Telen fig 1 (in Garratty et al). Interactions between sickle red cells and the endothelium.
Sickle red cells have been shown to bear an array of adhesion receptors. Some of these, such as CD47, VCAM-1, and the Lutheran blood group protein (LU), are capable of binding extracellular matrix components such as thrombospondin (TSP) and laminin (LAM). Others, including CD36, VLA-4 and LW, appear to mediate red cell binding to endothelial cells, possibly through intermediary linking molecules such as soluble plasma TSP in some cases. Collagen (COLL) is also a major component of the subendothelial extracellular matrix. Some investigators have theorized that endothelial cell damage in sickle cell disease results in exposure of subendothelial matrix to circulating blood cells between retracted endothelial cells.