Membrane alterations in irreversibly sickled cells: hemoglobin--membrane interaction

Atomic force microscopy reveals involvement of the cell envelope in biomechanical properties of sickle erythrocytes

BACKGROUND

Intracellular hemoglobin polymerization has been supposed to be the major determinant for the elevated rigidity/stiffness of sickle erythrocytes from sickle cell anemia (SCA) patients. However, the contribution of the cell envelope remains unclear.

RESULTS

In this study, using atomic force microscopy (AFM), we compared the normal and sickled erythrocyte surfaces for stiffness and topography. AFM detected that sickle cells had a rougher surface and were stiffer than normal erythrocytes and that sickle cell ghosts had a rougher surface (for both outer and inner surfaces) and were thicker than normal ghosts, the latter implying a higher membrane-associated hemoglobin content/layer in the sickle cell envelope. Compared to healthy subjects, the SCA patients had lower plasma lipoprotein levels. AFM further revealed that a mild concentration of methyl-β-cyclodextrin (MβCD, a putative cholesterol-depleting reagent) could induce an increase in roughness of erythrocytes/ghosts and a decrease in thickness of ghosts for both normal and sickle cells, implying that MβCD can alter the cell envelope from outside (cholesterol in the plasma membrane) to inside (membrane-associated hemoglobin). More importantly, MβCD also caused a more significant decrease in stiffness of sickle cells than that of normal erythrocytes.

CONCLUSIONS

The data reveal that besides the cytosolic hemoglobin fibers, the cell envelope containing the membrane-associated hemoglobin also is involved in the biomechanical properties (e.g., stiffness and shape maintenance) of sickle erythrocytes.

Shear-Stress-Gradient and Oxygen-Gradient Ektacytometry in Sickle Cell Patients at Steady State and during Vaso-Occlusive Crises

Oxygen gradient ektacytometry (oxygenscan) measures the changes in red blood cell (RBC) deformability in normoxia and during deoxygenation. We investigated the changes in RBC deformability, measured by both oxygenscan and classical shear-stress-gradient ektacytometry, in 10 patients with sickle cell disease (SCD) during vaso-occlusive crisis (VOC) versus steady state. Oxygenscan and shear-stress-gradient ektacytometry parameters were also measured in 38 SCD patients at steady state on two different occasions. Shear-stress-gradient ektacytometry parameters, maximal RBC deformability at normoxia and the minimum RBC deformability during deoxygenation were lower during VOC compared to steady state. The oxygen partial pressure at which RBCs started to sickle (PoS) was not significantly affected by VOC, but the results were very heterogeneous: the PoS increased in 5 in 10 patients and decreased in 4 in 10 patients. Both oxygenscan and shear-stress-gradient ektacytometry parameters remained unchanged in patients at steady state between two sets of measurements, performed at 17 ± 8 months intervals. In conclusion, the present study showed that both oxygen gradient ektacytometry and shear-stress-gradient ektacytometry are sensitive to disease activity in SCD, and that both techniques give comparable results; however, the oxygen-dependent propensity of RBCs to sickle was highly variable during VOC.

Phase changes in membrane lipids in sickle red cell shed-vesicles and sickle red cells

Lipid phase transformations may occur in the membranes of sickle red cell shed-vesicles and sickle red cells. The presence of such phase changes could be important in sickle cell disease since membrane phase changes appear to contribute to the generation of antiphospholipid antibodies that are thrombophilic and occur in sickle cell disease. In the present study, we have evaluated sickle red cell shed-vesicles and sickle red cells for the presence of non-bilayer lipid phases using 31P-NMR spectroscopy. Results show that the spectra of both the shed-vesicles and the sickle red cells are compatible with the occurrence of non-bilayer phases in the membrane bilayers. The findings support the concept that these membranes could contribute to the generation of antiphospholipid antibodies in sickle cell disease.

Erythrocyte membrane vesicles and irreversibly sickled cells bind protein S

Plasma levels of free protein S, a vitamin K-dependent anticoagulant, are decreased in persons with sickle cell anemia, but the etiology of the low levels is unknown. Protein S binds to phosphatidylserine-containing phospholipids in a calcium-dependent manner. Other studies have indicated that phosphatidylserine may be abnormally present on the outer surface of the membrane lipid bilayer of sickle cells and of the spectrin-depleted vesicles they shed in vivo. We studied the binding of purified, radiolabeled protein S to spectrin-depleted erythrocyte membrane vesicles and to density-separated fractions of sickle and normal erythrocytes. Calcium-dependent binding of protein S occurred with vesicles and with well-aerated dense irreversibly sickled cells, but not with well-aerated sickle discocytes or with normal erythrocytes. These data provide further evidence that phosphatidylserine is abnormally present on the outer surface of spectrin-depleted vesicles and of irreversibly sickled cells. In addition, protein S binding to such sickle membranes in vivo may be responsible, in part, for the decreased levels of free protein S in sickle cell plasma.

Hereditary elliptocytosis associated with spectrin Le Puy in a Japanese family: ultrastructural aspect of the red cell skeleton

A dominantly-inherited hereditary elliptocytosis of intermediate severity was recorded in a Japanese family from Yamagata. The condition was associated with a spectrin truncated beta-chain (MW: 214 kD; 31% of total beta-spectrin), and a defect of mutant spectrin as regards tetramerization and phosphorylation. cDNA analysis revealed skipping of exon X, the third-to-last exon of the spectrin beta-gene. At the gene level, a one-base substitution (A-->G) changed position +4 of the 5' donor splice site consensus sequence of intron X. This mutation has been described before in a French kindred, defining spectrin Le Puy. Electron micrographs following quick-freeze deep-etching showed that the skeletal network was disorganized.

Image analysis studies of the degree of irreversible deformation of sickle cells in relation to cell density and Hb F level

We analyzed, quantitatively by image analysis, the degree of irreversible deformation of red cells (SS cells) from patients with homozygous sickle cell disease, and studied the relationships among the degree of irreversible cell deformation, cell density, and Hb F level. SS cells from 25 patients (aged 1-36 years) whose Hb F levels ranged from 2.5% to 40.0%, were fully oxygenated and then were separated into four fractions by density centrifugation. Every fraction was studied for morphology and Hb F content. We found that the irreversible deformation of SS cells from the circulation occurred mainly by elongation and that the degree of elongation was extremely variable. We also found that in the cells of patients with Hb F levels < 20% the degree of irreversible elongation increases as cell density increases, suggesting that dehydration occurs concomitantly with irreversible elongation. Statistical analysis (Student t test) indicated that there were significant differences (P = 0.008 or < 0.001) in the degree of elongation among density-fractionated SS cells from patients with Hb F < 20%, although there was no significant difference (P > 0.1) among those from patients with Hb F > or = 20%. We also found that cell density increased as Hb F level of the density fraction decreased in all patients with Hb F < 20% but not always in those with Hb F > or = 20%. This suggests that cells with lower Hb F levels are selectively susceptible to dehydration. Furthermore, we found that the mean degree of irreversible elongation decreases linearly with increasing levels of Hb F and reaches the normal range at 21-24%. Since the degree of irreversible deformation of SS cells quantified by image analysis is directly related to cell density, and inversely to Hb F levels, mechanical stress or membrane damage caused by Hb S polymerization may be an important factor in the formation of dense cells in vivo.

Flow dynamics of human sickle erythrocytes in the mesenteric microcirculation of the exchange-transfused rat

To analyze the microvascular rheology of sickle cells in an intact animal model, rats were isovolemically exchange transfused with human normal (hemoglobin AA) or sickle (hemoglobin SS) erythrocytes (blood group O) or autologous red cells under ambient conditions, and the effects of the heterologous or autologous cells on (a) hemodynamics and respiration, (b) blood gases, and (c) acid-base status of the recipients were determined. Exchange transfusion of rats with autologous red cells or hemoglobin AA or hemoglobin SS erythrocytes was associated with stable mean arterial blood pressure, central venous pressure, respiration rate, blood pH, pCO2, and pO2 during the experimental period, except for tachycardia among the group of rats that received HbSS cells. Arteriovenous oxygen content varied among the three groups of animals, but, nonetheless, suggested adequate tissue oxygen supply under the conditions of the study. Acid-base status also was similar in the three groups of rats. The exchange-transfused rats were utilized to investigate the flow dynamics of red cells in the mesenteric microcirculation by applying intravital microscopy. Time-averaged velocities of the autologous red cells in 16- to 30-microns (id) vessels ranged from 1.07 to 1.25 mm/sec in single unbranched arterioles with varying flux and wall shear rates. Time-averaged velocities of the HbAA cells in single 15- to 35-microns arterioles ranged from 1.16 to 1.24 mm/sec with wall shear rates similar to the estimates for the autologous cells. For both rat and human HbAA RBCs, the flow dynamics were indicative of normal shear-dependent and deformability characteristics of the cells under the flow conditions. Sickle cells exhibited time-averaged velocities of 0.384 to 0.452 mm/sec, lower wall shear rates in 10- to 35-microns single unbranched arterioles, and three times less volumetric flux. In some arterioles, sickle cells with high axial ratio and low deformability showed definite adhesion to the endothelial surface, residing at such sites for several seconds until dislodged by the force of flow. Within single unbranched vessels or at microvascular bifurcations, sickle elliptocytes and sickle echinocytes with low deformability and high axial ratio obstructed flow and exhibited residence times of 2 to 88 sec, thereby causing stasis. These data illustrate the microvascular flow behavior of sickle cells and demonstrate the rheological disequilibrium state that can result as sickle cells course through successive segments of the microcirculation.

Changes in membrane polypeptides, polyphosphoinositides and phosphatidate in dense fractions of sickle cells

When sickle erythrocytes were fractionated on discontinuous isotonic stractan gradients the denser fractions, which were rich in irreversibly sickled cells contained less polyphosphoinositides and more phosphatidate than either lighter sickle cell fractions or normal cells. These changes could be due to activation of a polyphosphoinositide phosphodiesterase in the denser cells. Membrane polypeptide analysis of the denser fractions also showed a marked depletion of band 4.1 and a protein of molecular mass about 110 kDa but an increased amount of a 180 kDa polypeptide which might be a breakdown product of ankyrin. These biochemical alterations could be consequences of Ca2+ accumulation in the denser sickle cells and may contribute to the structural alterations which give rise to irreversibly sickled cells.

Lateral mobility of a lipid analog in the membrane of irreversible sickle erythrocytes

The major feature of sickle cell anemia is the tendency of erythrocytes to sickle when exposed to decreased oxygen tension and to unsickle when reoxygenated. Irreversible sickle cells (ISCs) are sickle erythrocytes which retain bipolar elongated shapes despite reoxygenation. ISCs are believed to owe their biophysical abnormalities to acquired membrane alterations which decrease membrane deformability. While increased membrane surface viscosity has been measured in ISCs, the lateral dynamics of membrane lipids in these cells have not heretofore been examined. We have measured the lateral diffusion of the lipid analog 3,3'-dioctadecylindocyanine iodide (DiI) in the plasma membrane of intact normal erythrocytes, reversible sickle cells (RSCs), and irreversible sickle cells by fluorescence photobleaching recovery (FPR). The diffusion coefficients +/- standard errors of the mean of DiI in intact normal red blood cells (RBCs), RSCs, and ISCs at 37 degrees C are (8.06 +/- 0.29) X 10(-9) cm2 X s-1, (7.74 +/- 0.22) X 10(-9) cm2 X s-1, and (7.29 +/- 0.24) X 10(-9) cm2 X s-1, respectively. A similar decrease in the diffusion coefficient of DiI in the plasma membranes of the three cell types was observed at 4, 10, 17, 23, and 30 degrees C. ANOVA analysis of the changes in DiI diffusion showed significant differences between the RBC and ISC membranes at all temperatures examined. The characteristic breaks in Arrhenius plots of the diffusion coefficients for the RBCs, RSCs, and ISCs occurred at 20, 19, and 18.6 degrees C, respectively. Photobleaching recovery data were used to estimate (Boullier, J.A., Melnykovich, G. and Barisas, B.G. (1982) Biochim. Biophys. Acta 692, 278-286) the microviscosities of the plasma membranes of the three cell types at 25 degrees C. We find significant differences between our microviscosity values and those obtained in previous fluorescence depolarization studies. However, both methods indicate qualitatively similar differences in membrane microviscosity among the various cell types.

The mechanism of in vitro formation of irreversibly sickled cells and modes of action of its inhibitors

When red blood cells from sickle-cell patients were exposed to repeated cycles of deoxygenation and reoxygenation (one cycle was 5 min), dehydration of the cells was observed after several cycles of the sickling-desickling process. These dehydrated cells still maintained a biconcave form after 1 h of such cycling, but they started to take the form of irreversibly sickled cells after several hours. If red cells were simply kept deoxygenated for 16 h, neither dehydrated cells nor irreversibly sickled cells were formed. The formation of dehydrated cells was inhibited either by elimination of Ca2+ from the medium, or by the increase of K+ concentration in the medium. Under conditions in which dehydrated cells were not formed, i.e., deoxygenation incubation (either in the absence or presence of Ca2+) or the deoxygenation-reoxygenation cycling in the absence of Ca2+, 15-25% of cellular K+ leaked out during 4 h of incubation. When dehydrated cells were formed in deoxygenation-reoxygenation cycling in the presence of Ca2+, 40-50% of K+ was lost in 4 h. Two different types of inhibitor were found. The first type includes inhibitors of the Ca2+-activated K+ efflux, such as quinine, quinidine or tetraethylammonium chloride. These compounds suppressed both the K+ efflux and the formation of dehydrated cells. The second type includes calmodulin-interacting drugs. For example, chlorpromazine (20 microM) inhibited the formation of dehydrated cells almost completely, even though it did not inhibit the K+ efflux remarkably. Several other calmodulin-binding drugs were found to inhibit the formation of dehydrated cells similarly, and the potency of these drugs to inhibit the formation seems to be related to the binding affinity of these drugs to calmodulin.

The effect of erythrocyte membrane on the birefringence formation of sickle cell hemoglobin

The birefringence formation of sickle cell hemoglobin (HbS) in a thin liquid layer was observed while its environment was deoxygenated at different rates, and the effect of membrane was examined. Under slow rate of deoxygenation at 37 degrees C, at pH 7.4, the birefringence of purified HbS appeared at a concentration higher than 24% and its relative magnitude increased as the concentration was increased. Similarly, the partial pressure of oxygen, at which the birefringence formation was evident, increased from 0 to 27 torr as the concentration of HbS was increased from 24 to 28%, but it remained the same above this protein concentration. In all the samples tested relative birefringence was largest at the slow rate of deoxygenation (30 torrO2/min) and the magnitude decreased as the rate of deoxygenation was increased. The samples showed different sensitivity to the rate of deoxygenation. For example, while the total untreated hemolysate made by freeze-thawing of packed sickle cells was most resistant to the increased rates of deoxygenation, purified HbS was not. Washed open ghosts partially restored the birefringence formation pattern of purified HbS. The results indicate that the inner surface of the membranes of erythrocytes could behave as a template for large HbS polymer formation at relatively higher rates of deoxygenation.

Abnormal membrane protein methylation and merocyanine 540 fluorescence in sickle erythrocyte membranes

Sickle cell erythrocytes exhibit reduced carboxyl methylation of membrane proteins compared to normal erythrocytes. This altered methylation in sickle membrane proteins is also observable when extracted membranes, both intact and alkali treated, were used as substrates for the homologous protein methylase II (S-adenosylmethionine:protein-carboxyl O-methyltransferase, EC. 2.1.1.24). However, when glycophorin A, one of the major methyl acceptors in both membranes, was extracted by lithium diiodosalicylate and used as the methyl acceptor, the proteins from both membranes were methylated equally, suggesting an involvement of membrane structure in membrane-bound protein methylation. Merocyanine 540 (MC-540), a fluorescent probe, was used to determine if the membranes differed in organization. Incubation of both normal and sickle erythrocytes membranes with MC-540 produced a marked increase in extrinsic fluorescence, reflecting a relatively nonpolar environment for the dye bound to the membranes. The fluorescence from sickle cell ghosts was only 87% as intense as that from normal ghosts, while the actual amount of MC-540 associated with sickle cell membranes was only 62% of normal. These data suggest that differences exist in the distribution of surface charges on these plasma membranes. These results are consistent with the hypothesis that abnormal levels of membrane protein methylation observed in sickle erythrocytes may be a result of abnormal membrane organization characteristic to sickle cell anemia.

Inhibition of the in vitro formation of irreversibly sickled cells by cepharanthine

A method was developed to prepare irreversibly sickled cells (ISC) in vitro under a physiological condition. By exposing sickle red cells to repeated deoxygenation-reoxygenation cycles for 15 h at 37 degrees C, 20-30% of the red cells formed ISC. These cells were separated from biconcave-shaped cells by a gradient density centrifugation. The percentage of the formation of ISC was determined spectrophotometrically after cells were haemolysed. Cepharanthine, a bisbenzylisoquinoline alkaloid, was found to inhibit this in vitro formation of irreversibly sickled cells by 50% at 15 microns. This concentration was much lower than that required to inhibit the in vitro sickling.

Impaired pentose phosphate shunt function in sickle cell disease: a potential mechanism for increased Heinz body formation and membrane lipid peroxidation

The red cells' antioxidant defense mechanisms were compared between individuals with sickle cell disease and those with hemolytic anemia and reticulocytosis. In sickle cell disease, there was a significant increase in incubated Heinz body formation (p less than .001), a decrease in reduced glutathione concentration (p less than .01), an increase in glucose-6-phosphate dehydrogenase activity (p less than .01), and a decrease in glutathione reductase activity (p less than .005). The patients with sickle cell disease hd an absolute increase in the activity of the pentose shunt in the intact red cell after methylene blue stimulation (p less than .05) and in red cell hemolysates (p less than .0250. Heinz body formation (r = .75) and pentose shunt activity in red cell hemolysates (r = .83) were strongly related to the degree of reticulocytosis. Although there was a correlation between the pentose shunt activity in the stimulated red cell and in red cell hemolysates for the patients with hemolytic anemia (r = .58), stimulated shunt activity did not increase as the hemolysate shunt activity increased for the patients with sickle cell disease. There were very strong relationships between the ATP concentration and the reticulocyte count (r = .80) and the hemolysate pentose shunt activity (r = .77) in sickle cel disease. These data suggest that in spite of an absolute increase in stimulated pentose shunt activity, there Is a relative suppression of stimulated shunt activity in the youngest sickle erythrocytes. This may be related, in part, to the inhibitory effects of high concentrations of ATP on the activity of glucose-6-phosphate dehydrogenase.

Effects of valinomycin, A23187 and repetitive sickling on irreversible sickle cell formation

The formation of irreversibly sickled red cells has been studied by inducing cell shrinkage, ion loss, Ca2+ accumulation and membrane loss either singly or in combination. Valinomycin, A23187+Ca2+ or hypertonic saline caused shrinkage of the cells with retention of the sickled form after reoxygenation. The cells which had retained the sickle shape after treatment with the ionophores and reoxygenation remained sickled after exposure to hypotonic media. These cells were also osmotically insensitive. Retention of the sickled form was not dependent upon membrane loss as induced by repeated sickle-unsickle cycles or by A23187+Ca2+ treatment although repetitive sickling did give rise to shorter, stubbier spicules. Sickled red cells, either the endogenous irreversibly sickled cells or the sickled cells induced by deoxygenation, did not lose membrane by vesicle or spicule loss as normal cells or oxygenated sickle red cells do. Cell water loss without cell membrane loss appears to be an important factor in the irreversible sickling of red cells.

Spin-label detection of sickle hemoglobin--membrane interaction at physiological pH

The spin-label electron paramagnetic resonance technique has been used to compare the interactions of normal and sickle hemoglobin molecules with human erythrocyte membranes. The sickle hemoglobin molecules show an enhanced binding to membranes when compared to normal hemoglobin (HbA) molecules. Using a simple equilibrium model for hemoglobin--membrane interactions, we obtain an equilibrium dissociation constant for sickle hemoglobin of about half that of HbA at pH 7.4 in 5 mM phosphate at 20 degrees C. The interactions are very low affinity in nature and are stronger at lower pH than at pH 7.4 (Fung, 1981a). The difference between normal and sickle hemoglobin persists at both high (pH 7.4) and low (pH 6.7) pH values. The concentrations of hemoglobin at the saturation level are close to physiological concentrations. Removal of spectrin--actin protein molecules from the membranes causes little change in the interactions, indicating that the remaining membrane proteins play the primary role in hemoglobin--membrane interactions. This observation is further supported by data of spectrin--actin-depleted inside-out vesicle samples. The stronger interaction of sickle hemoglobin than normal hemoglobin with membranes is discussed in relation to the formation of irreversibly sickled cells.

Cytosolic protein binding to band-3 protein inhibits endocytosis of isolated human erythrocyte membranes

Recent studies of haemoglobin binding to the cytoplasmic side of the erythrocyte membrane have shown that the predominant high-affinity interaction occurs with the major integral membrane protein known as band-3 protein and that this interaction may occur within the intact erythrocyte in a manner regulated by cell pH. We report here that haemoglobin and glyceraldehyde 3-phosphate dehydrogenase binding to band-3 protein in isolated membranes can inhibit endocytosis during vesiculation in vitro. The specificity of this effect was demonstrated by showing that myoglobin, which has an affinity for the membrane fully one to two orders of magnitude lower than that for haemoglobin, does not inhibit endocytosis.

Identification of the hemoglobin binding sites on the inner surface of the erythrocyte membrane

The hemoglobin binding sites on the inner surface of the erythrocyte membrane were identified by measuring the fraction of hemoglobin released following selective proteolytic or lipolytic enzyme digestion. In addition, binding stoichiometry to and fractional hemoglobin release from inside-out vesicle preparations of human and rabbit membranes were compared since rabbit membranes differ significantly from human membranes only in that they lack glycophorin. Our results show that rabbit inside-out vesicles bind about 65% less human or rabbit hemoglobin under conditions of optimal and stoichiometric binding, despite being otherwise similar in composition. We suggest that this difference is either directly or indirectly due to the absence of glycophorin in rabbit membranes. Further supportive evidence includes demonstrating (a) that neuraminidase treatment of human membranes did not affect hemoglobin binding and (b) that reconstitution of isolated glycophorin into phospholipid vesicles increased the hemoglobin binding capacity in a manner proportional to the fraction of glycophorin molecules oriented with their cytoplasmic sides exposed to the exterior of the vesicle. Proteolysis of human inside-out vesicles either before or after addition of hemoglobin reduced the binding capacity by about 25%. This is consistent with the known proportion of total hemoglobin binding sites involving band 3 protein and the selective lability of the cytoplasmic aspect of band 3 protein to proteolysis. Phospholipid involvement in hemoglobin binding was determined using various phospholipase C preparations which differ in their reactivity profiles. Approximately 38% of the bound hemoglobin was released upon cleavage of phospholipid headgroups. These results suggest that the predominant sites of binding for hemoglobin on the inner surface of the red cell membrane are the two major integral membrane glycoproteins.

Isolation of human erythrocyte inside-out vesicles alters their molecular architecture

Inside-out (I.O.) vesicles isolated from human erythrocyte ghosts induced to endocytose have been used for biochemical studies to determine localization of molecules within the membrane. It was the purpose of this study to examine such vesicles by freeze-etch electron microscopy to determine the architecture of the peripheral proteins on the protoplasmic surface. Examination of the I.O. vesicles while still in the interior of the ghosts showed that a globular material was randomly distributed on the outer surface (protoplasmic surface of the original plasma membrane) of the I.O. vesicles. The random distribution of the globular material becomes altered, however, if the I.O. vesicles are isolated from the ghosts by shearing and centrifugation. Freeze-etching of these isolated I.O. vesicles revealed that the globular material was now clustered on the protoplasmic surface (PS), as were the intramembranous particles (IMPs) in the extracellular face. Thus, the lateral mobility of the IMPs is dependent upon the distribution of molecules at the protoplasmic surface of the membrane. Moreover, this change in distribution of the globular material at the surface is not due to a partial loss of major membrane proteins, because SDS-polyacrylamide gel electrophoresis revealed that equal amounts of the major proteins were present in nonisolated vesicles as compared to isolated vesicles. Although isolated I.O. vesicles have been used extensively to demonstrate that glycoproteins span the membrane, these results suggest that one should cautiously interpret data obtained from such isolated vesicles in view of the fact that there is an alteration of the distribution and perhaps configuration of molecules at the PS following isolation of I.O. vesicles.

Spin-label detection of hemoglobin-membrane interaction at physiological pH

The interaction between hemoglobin and the cytoplasmic surface of human erythrocyte membranes at physiological pH was studied by monitoring the electron paramagnetic resonance (EPR) signal of spin-labeled membrane ghosts in hemoglobin solutions of various concentrations. The EPR spectra indicate the existence of a significant hemoglobin-membrane interaction which exhibits a substantial hemoglobin concentration dependence over the concentration range 0-12 mg/mL. An equilibrium binding model yields a hemoglobin-membrane dissociation constant, Kd, on the order of 10(-4) M, at and above physiological pH; the interaction is classified as very low-affinity binding. The interaction increases significantly when the pH is decreased. Half-saturation of the binding sites occurs at a ratio of about 10(8) hemoglobins per cell.

Microvesicles from sickle erythrocytes and their relation to irreversible sickling

Incubation of sickle (HbS) erythrocytes for periods up to 96 h leads to the formation of irreversibly sickled cells (ISCs) and to the release of spectrin-free microvesicles similar to those derived from aged or Ca2+-ionophore-treated normal erythrocytes. The sickle microvesicles were somewhat larger than those from normal cells and showed minor differences in their membrane polypeptide composition. Sickle microvesicles were no different from their parent cells in their content of fetal haemoglobin. Neither microvesiculation nor formation of irreversibly sickled cells required the presence of Ca2+ in the medium but Ca2+ did accelerate both processes. Although in these prolonged incubations microvesiculation appeared to occur concomitantly with the formation of ISCs, it is not clear whether or not microvesiculation is a necessary prelude to irreversible sickling.

Effect of a 'sickling pulse' on calcium and potassium transport in sickle cell trait red cells

1. To trace the early development of the extensive functional membrane abnormalities found in sickle cell anaemia red cells which result from polymerization of haemoglobin S, we followed the effects on Ca and K transport of an in vitro sickling pulse in sickle cell trait (SA) red cells, whose membranes are initially normal.2. Sickling induced a progressively larger uptake of Ca in fed, starved and ATP-depleted SA cells, always substantially higher than that in normal (AA) red cells under comparable conditions. The fraction of ionized Ca within the SA cells, estimated from the equilibrium distribution of (45)Ca induced by the ionophore A23187 was about 0.4 of the total Ca content and similar in SA and AA cells.3. With ATP-depleted SA cells, Ca uptake (representing Ca permeability) was maximal during sickling and was only partially reduced towards normal after desickling. Net Ca uptake during sickling of fed or starved SA cells reverted to net Ca loss upon reoxygenation, irrespective of the Ca gradient, indicating full restoration of the low Ca permeability of the control conditions.4. Following desickling of both fed and starved SA cells, the rates of uphill extrusion of Ca gained during sickling were much smaller than those expected with normal Ca pumps operating at similar internal Ca concentrations.5. After 2 hr sickling ATP levels in starved SA cells were reduced by 50% regardless of the presence or absence of Ca in the medium; therefore sickling-induced Ca uptake was associated with no measurable consumption of ATP due to Ca-pump activity.6. With ATP-depleted SA cells, a Ca uptake of 2-3 mumole/l. cells elicited a maximal response of the K permeability system resulting in full equilibration of the K pools in the cell suspensions. Sickling of fed and starved SA cells produced a small increase in K permeability which was entirely independent of the presence or absence of Ca.7. Sickled forms persisted after reoxygenation only with ATP-depleted SA cells and were more frequent after sickling in the presence of Ca (about 20%) than in a Ca-free medium (about 4%).8. These findings show that initial sickling produces an increased Ca permeability whose extent and reversibility depends on the metabolic state of the cells, and a partial Ca-pump failure, which appears to be irreversible. We confirm a small sickling-related, reversible increase in K permeability but a Ca-dependent increase in K permeability does not occur unless the cells are fully depleted of ATP. The implications for sequential development of related abnormalities in SS cells are discussed.

Interaction of sickle cell hemoglobin with erythrocyte membranes

The interactions of hemoglobin S with the erythrocyte membrane were compared with the corresponding interactions of hemoglobin A by measuring in both steady-state and kinetic experiments the quenching of the fluorescence of a probe embedded in erythrocyte membranes. Whereas hemoglobin A could be dissociated from membranes, a fraction of hemoglobin S was irreversibly bound even in the oxy state. Deoxyhemoglobin S interacted much more strongly with erythrocyte membranes than did deoxyhemoglobin A: a portion of the deoxyhemoglobin S was irreversibly bound, and the reversibly bound fraction of hemoglobin S dissociated more slowly than did deoxyhemoglobin A. It is suggested that the binding of deoxyhemoglobin S is a two-step reaction in which the first step involves electrostatic interaction with band III erythrocyte membrane protein and the second step involves a hydrophobic interaction with membrane lipids. The latter reaction reflects the greater hydrophobicity of hemoglobin S. The unique interaction of hemoglobin S with erythrocyte membranes may be important in the formation of irreversibly sickled cells.

Sickle red cell calcium metabolism: studies on Ca2+-Mg2+ATPase and Ca-binding properties of sickle red cell membranes

Sickle (Hb SS) red cells, preloaded with 45Ca by reversal of hemolysis, exhibit an incomplete 45Ca extrusion, retaining approximately four times more 45Ca than normal cells. Studies indicated that neither the reduction in Hb SS cell Ca2+-Mg2+ ATPase activity (84% of normal) nor the activation of Ca2+-Mg2+ ATPase by calmodulin was sufficiently different from normal cells to attribute a major role to the calcium pump in 45Ca retention. These results suggested that 45Ca retention may reflect an alteration in the calcium-binding properties of Hb SS cell membranes. Low-affinity calcium-binding (freely dissociable) was similar in normal and Hb SS cell membranes. However, the total calcium bound with high-affinity (tightly bound) was four-to-five times greater in Hb SS cell membranes than in normal membranes. These results are compatible with the hypothesis that Hb SS cell 45Ca retention reflects an exchange of a fraction of the total 45Ca with a tightly bound calcium pool, larger in Hb SS cell membranes than in normal membranes. A comparable degree of red cell 45Ca retention, which did not correlate with the reticulocyte population, was observed in other chronic anemic states. These findings suggest that the increased high-affinity calcium binding by the membrane may be a consequence of cellular changes induced by the anemic condition.