Armed with a $2 million grant from the National Institutes of Health, Case Western Reserve University researchers in Cleveland, Ohio, are developing a portable blood-adhesion monitor for sickle cell disease patients.

The engineers and doctors hope to make the device as useful as the at-home insulin monitors diabetes patients use to manage their disease.

Sickle cell disease alters the shape and stickiness of red blood cells. In the prototype, which proved capable of determining whether cells are sticky and the level of stickiness, blood flows through channels as wide as three to four cells across, reproducing microvessel size inside the body. The channel lining mimics the properties of endothelial cells lining blood vessels. Under a microscope, researchers can see cells stick to channel walls and determine the stickiness and number per unit volume of blood.

In the course of the disease, misshapen and abnormal sticky blood cells clog blood vessels. Hemoglobin molecules link into long chains inside red blood cells, stiffening the cells and changing cell shape from a doughnut without a hole to a crescent—thus the name of the disease. Adhesive proteins form on the surface of the cells, impeding cell flow in the bloodstream and increasing the likelihood they will clog blood vessels.

The scientists are working on a way to quickly identify proteins on the surface. About a dozen proteins contribute to adhesion, and different patients have different proteins on their cells, providing an opportunity to customize treatment.

The device may also be useful in monitoring new sickle cell drugs designed to either block adhesive proteins on blood-cell surfaces or resolve clogs that block blood vessels and starve joints and organs of oxygen.

An at-home version of the monitor would enable patients to use the test daily to manage their condition, similar to the way diabetes patients use at-home insulin monitors to manage their disease.