Red Blood Cells Beyond Oxygen Transport: Dynamic Regulators, Disease Biomarkers and Therapeutic Platforms—A Narrative Review
- 1Rare Anemias Ektacytometry Unit, Josep Carreras Leukaemia Research Institute, Ctra. de Can Ruti, Camí de les Escoles, 08916 Badalona, Catalonia, Spain
- 2Medical Centre for Ambulatory Medicine, Carrer de Còrsega 209, 08036 Barcelona, Catalonia, Spain
Abstract
Red blood cells (RBCs) have traditionally been regarded as passive carriers of respiratory gases. Increasing evidence, however, indicates that they are active participants in vascular homeostasis and respond to mechanical, metabolic, and oxidative stimuli. This narrative review examines the interconnected roles of RBCs as regulators of vascular physiology, indicators of hereditary and systemic disease, therapeutic targets, and delivery platforms. RBC deformability, membrane organization, ion-water balance, metabolism, and redox capacity support microcirculatory flow, while ATP release, nitric oxide handling, adhesion, and extracellular-vesicle formation influence vascular function. RBC morphology, mechanics, hydration, metabolism, oxidative status, and vesiculation can provide clinically relevant information, although emerging functional and molecular biomarkers require further standardization and validation. RBC-directed treatments and RBC-based carriers offer additional therapeutic opportunities. Automated image analysis and machine-learning-assisted microfluidic classification are the most substantiated artificial-intelligence applications; broader multimodal decision-support systems remain exploratory.
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BibTeX
@article{vivescorrons2026blood,
title = {{Red Blood Cells Beyond Oxygen Transport: Dynamic Regulators, Disease Biomarkers and Therapeutic Platforms—A Narrative Review}},
author = {Joan-Lluis Vives-Corrons},
journal = {International Journal of Molecular Sciences},
year = {2026},
month = oct,
doi = {10.3390/ijms27198848},
url = {https://www.mdpi.com/1422-0067/27/19/8848},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Red Blood Cells Beyond Oxygen Transport: Dynamic Regulators, Disease Biomarkers and Therapeutic Platforms—A Narrative Review
AU - Joan-Lluis Vives-Corrons
PY - 2026
DA - 2026/10/03
JO - International Journal of Molecular Sciences
DO - 10.3390/ijms27198848
UR - https://www.mdpi.com/1422-0067/27/19/8848
AB - Red blood cells (RBCs) have traditionally been regarded as passive carriers of respiratory gases. Increasing evidence, however, indicates that they are active participants in vascular homeostasis and respond to mechanical, metabolic, and oxidative stimuli. This narrative review examines the interconnected roles of RBCs as regulators of vascular physiology, indicators of hereditary and systemic disease, therapeutic targets, and delivery platforms. RBC deformability, membrane organization, ion-water balance, metabolism, and redox capacity support microcirculatory flow, while ATP release, nitric oxide handling, adhesion, and extracellular-vesicle formation influence vascular function. RBC morphology, mechanics, hydration, metabolism, oxidative status, and vesiculation can provide clinically relevant information, although emerging functional and molecular biomarkers require further standardization and validation. RBC-directed treatments and RBC-based carriers offer additional therapeutic opportunities. Automated image analysis and machine-learning-assisted microfluidic classification are the most substantiated artificial-intelligence applications; broader multimodal decision-support systems remain exploratory.
SN - 1422-0067
ER -