{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:26:53Z","timestamp":1791570413725,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013739","name":"Pfizer Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013739","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Blood cell adhesion to P\u2010selectin and vascular cell adhesion molecule\u20101 (VCAM\u20101) contributes to the pathophysiology of vaso\u2010occlusion crisis (VOC) events in individuals with sickle cell disease (SCD). We evaluated the use of standardized flow adhesion biomarkers in a six\u2010month, 35\u2010subjects longitudinal study (ELIPSIS). Flow adhesion of whole blood on P\u2010selectin (FA\u2010WB\u2010Psel) and VCAM1 (FA\u2010WB\u2010VCAM), and of isolated white blood cells on P\u2010selectin (FA\u2010WBC\u2010Psel) and VCAM\u20101 (FA\u2010WBC\u2010VCAM) were elevated on VOC days compared with non\u2010VOC days, but only FA\u2010WB\u2010Psel reached statistical significance (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00\u00b7015). Optimal cut\u2010off values were established with Cox regression models for FA\u2010WB\u2010Psel [46 cells\/mm\u00b2; hazard ratio (HR): 2\u00b73; 95% confidence interval (CI):1\u00b74\u20134\u00b70;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00\u00b701] and FA\u2010WB\u2010VCAM (408 cells\/mm\u00b2, HR:1\u00b78; 95% CI: 0\u00b79\u20133\u00b745;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00\u00b701). A combined (FA\u2010WB\u2010Psel and FA\u2010WB\u2010VCAM) multimarker risk score was also significantly (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00\u00b70006) correlated with VOC risk that was two\u2010fold higher for intermediate and 5\u00b764\u2010fold higher for high score. The concordance (C)\u2010index for the multimarker score was 0\u00b763 in the six\u2010month period (95% CI: 0\u00b756\u20130\u00b770), indicating a better ability to distinguish patient risk of VOC, compared to individual biomarkers FA\u2010WB\u2010VCAM (C\u2010index: 0\u00b757; 95% CI: 0\u00b749\u20130\u00b765) or FA\u2010WB\u2010Psel (C\u2010index: 0\u00b758; 95% CI: 0\u00b753\u20130\u00b762). The presented multimarker score can be used to risk\u2010stratify individuals with SCD during their steady state into low, intermediate, and high\u2010risk strata for self\u2010reported VOCs. Such risk stratification could help focus healthcare resources more efficiently to maintiain health, personalize treatment selection to each patient\u2019s individual needs, and potentially reduce healthcare costs.\n                  <\/jats:p>","DOI":"10.1111\/bjh.17643","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T02:45:56Z","timestamp":1630550756000},"page":"1074-1082","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Flow adhesion of whole blood to P\u2010selectin: a prognostic biomarker for vaso\u2010occlusive crisis in sickle cell disease"],"prefix":"10.1111","volume":"194","author":[{"given":"Patrick C.","family":"Hines","sequence":"first","affiliation":[{"name":"Functional Fluidics Detroit MI USA"},{"name":"Division of Pediatric Critical Care Medicine Children's Hospital of Michigan Detroit MI USA"},{"name":"Wayne Pediatrics Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael U.","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology Central Michigan University Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4551-661X","authenticated-orcid":false,"given":"Ahmar U.","family":"Zaidi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology Central Michigan University Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufeng","family":"Gao","sequence":"additional","affiliation":[{"name":"Functional Fluidics Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Liu","sequence":"additional","affiliation":[{"name":"Functional Fluidics Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2909-4779","authenticated-orcid":false,"given":"Jennell","family":"White","sequence":"additional","affiliation":[{"name":"Functional Fluidics Detroit MI USA"},{"name":"Division of Pediatric Critical Care Medicine Children's Hospital of Michigan Detroit MI USA"},{"name":"Department of Pharmacology Wayne State University School of Medicine Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tarasev","sequence":"additional","affiliation":[{"name":"Functional Fluidics Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"NHIBI.Sickle Cell Disease.https:\/\/wwwnhlbinihgov\/health\u2010topics\/sickle\u2010cell\u2010disease. 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