Sickle cell disease (SCD) is distinguished by the frequent and unpredictability of vaso-occlusive crises (VOCs). Sickle erythrocytes (SSRBCs) contribute to VOCs by interacting with blood cells and the vascular endothelium in a sequence of adhesion processes. For a study, it was determined that adhesion tests had been utilized to investigate the link between SSRBC adhesion and SCD severity. Researchers created a clinical flow adhesion assay of whole blood to vascular cell adhesion molecule (FA-WB-VCAM) that was standardized. Researchers sought to determine the variability and clinical predictive value of FA-WB-VCAM in a six-month longitudinal, observational study (ELIPSIS) in SCD participants during at-home, steady-state, and self-reported VOCs, as well as after VOC resolution. 

They discovered a substantial link between FA-WB-VCAM and the severity of SCD. Adhesion indices were considerably lower in patients with SCD on hydroxycarbamide and significantly greater during VOCs; at-home VOCs had significantly higher FA-WB-VCAM than steady-state and contact VOCs. At a steady state, patients with SCD with a high frequency of self-reported VOCs had a pro-adhesive phenotype and were classified into a high-adhesive phenotype cohort; two years later, they detected a greater frequency of VOCs in the high-adhesion cohort. The study backed up stratifying patients with SCD based on steady-state FA-WB-VCAM levels and implied that FA-WB-VCAM levels might be a viable surrogate end-point for SCD severity.