Erythrocyte Membrane Damage in Hemolytic Anemias. In: Harris JR, editor. Erythroid Cells. Boston: Springer US; 1990. pp. 455-73. [DOI: 10.1007/978-1-4757-9528-8_15]

Selective amphipathic nature of chlorpromazine binding to plasma membrane bilayers

Chlorpromazine (CPZ), an antipsychotic agent shown to inhibit the action of various neurophysiological receptors, also exhibits preferential association with the plasma membrane, inducing stomatocytic morphological response in red blood cells (RBC). Given the cationic nature of CPZ, fluorimetry, pH titration, and red cell morphological studies were performed to assess the associative predilection of CPZ for anionic membrane components. CPZ fluorescence intensity increased 320-370% upon addition of phosphatidylcholine (PC) small unilamellar vesicles (SUVs) to aqueous CPZ, indicating an affinity of the drug for lipidic phases. After removal of unbound drug, CPZ fluorescence increased up to 92% with increasing phosphatidylserine (PS) in the lipid phase (up to 30 mol% of total lipid), suggesting a preferential association of the drug with anionic lipids. In studies of pH titration, the pK(a) of CPZ in the presence of Triton X-100 micelles or phospholipid SUVs increased with increasing anionicity of the lipidic phase [7.8 with Triton X-100, 8.0 with PC, 8.3 with phosphatidylglycerol (PG)], lending further support to preferential drug interaction with anionic lipidic components. At 0 degrees C, CPZ-induced red cell shape change was less extensive in cells made echinocytic by adenosine triphosphate (ATP) depletion, compared to cells made echinocytic by PS treatment following vanadate preincubation. This suggests that polyphosphoinositide lipids are CPZ membrane binding sites. Since polyphosphoinositide lipids are implicated as important intermediates in a number of receptor-mediated cell signaling pathways, evidence of association with these specific lipids provides a means by which psychoactive drugs may induce neurophysiological effects through direct interaction with general membrane components.

Red blood cells

Red blood cells are derived from haemopoietic stem cells in bone marrow. Following a series of maturation steps, directed largely by the hormone erythropoietin (Epo), red cells enucleate and enter the circulatory system. In circulation these small, flexible biconcave cells containing haemoglobin transport O(2) from the lungs to the periphery, and CO(2) back from the periphery to the lungs. The most common disorders associated with red blood cells are anaemias. While there are numerous causes of anaemia, the reduced capacity for gaseous exchange is the underlying theme. Over the past 15 years, recombinant Epo has been used extremely successfully in the treatment of several forms of anaemia. The single gene disorders collectively known as haemoglobinopathies represent one of the best opportunities for gene therapy.