[Mechanism and significance of the accelerated erythrocyte sedimentation]

The erythrocyte sedimentation rate and stress

The effect of a 75-hour vigil on the erythrocyte sedimentation rate (ESR), i.a., was studied in two experiments with 63 healthy male volunteers. The ESR was increased at the end of the vigil compared with pre-exposure values. The increases did not correlate significantly with concomitant changes in serum triglycerides, free fatty acids, cholesterol or gammaglobulins, except for a significant, negative correlation with cholesterol changes in one of the two studies. Although the mechanism for the increases in ESR in response to stressor exposure remains unclear, it is concluded that when using the ESR in clinical practice, allowance should be made for situational factors such as the patient having experienced some stressful days and sleepless nights.

On the possibility of differential diagnosis at elevated erythrocyte sedimentation rate by analysis of the concentrations of blood plasma proteins--a model study

An elevated erythrocyte sedimentation rate is generally regarded as an unspecific and mostly pathological indicator of inflammation or tumour. However, we have determined the concentrations of plasma/serum proteins that influence the erythrocyte sedimentation rate in numerous samples from several groups of patients with different diseases, including 2 forms of cancer. Equations have been developed by which the 1 h value of erythrocyte sedimentation rate can be expressed as the sum of disease-specific coefficients for each protein multiplied by the measured concentrations of the respective proteins. These equations are shown to be disease-specific with 64-93% probability. Such equations may thus form the basis for differential diagnosis.

NMR relaxation times T1 and T2 of water in plasma from patients with lung carcinoma: correlation of T2 with blood sedimentation rate

The T1 and T2 NMR relaxation times of water protons in plasma, obtained from patients with lung carcinoma, healthy volunteers, and patients with nontumor diseases were measured at a resonance frequency of 20 MHz. Additionally hematologic parameters were determined. In tumor patients the mean plasma T2 was shortened by about 20%, and an increase in the blood sedimentation rate (BSR) was noted. Similar but less pronounced results were found for the nontumor group of patients, indicating that the shortening of T2 in plasma is a secondary host response. However, a plot of plasma 1/T2 versus BSR from tumor patients showed a significant correlation between these two parameters. No such correlation could be detected in the nontumor group of patients. The correlation of 1/T2 with BSR, found solely in the tumor patient group, increased the diagnostic sensitivity of T2 measurements and may help to differentiate between malignant and nonmalignant disease. No significant variation in the T1 spin-lattice relaxation time was observed.

Quick measurement of hematocrit and erythrocyte sedimentation-rate by means of a density tracking method

An instrument to track the sedimentation properties of red blood cells quickly and automatically and to evaluate the hematocrit as well as the plasma density of a blood sample in the same operation is described. Erythrocyte-sedimentation basically is due to the density difference between the red blood cells and the plasma and the new method makes use of the mechanical-oscillator-technique, where the resonant frequency of the bending-type oscillations of a U-shaped glass tube is related to the density of the fluid with which the tube is filled. The oscillating U-tube is part of a sedimentation-tube of special dimensions and particular spatial orientation. The tube is tilted at 60 degrees, the tip of the U-tube being raised above the horizontal plane. Filling the sedimentation-tube with anticoagulated blood first permits recording of the density of the homogeneous suspension. Then, after a few minutes, the onset of erythrocyte-sedimentation produces a decrease in recorded density. The final value is related to the density of the supernatant plasma-fluid. Hematocrit, blood and plasma density of the undiluted blood sample as well as the sedimentation-rate of the anticoagulated sample are automatically calculated from the recorded sedimentation-curve. The particular arrangement of the tilted sedimentation-tube facilitates a determination of the maximum sedimentation-rate within 15 min at most.

[Diagnostic significance of heat-induced inhibition of erythrocyte sedimentation (author's transl)]

Heat-induced inhibition of erythrocyte sedimentation (HIES) was examined in 158 cases. HIES is significantly lower in patients with a liver cell damage isolated or due to metastases of a neoplastic process in comparison to that in patients suffering from inflammation or malign tumor not involving the liver. Generally, HIES depends upon the concentration of lysophosphatidyl choline (lysolecithin) which is set free in plasma by lecithin-cholesterol-acyltransferase (LCAT) during incubation. In patients with lever cell damage, LCAT is diminished. HIES is being influenced by several factors: Lysophosphatidyl choline is bound to albumin, and this prevents its reaction on the erythrocyte surface. Lysophospholipase reduces the concentration of lysophosphatidyl choline in the plasma by splitting off its fatty acid in the alpha-position. Specific serum proteins, the so-called agglomerines, which are responsible for the acceleration of erythrocyte sedimentation, are counteracting the HIES. The concentration of albumin and agglomerines in plasma and the activity of lysophospholipase are subject to physiologically and pathologically caused deviations. Thereby, HIES is being influenced individually at varying degrees. This makes it difficult to estimate the LCAT activity which represents the principal cause of HIES. As a consequence, HIES seems not to be suitable for clinical diagnostics.

[The mechanism of blood cell sedimentation. XVIII. Sedimentation effect of fibrinogen plasminolysis products]

Various high molecular weight plasmin degradation products of fibrinogen were isolated by chromatographic procedures and investigated to what extent they influence the sedimentation rate of erythrocytes in heparinized serum. Among the early plasminolysis products Fragment X accelerated the sedimentation rate considerably although it was less effective than fibrinogen. Fragment Y showed a weaker but clearly demonstrable agglomerine activity. The late plasminolysis products D and E were ineffective, if applied alone and in concentrations equivalent to the fibrinogen content of plasma. However, they promoted the sedimentation effect of fibrinogen. If present in considerably higher concentrations are Fragments D and E, in absence of fibrinogen, also accelerated the sedimentation rate of erythrocytes significantly. A mixture of D and E was not more effective than the single compounds.