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Blood flow in sickle cell disease (SCD) can substantially differ from normalblood flow due to significant alterations in the physical properties of the redblood cells (RBCs). Chronic complications, such as inflammation of theendothelial cells lining blood vessel walls, are associated with SCD, forreasons that are unclear. Here, detailed boundary integral simulations areperformed to investigate an idealized model flow flow in SCD, a binarysuspension of flexible biconcave discoidal fluid-filled capsules and stiffcurved prolate capsules that represent healthy and sickle RBCs, respectively,subjected to pressure-driven flow in a planar slit. The key observation isthat, unlike healthy RBCs that concentrate around the center of the channel andform an RBC-depleted layer (i.e. cell-free layer) next to the walls, sicklecells are largely drained from the bulk of the suspension and aggregate insidethe cell-free layer, displaying strong margination. These cells are found toundergo a rigid-body-like rolling orbit near the walls. Furthermore, theadditional shear stress on the walls induced by the presence of marginatedcells is computed. Compared to the small fluctuations in wall shear stress fora suspension of healthy RBCs, large local peaks in wall shear stress areobserved for the binary suspensions, due to the proximity of the marginatedstiff cells to the walls. As endothelial cells are known to mechanotransducephysical forces such as aberrations in shear stress and convert them tophysiological processes such as activation of inflammatory signals, theseresults may aid in understanding mechanisms for endothelial dysfunctionassociated with SCD.

Flow-induced segregation and dynamics of red blood cells in sickle cell disease