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Alexandrova-Watanabe A, Abadjieva E, Giosheva I, Langari A, Tiankov T, Gartchev E, Komsa-Penkova R, Todinova S. Assessment of Red Blood Cell Aggregation in Preeclampsia by Microfluidic Image Flow Analysis-Impact of Oxidative Stress on Disease Severity. Int J Mol Sci 2024; 25:3732. [PMID: 38612543 PMCID: PMC11011533 DOI: 10.3390/ijms25073732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Preeclampsia (PE) is a hypertensive disease characterized by proteinuria, endothelial dysfunction, and placental hypoxia. Reduced placental blood flow causes changes in red blood cell (RBC) rheological characteristics. Herein, we used microfluidics techniques and new image flow analysis to evaluate RBC aggregation in preeclamptic and normotensive pregnant women. The results demonstrate that RBC aggregation depends on the disease severity and was higher in patients with preterm birth and low birth weight. The RBC aggregation indices (EAI) at low shear rates were higher for non-severe (0.107 ± 0.01) and severe PE (0.149 ± 0.05) versus controls (0.085 ± 0.01; p < 0.05). The significantly more undispersed RBC aggregates were found at high shear rates for non-severe (18.1 ± 5.5) and severe PE (25.7 ± 5.8) versus controls (14.4 ± 4.1; p < 0.05). The model experiment with in-vitro-induced oxidative stress in RBCs demonstrated that the elevated aggregation in PE RBCs can be partially due to the effect of oxidation. The results revealed that RBCs from PE patients become significantly more adhesive, forming large, branched aggregates at a low shear rate. Significantly more undispersed RBC aggregates at high shear rates indicate the formation of stable RBC clusters, drastically more pronounced in patients with severe PE. Our findings demonstrate that altered RBC aggregation contributes to preeclampsia severity.
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Affiliation(s)
| | - Emilia Abadjieva
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (A.A.-W.); (E.A.); (T.T.)
| | - Ina Giosheva
- University Obstetrics and Gynecology Hospital “Maichin Dom”, 1431 Sofia, Bulgaria; (I.G.); (E.G.)
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
| | - Ariana Langari
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
| | - Tihomir Tiankov
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (A.A.-W.); (E.A.); (T.T.)
| | - Emil Gartchev
- University Obstetrics and Gynecology Hospital “Maichin Dom”, 1431 Sofia, Bulgaria; (I.G.); (E.G.)
| | | | - Svetla Todinova
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
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Windberger U, Sparer A, Elsayad K. The role of plasma in the yield stress of blood. Clin Hemorheol Microcirc 2023; 84:369-383. [PMID: 37334582 DOI: 10.3233/ch-231701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND Yielding and shear elasticity of blood are merely discussed within the context of hematocrit and erythrocyte aggregation. However, plasma might play a substantial role due its own viscoelasticity. OBJECTIVE If only erythrocyte aggregation and hematocrit would determine yielding, blood of different species with comparable values would present comparable yield stresses. METHODS rheometry (SAOS: amplitude and frequency sweep tests; flow curves) of hematocrit-matched samples at 37°C. Brillouin Light Scattering Spectroscopy at 38°C. RESULTS Yield stress for pig: 20mPa, rat: 18mPa, and human blood: 9mPa. Cow and sheep blood were not in quasi-stationary state supporting the role of erythrocyte aggregation for the development of elasticity and yielding. However, pig and human erythrocytes feature similar aggregability, but yield stress of porcine blood was double. Murine and ruminant erythrocytes both rarely aggregate, but their blood behavior was fundamentally different. Pig plasma was shear-thinning and murine plasma was platelet-enriched, supporting the role of plasma for triggering collective effects and gel-like properties. CONCLUSIONS Blood behavior near zero shear flow is not based solely on erythrocyte aggregation and hematocrit, but includes the hydrodynamic interaction with plasma. The shear stress required to break down elasticity is not the critical shear stress for dispersing erythrocyte aggregates, but the shear stress required to fracture the entire assembly of blood cells within their intimate embedding.
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Affiliation(s)
- U Windberger
- Core Facility Laboratory Animal Breeding and Husbandry, Decentralized Biomedical Facilities, Medical University Vienna, Austria
| | - A Sparer
- Core Facility Laboratory Animal Breeding and Husbandry, Decentralized Biomedical Facilities, Medical University Vienna, Austria
| | - K Elsayad
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University Vienna, Austria
- Medical Imaging Cluster (MIC), Medical University of Vienna, Austria
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Le AV, Fenech M. Image-Based Experimental Measurement Techniques to Characterize Velocity Fields in Blood Microflows. Front Physiol 2022; 13:886675. [PMID: 35574441 PMCID: PMC9099138 DOI: 10.3389/fphys.2022.886675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Predicting blood microflow in both simple and complex geometries is challenging because of the composition and behavior of the blood at microscale. However, characterization of the velocity in microchannels is the key for gaining insights into cellular interactions at the microscale, mechanisms of diseases, and efficacy of therapeutic solutions. Image-based measurement techniques are a subset of methods for measuring the local flow velocity that typically utilize tracer particles for flow visualization. In the most basic form, a high-speed camera and microscope setup are the only requirements for data acquisition; however, the development of image processing algorithms and equipment has made current image-based techniques more sophisticated. This mini review aims to provide a succinct and accessible overview of image-based experimental measurement techniques to characterize the velocity field of blood microflow. The following techniques are introduced: cell tracking velocimetry, kymographs, micro-particle velocimetry, and dual-slit photometry as entry techniques for measuring various velocity fields either in vivo or in vitro.
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Affiliation(s)
- Andy Vinh Le
- Department of Mechanical Engineering, University of Ottawa, Ottawa, ON, Canada
- Centre de Biochimie Structurale, CNRS UMR 5048—INSERM UMR 1054, University of Montpellier, Montpellier, France
| | - Marianne Fenech
- Department of Mechanical Engineering, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Marianne Fenech,
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Cao Y, Zhao H, Hu Z, Ma S. Cascade Pumping Overcomes Hydraulic Resistance and Moderates Shear Conditions for Slow Gelatin Fiber Shaping in Narrow Tubes. iScience 2020; 23:101228. [PMID: 32540773 PMCID: PMC7298654 DOI: 10.1016/j.isci.2020.101228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/06/2020] [Accepted: 05/28/2020] [Indexed: 11/30/2022] Open
Abstract
In microextrusion-based 3D bioprinting, shaping gel fibers online, i.e., in narrow tubes, benefits the structural maintenance after extrusion, but it is challenging for materials possessing slow sol-gel transition dynamics. Gelatin, for example, transforms into thermostable fibers via transglutaminase (TG) reaction in as much as 10 min. It causes dramatic flow resistance accumulation and shear stress increase in fluids moving along narrow tubes, resulting in channel clogging and cell detriments. In this study, we overcome the limitations by adopting cascade pumping and performing in a single peristaltic pump that comprises multi-channel pumping units. The pressure and shear stress reduction by over 1-fold are verified by finite element simulation; continuous gelatin fiber production and patterning in a substrate-free manner are achieved via slow online enzymatic cross-linking. The online fiber shaping can be scaled up by numbering up the pumping units and provides another paradigm for biomanufacturing. Cascade pumping overcomes hydraulic resistance and reduces shear stress significantly Cascade pumping suits online gelatin fiber shaping via slow enzymatic cross-linking Online fiber shaping enables substrate-free 3D printing Gelatin fibers are stronger when gelled via thermal and enzymatic dual cross-linking
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Affiliation(s)
- Yuanxiong Cao
- Tsinghua-Berkeley Shenzhen Institute (TBSI), Tsinghua University, Shenzhen, 518055, China; Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, 518055, China
| | - Haoran Zhao
- Tsinghua-Berkeley Shenzhen Institute (TBSI), Tsinghua University, Shenzhen, 518055, China; Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, 518055, China
| | - Zhiwei Hu
- Tsinghua-Berkeley Shenzhen Institute (TBSI), Tsinghua University, Shenzhen, 518055, China; Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, 518055, China
| | - Shaohua Ma
- Tsinghua-Berkeley Shenzhen Institute (TBSI), Tsinghua University, Shenzhen, 518055, China; Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, 518055, China.
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Mehri R, Mavriplis C, Fenech M. Red blood cell aggregates and their effect on non-Newtonian blood viscosity at low hematocrit in a two-fluid low shear rate microfluidic system. PLoS One 2018; 13:e0199911. [PMID: 30024907 PMCID: PMC6053157 DOI: 10.1371/journal.pone.0199911] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 06/16/2018] [Indexed: 11/18/2022] Open
Abstract
Red blood cells (RBCs) are the most abundant cells in human blood. Remarkably RBCs deform and bridge together to form aggregates under very low shear rates. The theory and mechanics behind aggregation are, however, not yet completely understood. The main objective of this work is to quantify and characterize RBC aggregates in order to enhance the current understanding of the non-Newtonian behaviour of blood in microcirculation. Suspensions of human blood were flowed and observed in vitro in poly-di-methyl-siloxane (PDMS) microchannels to characterize RBC aggregates. These microchannels were fabricated using standard photolithography methods. Experiments were performed using a micro particle image velocimetry (μPIV) system for shear rate measurements, coupled with a high-speed camera for flow visualization. RBC aggregate sizes were quantified in controlled and measurable shear rate environments for 5, 10 and 15% hematocrit. Aggregate sizes were determined using image processing techniques, while apparent viscosity was measured using optical viscometry. For the samples suspended at 5% H, aggregate size was not strongly correlated with shear rate. For the 10% H suspensions, in contrast, lowering the shear rate below 10 s-1 resulted in a significant increase of RBC aggregate sizes. The viscosity was found to increase with decreasing shear rate and increasing hematocrit, exemplifying the established non-Newtonian shear-thinning behaviour of blood. Increase in aggregation size did not translate into a linear increase of the blood viscosity. Temperature was shown to affect blood viscosity as expected, however, no correlation for aggregate size with temperature was observed. Non-Newtonian parameters associated with power law and Carreau models were determined by fitting the experimental data and can be used towards the simple modeling of blood's non-Newtonian behaviour in microcirculation. This work establishes a relationship between RBC aggregate sizes and corresponding shear rates and one between RBC aggregate sizes and apparent blood viscosity at body and room temperatures, in a microfluidic environment for low hematocrit. Effects of hematocrit, shear rate, viscosity and temperature on RBC aggregate sizes have been quantified.
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Affiliation(s)
- Rym Mehri
- Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario, Canada
| | - Catherine Mavriplis
- Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario, Canada
| | - Marianne Fenech
- Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario, Canada
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Mehri R, Niazi E, Mavriplis C, Fenech M. An automated method for dynamic red blood cell aggregate detection in microfluidic flow. Physiol Meas 2018; 39:01NT02. [PMID: 29227278 DOI: 10.1088/1361-6579/aaa0ad] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Red blood cell (RBC) aggregation is a unique phenomenon that occurs when red blood cells are subjected to low shear rates. Little is known about the sizes, shapes and behaviour of aggregates flowing in healthy humans. However, excessive aggregation has been shown to be an indication of pathological conditions. Therefore, characterizing RBC aggregates is important to medical research. The objective of this study was to develop a reliable technique based on image processing to assess and characterize human RBC aggregation subjected to controlled and measurable shear rates in a two-fluid flow microfluidic shearing system. APPROACH Images of RBC suspensions at [Formula: see text], [Formula: see text] and [Formula: see text] entrained by a phosphate buffered saline solution in a PDMS microchannel were captured with a high speed camera. An algorithm for processing the RBC aggregate images is presented and validated (1) on a sample of known diameter hollow glass microspheres and (2) by comparing RBC aggregate size results with those of an ImageJ image processing technique and those obtained by manual detection by two independent researchers. MAIN RESULTS The proposed image processing algorithm provides a very good agreement with the manufacturer data for the glass microspheres. It also performs well on the RBC suspension images, with errors of 2-4 [Formula: see text] with respect to the manual results. SIGNIFICANCE The proposed automated method for RBC aggregate detection is found to be reliable and fairly accurate and will serve researchers and, perhaps in the future, clinicians to assess healthy and pathological RBC aggregation under flowing conditions.
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Affiliation(s)
- R Mehri
- Author to whom any correspondence should be addressed
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7
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Kaliviotis E, Sherwood JM, Balabani S. Partitioning of red blood cell aggregates in bifurcating microscale flows. Sci Rep 2017; 7:44563. [PMID: 28303921 PMCID: PMC5355999 DOI: 10.1038/srep44563] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/09/2017] [Indexed: 12/12/2022] Open
Abstract
Microvascular flows are often considered to be free of red blood cell aggregates, however, recent studies have demonstrated that aggregates are present throughout the microvasculature, affecting cell distribution and blood perfusion. This work reports on the spatial distribution of red blood cell aggregates in a T-shaped bifurcation on the scale of a large microvessel. Non-aggregating and aggregating human red blood cell suspensions were studied for a range of flow splits in the daughter branches of the bifurcation. Aggregate sizes were determined using image processing. The mean aggregate size was marginally increased in the daughter branches for a range of flow rates, mainly due to the lower shear conditions and the close cell and aggregate proximity therein. A counterintuitive decrease in the mean aggregate size was apparent in the lower flow rate branches. This was attributed to the existence of regions depleted by aggregates of certain sizes in the parent branch, and to the change in the exact flow split location in the T-junction with flow ratio. The findings of the present investigation may have significant implications for microvascular flows and may help explain why the effects of physiological RBC aggregation are not deleterious in terms of in vivo vascular resistance.
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Affiliation(s)
- E Kaliviotis
- Dept. of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Cyprus.,Dept. of Mechanical Engineering, University College London, UK
| | - J M Sherwood
- Dept. of Bioengineering, Imperial College London, UK
| | - S Balabani
- Dept. of Mechanical Engineering, University College London, UK
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8
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Kaliviotis E, Dusting J, Sherwood JM, Balabani S. Quantifying local characteristics of velocity, aggregation and hematocrit of human erythrocytes in a microchannel flow. Clin Hemorheol Microcirc 2016; 63:123-48. [DOI: 10.3233/ch-151980] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Efstathios Kaliviotis
- Department of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol, Cyprus
- Department of Mechanical Engineering, University College London, UK
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10
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Mehri R, Mavriplis C, Fenech M. Controlled Microfluidic Environment for Dynamic Investigation of Red Blood Cell Aggregation. J Vis Exp 2015:e52719. [PMID: 26065667 PMCID: PMC4545193 DOI: 10.3791/52719] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Blood, as a non-Newtonian biofluid, represents the focus of numerous studies in the hemorheology field. Blood constituents include red blood cells, white blood cells and platelets that are suspended in blood plasma. Due to the abundance of the RBCs (40% to 45% of the blood volume), their behavior dictates the rheological behavior of blood especially in the microcirculation. At very low shear rates, RBCs are seen to assemble and form entities called aggregates, which causes the non-Newtonian behavior of blood. It is important to understand the conditions of the aggregates formation to comprehend the blood rheology in microcirculation. The protocol described here details the experimental procedure to determine quantitatively the RBC aggregates in microcirculation under constant shear rate, based on image processing. For this purpose, RBC-suspensions are tested and analyzed in 120 x 60 µm poly-dimethyl-siloxane (PDMS) microchannels. The RBC-suspensions are entrained using a second fluid in order to obtain a linear velocity profile within the blood layer and thus achieve a wide range of constant shear rates. The shear rate is determined using a micro Particle Image Velocimetry (µPIV) system, while RBC aggregates are visualized using a high speed camera. The videos captured of the RBC aggregates are analyzed using image processing techniques in order to determine the aggregate sizes based on the images intensities.
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Affiliation(s)
- Rym Mehri
- Department of Mechanical Engineering, University of Ottawa
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11
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Ma S, Sherwood JM, Huck WTS, Balabani S. The microenvironment of double emulsions in rectangular microchannels. LAB ON A CHIP 2015; 15:2327-2334. [PMID: 25900541 DOI: 10.1039/c5lc00346f] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The flow environment in inner cores of water-in-oil-in-water (w/o/w) microfluidic double emulsions has a significant impact on industrial applications of such systems. For example, in the case of shear sensitive cells compartmentalised in the cores, high shear conditions may be deleterious. This study reports on the flow characteristics of w/o/w inner cores in comparison to those in single water-in-oil (w/o) microdroplets of equal size moving in the same microchannel, resolved by means of micro-particle image velocimetry (μPIV). The multiphase flow system employed in the study had a viscosity ratio, λ, between aqueous and oil phase of the order of unity (λ = 0.78) and both single droplets and inner cores of double emulsions filled the channel. This configuration resulted in a weak recirculating flow inside the w/o single droplet: the measured flow field exhibited a uniform low velocity flow field in the central region surrounded by small regions of reversed flow near the channel walls. This flow topology was maintained in the inner cores of w/o/w double emulsions for intermediate capillary numbers (Ca) ranging from 10(-3) to 10(-2), and core morphologies varying from large plugs to pancake cores. The core morphology affected the magnitude and distribution of the velocity in the droplets. The similarity in the flow topology resulted from the fact that inner cores were located at the back of the outer droplet in such a way that inner and outer interfaces were in contact for over half of core surface area and separated only by a thin lubricating film. Both single droplets and inner cores exhibited a narrow shear rate distribution characterised by small regions of maximum shear confined near the channel walls. Shear rate magnitude values were found to be an order of magnitude lower than those in the channel and hence capable of reducing stresses in flow cytometry to far below reported values for cell damage. Hence, it can be concluded that double emulsions are suitable candidates to substitute single droplets in flow cytometry to protect the screened items and are compatible with the commercial flow cytometry systems.
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Affiliation(s)
- Shaohua Ma
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
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12
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Large scale simulation of red blood cell aggregation in shear flows. J Biomech 2013; 46:1810-7. [DOI: 10.1016/j.jbiomech.2013.05.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 05/20/2013] [Indexed: 11/22/2022]
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Sherwood JM, Kaliviotis E, Dusting J, Balabani S. Hematocrit, viscosity and velocity distributions of aggregating and non-aggregating blood in a bifurcating microchannel. Biomech Model Mechanobiol 2012; 13:259-73. [DOI: 10.1007/s10237-012-0449-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
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Sherwood JM, Dusting J, Kaliviotis E, Balabani S. The effect of red blood cell aggregation on velocity and cell-depleted layer characteristics of blood in a bifurcating microchannel. BIOMICROFLUIDICS 2012; 6:24119. [PMID: 23667411 PMCID: PMC3401208 DOI: 10.1063/1.4717755] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 04/27/2012] [Indexed: 05/10/2023]
Abstract
Red blood cell (RBC) aggregation is a multifaceted phenomenon, and whether it is generally beneficial or deleterious remains unclear. In order to better understand its effect on microvascular blood flow, the phenomenon must be studied in complex geometries, as it is strongly dependent on time, flow, and geometry. The cell-depleted layer (CDL) which forms at the walls of microvessels has been observed to be enhanced by aggregation; however, details of the characteristics of the CDL in complex regions, such as bifurcations, require further investigation. In the present study, a microchannel with a T-junction was used to analyze the influence of aggregation on the flow field and the CDL. Micro-PIV using RBCs as tracers provided high resolution cell velocity data. CDL characteristics were measured from the same data using a newly developed technique based on motion detection. Skewed and sharpened velocity profiles in the daughter branches were observed, contrary to the behavior of a continuous Newtonian fluid. RBC aggregation was observed to increase the skewness, but decrease the sharpening, of the velocity profiles in the daughter branches. The CDL width was found to be significantly greater, with a wider distribution, in the presence of aggregation and the mean width increased proportionally with the reciprocal of the fraction of flow entering the daughter branch. Aggregation also significantly increased the roughness of the interface between the CDL and the RBC core. The present results provide further insight into how RBC aggregation may affect the flow in complex geometries, which is of importance in both understanding its functions invivo, and utilizing it as a tool in microfluidic devices.
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Affiliation(s)
- J M Sherwood
- Department of Mechanical Engineering, University College London, London WC1E 7JE, United Kingdom
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