Using single-molecule atomic force microscopy (AFM) experiments, we report that epinephrine, a hormone secreted during stress and strenuous exercise, increases both the frequency and strength of adhesion events of sickle cell trait erythrocytes to the endothelial extracellular matrix (ECM). The specific interactions quantified include Lutheran (BCAM/Lu) and intercellular adhesion molecule-4 (ICAM-4) on the RBC surface with ECM laminin and endothelial αvβ3, respectively. These data present significant evidence of the role of epinephrine in BCAM/Lu-laminin and ICAM-4-αvβ3 bonding, and suggest mechanisms of vaso-occlusion during physical exertion in SCT.

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