{Biochemistry} Sickle cell anemia is a genetic disease resulting from a single amino acid substitution (glutamate to valine in the sixth position, or E6V) in the hemoglobin chain. This mutation causes hemoglobin to polymerize into strands in the deoxygenated state, leading to the erythrocytes forming a sickled shape. Explain why the mutation leads to the polymerization of hemoglobin and why this only happens in the deoxygenated state..