What is a common consequence of repeated oxygenation in sickle cell anemia?

Repeated episodes of oxygenation in sickle cell anemia can lead to irreversible sickling of red blood cells (RBCs). In sickle cell anemia, the hemoglobin (HbS) in red blood cells polymerizes when oxygen levels are low, causing the cells to deform into a sickle shape. While brief reoxygenation can cause some of these cells to return to their normal disc shape, prolonged or repetitive cycles of sickling and reoxygenation can cause damage to the red blood cells and lead to a point where they become irreversibly sickled.

This irreversibility occurs due to structural changes in the cell membrane and the cytoskeleton of the RBCs, making them more susceptible to hemolysis and preventing them from regaining their normal shape even when oxygen levels improve. Consequently, this results in a decrease in the overall number of functional RBCs and can exacerbate the anemic state and related complications.

In contrast, increased RBC production would typically be a compensatory mechanism in response to anemia rather than a consequence of oxygenation. While reversible sickling can occur initially, repeated oxygenation affecting RBCs generally does not lead to more reversible sickling over time but rather contributes to the permanent sickling effect. Similarly, while