Historically, the first observations of red blood cell (RBC) association into larger structures in human blood were performed in the 18th century. Since that time extensive research has been performed to explain this phenomenon, which determines the rheological properties of blood, affects the microvascular blood flow, and often leads to the development of blood flow abnormalities in large vessels.
The RBC aggregation process takes place in both in vivo and in vitro conditions. Normal human RBCs suspended in a solution of high molecular weight proteins or synthetic colloids of various chemical contents tend to associate into linear structures resembling rouleaux, while in an isotonic salt solution the cells stay monodisperse. A manifold of different experiments with blood samples showed that the extent of RBC aggregation and the aggregation rate depend not only on the concentration of cells, but on physico-chemical properties and the concentration of blood plasma proteins. This brought the researchers to a conclusion that this phenomenon is a result of the interaction of RBCs and macromolecules.
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