Inflammation-Related Erythrocyte Aggregation in Patients with Inflammatory Bowel Disease

Abstract

Chronic inflammation is associated with increased erythrocyte adhesiveness/aggregation. This might have deleterious effects on the microcirculatory flow and tissue oxygenation. We aimed to determine the degree of erythrocyte adhesiveness/aggregation in the peripheral blood of individuals with inflammatory bowel disease (IBD). Fifty-two patients (24 women and 28 men) with ulcerative colitis (UC) at a mean age of 44.0+/-16.8 years and 96 patients (44 women and 52 men) with Crohn's disease (CD) at a mean age of 38.0+/-15.5 years, with various degrees of disease activity, were matched to normal controls. A simple slide test and image analysis were used to determine the degree of erythrocyte adhesiveness/aggregation. CD activity index (CDAI) was determined in patients with CD, while clinical colitis activity index was applied for patients with UC. A significant (P < 0.0005) increment in the degree of erythrocyte adhesiveness/aggregation was noted in both groups of IBD patients compared with matched control groups. This increment was evident even in individuals with a low index of disease activity and during remission. The highly significant correlation with the concentrations of fibrinogen suggests that the degree of erythrocyte adhesiveness/aggregation is an inflammation-related phenomenon. An enhanced state of erythrocyte adhesiveness/aggregation was noted in the peripheral blood of patients with IBD. This might have a deleterious effect on intestinal microcirculatory flow and tissue oxygenation.

Erythrocyte Deformability and Oxidative Stress in Inflammatory Bowel Disease

“…This phenomenon can contribute tissue injury in inflammatory and ischemic conditions. In a few studies with IBD, Liaz et al [7] evaluated erythrocyte aggregation in peripheral venous blood. Totals of 52 UC and 96 CD patients with different activity degrees were matched with control groups.…”

“…Although there are many studies evaluating erythrocyte deformability in chronic diseases, such as diabetes mellitus, chronic renal failure and coronary artery disease, there are no studies with IBD. Erythrocyte aggregation in IBD was evaluated in just one study [7].…”

Association of Novel Genetic Loci With Circulating Fibrinogen Levels

“…Individuals with inflammatory bowel disease (IBD), including Crohn's disease, are at a threefold higher risk of venous thrombosis 24, accounting for substantial morbidity and mortality in this group 25. Furthermore, multiple studies have indicated significantly elevated levels of fibrinogen in IBD patients 26. This suggests that IRF1 or nearby genes may contribute to Crohn's disease via a mechanism mediated through an increase in acute phase responsiveness and fibrinogen levels.…”

Blood Rheological Properties in Patients with Atopic Dermatitis (AD)

“…Increased aggregation and decreased deformability of RBCs result in increased flow resistance and hampers the microvascular bed flow [25][26][27], which may lead to suppression of oxygen release from erythrocytes [28]. Similarly to other immune-inflammatory diseases [29][30][31], AD is associated with increased aggregation and decreased deformation of RBCs, which could impair microcirculatory blood flow and tissue oxygenation. Abnormalities in blood rheological properties are considered as an independent risk factor for cardiovascular diseases and play a role in atherothrombogenesis.…”