“…Sickle cells are consequently largely deoxygenated at the oxygen tension in the capillary circulation. Although sickle cell membrane abnormalities, abnormal cation homeostasis, and altered cation transport pathways have attracted much interest (Hebbel et al, 1980;Bookchin & Lew, 1980;Brugnara et al, 1989a;Joiner, 1993), it has become increasingly apparent that the decrease in deformability and filterability of sickle cells, as well as the formation of irreversible sickle cells, arises from intracellular polymerization of deoxy-HbSS (Evans et al, 1984;Green et al, 1988). The degree of polymerization of deoxy-HbSS, as well as the rate of polymer formation, is in turn highly dependent on oxygen tension, temperature and concentration of HbSS (Hofrichter et al, 1974;Noguchi et al, 1983).…”