Too slow Erythrocyte Sedimentation Rate: Deeper biophysical understanding, novel accurate parameters and new medical applications
- 1School of Physics, University of Bristol, Bristol, United Kingdom
Abstract
The erythrocyte sedimentation rate (ESR) is one of the most widely used laboratory diagnostic parameters in the preliminary assessment of inflammation; indeed, every reader of this work has likely received an ESR assessment in their lifetime. A rapid ESR is a non-specific parameter that provides information about the inflammatory process. Although the origins of this methodology date back to antiquity, the prevailing view that ESR simply reflected particle settling of erythrocytes has recently undergone a paradigm shift: once cell aggregates form a system-spanning network, gravitational collapse of a weak and percolating gel reveals a more complex process reflecting the failure. The apparent non-specific nature of the cells and proteins involved also called into question the medical utility of ESR, at least in well-resourced environments. Here we show a new experimentally derived and physically modelled approach ("supraESR") that enhances the value and accuracy of ESR for a variety of conditions that exhibit abnormally slow ESR (e.g., sickle cell disease, neuroacanthocytosis syndromes, chronic mountain sickness). We introduce a completely new diagnostic parameter that is based on an established and easily automated measurement method that promises low-cost screening for neuroacanthocytosis syndrome, a group of rare neurodegenerative diseases that are currently detectable only through integration of complex multimodal findings.
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BibTeX
@misc{darras2026slow,
title = {{Too slow Erythrocyte Sedimentation Rate: Deeper biophysical understanding, novel accurate parameters and new medical applications}},
author = {A. Darras and M. Qiao and K. Peikert and A. Hecksteden and T. John and H. Glass and E. Stauffer and I. Muniansi and B. Champigneulle and A. Pichon and M. Furian and I. Hancco Zirena and J. V. Brugniaux and A. Mühlbäck and M. J. Simmonds and E. Nader and P. Joly and T. Meyer and S. Verges and A. Hermann and A. Danek and P. Connes and C. Wagner and L. Kaestner},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.26.26360269},
url = {https://www.medrxiv.org/content/10.64898/2026.08.26.26360269v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Too slow Erythrocyte Sedimentation Rate: Deeper biophysical understanding, novel accurate parameters and new medical applications
AU - A. Darras
AU - M. Qiao
AU - K. Peikert
AU - A. Hecksteden
AU - T. John
AU - H. Glass
AU - E. Stauffer
AU - I. Muniansi
AU - B. Champigneulle
AU - A. Pichon
AU - M. Furian
AU - I. Hancco Zirena
AU - J. V. Brugniaux
AU - A. Mühlbäck
AU - M. J. Simmonds
AU - E. Nader
AU - P. Joly
AU - T. Meyer
AU - S. Verges
AU - A. Hermann
AU - A. Danek
AU - P. Connes
AU - C. Wagner
AU - L. Kaestner
PY - 2026
DA - 2026/08/26
PB - medRxiv
DO - 10.64898/2026.08.26.26360269
UR - https://www.medrxiv.org/content/10.64898/2026.08.26.26360269v1
AB - The erythrocyte sedimentation rate (ESR) is one of the most widely used laboratory diagnostic parameters in the preliminary assessment of inflammation; indeed, every reader of this work has likely received an ESR assessment in their lifetime. A rapid ESR is a non-specific parameter that provides information about the inflammatory process. Although the origins of this methodology date back to antiquity, the prevailing view that ESR simply reflected particle settling of erythrocytes has recently undergone a paradigm shift: once cell aggregates form a system-spanning network, gravitational collapse of a weak and percolating gel reveals a more complex process reflecting the failure. The apparent non-specific nature of the cells and proteins involved also called into question the medical utility of ESR, at least in well-resourced environments. Here we show a new experimentally derived and physically modelled approach ("supraESR") that enhances the value and accuracy of ESR for a variety of conditions that exhibit abnormally slow ESR (e.g., sickle cell disease, neuroacanthocytosis syndromes, chronic mountain sickness). We introduce a completely new diagnostic parameter that is based on an established and easily automated measurement method that promises low-cost screening for neuroacanthocytosis syndrome, a group of rare neurodegenerative diseases that are currently detectable only through integration of complex multimodal findings.
ER -