Figure 2. SS REVs activate HPMECs, increase vWF expression and mediates enhanced adhesion of SS RBCs, which can be reduced by hemopexin and ADAMTS13.

(A, B): HPMECs were treated with SS REVs (A) and AA REVs (B) for 2 hours in 37 °C and incubated with fluorescently labeled antibodies against vWF following a fixing step with 4% PFA. The SS REV treated HPMECs demonstrated significantly increased vWF expression comparing to HPMECs incubated with AA REVs (C, n=5, p=0.012, 2 Sample t test). (D) SS RBC adhesion on HPMECs activated with SS REVs. (E) SS RBCs adhesion on HPMECs treated with AA REVs. (F) AA RBCs adhesion on HPMECs treated with SS REVs. Insets are closer view of RBCs adhered to HPMECs. (G) Interaction between SS RBC and SS REV activated HPMECs is significantly stronger than the other test groups, and this interaction is reduced by hemopexin and ADAMTS13 (mean ± SD: SS REV-SS RBC = 157 ± 42, AA REV-SS RBC = 16 ± 12, AA REV-SS RBC = 19 ± 12, AA REV-AA RBC (5 ± 4), SS REV-SS RBC with hemopexin = 14 ± 8, SS REV-SS RBC with ADAMTS13 = 19 ± 10, and heme-SS RBC = 140 ± 49, p < 0.05 for all groups except for heme-SS RBC, n = 5 in each group, 2-Group t test).

*: p = 0.002

**: p = 0.001

NS: p = 0.058