{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:40:05Z","timestamp":1791859205550,"version":"4.3.4"},"reference-count":166,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SUTD GAP Funding","award":["GAP-035"],"award-info":[{"award-number":["GAP-035"]}]},{"name":"SUTD GAP Funding","award":["RTIP-2024-02"],"award-info":[{"award-number":["RTIP-2024-02"]}]},{"name":"SUTD GAP Funding","award":["NRF-CG2025-CG02-IG2-001016"],"award-info":[{"award-number":["NRF-CG2025-CG02-IG2-001016"]}]},{"name":"Research Translation Innovation Platform Funding","award":["GAP-035"],"award-info":[{"award-number":["GAP-035"]}]},{"name":"Research Translation Innovation Platform Funding","award":["RTIP-2024-02"],"award-info":[{"award-number":["RTIP-2024-02"]}]},{"name":"Research Translation Innovation Platform Funding","award":["NRF-CG2025-CG02-IG2-001016"],"award-info":[{"award-number":["NRF-CG2025-CG02-IG2-001016"]}]},{"name":"National Research Foundation, Singapore","award":["GAP-035"],"award-info":[{"award-number":["GAP-035"]}]},{"name":"National Research Foundation, Singapore","award":["RTIP-2024-02"],"award-info":[{"award-number":["RTIP-2024-02"]}]},{"name":"National Research Foundation, Singapore","award":["NRF-CG2025-CG02-IG2-001016"],"award-info":[{"award-number":["NRF-CG2025-CG02-IG2-001016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biosensors"],"abstract":"<jats:p>Red blood cell (RBC), accounting for approximately 45% of total blood volume, are essential for oxygen delivery and carbon dioxide removal. Their unique biconcave morphology, high surface area-to-volume ratio, and remarkable deformability enable them to navigate microvessels narrower than their resting diameter, ensuring efficient microcirculation. RBC deformability is primarily determined by membrane viscoelasticity, cytoplasmic viscosity, and cell geometry, all of which can be altered under various physiological and pathological conditions. Reduced deformability is a hallmark of numerous diseases, including sickle cell disease, malaria, diabetes mellitus, sepsis, ischemia\u2013reperfusion injury, and storage lesions in transfused blood. As these mechanical changes often precede overt clinical symptoms, RBC deformability is increasingly recognized as a sensitive biomarker for disease diagnosis, prognosis, and treatment monitoring. Over the past decades, diverse techniques have been developed to measure RBC deformability. These include single-cell methods such as micropipette aspiration, optical tweezers, atomic force microscopy, magnetic twisting cytometry, and quantitative phase imaging; bulk approaches like blood viscometry, ektacytometry, filtration assays, and erythrocyte sedimentation rate; and emerging microfluidic platforms capable of high-throughput, physiologically relevant measurements. Each method captures distinct aspects of RBC mechanics, offering unique advantages and limitations. This review synthesizes current knowledge on the pathophysiological significance of RBC deformability and the methods for its measurement. We discuss disease contexts in which deformability is altered, outline mechanical models describing RBC viscoelasticity, and provide a comparative analysis of measurement techniques. Our aim is to guide the selection of appropriate approaches for research and clinical applications, and to highlight opportunities for developing robust, clinically translatable diagnostic tools.<\/jats:p>","DOI":"10.3390\/bios15090566","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T15:03:14Z","timestamp":1756393394000},"page":"566","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Pathophysiological Associations and Measurement Techniques of Red Blood Cell Deformability"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2577-2405","authenticated-orcid":false,"given":"Minhui","family":"Liang","sequence":"first","affiliation":[{"name":"School of Mechanical Engineering, Guangxi University, Nanning 530004, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawei","family":"Ming","sequence":"additional","affiliation":[{"name":"School of Mechanical Engineering, Guangxi University, Nanning 530004, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Zhong","sequence":"additional","affiliation":[{"name":"Pillar of Engineering Product Development, Singapore University of Technology and Design, 8 Somapah Road, Singapore 487372, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1820-0654","authenticated-orcid":false,"given":"Choo Sheriel","family":"Shannon","sequence":"additional","affiliation":[{"name":"National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Rojas-Carabali","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kajal","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8638-1649","authenticated-orcid":false,"given":"Ye","family":"Ai","sequence":"additional","affiliation":[{"name":"Pillar of Engineering Product Development, Singapore University of Technology and Design, 8 Somapah Road, Singapore 487372, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupesh","family":"Agrawal","sequence":"additional","affiliation":[{"name":"National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore"},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1053\/j.jvca.2018.08.001","article-title":"Red Blood Cell Disorders: Perioperative Considerations for Patients Undergoing Cardiac Surgery","volume":"33","author":"Smith","year":"2019","journal-title":"J. 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