We evaluated the influence of pretreatment with aspirin in vitro, alone or combined with dipyridamole, on red cell aggregability. Samples were tested before and after being exposed to well-defined flow conditions. An aggregation rate was estimated through digital analysis of light microscopy images. Red cells of untreated blood that had been exposed to flow showed a higher aggregation rate (38.54 +/- 1.63 vs. 27.52 +/- 1.36; P < 0.05). This effect was not observed in the absence of platelets. Treatment with aspirin induced a high aggregation rate, with or without exposure to flow conditions. Dipyridamole alone or combined with aspirin provoked echinocytosis, disturbing the rouleaux arrangement (rates ranging from 11.25 +/- 1.91 - 13.62 +/- 1.62). Washing red cells after treatment restored about 90% of echinocytes to their biconcave shape, but aggregation rate did not recover in parallel. These results highlight the influence of red cell-platelet interactions in the regulation of haemostasis and show how therapeutic agents can interfere with rheological phenomena.
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