Cited by 813Hemoglobinopathies and Related DisordersHemoglobin structure and functionBlood properties and coagulation

The DOI matches its Crossref record; 237 of the 239 references it cites were found in a registry or an index; 80 of the 157 sources its claims cite were checked for support.

Pathophysiology of Sickle Cell Disease

Open access
Sundd, Prithu, Gladwin, Mark T., Novelli, Enrico M.·2019·Annual Review of Pathology Mechanisms of Disease

Abstract

Since the discovery of sickle cell disease (SCD) in 1910, enormous strides have been made in the elucidation of the pathogenesis of its protean complications, which has inspired recent advances in targeted molecular therapies. In SCD, a single amino acid substitution in the β-globin chain leads to polymerization of mutant hemoglobin S, impairing erythrocyte rheology and survival. Clinically, erythrocyte abnormalities in SCD manifest in hemolytic anemia and cycles of microvascular vaso-occlusion leading to end-organ ischemia-reperfusion injury and infarction. Vaso-occlusive events and intravascular hemolysis promote inflammation and redox instability that lead to progressive small- and large-vessel vasculopathy. Based on current evidence, the pathobiology of SCD is considered to be a vicious cycle of four major processes, all the subject of active study and novel therapeutic targeting: ( a) hemoglobin S polymerization, ( b) impaired biorheology and increased adhesion-mediated vaso-occlusion, ( c) hemolysis-mediated endothelial dysfunction, and ( d) concerted activation of sterile inflammation (Toll-like receptor 4- and inflammasome-dependent innate immune pathways). These molecular, cellular, and biophysical processes synergize to promote acute and chronic pain and end-organ injury and failure in SCD. This review provides an exhaustive overview of the current understanding of the molecular pathophysiology of SCD, how this pathophysiology contributes to complications of the central nervous and cardiopulmonary systems, and how this knowledge is being harnessed to develop current and potential therapies.

Overview

Integrity signals

Registry

Crossref · 10.1146/annurev-pathmechdis-012418-012838

Cites

237 of 237 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

39 Partly supported · 32 No full text of the sources · 16 Own interpretation · 15 Supported · 12 No basis given · 9 Supported so far · 5 Not checked yet · 1 Mixed support · 1 Sources not found · accuracy not yet measured

Show all 79 claims

  • It may state two separate claims as one. 45
  • Borderline: one of the tests for a substantial claim is unclear. 1
  • Probably not a substantial claim. 5
  • The quote only partly states this claim. 1
51 of 51
  • The paper relies on this without support.

    Findings from transgenic SCD mice, non-SCD mice with adoptively transferred sickle erythrocytes, and in vitro flow chamber systems are representative of human SCD pathophysiology.

    “Intravital imaging studies done in transgenic humanized SCD mice and in vitro flow chamber studies done with SCD human blood over the past decade have contributed to the current understanding of vaso-occlusion as the interplay among impaired blood rheology, increased adhesiveness of erythrocytes with inflammatory cells and vascular endothelium, and hemostatic activation (14).”
1 of 1

Citations

Cites

Show all 239 references

Research works printed but not linked: 4

  1. Westwick J, 1983, J. Med., 14, 17
  2. Ohene-Frempong K, 1998, Blood, 91, 288
  3. Malik Z, 1983, Cytobios, 38, 33
  4. Koshy M, 1990, J. Assoc. Acad. Minor. Phys., 1, 71

Cited by

Sorted by citations

Items 601–700 of 798

Metadata

Authors
Sundd, P., Gladwin, M. T., & Novelli, E. M.
Affiliations
University of Pittsburgh (US)
Venue
Annual Review of Pathology Mechanisms of Disease
Published
2019-01-24
Volume
14
Issue
1
Pages
263-292
ISSN
  • 1553-4006 (ISSN-L)
  • 1553-4014
OpenAlex
W2898014977
Cited by
813
References
239
Citations by year
2026: 121 · 2025: 155 · 2024: 132 · 2023: 133 · 2022: 114 · 2021: 75 · 2020: 53 · 2019: 22
FWCI
5.54
Type
journal article
Language
en
Open access
Locations
  • Annual Review of Pathology Mechanisms of Disease (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • American Heart Association (18TPA34170588)
  • National Heart, Lung, and Blood Institute (R01HL127107, K23HL112848, P01HL103455, HL110849, R01HL141080, R01HL128297, R01HL125886, R01HL098032, T32HL110849)
Topics
  • Health Sciences › Medicine › Genetics (clinical) › Hemoglobinopathies and Related Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Hemoglobin structure and function
  • Health Sciences › Medicine › Hematology › Blood properties and coagulation
Keywords
sickle cell disease, hemoglobin S polymerization, erythrocyte rheology, vascular occlusion, hemolysis, endothelial dysfunction, sterile inflammation, TLR4, inflammasome, redox imbalance, vasculopathy, pain, end-organ failure, beta-globin gene mutations, targeted therapy
MeSH terms
Anemia, Sickle Cell, Hemolysis, Humans, Inflammation, Reperfusion Injury, Oxidative Stress, Toll-Like Receptor 4

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