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Red blood cell membrane integrity is a term describing the collective ability of the erythrocyte membrane to maintain its structure, shape, mechanical strength, and function when exposed to physiological stress in circulation[1][3][4][5][7]. It is not a discrete molecular target but rather an emergent property resulting from the coordinated structure of the lipid bilayer, integral and peripheral proteins (such as spectrin, ankyrin, actin, band 3, protein 4.1), and their interactions. The membrane’s integrity allows RBCs to deform as they move through capillaries, prevents hemolysis, and enables efficient oxygen transport. Disorders of membrane integrity usually result from inherited defects in membrane or cytoskeletal proteins, leading to hemolytic anemias due to increased fragility and decreased deformability[3][5][7]. Therapies may target underlying causative defects but do not “target” membrane integrity itself as a canonical entity.
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