{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:39:39Z","timestamp":1785890379137,"version":"3.56.0"},"reference-count":80,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science and Education for Smart Growth Operational Program","award":["BG05M2OP001-1.002-0011-C02"],"award-info":[{"award-number":["BG05M2OP001-1.002-0011-C02"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Preeclampsia (PE) is a hypertensive disease characterized by proteinuria, endothelial dysfunction, and placental hypoxia. Reduced placental blood flow causes changes in red blood cell (RBC) rheological characteristics. Herein, we used microfluidics techniques and new image flow analysis to evaluate RBC aggregation in preeclamptic and normotensive pregnant women. The results demonstrate that RBC aggregation depends on the disease severity and was higher in patients with preterm birth and low birth weight. The RBC aggregation indices (EAI) at low shear rates were higher for non-severe (0.107 \u00b1 0.01) and severe PE (0.149 \u00b1 0.05) versus controls (0.085 \u00b1 0.01; p &lt; 0.05). The significantly more undispersed RBC aggregates were found at high shear rates for non-severe (18.1 \u00b1 5.5) and severe PE (25.7 \u00b1 5.8) versus controls (14.4 \u00b1 4.1; p &lt; 0.05). The model experiment with in-vitro-induced oxidative stress in RBCs demonstrated that the elevated aggregation in PE RBCs can be partially due to the effect of oxidation. The results revealed that RBCs from PE patients become significantly more adhesive, forming large, branched aggregates at a low shear rate. Significantly more undispersed RBC aggregates at high shear rates indicate the formation of stable RBC clusters, drastically more pronounced in patients with severe PE. Our findings demonstrate that altered RBC aggregation contributes to preeclampsia severity.<\/jats:p>","DOI":"10.3390\/ijms25073732","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T13:45:01Z","timestamp":1711547101000},"page":"3732","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Assessment of Red Blood Cell Aggregation in Preeclampsia by Microfluidic Image Flow Analysis\u2014Impact of Oxidative Stress on Disease Severity"],"prefix":"10.3390","volume":"25","author":[{"given":"Anika","family":"Alexandrova-Watanabe","sequence":"first","affiliation":[{"name":"Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-9231","authenticated-orcid":false,"given":"Emilia","family":"Abadjieva","sequence":"additional","affiliation":[{"name":"Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"Giosheva","sequence":"additional","affiliation":[{"name":"University Obstetrics and Gynecology Hospital \u201cMaichin Dom\u201d, 1431 Sofia, Bulgaria"},{"name":"Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Langari","sequence":"additional","affiliation":[{"name":"Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tihomir","family":"Tiankov","sequence":"additional","affiliation":[{"name":"Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Gartchev","sequence":"additional","affiliation":[{"name":"University Obstetrics and Gynecology Hospital \u201cMaichin Dom\u201d, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-9555","authenticated-orcid":false,"given":"Regina","family":"Komsa-Penkova","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Medical University-Pleven, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7108-051X","authenticated-orcid":false,"given":"Svetla","family":"Todinova","sequence":"additional","affiliation":[{"name":"Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"ref_1","first-page":"2317","article-title":"Diagnosis and management of preeclampsia","volume":"70","author":"Wagner","year":"2004","journal-title":"Am. 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