peritumor blood vessel crossing ability. NANOSCALE 2023; 15:14227-14237. [PMID: 37599587 DOI: 10.1039/d3nr02610h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Micro-nano-robots show great potential and value for applications in targeted drug delivery; however, very few current studies have enabled micro-nano-robots to move against blood flow, and in addition, how micro-nano-robots can penetrate endothelial cells and enter tissues via vascular permeation remains unclear. Inspired by the bionics of dynamic aggregation in wild herring schools and transvascular permeation of leukocytes, we propose a novel drug delivery strategy where thousands of magnetic nanoparticles (MNPs) can be assembled into swarms under the guidance of a specially designed electromagnetic field. The vortex-like swarms of magnetic nanoparticles exhibit excellent stability, allowing them to withstand the impact of high-speed flow and move upstream along the vessel wall, stopping at the target location. When the vortex-like swarms encounter a tumor periphery without a continuous vessel wall, their rheological properties actively adhere them to the edges of the vascular endothelial gap, using their deformability to crawl through narrow intercellular gaps, enabling large-scale targeted drug delivery. This cluster of miniature nanorobots can be reshaped and reconfigured to perform a variety of tasks according to the environmental demands of the circulatory system, providing new solutions for a variety of biomedical field applications.
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Affiliation(s)
- Luyao Wang
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China.
| | - Chunyuan Gan
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China.
| | - Hongyan Sun
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China.
| | - Lin Feng
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China.
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100191, China
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7
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Fay ME, Oshinowo O, Iffrig E, Fibben KS, Caruso C, Hansen S, Musick JO, Valdez JM, Azer SS, Mannino RG, Choi H, Zhang DY, Williams EK, Evans EN, Kanne CK, Kemp ML, Sheehan VA, Carden MA, Bennett CM, Wood DK, Lam WA. iCLOTS: open-source, artificial intelligence-enabled software for analyses of blood cells in microfluidic and microscopy-based assays. Nat Commun 2023; 14:5022. [PMID: 37596311 PMCID: PMC10439163 DOI: 10.1038/s41467-023-40522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 07/28/2023] [Indexed: 08/20/2023] Open
Abstract
While microscopy-based cellular assays, including microfluidics, have significantly advanced over the last several decades, there has not been concurrent development of widely-accessible techniques to analyze time-dependent microscopy data incorporating phenomena such as fluid flow and dynamic cell adhesion. As such, experimentalists typically rely on error-prone and time-consuming manual analysis, resulting in lost resolution and missed opportunities for innovative metrics. We present a user-adaptable toolkit packaged into the open-source, standalone Interactive Cellular assay Labeled Observation and Tracking Software (iCLOTS). We benchmark cell adhesion, single-cell tracking, velocity profile, and multiscale microfluidic-centric applications with blood samples, the prototypical biofluid specimen. Moreover, machine learning algorithms characterize previously imperceptible data groupings from numerical outputs. Free to download/use, iCLOTS addresses a need for a field stymied by a lack of analytical tools for innovative, physiologically-relevant assays of any design, democratizing use of well-validated algorithms for all end-user biomedical researchers who would benefit from advanced computational methods.
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Affiliation(s)
- Meredith E Fay
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Oluwamayokun Oshinowo
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Elizabeth Iffrig
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Kirby S Fibben
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Christina Caruso
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Scott Hansen
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Jamie O Musick
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - José M Valdez
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Sally S Azer
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Robert G Mannino
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Hyoann Choi
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Dan Y Zhang
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Evelyn K Williams
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Erica N Evans
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Celeste K Kanne
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Melissa L Kemp
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Vivien A Sheehan
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Marcus A Carden
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Carolyn M Bennett
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - David K Wood
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Wilbur A Lam
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA.
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA.
- Winship Cancer Institute of Emory University, Atlanta, GA, USA.
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA.
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8
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Ke R, Kucukal E, Gurkan UA, Li B. Characterization of fibronectin properties by integrated micro-fluidic experiments and fluid-structure interaction simulations. J Biomech 2023; 150:111505. [PMID: 36867952 DOI: 10.1016/j.jbiomech.2023.111505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/17/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
Fibronectin (Fn) has been observed to assemble in the extracellular matrix (ECM) of cell culture and stretch in response to the external force. The alteration of molecule domain functions generally follows the extension of Fn. Several researchers have investigated fibronectin extensively in molecular architecture and conformation structure. However, the bulk material behavior of the Fn in the ECM has not been fully depicted at the cell scale, and many studies have ignored physiological conditions. Conversely, microfluidic techniques that explore cellular properties based on cell deformation and adhesion have emerged as a powerful and effective platform to study cell rheological transformation in a physiological environment. However, directly quantifying properties from microfluidic measurements remains a challenge. Therefore, it is an efficient way to combine experimental measurements with a robust and reliable numerical framework to calibrate the mechanical stress distribution in the test sample. In this paper, we present a monolithic Lagrangian fluid-structure interaction (FSI) approach within the Optimal Transportation Meshfree (OTM) framework that enables the investigation of the adherent Red Blood Cell (RBC) interacting with fluid and overcomes the drawbacks of the traditional computational tools such as the mesh entanglement and interface tracking, etc. This study aims to assess the material properties of the RBC and Fn fiber by calibrating the numerical predictions to experimental measurements. Moreover, a physical-based constitutive model will be proposed to describe the bulk behavior of the Fn fiber inflow, and the rate-dependent deformation and separation of the Fn fiber will be discussed.
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Affiliation(s)
- Renjie Ke
- Department of Mechanical and Aerospace Engineering, Case Western Reserve, University, Cleveland, 44106 OH, USA
| | - Erdem Kucukal
- Department of Mechanical and Aerospace Engineering, Case Western Reserve, University, Cleveland, 44106 OH, USA
| | - Umut A Gurkan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve, University, Cleveland, 44106 OH, USA
| | - Bo Li
- College of Engineering, Peking University, Beijing 100871, China.
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9
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Grigorev GV, Lebedev AV, Wang X, Qian X, Maksimov GV, Lin L. Advances in Microfluidics for Single Red Blood Cell Analysis. BIOSENSORS 2023; 13:117. [PMID: 36671952 PMCID: PMC9856164 DOI: 10.3390/bios13010117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/04/2022] [Accepted: 12/23/2022] [Indexed: 05/24/2023]
Abstract
The utilizations of microfluidic chips for single RBC (red blood cell) studies have attracted great interests in recent years to filter, trap, analyze, and release single erythrocytes for various applications. Researchers in this field have highlighted the vast potential in developing micro devices for industrial and academia usages, including lab-on-a-chip and organ-on-a-chip systems. This article critically reviews the current state-of-the-art and recent advances of microfluidics for single RBC analyses, including integrated sensors and microfluidic platforms for microscopic/tomographic/spectroscopic single RBC analyses, trapping arrays (including bifurcating channels), dielectrophoretic and agglutination/aggregation studies, as well as clinical implications covering cancer, sepsis, prenatal, and Sickle Cell diseases. Microfluidics based RBC microarrays, sorting/counting and trapping techniques (including acoustic, dielectrophoretic, hydrodynamic, magnetic, and optical techniques) are also reviewed. Lastly, organs on chips, multi-organ chips, and drug discovery involving single RBC are described. The limitations and drawbacks of each technology are addressed and future prospects are discussed.
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Affiliation(s)
- Georgii V. Grigorev
- Data Science and Information Technology Research Center, Tsinghua Berkeley Shenzhen Institute, Tsinghua University, Shenzhen 518055, China
- Mechanical Engineering Department, University of California in Berkeley, Berkeley, CA 94720, USA
- School of Information Technology, Cherepovets State University, 162600 Cherepovets, Russia
| | - Alexander V. Lebedev
- Machine Building Department, Bauman Moscow State University, 105005 Moscow, Russia
| | - Xiaohao Wang
- Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Xiang Qian
- Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - George V. Maksimov
- Faculty of Biology, Lomonosov Moscow State University, 119991 Moscow, Russia
- Physical metallurgy Department, Federal State Autonomous Educational Institution of Higher Education National Research Technological University “MISiS”, 119049 Moscow, Russia
| | - Liwei Lin
- Mechanical Engineering Department, University of California in Berkeley, Berkeley, CA 94720, USA
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10
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Taraconat P, Gineys JP, Isebe D, Nicoud F, Mendez S. Red blood cell rheology during a complete blood count: A proof of concept. PLoS One 2023; 18:e0280952. [PMID: 36706122 PMCID: PMC9882912 DOI: 10.1371/journal.pone.0280952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
Counting and sizing blood cells in hematological analyzers is achieved using the Coulter principle. The cells flow in a micro-aperture in which a strong electrical field is imposed, so that an electrical perturbation, called pulse, is measured each time a cell crosses the orifice. The pulses are expected to contain information on the shape and deformability of Red Blood Cells (RBCs), since recent studies state that RBCs rotate and deform in the micro-orifice. By implementing a dedicated numerical model, the present study sheds light on a variety of cells dynamics, which leads to different associated pulse signatures. Furthermore, simulations provide new insights on how RBCs shapes and mechanical properties affect the measured signals. Those numerical observations are confirmed by experimental assays. Finally, specific features are introduced for assessing the most relevant characteristics from the various pulse signatures and shown to highlight RBCs alterations induced by drugs. In summary, this study paves the way to a characterization of RBC rheology by routine hematological instruments.
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Affiliation(s)
- Pierre Taraconat
- Horiba Medical, Montpellier, France
- Institut Montpellierain Alexander Grothendieck, CNRS, Univ. Montpellier, Montpellier, France
- * E-mail: (PT); (SM)
| | | | | | - Franck Nicoud
- Institut Montpellierain Alexander Grothendieck, CNRS, Univ. Montpellier, Montpellier, France
| | - Simon Mendez
- Institut Montpellierain Alexander Grothendieck, CNRS, Univ. Montpellier, Montpellier, France
- * E-mail: (PT); (SM)
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11
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Sickle Cell Disease Pathophysiology and Related Molecular and Biophysical Biomarkers. Hematol Oncol Clin North Am 2022; 36:1077-1095. [DOI: 10.1016/j.hoc.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Zhang X, Chan T, Carbonella J, Gong X, Ahmed N, Liu C, Demandel I, Zhang J, Pashankar F, Mak M. A microfluidic-informatics assay for quantitative physical occlusion measurement in sickle cell disease. LAB ON A CHIP 2022; 22:1126-1136. [PMID: 35174373 DOI: 10.1039/d2lc00043a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sickle cell disease (SCD) is a genetic condition that causes abnormalities in hemoglobin mechanics. Those affected are at high risk of vaso-occlusive crisis (VOC), which can induce life-threatening symptoms. The development of measurements related to vaso-occlusion facilitates the diagnosis of the patient's disease state. To complement existing readouts, we design a microfluidic-informatics analytical system with varied confined geometries for the quantification of sickle cell disease occlusion. We detect an increase in physical occlusion events in the most severe hemoglobin SS group. We use bioinformatics and modeling to quantify the in vitro disease severity score (DSS) of individual patients. We also show the potential effect of hydration, clinically recommended for crisis management, on reducing the disease severity of high-risk patients. Overall, we demonstrate the device as an easy-to-use assay for quick occlusion information extraction with a simple setup and minimal additional instruments. We show the device can provide physical readouts distinct from clinical data. We also show the device sensitivity in separate samples from patients with different disease severity. Finally, we demonstrate the system as a potential platform for testing the effectiveness of therapeutic strategies (e.g. hydration) on reducing sickle cell disease severity.
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Affiliation(s)
- Xingjian Zhang
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
| | - Trevor Chan
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
| | - Judith Carbonella
- Section of Pediatric Hematology and Oncology, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Xiangyu Gong
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
| | - Noureen Ahmed
- Section of Pediatric Hematology and Oncology, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Chang Liu
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
| | - Israel Demandel
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
| | - Junqi Zhang
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
| | - Farzana Pashankar
- Section of Pediatric Hematology and Oncology, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Michael Mak
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
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13
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Shear-Stress-Gradient and Oxygen-Gradient Ektacytometry in Sickle Cell Patients at Steady State and during Vaso-Occlusive Crises. Cells 2022; 11:cells11030585. [PMID: 35159394 PMCID: PMC8834105 DOI: 10.3390/cells11030585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/24/2022] [Accepted: 02/07/2022] [Indexed: 12/02/2022] Open
Abstract
Oxygen gradient ektacytometry (oxygenscan) measures the changes in red blood cell (RBC) deformability in normoxia and during deoxygenation. We investigated the changes in RBC deformability, measured by both oxygenscan and classical shear-stress-gradient ektacytometry, in 10 patients with sickle cell disease (SCD) during vaso-occlusive crisis (VOC) versus steady state. Oxygenscan and shear-stress-gradient ektacytometry parameters were also measured in 38 SCD patients at steady state on two different occasions. Shear-stress-gradient ektacytometry parameters, maximal RBC deformability at normoxia and the minimum RBC deformability during deoxygenation were lower during VOC compared to steady state. The oxygen partial pressure at which RBCs started to sickle (PoS) was not significantly affected by VOC, but the results were very heterogeneous: the PoS increased in 5 in 10 patients and decreased in 4 in 10 patients. Both oxygenscan and shear-stress-gradient ektacytometry parameters remained unchanged in patients at steady state between two sets of measurements, performed at 17 ± 8 months intervals. In conclusion, the present study showed that both oxygen gradient ektacytometry and shear-stress-gradient ektacytometry are sensitive to disease activity in SCD, and that both techniques give comparable results; however, the oxygen-dependent propensity of RBCs to sickle was highly variable during VOC.
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14
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Praljak N, Iram S, Goreke U, Singh G, Hill A, Gurkan UA, Hinczewski M. Integrating deep learning with microfluidics for biophysical classification of sickle red blood cells adhered to laminin. PLoS Comput Biol 2021; 17:e1008946. [PMID: 34843453 PMCID: PMC8659663 DOI: 10.1371/journal.pcbi.1008946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/09/2021] [Accepted: 11/19/2021] [Indexed: 12/02/2022] Open
Abstract
Sickle cell disease, a genetic disorder affecting a sizeable global demographic, manifests in sickle red blood cells (sRBCs) with altered shape and biomechanics. sRBCs show heightened adhesive interactions with inflamed endothelium, triggering painful vascular occlusion events. Numerous studies employ microfluidic-assay-based monitoring tools to quantify characteristics of adhered sRBCs from high resolution channel images. The current image analysis workflow relies on detailed morphological characterization and cell counting by a specially trained worker. This is time and labor intensive, and prone to user bias artifacts. Here we establish a morphology based classification scheme to identify two naturally arising sRBC subpopulations-deformable and non-deformable sRBCs-utilizing novel visual markers that link to underlying cell biomechanical properties and hold promise for clinically relevant insights. We then set up a standardized, reproducible, and fully automated image analysis workflow designed to carry out this classification. This relies on a two part deep neural network architecture that works in tandem for segmentation of channel images and classification of adhered cells into subtypes. Network training utilized an extensive data set of images generated by the SCD BioChip, a microfluidic assay which injects clinical whole blood samples into protein-functionalized microchannels, mimicking physiological conditions in the microvasculature. Here we carried out the assay with the sub-endothelial protein laminin. The machine learning approach segmented the resulting channel images with 99.1±0.3% mean IoU on the validation set across 5 k-folds, classified detected sRBCs with 96.0±0.3% mean accuracy on the validation set across 5 k-folds, and matched trained personnel in overall characterization of whole channel images with R2 = 0.992, 0.987 and 0.834 for total, deformable and non-deformable sRBC counts respectively. Average analysis time per channel image was also improved by two orders of magnitude (∼ 2 minutes vs ∼ 2-3 hours) over manual characterization. Finally, the network results show an order of magnitude less variance in counts on repeat trials than humans. This kind of standardization is a prerequisite for the viability of any diagnostic technology, making our system suitable for affordable and high throughput disease monitoring.
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MESH Headings
- Anemia, Sickle Cell/blood
- Anemia, Sickle Cell/diagnostic imaging
- Biophysical Phenomena
- Computational Biology
- Deep Learning
- Diagnosis, Computer-Assisted/statistics & numerical data
- Erythrocyte Deformability/physiology
- Erythrocytes, Abnormal/classification
- Erythrocytes, Abnormal/pathology
- Erythrocytes, Abnormal/physiology
- Hemoglobin, Sickle/chemistry
- Hemoglobin, Sickle/metabolism
- High-Throughput Screening Assays/statistics & numerical data
- Humans
- Image Interpretation, Computer-Assisted/statistics & numerical data
- In Vitro Techniques
- Lab-On-A-Chip Devices/statistics & numerical data
- Laminin/metabolism
- Microfluidics/statistics & numerical data
- Neural Networks, Computer
- Protein Multimerization
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Affiliation(s)
- Niksa Praljak
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
- Department of Physics, Cleveland State University, Cleveland, Ohio, United States of America
| | - Shamreen Iram
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Utku Goreke
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Gundeep Singh
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ailis Hill
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Michael Hinczewski
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
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15
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Qua K, Swiatkowski SM, Gurkan UA, Pelfrey CM. A retrospective case study of successful translational research: Gazelle Hb variant point-of-care diagnostic device for sickle cell disease. J Clin Transl Sci 2021; 5:e207. [PMID: 35047218 PMCID: PMC8727719 DOI: 10.1017/cts.2021.871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/06/2022] Open
Abstract
Evaluation researchers at Clinical and Translational Science Award (CTSA) hubs are conducting retrospective case studies to evaluate the translational research process. The objective of this study was to deepen knowledge of the translational process and identify contributors to successful translation. We investigated the successful translation of the HemeChip, a low-cost point-of-care diagnostic device for sickle cell disease, using a protocol for retrospective translational science case studies of health interventions developed by evaluators at the National Health Institutes (NIH) and CTSA hubs. Development of the HemeChip began in 2013 and evidence of device use and impact on public health is growing. Data collection methods included five interviews and a review of press, publications, patents, and grants. Barriers to translation included proving novelty, manufacturing costs, fundraising, and academic-industry relations. Facilitators to translation were CTSA pilot program funding, university resources, entrepreneurship training, due diligence, and collaborations. The barriers to translation, how they were overcome, and the key facilitators identified in this case study pinpoint areas for consideration in future funding mechanisms and the infrastructure required to enable successful translation.
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Affiliation(s)
- Kelli Qua
- Clinical and Translational Science Collaborative, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Shannon M. Swiatkowski
- Clinical and Translational Science Collaborative, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering, School of Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Biomedical Engineering, Case School of Engineering, Case Wetern Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Clara M. Pelfrey
- Clinical and Translational Science Collaborative, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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16
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Al-Khateeb RS, Althagafy HS, ElAssouli MZ, Nori DA, AlFattani M, Al-Najjar SA, Al Amri T, Hashem AM, Harakeh S, Helmi N. Iron Chelation Reduces DNA Damage in Sickle Cell Anemia. Clin Appl Thromb Hemost 2021; 27:10760296211047230. [PMID: 34633875 PMCID: PMC8521763 DOI: 10.1177/10760296211047230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sickle cell anemia (SCA) is a blood condition that causes severe pain. One of the therapeutic agents used for the treatment of SCA is hydroxyurea, which reduces the episodes of pain but causes DNA damage to white blood cells. The aim of this study was to evaluate the efficacy of the combination of hydroxyurea and iron chelation therapy in relation to the extent of DNA-associated damage. Blood samples were collected from 120 subjects from five groups. Various hematological parameters of the obtained serum were analyzed. The amount of damage caused to their DNA was detected using the comet assay and fluorescent microscopy techniques. The percentage of DNA damage in the group that was subjected to the combination therapy (target group) was 1.32% ± 1.51%, which was significantly lower (P < .05) than that observed in the group treated with hydroxyurea alone (6.36% ± 2.36%). While the target group showed comparable levels of hemoglobin F and lactate dehydrogenase compared to the group that was treated with hydroxyurea alone, highly significant levels of transferrin receptors and ferritin were observed in the target group. The results of this study revealed that the administration of iron chelation drugs with hydroxyurea may help improve patients' health and prevent the DNA damage caused to white blood cells due to hydroxyurea. Further studies are needed to better understand the underlying mechanisms that are involved in this process.
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Affiliation(s)
- Rawan S Al-Khateeb
- 37848Department of Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia, KSA
| | | | - Mohammad Zaki ElAssouli
- 37848Vaccines and Immunotherapy Unit, King Fahd Medical Research Center (KFMRC); Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, KSA
| | - Dunya A Nori
- 37848Department of Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia, KSA
| | | | | | - Turki Al Amri
- 37848Family and Community Medicine Department, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anwar M Hashem
- 37848Vaccines and Immunotherapy Unit, King Fahd Medical Research Center (KFMRC); Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, KSA
| | - Steve Harakeh
- 37848Special Infectious Agents Unit, and Yousef Abdullatif Jameel Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, KSA
| | - Nawal Helmi
- 441424Department of Biochemistry, University of Jeddah, Jeddah, KSA
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17
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Lizarralde-Iragorri MA, Lefevre SD, Cochet S, El Hoss S, Brousse V, Filipe A, Dussiot M, Azouzi S, Le Van Kim C, Rodrigues-Lima F, Français O, Le Pioufle B, Klei T, van Bruggen R, El Nemer W. Oxidative stress activates red cell adhesion to laminin in sickle cell disease. Haematologica 2021; 106:2478-2488. [PMID: 32855277 PMCID: PMC8409043 DOI: 10.3324/haematol.2020.261586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/12/2020] [Indexed: 12/22/2022] Open
Abstract
Vaso-occlusive crises are the hallmark of sickle cell disease (SCD). They are believed to occur in two steps, starting with adhesion of deformable low-dense red blood cells (RBCs), or other blood cells such as neutrophils, to the wall of post-capillary venules, followed by trapping of the denser RBCs or leukocytes in the areas of adhesion because of reduced effective lumen-diameter. In SCD, RBCs are heterogeneous in terms of density, shape, deformability and surface proteins, which accounts for the differences observed in their adhesion and resistance to shear stress. Sickle RBCs exhibit abnormal adhesion to laminin mediated by Lu/BCAM protein at their surface. This adhesion is triggered by Lu/BCAM phosphorylation in reticulocytes but such phosphorylation does not occur in mature dense RBCs despite firm adhesion to laminin. In this study, we investigated the adhesive properties of sickle RBC subpopulations and addressed the molecular mechanism responsible for the increased adhesion of dense RBCs to laminin in the absence of Lu/BCAM phosphorylation. We provide evidence for the implication of oxidative stress in post-translational modifications of Lu/BCAM that impact its distribution and cis-interaction with glycophorin C at the cell surface activating its adhesive function in sickle dense RBCs.
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Affiliation(s)
- Maria Alejandra Lizarralde-Iragorri
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
| | - Sophie D. Lefevre
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
| | - Sylvie Cochet
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
| | - Sara El Hoss
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
| | - Valentine Brousse
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
- Service de Pédiatrie Générale et Maladies Infectieuses, Hôpital Universitaire Necker Enfants Malades, Paris, France
| | - Anne Filipe
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
- Université de Paris, BFA, UMR 8251, CNRS, Paris, France
| | - Michael Dussiot
- Institut Imagine, INSERM U1163, CNRS UMR8254, Université Paris Descartes, Hôpital Necker Enfants Malades, Paris, France
| | - Slim Azouzi
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
| | - Caroline Le Van Kim
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
| | | | - Olivier Français
- ESYCOM, Université Gustave Eiffel, CNRS UMR 9007, ESIEE Paris, Marne-la-Vallee, France
| | - Bruno Le Pioufle
- Université Paris-Saclay, ENS Paris-Saclay, CNRS Institut d'Alembert, LUMIN, Gif sur Yvette, France
| | - Thomas Klei
- Department of Blood Cell Research, Sanquin Research and Lab Services and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Robin van Bruggen
- Department of Blood Cell Research, Sanquin Research and Lab Services and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Wassim El Nemer
- Université de Paris, UMR S1134, BIGR, INSERM, Paris, France
- Institut National de la Transfusion Sanguine, Paris, France
- Laboratoire d’Excellence GR-Ex, Paris, France
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18
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Abstract
PURPOSE OF REVIEW This review summarizes the significant biophysical and rheological aspects of red blood cell physiology and pathophysiology in relation to recent advances in microfluidic biomarker assays and emerging targeted or curative intent therapies. RECENT FINDINGS Alterations in red cell biophysical properties and blood rheology have been associated with numerous hematologic and circulatory disorders. Recent advances in biomarker assays enable effective assessment of these biophysical and rheological properties in normoxia or physiological hypoxia in a clinically meaningful way. There are emerging targeted or curative therapies that aim to improve red cell pathophysiology, especially in the context of inherited hemoglobin disorders, such as sickle cell disease. SUMMARY Red cell pathophysiology can be therapeutically targeted and the improvements in membrane and cellular biophysics and blood rheology can now be feasibly assessed via new microfluidic biomarker assays. Recent advances provide a new hope and novel treatment options for major red cell ailments, including inherited hemoglobin disorders, membrane disorders, and other pathologies of the red cell, such as malaria.
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Affiliation(s)
- Umut A. Gurkan
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH 44106, USA
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH 44106, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
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19
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Lu M, Kanne CK, Reddington RC, Lezzar DL, Sheehan VA, Shevkoplyas SS. Concurrent Assessment of Deformability and Adhesiveness of Sickle Red Blood Cells by Measuring Perfusion of an Adhesive Artificial Microvascular Network. Front Physiol 2021; 12:633080. [PMID: 33995119 PMCID: PMC8113687 DOI: 10.3389/fphys.2021.633080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
Biomarker development is a key clinical research need in sickle cell disease (SCD). Hemorheological parameters are excellent candidates as abnormal red blood cell (RBC) rheology plays a critical role in SCD pathophysiology. Here we describe a microfluidic device capable of evaluating RBC deformability and adhesiveness concurrently, by measuring their effect on perfusion of an artificial microvascular network (AMVN) that combines microchannels small enough to require RBC deformation, and laminin (LN) coating on channel walls to model intravascular adhesion. Each AMVN device consists of three identical capillary networks, which can be coated with LN (adhesive) or left uncoated (non-adhesive) independently. The perfusion rate for sickle RBCs in the LN-coated networks (0.18 ± 0.02 nL/s) was significantly slower than in non-adhesive networks (0.20 ± 0.02 nL/s), and both were significantly slower than the perfusion rate for normal RBCs in the LN-coated networks (0.22 ± 0.01 nL/s). Importantly, there was no overlap between the ranges of perfusion rates obtained for sickle and normal RBC samples in the LN-coated networks. Interestingly, treatment with poloxamer 188 decreased the perfusion rate for sickle RBCs in LN-coated networks in a dose-dependent manner, contrary to previous studies with conventional assays, but in agreement with the latest clinical trial which showed no clinical benefit. Overall, these findings suggest the potential utility of the adhesive AMVN device for evaluating the effect of novel curative and palliative therapies on the hemorheological status of SCD patients during clinical trials and in post-market clinical practice.
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Affiliation(s)
- Madeleine Lu
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
| | - Celeste K Kanne
- Division of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Riley C Reddington
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
| | - Dalia L Lezzar
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
| | - Vivien A Sheehan
- Division of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Sergey S Shevkoplyas
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
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20
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Mohi SM, Saadon HL, Khalaf AA. Laser tweezers as a biophotonic tool to investigate the efficacy of living sickle red blood cells in response to optical deformation. Biophys Rev 2021; 13:173-184. [PMID: 33936317 PMCID: PMC8046874 DOI: 10.1007/s12551-021-00790-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/25/2021] [Indexed: 12/25/2022] Open
Abstract
A laser tweezer technique based on single and/or dual-laser beams is proposed as a biophotonic tool to trap single cells and investigate their biophysical and biomechanical characteristics. Optical deformability and changes in size and cellular morphology of living and nonliving cells can be measured using the proposed technique. Representative results of red blood cell (RBC) optical deformability of 20 homozygous patients with sickle cell disease, including follow-up patients after treating with hydroxyurea (HU) for at least 3 months and 20 healthy control groups, are presented and compared. Shape recovery of deformed RBCs and relaxation time are recorded for each RBC. Results showed that healthy blood and patients treated with HU demonstrate significantly higher optical deformability and degree of optical elongation with morphological change of RBCs than untreated patients. Moreover, the healthy control group and patients treated with HU exhibited faster relaxation time for RBCs than untreated patients. A trapping power that reaches 180 mW caused no observable photo-damage at a wavelength 1064 nm. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12551-021-00790-0.
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Affiliation(s)
- Shaimaa M. Mohi
- Department of Physics, Laser Applications Research Group (LARG), College of Science, University of Basrah, Basrah, Iraq
| | - H. L. Saadon
- Department of Physics, Laser Applications Research Group (LARG), College of Science, University of Basrah, Basrah, Iraq
| | - Asaad A. Khalaf
- Basrah Centre for Hereditary Blood Diseases, Basrah Health Directorate, Basrah, Iraq
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21
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Man Y, Maji D, An R, Ahuja SP, Little JA, Suster MA, Mohseni P, Gurkan UA. Microfluidic electrical impedance assessment of red blood cell-mediated microvascular occlusion. LAB ON A CHIP 2021; 21:1036-1048. [PMID: 33666615 PMCID: PMC8170703 DOI: 10.1039/d0lc01133a] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Alterations in the deformability of red blood cells (RBCs), occurring in hemolytic blood disorders such as sickle cell disease (SCD), contribute to vaso-occlusion and disease pathophysiology. There are few functional in vitro assays for standardized assessment of RBC-mediated microvascular occlusion. Here, we present the design, fabrication, and clinical testing of the Microfluidic Impedance Red Cell Assay (MIRCA) with embedded capillary network-based micropillar arrays and integrated electrical impedance measurement electrodes to address this need. The micropillar arrays consist of microcapillaries ranging from 12 μm to 3 μm, with each array paired with two sputtered gold electrodes to measure the impedance change of the array before and after sample perfusion through the microfluidic device. We define RBC occlusion index (ROI) and RBC electrical impedance index (REI), which represent the cumulative percentage occlusion and cumulative percentage impedance change, respectively. We demonstrate the promise of MIRCA in two common red cell disorders, SCD and hereditary spherocytosis. We show that the electrical impedance measurement reflects the microvascular occlusion, where REI significantly correlates with ROI that is obtained via high-resolution microscopy imaging of the microcapillary arrays. Further, we show that RBC-mediated microvascular occlusion, represented by ROI and REI, associates with clinical treatment outcomes and correlates with in vivo hemolytic biomarkers, lactate dehydrogenase (LDH) level and absolute reticulocyte count (ARC) in SCD. Impedance measurement obviates the need for high-resolution imaging, enabling future translation of this technology for widespread access, portable and point-of-care use. Our findings suggest that the presented microfluidic design and the integrated electrical impedance measurement provide a reproducible functional test for standardized assessment of RBC-mediated microvascular occlusion. MIRCA and the newly defined REI may serve as an in vitro therapeutic efficacy benchmark for assessing the clinical outcome of emerging RBC-modifying targeted and curative therapies.
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Affiliation(s)
- Yuncheng Man
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA.
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22
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Aich A, Lamarre Y, Sacomani DP, Kashima S, Covas DT, de la Torre LG. Microfluidics in Sickle Cell Disease Research: State of the Art and a Perspective Beyond the Flow Problem. Front Mol Biosci 2021; 7:558982. [PMID: 33763448 PMCID: PMC7982466 DOI: 10.3389/fmolb.2020.558982] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/24/2020] [Indexed: 01/21/2023] Open
Abstract
Sickle cell disease (SCD) is the monogenic hemoglobinopathy where mutated sickle hemoglobin molecules polymerize to form long fibers under deoxygenated state and deform red blood cells (RBCs) into predominantly sickle form. Sickled RBCs stick to the vascular bed and obstruct blood flow in extreme conditions, leading to acute painful vaso-occlusion crises (VOCs) – the leading cause of mortality in SCD. Being a blood disorder of deformed RBCs, SCD manifests a wide-range of organ-specific clinical complications of life (in addition to chronic pain) such as stroke, acute chest syndrome (ACS) and pulmonary hypertension in the lung, nephropathy, auto-splenectomy, and splenomegaly, hand-foot syndrome, leg ulcer, stress erythropoiesis, osteonecrosis and osteoporosis. The physiological inception for VOC was initially thought to be only a fluid flow problem in microvascular space originated from increased viscosity due to aggregates of sickled RBCs; however, over the last three decades, multiple molecular and cellular mechanisms have been identified that aid the VOC in vivo. Activation of adhesion molecules in vascular endothelium and on RBC membranes, activated neutrophils and platelets, increased viscosity of the blood, and fluid physics driving sickled and deformed RBCs to the vascular wall (known as margination of flow) – all of these come together to orchestrate VOC. Microfluidic technology in sickle research was primarily adopted to benefit from mimicking the microvascular network to observe RBC flow under low oxygen conditions as models of VOC. However, over the last decade, microfluidics has evolved as a valuable tool to extract biophysical characteristics of sickle red cells, measure deformability of sickle red cells under simulated oxygen gradient and shear, drug testing, in vitro models of intercellular interaction on endothelialized or adhesion molecule-functionalized channels to understand adhesion in sickle microenvironment, characterizing biomechanics and microrheology, biomarker identification, and last but not least, for developing point-of-care diagnostic technologies for low resource setting. Several of these platforms have already demonstrated true potential to be translated from bench to bedside. Emerging microfluidics-based technologies for studying heterotypic cell–cell interactions, organ-on-chip application and drug dosage screening can be employed to sickle research field due to their wide-ranging advantages.
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Affiliation(s)
- Anupam Aich
- Intel Corporation, Hillsboro, OR, United States
| | - Yann Lamarre
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel Pereira Sacomani
- Department of Material and Bioprocess Engineering, School of Chemical Engineering, University of Campinas (UNICAMP), Campinas, Brazil
| | - Simone Kashima
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Dimas Tadeu Covas
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Lucimara Gaziola de la Torre
- Department of Material and Bioprocess Engineering, School of Chemical Engineering, University of Campinas (UNICAMP), Campinas, Brazil
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23
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Alapan Y, Yasa O, Schauer O, Giltinan J, Tabak AF, Sourjik V, Sitti M. Soft erythrocyte-based bacterial microswimmers for cargo delivery. Sci Robot 2021; 3:3/17/eaar4423. [PMID: 33141741 DOI: 10.1126/scirobotics.aar4423] [Citation(s) in RCA: 181] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/30/2018] [Indexed: 12/15/2022]
Abstract
Bacteria-propelled biohybrid microswimmers have recently shown to be able to actively transport and deliver cargos encapsulated into their synthetic constructs to specific regions locally. However, usage of synthetic materials as cargo carriers can result in inferior performance in load-carrying efficiency, biocompatibility, and biodegradability, impeding clinical translation of biohybrid microswimmers. Here, we report construction and external guidance of bacteria-driven microswimmers using red blood cells (RBCs; erythrocytes) as autologous cargo carriers for active and guided drug delivery. Multifunctional biohybrid microswimmers were fabricated by attachment of RBCs [loaded with anticancer doxorubicin drug molecules and superparamagnetic iron oxide nanoparticles (SPIONs)] to bioengineered motile bacteria, Escherichia coli MG1655, via biotin-avidin-biotin binding complex. Autonomous and on-board propulsion of biohybrid microswimmers was provided by bacteria, and their external magnetic guidance was enabled by SPIONs loaded into the RBCs. Furthermore, bacteria-driven RBC microswimmers displayed preserved deformability and attachment stability even after squeezing in microchannels smaller than their sizes, as in the case of bare RBCs. In addition, an on-demand light-activated hyperthermia termination switch was engineered for RBC microswimmers to control bacteria population after operations. RBCs, as biological and autologous cargo carriers in the biohybrid microswimmers, offer notable advantages in stability, deformability, biocompatibility, and biodegradability over synthetic cargo-carrier materials. The biohybrid microswimmer design presented here transforms RBCs from passive cargo carriers into active and guidable cargo carriers toward targeted drug and other cargo delivery applications in medicine.
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Affiliation(s)
- Yunus Alapan
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
| | - Oncay Yasa
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
| | - Oliver Schauer
- Systems and Synthetic Microbiology Department, Max Planck Institute for Terrestrial Microbiology, 35043 Marburg, Germany
| | - Joshua Giltinan
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
| | - Ahmet F Tabak
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
| | - Victor Sourjik
- Systems and Synthetic Microbiology Department, Max Planck Institute for Terrestrial Microbiology, 35043 Marburg, Germany
| | - Metin Sitti
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany.
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24
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Kucukal E, Man Y, Hill A, Liu S, Bode A, An R, Kadambi J, Little JA, Gurkan UA. Whole blood viscosity and red blood cell adhesion: Potential biomarkers for targeted and curative therapies in sickle cell disease. Am J Hematol 2020; 95:1246-1256. [PMID: 32656816 PMCID: PMC7689825 DOI: 10.1002/ajh.25933] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022]
Abstract
Sickle cell disease (SCD) is a recessive genetic blood disorder exhibiting abnormal blood rheology. Polymerization of sickle hemoglobin, due to a point mutation in the β‐globin gene of hemoglobin, results in aberrantly adhesive and stiff red blood cells (RBCs). Hemolysis, abnormal RBC adhesion, and abnormal blood rheology together impair endothelial health in people with SCD, which leads to cumulative systemic complications. Here, we describe a microfluidic assay combined with a micro particle image velocimetry technique for the integrated in vitro assessment of whole blood viscosity (WBV) and RBC adhesion. We examined WBV and RBC adhesion to laminin (LN) in microscale flow in whole blood samples from 53 individuals with no hemoglobinopathies (HbAA, N = 10), hemoglobin SC disease (HbSC, N = 14), or homozygous SCD (HbSS, N = 29) with mean WBV of 4.50 cP, 4.08 cP, and 3.73 cP, respectively. We found that WBV correlated with RBC count and hematocrit in subjects with HbSC or HbSS. There was a significant inverse association between WBV and RBC adhesion under both normoxic and physiologically hypoxic (SpO2 of 83%) tests, in which lower WBV associated with higher RBC adhesion to LN in subjects with HbSS. Low WBV has been found by others to associate with endothelial activation. Altered WBV and abnormal RBC adhesion may synergistically contribute to the endothelial damage and cumulative pathophysiology of SCD. These findings suggest that WBV and RBC adhesion may serve as clinically relevant biomarkers and endpoints in assessing emerging targeted and curative therapies in SCD.
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Affiliation(s)
- Erdem Kucukal
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Yuncheng Man
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Ailis Hill
- Division of Hematology and Oncology, School of Medicine Case Western Reserve University Cleveland Ohio
| | - Shichen Liu
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Allison Bode
- Division of Hematology and Oncology, School of Medicine Case Western Reserve University Cleveland Ohio
| | - Ran An
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Jaikrishnan Kadambi
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
| | - Jane A. Little
- Division of Hematology and Blood Research Center, Department of Medicine University of North Carolina Chapel Hill North Carolina
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio
- Department of Biomedical Engineering Case Western Reserve University Cleveland Ohio
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25
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Huang H, Dai C, Shen H, Gu M, Wang Y, Liu J, Chen L, Sun L. Recent Advances on the Model, Measurement Technique, and Application of Single Cell Mechanics. Int J Mol Sci 2020; 21:E6248. [PMID: 32872378 PMCID: PMC7504142 DOI: 10.3390/ijms21176248] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/19/2020] [Accepted: 08/27/2020] [Indexed: 02/06/2023] Open
Abstract
Since the cell was discovered by humans, it has been an important research subject for researchers. The mechanical response of cells to external stimuli and the biomechanical response inside cells are of great significance for maintaining the life activities of cells. These biomechanical behaviors have wide applications in the fields of disease research and micromanipulation. In order to study the mechanical behavior of single cells, various cell mechanics models have been proposed. In addition, the measurement technologies of single cells have been greatly developed. These models, combined with experimental techniques, can effectively explain the biomechanical behavior and reaction mechanism of cells. In this review, we first introduce the basic concept and biomechanical background of cells, then summarize the research progress of internal force models and experimental techniques in the field of cell mechanics and discuss the latest mechanical models and experimental methods. We summarize the application directions of cell mechanics and put forward the future perspectives of a cell mechanics model.
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Affiliation(s)
| | | | | | | | | | - Jizhu Liu
- School of Mechanical and Electric Engineering, Jiangsu Provincial Key Laboratory of Advanced Robotics, Soochow University, Suzhou 215123, China; (H.H.); (C.D.); (H.S.); (M.G.); (Y.W.); (L.S.)
| | - Liguo Chen
- School of Mechanical and Electric Engineering, Jiangsu Provincial Key Laboratory of Advanced Robotics, Soochow University, Suzhou 215123, China; (H.H.); (C.D.); (H.S.); (M.G.); (Y.W.); (L.S.)
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26
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Xu T, Lizarralde-Iragorri MA, Roman J, Ghasemi R, Lefèvre JP, Martincic E, Brousse V, Français O, El Nemer W, Le Pioufle B. Characterization of red blood cell microcirculatory parameters using a bioimpedance microfluidic device. Sci Rep 2020; 10:9869. [PMID: 32555353 PMCID: PMC7299978 DOI: 10.1038/s41598-020-66693-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/26/2020] [Indexed: 02/07/2023] Open
Abstract
This paper describes the use of a microfluidic device comprising channels with dimensions mimicking those of the smallest capillaries found in the human microcirculation. The device structure, associated with a pair of microelectrodes, provides a tool to electrically measure the transit time of red blood cells through fine capillaries and thus generate an electrical signature for red blood cells in the context of human erythroid genetic disorders, such as sickle cell disease or hereditary spherocytosis, in which red cell elasticity is altered. Red blood cells from healthy individuals, heated or not, and red blood cells from patients with sickle cell disease or hereditary spherocytosis where characterized at a single cell level using our device. Transit time and blockade amplitude recordings were correlated with microscopic observations, and analyzed. The link between the electrical signature and the mechanical properties of the red blood cells is discussed in the paper, with greater transit time and modified blockade amplitude for heated and pathological red blood cells as compared to those from healthy individuals. Our single cell-based methodology offers a new and complementary approach to characterize red cell mechanical properties in human disorders under flow conditions mimicking the microcirculation.
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Affiliation(s)
- Tieying Xu
- Université Paris-Saclay, ENS Paris-Saclay, CNRS, Institut d'Alembert, SATIE, F-91190, Gif sur Yvette, France
| | - Maria A Lizarralde-Iragorri
- Université de Paris, UMR_S1134, BIGR, Inserm, F-75015, Paris, France
- Institut National de Transfusion Sanguine, F-75015, Paris, France
- Laboratoire d'Excellence GR-Ex, F-75013, Paris, France
| | - Jean Roman
- Université Paris-Saclay, ENS Paris-Saclay, CNRS, Institut d'Alembert, SATIE, F-91190, Gif sur Yvette, France
| | - Rasta Ghasemi
- Université Paris-Saclay, ENS Paris-Saclay, CNRS, Institut d'Alembert, F-91190, Gif sur Yvette, France
| | - Jean-Pierre Lefèvre
- Université Paris-Saclay, ENS Paris-Saclay, CNRS, PPSM, Institut d'Alembert, F-91190, Gif sur Yvette, France
- CNAM, F-75003, Paris, France
| | - Emile Martincic
- Centre de Nanosciences et de Nanotechnologies C2N, CNRS, Université Paris-Sud, Université Paris-Saclay, F-91120, Palaiseau, France
| | - Valentine Brousse
- Université de Paris, UMR_S1134, BIGR, Inserm, F-75015, Paris, France
- Institut National de Transfusion Sanguine, F-75015, Paris, France
- Laboratoire d'Excellence GR-Ex, F-75013, Paris, France
- Service de Pédiatrie Générale et Maladies Infectieuses, Hôpital Universitaire Necker Enfants Malades, F-75015, Paris, France
| | - Olivier Français
- Université Paris-Saclay, ENS Paris-Saclay, CNRS, Institut d'Alembert, SATIE, F-91190, Gif sur Yvette, France
- ESYCOM, Univ Gustave Eiffel, CNRS UMR 9007, ESIEE Paris, F-77454, Marne-la-Vallee, France
| | - Wassim El Nemer
- Université de Paris, UMR_S1134, BIGR, Inserm, F-75015, Paris, France
- Institut National de Transfusion Sanguine, F-75015, Paris, France
- Laboratoire d'Excellence GR-Ex, F-75013, Paris, France
| | - Bruno Le Pioufle
- Université Paris-Saclay, ENS Paris-Saclay, CNRS, Institut d'Alembert, SATIE, F-91190, Gif sur Yvette, France.
- Université Paris-Saclay, ENS Paris-Saclay, CNRS, Institut d'Alembert, LUMIN, F-91190, Gif sur Yvette, France.
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27
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Alapan Y, Bozuyuk U, Erkoc P, Karacakol AC, Sitti M. Multifunctional surface microrollers for targeted cargo delivery in physiological blood flow. Sci Robot 2020; 5:5/42/eaba5726. [DOI: 10.1126/scirobotics.aba5726] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 04/03/2020] [Indexed: 12/14/2022]
Abstract
Mobile microrobots offer great promise for minimally invasive targeted medical theranostic applications at hard-to-access regions inside the human body. The circulatory system represents the ideal route for navigation; however, blood flow impairs propulsion of microrobots especially for the ones with overall sizes less than 10 micrometers. Moreover, cell- and tissue-specific targeting is required for efficient recognition of disease sites and long-term preservation of microrobots under dynamic flow conditions. Here, we report cell-sized multifunctional surface microrollers with ~3.0 and ~7.8-micrometer diameters, inspired by leukocytes in the circulatory system, for targeted drug delivery into specific cells and controlled navigation inside blood flow. The leukocyte-inspired spherical microrollers are composed of magnetically responsive Janus microparticles functionalized with targeting antibodies against cancer cells (anti-HER2) and light-cleavable cancer drug molecules (doxorubicin). Magnetic propulsion and steering of the microrollers resulted in translational motion speeds up to 600 micrometers per second, around 76 body lengths per second. Targeting cancer cells among a heterogeneous cell population was demonstrated by active propulsion and steering of the microrollers over the cell monolayers. The multifunctional microrollers were propelled against physiologically relevant blood flow (up to 2.5 dynes per square centimeter) on planar and endothelialized microchannels. Furthermore, the microrollers generated sufficient upstream propulsion to locomote on inclined three-dimensional surfaces in physiologically relevant blood flow. The multifunctional microroller platform described here presents a bioinspired approach toward in vivo controlled propulsion, navigation, and targeted active cargo delivery in the circulatory system.
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Affiliation(s)
- Yunus Alapan
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
| | - Ugur Bozuyuk
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
| | - Pelin Erkoc
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
- Faculty of Engineering and Natural Sciences, Bahcesehir University, Istanbul 34353, Turkey
| | - Alp Can Karacakol
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Metin Sitti
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany
- School of Medicine and School of Engineering, Koç University, Istanbul 34450, Turkey
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Kumar A, Schmidt BR, Sanchez ZAC, Yazar F, Davis RW, Ramasubramanian AK, Saha AK. Automated Motion Tracking and Data Extraction for Red Blood Cell Biomechanics. ACTA ACUST UNITED AC 2020; 93:e75. [PMID: 32391975 DOI: 10.1002/cpcy.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Red blood cell biomechanics can provide us with a deeper understanding of macroscopic physiology and have the potential of being used for diagnostic purposes. In diseases like sickle cell anemia and malaria, reduced red blood cell deformability can be used as a biomarker, leading to further assays and diagnoses. A microfluidic system is useful for studying these biomechanical properties. We can observe detailed red blood cell mechanical behavior as they flow through microcapillaries using high-speed imaging and microscopy. Microfluidic devices are advantageous over traditional methods because they can serve as high-throughput tests. However, to rapidly analyze thousands of cells, there is a need for powerful image processing tools and software automation. We describe a workflow process using Image-Pro to identify and track red blood cells in a video, take measurements, and export the data for use in statistical analysis tools. The information in this protocol can be applied to large-scale blood studies where entire cell populations need to be analyzed from many cohorts of donors. © 2020 The Authors. Basic Protocol 1: Enhancing raw video for motion tracking Basic Protocol 2: Extracting motion tracking data from enhanced video.
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Affiliation(s)
- Arun Kumar
- Department of Biomedical Engineering, San José State University, San José, California
| | - Brendan R Schmidt
- Department of Chemical and Materials Engineering, San José State University, San José, California
| | | | - Feyza Yazar
- Department of Biomedical Engineering, San José State University, San José, California
| | - Ronald W Davis
- Department of Biochemistry, Stanford University, Stanford, California
| | - Anand K Ramasubramanian
- Department of Chemical and Materials Engineering, San José State University, San José, California
| | - Amit K Saha
- Department of Biochemistry, Stanford University, Stanford, California
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Man Y, Goreke U, Kucukal E, Hill A, An R, Liu S, Bode A, Solis-Fuentes A, Nayak LV, Little JA, Gurkan UA. Leukocyte adhesion to P-selectin and the inhibitory role of Crizanlizumab in sickle cell disease: A standardized microfluidic assessment. Blood Cells Mol Dis 2020; 83:102424. [PMID: 32208292 DOI: 10.1016/j.bcmd.2020.102424] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/08/2020] [Indexed: 01/21/2023]
Abstract
Upregulated expression of P-selectin on activated endothelium and platelets significantly contributes to the initiation and progression of vaso-occlusive crises (VOC), a major cause of morbidity in sickle cell disease (SCD). Crizanlizumab (ADAKVEO®), a humanized monoclonal antibody against P-selectin, primarily inhibits the interaction between leukocytes and P-selectin, and has been shown to decrease the frequency of VOCs in clinical trials. However, the lack of reliable in vitro assays that objectively measure leukocyte adhesion to P-selectin remains a critical barrier to evaluating and improving the therapeutic treatment in SCD. Here, we present a standardized microfluidic BioChip whole blood adhesion assay to assess leukocyte adhesion to P-selectin under physiologic flow conditions. Our results demonstrated heterogeneous adhesion by leukocytes to immobilized P-selectin, and dose-dependent inhibition of this adhesion following pre-exposure to Crizanlizumab. Importantly, treatment with Crizanlizumab following adhesion to P-selectin promoted detachment of rolling, but not of firmly adherent leukocytes. Taken together, our results suggest that the microfluidic BioChip system is a promising in vitro assay with which to screen patients, monitor treatment response, and guide current and emerging anti-adhesive therapies in SCD.
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Affiliation(s)
- Yuncheng Man
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Utku Goreke
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Erdem Kucukal
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ailis Hill
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ran An
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Shichen Liu
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Allison Bode
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ambar Solis-Fuentes
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Lalitha V Nayak
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Jane A Little
- Department of Hematology and Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Umut A Gurkan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA.
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30
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Hasan MN, Fraiwan A, An R, Alapan Y, Ung R, Akkus A, Xu JZ, Rezac AJ, Kocmich NJ, Creary MS, Oginni T, Olanipekun GM, Hassan-Hanga F, Jibir BW, Gambo S, Verma AK, Bharti PK, Riolueang S, Ngimhung T, Suksangpleng T, Thota P, Werner G, Shanmugam R, Das A, Viprakasit V, Piccone CM, Little JA, Obaro SK, Gurkan UA. Paper-based microchip electrophoresis for point-of-care hemoglobin testing. Analyst 2020; 145:2525-2542. [PMID: 32123889 DOI: 10.1039/c9an02250c] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Nearly 7% of the world's population live with a hemoglobin variant. Hemoglobins S, C, and E are the most common and significant hemoglobin variants worldwide. Sickle cell disease, caused by hemoglobin S, is highly prevalent in sub-Saharan Africa and in tribal populations of Central India. Hemoglobin C is common in West Africa, and hemoglobin E is common in Southeast Asia. Screening for significant hemoglobin disorders is not currently feasible in many low-income countries with the high disease burden. Lack of early diagnosis leads to preventable high morbidity and mortality in children born with hemoglobin variants in low-resource settings. Here, we describe HemeChip, the first miniaturized, paper-based, microchip electrophoresis platform for identifying the most common hemoglobin variants easily and affordably at the point-of-care in low-resource settings. HemeChip test works with a drop of blood. HemeChip system guides the user step-by-step through the test procedure with animated on-screen instructions. Hemoglobin identification and quantification is automatically performed, and hemoglobin types and percentages are displayed in an easily understandable, objective way. We show the feasibility and high accuracy of HemeChip via testing 768 subjects by clinical sites in the United States, Central India, sub-Saharan Africa, and Southeast Asia. Validation studies include hemoglobin E testing in Bangkok, Thailand, and hemoglobin S testing in Chhattisgarh, India, and in Kano, Nigeria, where the sickle cell disease burden is the highest in the world. Tests were performed by local users, including healthcare workers and clinical laboratory personnel. Study design, methods, and results are presented according to the Standards for Reporting Diagnostic Accuracy (STARD). HemeChip correctly identified all subjects with hemoglobin S, C, and E variants with 100% sensitivity, and displayed an overall diagnostic accuracy of 98.4% in comparison to reference standard methods. HemeChip is a versatile, mass-producible microchip electrophoresis platform that addresses a major unmet need of decentralized hemoglobin analysis in resource-limited settings.
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Affiliation(s)
- Muhammad Noman Hasan
- Case Biomanufacturing and Microfabrication Laboratory, Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, Ohio 44106, USA.
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31
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Yigit B, Alapan Y, Sitti M. Cohesive self-organization of mobile microrobotic swarms. SOFT MATTER 2020; 16:1996-2004. [PMID: 32003392 DOI: 10.1039/c9sm01284b] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Mobile microrobots are envisioned to be useful in a wide range of high-impact applications, many of which require cohesive group formation to maintain self-bounded swarms in the absence of confining boundaries. Cohesive group formation relies on a balance between attractive and repulsive interactions between agents. We found that a balance of magnetic dipolar attraction and multipolar repulsion between self-assembled particle chain microrobots enables their self-organization into cohesive clusters. Self-organized microrobotic clusters move above a solid substrate via a hydrodynamic self-propulsion mechanism. Cluster velocity increases with cluster size, resulting from collective hydrodynamic effects. Clustering is promoted by the strength of cohesive interactions and is hindered by the heterogeneities of individual microrobots. The scalability of cohesive interactions allows the formation of larger groups, whose internal spatiotemporal organization undergoes a transition from solid-like ordering to a liquid-like behavior with increasing cluster size. Our work elucidates the dynamics of clustering under cohesive interactions, and presents an approach for addressing the operation of microrobots as localized collectives.
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Affiliation(s)
- Berk Yigit
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany.
| | - Yunus Alapan
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany.
| | - Metin Sitti
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569 Stuttgart, Germany.
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32
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Alapan Y, Yigit B, Beker O, Demirörs AF, Sitti M. Shape-encoded dynamic assembly of mobile micromachines. NATURE MATERIALS 2019; 18:1244-1251. [PMID: 31235903 DOI: 10.1038/s41563-019-0407-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
Field-directed and self-propelled colloidal assembly have been used to build micromachines capable of performing complex motions and functions. However, integrating heterogeneous components into micromachines with specified structure, dynamics and function is still challenging. Here, we describe the dynamic self-assembly of mobile micromachines with desired configurations through pre-programmed physical interactions between structural and motor units. The assembly is driven by dielectrophoretic interactions, encoded in the three-dimensional shape of the individual parts. Micromachines assembled from magnetic and self-propelled motor parts exhibit reconfigurable locomotion modes and additional rotational degrees of freedom that are not available to conventional monolithic microrobots. The versatility of this site-selective assembly strategy is demonstrated on different reconfigurable, hierarchical and three-dimensional micromachine assemblies. Our results demonstrate how shape-encoded assembly pathways enable programmable, reconfigurable mobile micromachines. We anticipate that the presented design principle will advance and inspire the development of more sophisticated, modular micromachines and their integration into multiscale hierarchical systems.
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Affiliation(s)
- Yunus Alapan
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany
| | - Berk Yigit
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany
| | - Onur Beker
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany
| | - Ahmet F Demirörs
- Complex Materials, Department of Materials, ETH Zurich, Zurich, Switzerland
| | - Metin Sitti
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany.
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33
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Lee H, Na W, Lee SB, Ahn CW, Moon JS, Won KC, Shin S. Potential Diagnostic Hemorheological Indexes for Chronic Kidney Disease in Patients With Type 2 Diabetes. Front Physiol 2019; 10:1062. [PMID: 31481899 PMCID: PMC6710411 DOI: 10.3389/fphys.2019.01062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/02/2019] [Indexed: 11/24/2022] Open
Abstract
Many studies have demonstrated that an alteration in hemorheological properties is closely correlated with diabetic microcirculatory diseases. However, most of these studies have been limited to animal studies or used a small number of clinical samples, due to a lack of effective point-of-care (POC) devices to measure such properties within clinical environments. Owing to recent developments in microfluidic technology, several hemorheological POC devices have been designed that allow for the possibility of conducting extensive clinical studies using hemorheological measurements. Here, we reviewed recent clinical studies of diabetic kidney disease (DKD) associated with hemorheological parameters. We found that RBC deformability alone did not show a significant difference according to the degree of DKD, whereas critical shear stress (CSS) was found to be closely related to the ratio of albumin to creatinine and glomerular filtration rate. We also reviewed studies that alteration of hemorheological properties are associated with the development of DKD, which showed that CSS could be considered as a potential index to diagnose other diabetic complications as well as DKD.
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Affiliation(s)
- Hoyoon Lee
- School of Mechanical Engineering, Korea University, Seoul, South Korea
| | - Wonwhi Na
- School of Mechanical Engineering, Korea University, Seoul, South Korea
| | - Sang Bae Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul Woo Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jun Sung Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam College of Medicine, Daegu, South Korea
| | - Kyu Chang Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam College of Medicine, Daegu, South Korea
| | - Sehyun Shin
- School of Mechanical Engineering, Korea University, Seoul, South Korea
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34
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Saha AK, Schmidt BR, Wilhelmy J, Nguyen V, Abugherir A, Do JK, Nemat-Gorgani M, Davis RW, Ramasubramanian AK. Red blood cell deformability is diminished in patients with Chronic Fatigue Syndrome. Clin Hemorheol Microcirc 2019; 71:113-116. [PMID: 30594919 PMCID: PMC6398549 DOI: 10.3233/ch-180469] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND: Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a poorly understood disease. Amongst others symptoms, the disease is associated with profound fatigue, cognitive dysfunction, sleep abnormalities, and other symptoms that are made worse by physical or mental exertion. While the etiology of the disease is still debated, evidence suggests oxidative damage to immune and hematological systems as one of the pathophysiological mechanisms of the disease. Since red blood cells (RBCs) are well-known scavengers of oxidative stress, and are critical in microvascular perfusion and tissue oxygenation, we hypothesized that RBC deformability is adversely affected in ME/CFS. METHODS: We used a custom microfluidic platform and high-speed microscopy to assess the difference in deformability of RBCs obtained from ME/CFS patients and age-matched healthy controls. RESULTS AND CONCLUSION: We observed from various measures of deformability that the RBCs isolated from ME/CFS patients were significantly stiffer than those from healthy controls. Our observations suggest that RBC transport through microcapillaries may explain, at least in part, the ME/CFS phenotype, and promises to be a novel first-pass diagnostic test.
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Affiliation(s)
- Amit K Saha
- Department of Chemical and Materials Engineering, San José State University, San José, CA, USA.,Stanford Genome Technology Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Brendan R Schmidt
- Department of Chemical and Materials Engineering, San José State University, San José, CA, USA
| | - Julie Wilhelmy
- Stanford Genome Technology Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Vy Nguyen
- Department of Chemical and Materials Engineering, San José State University, San José, CA, USA
| | - Abed Abugherir
- Department of Chemical and Materials Engineering, San José State University, San José, CA, USA
| | - Justin K Do
- Department of Chemical and Materials Engineering, San José State University, San José, CA, USA
| | - Mohsen Nemat-Gorgani
- Stanford Genome Technology Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Ronald W Davis
- Stanford Genome Technology Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Anand K Ramasubramanian
- Department of Chemical and Materials Engineering, San José State University, San José, CA, USA
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35
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Kucukal E, Little JA, Gurkan UA. Shear dependent red blood cell adhesion in microscale flow. Integr Biol (Camb) 2019; 10:194-206. [PMID: 29557482 DOI: 10.1039/c8ib00004b] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Non-adherence and deformability are the key intrinsic biomechanical features of the red blood cell (RBC), which allow it to tightly squeeze and pass through even the narrowest of microcirculatory networks. Blockage of microcirculatory flow, also known as vaso-occlusion, is a consequence of abnormal cellular adhesion to the vascular endothelium. In sickle cell disease (SCD), an inherited anaemia, even though RBCs have been shown to be heterogeneous in adhesiveness and deformability, this has not been studied in the context of physiologically relevant dynamic shear gradients at the microscale. We developed a microfluidic system that simulates physiologically relevant shear gradients of microcirculatory blood flow at a constant single volumetric flow rate. Using this system, shear dependent adhesion of RBCs from 28 subjects with SCD and from 11 healthy subjects was investigated using vascular endothelial protein functionalized microchannels. We defined a new term, RBC Shear Gradient Microfluidic Adhesion (SiGMA) index to assess shear dependent RBC adhesion in a subject-specific manner. We have shown for the first time that shear dependent adhesion of RBCs is heterogeneous in a microfluidic flow model, which correlates clinically with inflammatory markers and iron overload in subjects with SCD. This study reveals the complex dynamic interactions between RBC-mediated microcirculatory occlusion and clinical outcomes in SCD. These interactions may also be relevant to other microcirculatory disorders and microvascular diseases.
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Affiliation(s)
- Erdem Kucukal
- Department of Mechanical and Aerospace Engineering, Case Biomanufacturing and Microfabrication Laboratory, Case Western Reserve University, Glennan 616B, 10900 Euclid Ave., Cleveland, OH, USA.
| | - Jane A Little
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA and Seidman Cancer Center at University Hospitals, Case Medical Center, Cleveland, OH, USA
| | - Umut A Gurkan
- Department of Mechanical and Aerospace Engineering, Case Biomanufacturing and Microfabrication Laboratory, Case Western Reserve University, Glennan 616B, 10900 Euclid Ave., Cleveland, OH, USA. and Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA and Department of Orthopaedics, Case Western Reserve University, Cleveland, OH 44106, USA
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36
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Yigit B, Alapan Y, Sitti M. Programmable Collective Behavior in Dynamically Self-Assembled Mobile Microrobotic Swarms. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2019; 6:1801837. [PMID: 30937264 PMCID: PMC6425453 DOI: 10.1002/advs.201801837] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/14/2018] [Indexed: 05/05/2023]
Abstract
Collective control of mobile microrobotic swarms is indispensable for their potential high-impact applications in targeted drug delivery, medical diagnostics, parallel micromanipulation, and environmental sensing and remediation. Without integrated electronics for sensing and actuation, current microrobotic systems should rely on physical interactions among individual microrobots for local communication and cooperation. Here, it is shown that mobile microrobotic swarms with well-defined collective behavior can be designed by engineering magnetic interactions among individual units. Microrobots, dynamically self-assembled from magnetic microparticles into linear chains, locomote on surfaces in response to a precessing magnetic field. Control over precessing magnetic field allows engineering attractive and repulsive interactions among microrobots and, thus, collective order with well-defined spatial organization and stable parallel operation over macroscale distances (≈1 cm) and through confining obstacles. The design approach described here addresses programmable assembly, propulsion, and collective behavior of dense mobile microrobot swarms simultaneously by engineering magnetic interactions and dynamic actuation of microrobots. The presented approach will advance swarm microrobotics by enabling facile and rapid formation of self-organized and reconfigurable microrobotic swarms with programmable collective order and stability.
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Affiliation(s)
- Berk Yigit
- Physical Intelligence DepartmentMax Planck Institute for Intelligent Systems70569StuttgartGermany
| | - Yunus Alapan
- Physical Intelligence DepartmentMax Planck Institute for Intelligent Systems70569StuttgartGermany
| | - Metin Sitti
- Physical Intelligence DepartmentMax Planck Institute for Intelligent Systems70569StuttgartGermany
- School of Medicine and School of EngineeringKoc University34450IstanbulTurkey
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37
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Guruprasad P, Mannino RG, Caruso C, Zhang H, Josephson CD, Roback JD, Lam WA. Integrated automated particle tracking microfluidic enables high-throughput cell deformability cytometry for red cell disorders. Am J Hematol 2019; 94:189-199. [PMID: 30417938 DOI: 10.1002/ajh.25345] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 12/17/2022]
Abstract
Investigating individual red blood cells (RBCs) is critical to understanding hematologic diseases, as pathology often originates at the single-cell level. Many RBC disorders manifest in altered biophysical properties, such as deformability of RBCs. Due to limitations in current biophysical assays, there exists a need for high-throughput analysis of RBC deformability with single-cell resolution. To that end, we present a method that pairs a simple in vitro artificial microvasculature network system with an innovative MATLAB-based automated particle tracking program, allowing for high-throughput, single-cell deformability index (sDI) measurements of entire RBC populations. We apply our technology to quantify the sDI of RBCs from healthy volunteers, Sickle cell disease (SCD) patients, a transfusion-dependent beta thalassemia major patient, and in stored packed RBCs (pRBCs) that undergo storage lesion over 4 weeks. Moreover, our system can also measure cell size for each RBC, thereby enabling 2D analysis of cell deformability vs cell size with single cell resolution akin to flow cytometry. Our results demonstrate the clear existence of distinct biophysical RBC subpopulations with high interpatient variability in SCD as indicated by large magnitude skewness and kurtosis values of distribution, the "shifting" of sDI vs RBC size curves over transfusion cycles in beta thalassemia, and the appearance of low sDI RBC subpopulations within 4 days of pRBC storage. Overall, our system offers an inexpensive, convenient, and high-throughput method to gauge single RBC deformability and size for any RBC population and has the potential to aid in disease monitoring and transfusion guidelines for various RBC disorders.
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Affiliation(s)
- Puneeth Guruprasad
- Wallace H. Coulter Department of Biomedical Engineering; Georgia Institute of Technology and Emory University; Atlanta Georgia
| | - Robert G. Mannino
- Wallace H. Coulter Department of Biomedical Engineering; Georgia Institute of Technology and Emory University; Atlanta Georgia
- Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta, Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia
| | - Christina Caruso
- Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta, Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia
| | | | - Cassandra D. Josephson
- Department of Pathology and Laboratory Medicine; Emory University School of Medicine, Center for Transfusion and Cellular Therapies; Atlanta Georgia
| | - John D. Roback
- Department of Pathology and Laboratory Medicine; Emory University School of Medicine, Center for Transfusion and Cellular Therapies; Atlanta Georgia
| | - Wilbur A. Lam
- Wallace H. Coulter Department of Biomedical Engineering; Georgia Institute of Technology and Emory University; Atlanta Georgia
- Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta, Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia
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38
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Deng Y, Papageorgiou DP, Chang HY, Abidi SZ, Li X, Dao M, Karniadakis GE. Quantifying Shear-Induced Deformation and Detachment of Individual Adherent Sickle Red Blood Cells. Biophys J 2018; 116:360-371. [PMID: 30612714 DOI: 10.1016/j.bpj.2018.12.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/26/2018] [Accepted: 12/10/2018] [Indexed: 02/02/2023] Open
Abstract
Vaso-occlusive crisis, a common painful complication of sickle cell disease, is a complex process triggered by intercellular adhesive interactions among blood cells and the endothelium in all human organs (e.g., the oxygen-rich lung as well as hypoxic systems such as liver and kidneys). We present a combined experimental-computational study to quantify the adhesive characteristics of sickle mature erythrocytes (SMEs) and irreversibly sickled cells (ISCs) under flow conditions mimicking those in postcapillary venules. We employed an in vitro microfluidic cell adherence assay, which is coated uniformly with fibronectin. We investigated the adhesion dynamics of SMEs and ISCs in pulsatile flow under well-controlled hypoxic conditions, inferring the cell adhesion strength by increasing the flow rate (or wall shear stress (WSS)) until the onset of cell detachment. In parallel, we performed simulations of individual SMEs and ISCs under shear. We introduced two metrics to quantify the adhesion process, the cell aspect ratio (AR) as a function of WSS and its rate of change (the dynamic deformability index). We found that the AR of SMEs decreases significantly with the increase of WSS, consistent between the experiments and simulations. In contrast, the AR of ISCs remains constant in time and independent of the flow rate. The critical WSS value for detaching a single SME in oxygenated state is in the range of 3.9-5.5 Pa depending on the number of adhesion sites; the critical WSS value for ISCs is lower than that of SMEs. Our simulations show that the critical WSS value for SMEs in deoxygenated state is above 6.2 Pa (multiple adhesion sites), which is greater than their oxygenated counterparts. We investigated the effect of cell shear modulus on the detachment process; we found that for the same cell adhesion spring constant, the higher shear modulus leads to an earlier cell detachment from the functionalized surface. These findings may aid in the understanding of individual roles of sickle cell types in sickle cell disease vaso-occlusion.
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Affiliation(s)
- Yixiang Deng
- Division of Applied Mathematics, Brown University, Providence, Rhode Island; School of Engineering, Brown University, Providence, Rhode Island
| | - Dimitrios P Papageorgiou
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Hung-Yu Chang
- Division of Applied Mathematics, Brown University, Providence, Rhode Island
| | - Sabia Z Abidi
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts; Department of Bioengineering, Rice University, Houston, Texas
| | - Xuejin Li
- Division of Applied Mathematics, Brown University, Providence, Rhode Island; Department of Engineering Mechanics, Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, Zhejiang University, Hangzhou, People's Republic of China.
| | - Ming Dao
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
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39
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Lakkakula BV, Sahoo R, Verma H, Lakkakula S. Pain Management Issues as Part of the Comprehensive Care of Patients with Sickle Cell Disease. Pain Manag Nurs 2018; 19:558-572. [DOI: 10.1016/j.pmn.2018.06.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 05/14/2018] [Accepted: 06/26/2018] [Indexed: 12/14/2022]
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40
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Lizarralde Iragorri MA, El Hoss S, Brousse V, Lefevre SD, Dussiot M, Xu T, Ferreira AR, Lamarre Y, Silva Pinto AC, Kashima S, Lapouméroulie C, Covas DT, Le Van Kim C, Colin Y, Elion J, Français O, Le Pioufle B, El Nemer W. A microfluidic approach to study the effect of mechanical stress on erythrocytes in sickle cell disease. LAB ON A CHIP 2018; 18:2975-2984. [PMID: 30168832 DOI: 10.1039/c8lc00637g] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The human red blood cell is a biconcave disc of 6-8 × 2 μm that is highly elastic. This capacity to deform enables it to stretch while circulating through narrow capillaries to ensure its main function of gas exchange. Red cell shape and deformability are altered in membrane disorders because of defects in skeletal or membrane proteins affecting protein-protein interactions. Red cell properties are also altered in other pathologies such as sickle cell disease. Sickle cell disease is a genetic hereditary disorder caused by a single point mutation in the β-globin gene generating sickle haemoglobin (HbS). Hypoxia drives HbS polymerisation that is responsible for red cell sickling and reduced deformability. The main clinical features of sickle cell disease are vaso-occlusive crises and haemolytic anaemia. Foetal haemoglobin (HbF) inhibits HbS polymerisation and positively impacts red cell survival in the circulation but the mechanism through which it exerts this action is not fully characterized. In this study, we designed a microfluidic biochip mimicking the dimensions of human capillaries to measure the impact of repeated mechanical stress on the survival of red cells at the single cell scale under controlled pressure. We show that mechanical stress is a critical parameter underlying intravascular haemolysis in sickle cell disease and that high intracellular levels of HbF protect against lysis. The biochip is a promising tool to address red cell deformability in pathological situations and to screen for molecules positively impacting this parameter in order to improve red cell survival in the circulation.
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Affiliation(s)
- Maria Alejandra Lizarralde Iragorri
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Univ. Paris Diderot, Sorbonne Paris Cité, Univ. de la Réunion, Univ. des Antilles, INTS, 6 rue Alexandre Cabanel, 75015 Paris, France.
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41
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Kucukal E, Ilich A, Key NS, Little JA, Gurkan UA. Red Blood Cell Adhesion to Heme-Activated Endothelial Cells Reflects Clinical Phenotype in Sickle Cell Disease. Am J Hematol 2018; 93:10.1002/ajh.25159. [PMID: 29905377 PMCID: PMC6295270 DOI: 10.1002/ajh.25159] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 12/19/2022]
Abstract
In sickle cell disease (SCD), 'disease severity' associates with increased RBC adhesion to quiescent endothelium, but the impact on activated endothelium is not known. Increased concentrations of free heme result from intravascular hemolysis in SCD. Heme is essential for aerobic metabolism, and plays an important role in numerous biological processes. Excess free heme induces reactive oxygen species generation and endothelial activation, which are associated with cardiovascular disorders including atherosclerosis, hypertension, and thrombosis. Here, we utilized an endothelialized microfluidic platform (Endothelium-on-a-chip) to assess adhesion of sickle hemoglobin-containing red blood cells (HbS RBCs), from adults with homozygous SCD, to heme-activated human endothelial cells (EC) in vitro. Confluent EC monolayers in microchannels were treated with pathophysiologically relevant levels of heme in order to simulate the highly hemolytic intravascular milieu seen in SCD. RBC adhesion to heme-activated ECs varied from subject to subject, and was associated with plasma markers of hemolysis (LDH) and reticulocytosis, thereby linking those RBCs that are most likely to adhere with those that are most likely to hemolyze. These results re-emphasize the critical contribution made by heterogeneous adhesive HbS RBCs to the pathophysiology of SCD. We found that adhesion of HbS RBCs to heme-activated ECs varied amongst individuals in the study population, and associated with biomarkers of hemolysis and inflammation, age, and a recent history of transfusion. Importantly, the microfluidic approach described herein holds promise as a clinically feasible Endothelium-on-a-chip platform with which to study complex heterocellular adhesive interactions in SCD. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Erdem Kucukal
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Anton Ilich
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Nigel S. Key
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Jane A. Little
- Division of Hematology/Oncology, Case Western Reserve University, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
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42
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Huisjes R, Bogdanova A, van Solinge WW, Schiffelers RM, Kaestner L, van Wijk R. Squeezing for Life - Properties of Red Blood Cell Deformability. Front Physiol 2018; 9:656. [PMID: 29910743 PMCID: PMC5992676 DOI: 10.3389/fphys.2018.00656] [Citation(s) in RCA: 179] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/14/2018] [Indexed: 12/25/2022] Open
Abstract
Deformability is an essential feature of blood cells (RBCs) that enables them to travel through even the smallest capillaries of the human body. Deformability is a function of (i) structural elements of cytoskeletal proteins, (ii) processes controlling intracellular ion and water handling and (iii) membrane surface-to-volume ratio. All these factors may be altered in various forms of hereditary hemolytic anemia, such as sickle cell disease, thalassemia, hereditary spherocytosis and hereditary xerocytosis. Although mutations are known as the primary causes of these congenital anemias, little is known about the resulting secondary processes that affect RBC deformability (such as secondary changes in RBC hydration, membrane protein phosphorylation, and RBC vesiculation). These secondary processes could, however, play an important role in the premature removal of the aberrant RBCs by the spleen. Altered RBC deformability could contribute to disease pathophysiology in various disorders of the RBC. Here we review the current knowledge on RBC deformability in different forms of hereditary hemolytic anemia and describe secondary mechanisms involved in RBC deformability.
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Affiliation(s)
- Rick Huisjes
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Anna Bogdanova
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zürich, Switzerland
| | - Wouter W van Solinge
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Raymond M Schiffelers
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Saarland University, Saarbrücken, Germany.,Experimental Physics, Saarland University, Saarbrücken, Germany
| | - Richard van Wijk
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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Ciciliano JC, Abbaspour R, Woodall J, Wu C, Bakir MS, Lam WA. Probing blood cell mechanics of hematologic processes at the single micron level. LAB ON A CHIP 2017; 17:3804-3816. [PMID: 29052682 DOI: 10.1039/c7lc00720e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Blood cells circulate in a dynamic fluidic environment, and during hematologic processes such as hemostasis, thrombosis, and inflammation, blood cells interact biophysically with a myriad of vascular matrices-blood clots and the subendothelial matrix. While it is known that adherent cells physiologically respond to the mechanical properties of their underlying matrices, how blood cells interact with their mechanical microenvironment of vascular matrices remains poorly understood. To that end, we developed microfluidic systems that achieve high fidelity, high resolution, single-micron PDMS features that mimic the physical geometries of vascular matrices. With these electron beam lithography (EBL)-based microsystems, the physical interactions of individual blood cells with the mechanical properties of the matrices can be directly visualized. We observe that the physical presence of the matrix, in and of itself, mediates hematologic processes of the three major blood cell types: platelets, erythrocytes, and leukocytes. First, we find that the physical presence of single micron micropillars creates a shear microgradient that is sufficient to cause rapid, localized platelet adhesion and aggregation that leads to complete microchannel occlusion; this response is enhanced with the presence of fibrinogen or collagen on the micropillar surface. Second, we begin to describe the heretofore unknown biophysical parameters for the formation of schistocytes, pathologic erythrocyte fragments associated with various thrombotic microangiopathies (poorly understood, yet life-threatening blood disorders associated with microvascular thrombosis). Finally, we observe that the physical interactions with a vascular matrix is sufficient to cause neutrophils to form procoagulant neutrophil extracellular trap (NET)-like structures. By combining electron beam lithography (EBL), photolithography, and soft lithography, we thus create microfluidic devices that provide novel insight into the response of blood cells to the mechanical microenvironment of vascular matrices and have promise as research-enabling and diagnostic platforms.
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Affiliation(s)
- Jordan C Ciciliano
- Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
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44
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Hansen CE, Lam WA. Clinical Implications of Single-Cell Microfluidic Devices for Hematological Disorders. Anal Chem 2017; 89:11881-11892. [PMID: 28942646 DOI: 10.1021/acs.analchem.7b01013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Single-cell microfluidic devices are poised to substantially impact the hematology field by providing a high-throughput and rapid device to analyze disease-mediated biophysical cellular changes in the clinical setting in order to diagnose patients and monitor disease prognosis. In this Feature, we cover recent advances of single-cell microfluidic devices for studying and diagnosing hematological dysfunctions and the clinical impact made possible by these advances.
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Affiliation(s)
- Caroline E Hansen
- Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta/Emory University School of Medicine , Atlanta, Georgia 30322, United States.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia 30332, United States.,School of Chemistry and Biochemistry, Georgia Institute of Technology , Atlanta, Georgia 30332, United States
| | - Wilbur A Lam
- Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta/Emory University School of Medicine , Atlanta, Georgia 30322, United States.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia 30332, United States.,School of Chemistry and Biochemistry, Georgia Institute of Technology , Atlanta, Georgia 30332, United States
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Kim M, Alapan Y, Adhikari A, Little JA, Gurkan UA. Hypoxia-enhanced adhesion of red blood cells in microscale flow. Microcirculation 2017; 24:10.1111/micc.12374. [PMID: 28387057 PMCID: PMC5679205 DOI: 10.1111/micc.12374] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/03/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The advancement of microfluidic technology has facilitated the simulation of physiological conditions of the microcirculation, such as oxygen tension, fluid flow, and shear stress in these devices. Here, we present a micro-gas exchanger integrated with microfluidics to study RBC adhesion under hypoxic flow conditions mimicking postcapillary venules. METHODS We simulated a range of physiological conditions and explored RBC adhesion to endothelial or subendothelial components (FN or LN). Blood samples were injected into microchannels at normoxic or hypoxic physiological flow conditions. Quantitative evaluation of RBC adhesion was performed on 35 subjects with homozygous SCD. RESULTS Significant heterogeneity in RBC adherence response to hypoxia was seen among SCD patients. RBCs from a HEA population showed a significantly greater increase in adhesion compared to RBCs from a HNA population, for both FN and LN. CONCLUSIONS The approach presented here enabled the control of oxygen tension in blood during microscale flow and the quantification of RBC adhesion in a cost-efficient and patient-specific manner. We identified a unique patient population in which RBCs showed enhanced adhesion in hypoxia in vitro. Clinical correlates suggest a more severe clinical phenotype in this subgroup.
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Affiliation(s)
- Myeongseop Kim
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Yunus Alapan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany
| | - Anima Adhikari
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Jane A. Little
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Seidman Cancer Center at University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Umut A. Gurkan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Department of Orthopaedics, Case Western Reserve University, Cleveland, OH, USA
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Abstract
Cytological analysis of synovial fluid is widely used in the clinic to assess joint health and disease. However, in general practice, only the total number of white blood cells (WBCs) are available for cytologic evaluation of the joint. Moreover, sufficient volume of synovial aspirates is critical to run conventional analyses, despite limited volume of aspiration that can normally be obtained from a joint. Therefore, there is a lack of consistent and standardized synovial fluid cytological tests in the clinic. To address these shortcomings, we developed a microfluidic platform (Synovial Chip), for the first time in the literature, to achieve repeatable, cost- and time-efficient, and standardized synovial fluid cytological analysis based on specific cell surface markers. Microfluidic channels functionalized with antibodies against specific cell surface antigens are connected in series to capture WBC subpopulations, including CD4+, CD8+, and CD66b+ cells, simultaneously from miniscule volumes (100 μL) of synovial fluid aspirates. Cell capture specificity was evaluated by fluorescent labeling of isolated cells in microchannels and was around 90% for all three WBC subpopulations. Furthermore, we investigated the effect of synovial fluid viscosity on capture efficiency in the microfluidic channels and utilized hyaluronidase enzyme treatment to reduce viscosity and to improve cell capture efficiency (>60%) from synovial fluid samples. Synovial Chip allows efficient and standardized point-of-care isolation and analysis of WBC subpopulations in miniscule volumes of patient synovial fluid samples in the clinic.
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Alapan Y, Fraiwan A, Kucukal E, Hasan MN, Ung R, Kim M, Odame I, Little JA, Gurkan UA. Emerging point-of-care technologies for sickle cell disease screening and monitoring. Expert Rev Med Devices 2016; 13:1073-1093. [PMID: 27785945 PMCID: PMC5166583 DOI: 10.1080/17434440.2016.1254038] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Sickle Cell Disease (SCD) affects 100,000 Americans and more than 14 million people globally, mostly in economically disadvantaged populations, and requires early diagnosis after birth and constant monitoring throughout the life-span of the patient. Areas covered: Early diagnosis of SCD still remains a challenge in preventing childhood mortality in the developing world due to requirements of skilled personnel and high-cost of currently available modalities. On the other hand, SCD monitoring presents insurmountable challenges due to heterogeneities among patient populations, as well as in the same individual longitudinally. Here, we describe emerging point-of-care micro/nano platform technologies for SCD screening and monitoring, and critically discuss current state of the art, potential challenges associated with these technologies, and future directions. Expert commentary: Recently developed microtechnologies offer simple, rapid, and affordable screening of SCD and have the potential to facilitate universal screening in resource-limited settings and developing countries. On the other hand, monitoring of SCD is more complicated compared to diagnosis and requires comprehensive validation of efficacy. Early use of novel microdevices for patient monitoring might come in especially handy in new clinical trial designs of emerging therapies.
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Affiliation(s)
- Yunus Alapan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Arwa Fraiwan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Erdem Kucukal
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - M. Noman Hasan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Ryan Ung
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Myeongseop Kim
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Isaac Odame
- Division of Haematology/Oncology, The Hospital for Sick Children; Toronto, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jane A. Little
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Seidman Cancer Center at University Hospitals, Case Medical Center, Cleveland, OH, USA
| | - Umut A. Gurkan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Department of Orthopedics, Case Western Reserve University, Cleveland, OH, USA
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48
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Sickle cell disease biochip: a functional red blood cell adhesion assay for monitoring sickle cell disease. Transl Res 2016; 173:74-91.e8. [PMID: 27063958 PMCID: PMC4959913 DOI: 10.1016/j.trsl.2016.03.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 03/08/2016] [Accepted: 03/12/2016] [Indexed: 01/10/2023]
Abstract
Sickle cell disease (SCD) afflicts millions of people worldwide and is associated with considerable morbidity and mortality. Chronic and acute vaso-occlusion are the clinical hallmarks of SCD and can result in pain crisis, widespread organ damage, and early movtality. Even though the molecular underpinnings of SCD were identified more than 60 years ago, there are no molecular or biophysical markers of disease severity that are feasibly measured in the clinic. Abnormal cellular adhesion to vascular endothelium is at the root of vaso-occlusion. However, cellular adhesion is not currently evaluated clinically. Here, we present a clinically applicable microfluidic device (SCD biochip) that allows serial quantitative evaluation of red blood cell (RBC) adhesion to endothelium-associated protein-immobilized microchannels, in a closed and preprocessing-free system. With the SCD biochip, we have analyzed blood samples from more than 100 subjects and have shown associations between the measured RBC adhesion to endothelium-associated proteins (fibronectin and laminin) and individual RBC characteristics, including hemoglobin content, fetal hemoglobin concentration, plasma lactate dehydrogenase level, and reticulocyte count. The SCD biochip is a functional adhesion assay, reflecting quantitative evaluation of RBC adhesion, which could be used at baseline, during crises, relative to various long-term complications, and before and after therapeutic interventions.
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