On the shape of human red blood cells interacting with flat artificial surfaces--the 'glass effect'

The Shape of Human Red Blood Cells Suspended in Autologous Plasma and Serum

(1) Background: In almost all studies of the shape of the human red blood cell (RBC), the suspending medium was a salt solution supplemented with albumin. However, the ratio of thickness across the dimple region to the thickness of the rim (THR) depends on the albumin concentration. Values of the THR in the literature range from 0.27 to 0.627 whereas in the present work it was 0.550 or 0.601 whether measured in plasma or serum. (2) Methods: 9911 RBCs of eight donors were suspended in autologous plasma or serum. Sedimented RBCs were observed under bright field illumination at 416 nm. From the profiles of gray value, the THR was determined. (3) Results: The THR displays a wide distribution within a single blood sample. A direct correlation of THR and spontaneous curvature of the membrane is likely. The variation of the mean THR between different donors is large. The aspect ratio of RBCs viewed face-on ranged on average from 1 to 1.48. In oval RBCs, the rim is thicker along the major axis than along the minor axis, an effect increasing with increasing aspect ratio. Remodeling of the membrane skeleton occurs in vivo with a characteristic time (τ) on the order of 1 h. (4) Conclusions: Consideration of these data in models of RBC behavior might improve the agreement with observations. τ≈1 h suggests a more general type of reference configuration of the membrane skeleton than a stress free shape.

Label-free imaging and classification of live P. falciparum enables high performance parasitemia quantification without fixation or staining

Manual microscopic inspection of fixed and stained blood smears has remained the gold standard for Plasmodium parasitemia analysis for over a century. Unfortunately, smear preparation consumes time and reagents, while manual microscopy is skill-dependent and labor-intensive. Here, we demonstrate that deep learning enables both life stage classification and accurate parasitemia quantification of ordinary brightfield microscopy images of live, unstained red blood cells. We tested our method using both a standard light microscope equipped with visible and near-ultraviolet (UV) illumination, and a custom-built microscope employing deep-UV illumination. While using deep-UV light achieved an overall four-category classification of Plasmodium falciparum blood stages of greater than 99% and a recall of 89.8% for ring-stage parasites, imaging with near-UV light on a standard microscope resulted in 96.8% overall accuracy and over 90% recall for ring-stage parasites. Both imaging systems were tested extrinsically by parasitemia titration, revealing superior performance over manually-scored Giemsa-stained smears, and a limit of detection below 0.1%. Our results establish that label-free parasitemia analysis of live cells is possible in a biomedical laboratory setting without the need for complex optical instrumentation. We anticipate future extensions of this work could enable label-free clinical diagnostic measurements, one day eliminating the need for conventional blood smear analysis.

Serum Prevents Interactions between Antimicrobial Amphiphilic Aminoglycosides and Plasma Membranes

Antimicrobial cationic amphiphiles have broad-spectrum activity, and microbes do not readily develop resistance to these agents, highlighting their clinical and industrial potential. Cationic amphiphiles perturb the integrity of membranes leading to cell death, and the lack of discrimination between microbial and mammalian plasma membranes is thought to be one of the main barriers of using these agents for the treatment of systemic infections. Here, we describe the synthesis and study of 20 antimicrobial cationic amphiphiles that are derivatives of the aminoglycoside nebramine with different numbers of alkyl chain ethers that differ in length and degree of unsaturation. We determined antifungal activities and evaluated hemoglobin release from red blood cells as a measure of membrane selectivity and analyzed how serum influences these activities. Microscopic images revealed morphological transformations of red blood cells from the normal double-disc shape to empty ghost cells upon treatment with the cationic amphiphiles. Antifungal activity, hemolysis, and morphological changes in red blood cells decreased as the percentage of serum in the culture medium was increased. In images of red blood cells treated with fluorescently labeled amphiphilic nebramine probes, the accumulation of the cationic amphiphiles in the membranes decreased as serum concentration increased. This suggests that, in addition to its known effect of preventing the deformability of red blood cells, serum prevents interactions between cationic amphiphiles and the plasma membrane. The results of this study indicate that biological activities of cationic amphiphiles are abrogated in serum. Thus, these agents are suitable for external and industrial uses but probably not for effective treatment of systemic infections.

Simultaneous Determination of Human Erythrocyte Deformability and Adhesion Energy: A Novel Approach Using a Microfluidic Chamber and the "Glass Effect"

The simultaneous determination of adhesion and deformability parameters of erythrocytes was carried out through a microfluidic device, which uses an inverted optical microscope with new image acquisition and analysis technologies. Also, an update of the models describing erythrocyte adhesion and deformation was proposed. Measurements were carried out with red blood cells suspended in saline solution with human serum albumin at different concentrations. Erythrocytes adhered to a glass surface were subjected to different low shear stress (from 0.04 to 0.25 Pa), causing cellular deformation and dissociation. The maximum value obtained of the erythrocyte deformability index was 0.3, and that of the adhesion energy per unit area was 1.1 × 10^-6 Pa m, both according to previous works. The obtained images of RBCs adhered to glass reveal that the adhesion is stronger in a single point of the cell, suggesting a ligand migration that concentrates the adhesion in a "spike-like tip" in the cell. Moreover, adhesion energy results indicate that the energy required to separate erythrocytes in media with a lower albumin concentration is greater. Both results could be explained by the mobility of membrane receptors.

An optofluidic "tweeze-and-drag" cell stretcher in a microfluidic channel

The mechanical properties of biological cells are utilized as an inherent, label-free biomarker to indicate physiological and pathological changes of cells. Although various optical and microfluidic techniques have been developed for cell mechanical characterization, there is still a strong demand for non-contact and continuous methods. Here, by combining optical and microfluidic techniques in a single desktop platform, we demonstrate an optofluidic cell stretcher based on a "tweeze-and-drag" mechanism using a periodically chopped, tightly focused laser beam as an optical tweezer to trap a cell temporarily and a flow-induced drag force to stretch the cell in a microfluidic channel transverse to the tweezer. Our method leverages the advantages of non-contact optical forces and a microfluidic flow for both cell stretching and continuous cell delivery. We demonstrate the stretcher for mechanical characterization of rabbit red blood cells (RBCs), with a throughput of ∼1 cell per s at a flow rate of 2.5 μl h^-1 at a continuous-wave laser power of ∼25 mW at a wavelength of 1064 nm (chopped at 2 Hz). We estimate the spring constant of RBCs to be ∼14.9 μN m^-1. Using the stretcher, we distinguish healthy RBCs and RBCs treated with glutaraldehyde at concentrations of 5 × 10^-4% to 2.5 × 10^-3%, with a strain-to-concentration sensitivity of ∼-1529. By increasing the optical power to ∼45 mW, we demonstrate cell-stretching under a higher flow rate of 4 μl h^-1, with a higher throughput of ∼1.5 cells per s and a higher sensitivity of ∼-2457. Our technique shows promise for applications in the fields of healthcare monitoring and biomechanical studies.

Surface property induced morphological alterations of human erythrocytes

Microscopic investigations of any abnormality associated with erythrocyte/red blood cell morphology constitute an important segment of the age-old peripheral smear test. Though the test is conducted on a glass slide, the effect of glass and similar other solid substrates on erythrocyte morphology remained majorly unexplored. In the first of its kind investigation, we have outlined the effect of varying the substrate surface potential on erythrocyte morphology. Such a substrate induced phenomenon has been quantified for two distinctly different drying configurations (droplets and film) upon systematically varying the cell concentration. Experimental results and supporting theoretical analysis unambiguously show the surface potential of the solid substrate to be the most influential parameter in the process of morphological alteration. The findings of the present investigation may be utilized to formulate an error-free protocol for the baseline peripheral smear test of hematological diagnosis.

Flow morphometry to assess the red blood cell storage lesion

We present a novel automated system for morphology analysis of red blood cells (RBC) under flow. RBC concentrates collected by blood banks for transfusions are stored for periods of up to several weeks, during which time a number of changes occur, collectively termed the storage lesion. Typically the extent of hemolysis is the defining criterion to determine the acceptability of the RBCs for transfusions. Morphological changes are related with biochemical alteration during the storage of RBCs. The typical blood smear procedure for determining such changes is a labor-intensive and potentially biased manual process. The advantage of the flow morphometry system presented here is that it provides fully automated morphological classification of RBCs with large sample numbers in a short time. Our system uses a commercially available flow cell and flow conditions that prevent adhesion of RBCs, thus eliminating the need for blocking agents such as albumin that affect the distribution of cell shapes. Our morphometry results are validated by comparison with standard biochemical assays (hemolysis, ATP) for blood from 17 donors stored under blood bank conditions for 13 weeks. We show that the percentage of spherocytes present can be used to estimate the status of RBC concentrates. © 2017 International Society for Advancement of Cytometry.

Descriptive parameters of the erythrocyte aggregation phenomenon using a laser transmission optical chip

The study of red blood cell (RBC) aggregation is of great interest because of its implications for human health. Altered RBC aggregation can lead to microcirculatory problems as in vascular pathologies, such as hypertension and diabetes, due to a decrease in the erythrocyte surface electric charge and an increase in the ligands present in plasma. The process of erythrocyte aggregation was studied in stasis situation (free shear stresses), using an optical chip based on the laser transmission technique. Kinetic curves of erythrocyte aggregation under different conditions were obtained, allowing evaluation and characterization of this process. Two main characteristics of blood that influence erythrocyte aggregation were analyzed: the erythrocyte surface anionic charge (EAC) after digestion with the enzyme trypsin and plasmatic protein concentration in suspension medium using plasma dissolutions in physiological saline with human albumin. A theoretical approach was evaluated to obtain aggregation and disaggregation ratios by syllectograms data fitting. Sensible parameters ( Amp 100 , t 1 \ 2 ) regarding a reduced erythrocyte EAC were determined, and other parameters (AI, M-Index) resulted that are representative of a variation in the plasmatic protein content of the suspension medium. These results are very useful for further applications in biomedicine.

Stimuli-responsive polypropylene for the sustained delivery of TPGS and interaction with erythrocytes

Hemocompatibility and oxidative stress are significant for blood-contacting devices. In this study, N-isopropylacrylamide (NIPAAm) and N-(3-aminopropyl)methacrylamide hydrochloride (APMA) were cografted on polypropylene (PP) membrane using ultraviolet grafting to load antioxidative d-α-tocopheryl polyethylene glycol 1000 succinate (TPGS) and control the release of TPGS. The immobilization of NIPAAm and APMA onto PP membrane was confirmed by attenuated total reflectance Fourier-transform infrared spectroscopy and X-ray photoelectron spectroscopy. Combined with data from platelet adhesion, red blood cell (RBC) attachment, and hemolysis rate, the hemocompatibility of PP was significantly improved. An in-depth characterization using hemolysis rate test, scanning electron microscopy, atomic force microscopy, and confocal laser scanning microscopy was conducted to confirm that the mechanism of the release of TPGS interacted with RBCs was different at different stages. The release of TPGS from the loading PP membranes affected hemolysis at different stages. At the early stage of release, TPGS maintained the tiny (nanometer-sized) tubers on the membrane surface and enhanced the membrane permeabilization by generating nanosized pores on the cell membranes. Afterward, the incorporated TPGS slowed the lipid peroxidation of erythrocytes and filled in the lipid bilayer of erythrocyte to prevent hemolysis. Thus, the approach implemented to graft NIPAAm and APMA and load TPGS was suitable to develop medical device with excellent hemocompatibility and antioxidative property.

A bilayer-couple model of bacterial outer membrane vesicle biogenesis

Gram-negative bacteria naturally produce outer membrane vesicles (OMVs) that arise through bulging and pinching off of the outer membrane. OMVs have several biological functions for bacteria, most notably as trafficking vehicles for toxins, antimicrobials, and signaling molecules. While their biological roles are now appreciated, the mechanism of OMV formation has not been fully elucidated. We recently demonstrated that the signaling molecule 2-heptyl-3-hydroxy-4-quinolone (PQS) is required for OMV biogenesis in P. aeruginosa. We hypothesized that PQS stimulates OMV formation through direct interaction with the outer leaflet of the outer membrane. To test this hypothesis, we employed a red blood cell (RBC) model that has been used extensively to study small-molecule–membrane interactions. Our results revealed that addition of PQS to RBCs induced membrane curvature, resulting in the formation of membrane spicules (spikes), consistent with small molecules that are inserted stably into the outer leaflet of the membrane. Radiotracer experiments demonstrated that sufficient PQS was inserted into the membrane to account for this curvature and that curvature induction was specific to PQS structure. These data suggest that a low rate of interleaflet flip-flop forces PQS to accumulate in and expand the outer leaflet relative to the inner leaflet, thus inducing membrane curvature. In support of PQS-mediated outer leaflet expansion, the PQS effect was antagonized by chlorpromazine, a molecule known to be preferentially inserted into the inner leaflet. Based on these data, we propose a bilayer-couple model to describe P. aeruginosa OMV biogenesis and suggest that this is a general mechanism for bacterial OMV formation.

Despite the ubiquity and importance of outer membrane vesicle (OMV) production in Gram-negative bacteria, the molecular details of OMV biogenesis are not fully understood. Early experiments showed that 2-heptyl-3-hydroxy-4-quinolone (PQS) induces OMV formation through physical interaction with the membrane but did not elucidate the mechanism. The present study demonstrates that PQS specifically and reversibly promotes blebbing of model membranes dependent upon the same properties that are required for OMV formation in P. aeruginosa. These results are consistent with a mechanism where expansion of the outer leaflet relative to the inner leaflet induces localized membrane curvature. This “bilayer-couple” model can account for OMV formation under all conditions and is easily generalized to other Gram-negative bacteria. The model therefore raises the possibility of a universal paradigm for vesicle production in prokaryotes with features strikingly different from what is known in eukaryotes.

Reconstruction of erythrocyte shape during modified morphological response

Changes in erythrocyte shape during morphological response modified by benzalkonium chloride (BzA) were studied in sucrose solutions. Fixation of the cells with glutaraldehyde- and formaldehyde-containing fixatives at some time points is usually inadequate to maintain the current cell shape. Considering the reconstruction of erythrocyte shape, which takes into account the mode of fixative action, we showed that the echinocyte-forming activity of BzA depends on the concentration of this surfactant. It can induce a direct spherostomatocyte-spheroechinocyte transition without altering the near-spherical shape of the cells. On the other hand, the reverse spheroechinocyte-spherostomatocyte transition was always accompanied by some flattening of the cells, although in some instances discoidal shape was not achieved. The data point to asymmetric shape transitions of erythrocytes in sucrose solution, which contradicts the continuum and bilayer-couple models of shape regulation. It seems that the nonuniform structure of native erythrocyte membrane plays a more important role in morphological transitions of these cells than suggested earlier.

Shape memory of human red blood cells

The human red cell can be deformed by external forces but returns to the biconcave resting shape after removal of the forces. If after such shape excursions the rim is always formed by the same part of the membrane, the cell is said to have a memory of its biconcave shape. If the rim can form anywhere on the membrane, the cell would have no shape memory. The shape memory was probed by an experiment called go-and-stop. Locations on the membrane were marked by spontaneously adhering latex spheres. Shape excursions were induced by shear flow. In virtually all red cells, a shape memory was found. After stop of flow and during the return of the latex spheres to the original location, the red cell shape was biconcave. The return occurred by a tank-tread motion of the membrane. The memory could not be eliminated by deforming the red cells in shear flow up to 4 h at room temperature as well as at 37 degrees C. It is suggested that 1). the characteristic time of stress relaxation is >80 min and 2). red cells in vivo also have a shape memory.

A hypothesis of the disc-sphere transformation of the erythrocytes between glass surfaces and of related observations

Erythrocytes suspended at a low hematocrit in a non-buffered isotonic saline change from biconcave discs to spheres between glass surfaces of a slide and of a coverslip with the echinocyte as an intermediate. A pH increase is a major factor responsible for this disc-sphere transformation or glass effect. It is also observed between surfaces made of various polymers and of mica provided that the distance between them is controlled (0.1 mm). The glass effect is antagonized by serum, plasma, serum albumin, ammonium salts and CO2. It is not observed above a 1-2% hematocrit, but is enhanced by gamma-globulins. The sites of reappearance of the spicules are the same and the order of their disappearance is the inverse of the order of their reappearance during the repetitive cycle of the disc-sphere transformation and reversal when a small glass rod is alternatively approached near a site on the erythrocyte surface and withdrawn. A mechanism of erythrocyte shape control has been previously hypothesized in which Band 3 (AE1), the anion exchange protein, plays a central role. Specifically, decrease and increase of the ratio of its outward-facing conformation (Band 3o) and inward-facing conformation (Band 3i) contract and relax the membrane skeleton, promoting the echinocytosis and stomatocytosis, respectively. The Band 3o/Band 3i equilibrium ratio is determined by the Donnan equilibrium ratio of Cl-, HCO3- and H+ (r=Cl(i)-/Cl(o)-=HCO3i-/HCO3o-=Ho+/Hi+), increasing with it. The mechanism could explain by a change of the Donnan ratio the above observations with the assumptions that polymers are permeable to CO2 and that an unstirred layer slows the propagation of the change occurring at the site of approach of the glass rod to peripheral sites. The presence of HCO3- in serum or plasma may be the basis for the absence of the glass effect in these fluids.

Artifacts that may be present on a blood film

Many artifacts or pseudoartifacts may be noted during the examination of a blood film. Artifactual results also may be generated by automated hematology analyzers, which in turn may be investigated by blood film examination. Some artifacts are misdiagnosed, and this in turn leads to inappropriate investigations or treatment. An awareness of the spectrum of spurious or artifactual results may help to prevent such an unfortunate occurrence.

Reversible cross-linking and CO treatment as an approach in red cell stabilization

We explored the use of the reversible cross-linking reagent dimethyl 3,3-dithiobispropionimidate (DTBP) in combination with CO treatment as an approach to stabilizing erythrocyte structure and function. Erythrocytes were cross-linked with different concentrations of DTBP for different times. DTBP increased erythrocyte osmotic stability, blocked lysolecithin-induced echinocytosis, and decreased erythrocyte deformability in a concentration- and time-dependent manner. Reversal of the cross-linking with the reducing agent dithioerythritol (DTE) restored osmotic fragility and response to lysolecithin as well as deformability. Complete reversal, however, is a function of the DTBP concentration and the time of cross-linking. The effects of cross-linking with 5 mM DTBP for 1 h were completely reversible after treatment with 10 mM DTE for 20 min. Longer incubation times or higher concentrations of DTBP resulted in partial reversal by DTE of the effects produced by DTBP. Cross-linking and reversal only slightly reduced the ATP content. The hemoglobin contained in the cross-linked and reversed cells could still undergo reversible oxygenation and deoxygenation. Erythrocytes were pretreated with CO, cross-linked with 5 mM DTBP for 1 or 3 h, loaded with a solution containing 500 mM glucose for 24 h, and freeze-dried in a medium containing 15% (w/v) albumin. Rehydration followed in distilled water. Complete recovery, measured as the percentage of free hemoglobin, was achieved for cells cross-linked with 5 mM DTBP for 3 h and freeze-dried to a final water content of 10-15%. Non-cross-linked cells lysed 100% on rehydration in distilled water. No methemoglobin (MetHb) formation as a result of freeze-drying was detected in CO-treated cells. In non-CO-treated cells 20% of the Hb was converted to MetHb.

Effects of salicylic acid derivatives on red blood cell membranes

Salicylamide, sodium salicylate and acetylsalicylic acid are salicylic acid derivates. They differ in their substitution on the benzene ring and may have different effects on membranes. Red blood cells were used as a prototypical cellular system regarding drug mediated plasma bilayer effects. Established photometric methods sensing tiny changes of red blood cell morphology at rest (red blood cell shape) and at very low shear forces (red blood cell stiffness, red blood cell relaxation time) were applied. The derivative induced effects were detected in a time- and dose-dependent manner. Salicylamide induced a most pronounced echinocytic shape at 5 mM. The shape effect was smaller above as well as below 5 mM. Sodium salicylate induced echinocytes with increasing concentrations showing a saturation above 10 mM. In contrast, the shape was not affected by acetylsalicylic acid. All shape changes occurred within 2 min, and were reversible. The above tendencies were in parallel to a slight red blood cell stiffening. The relaxation time continuously increased with increasing concentrations in both salicylamide and sodium salicylate, with salicylamide always acting stronger. Acetylsalicylic acid again showed no effect. We hypothesize that the observed effects of sodium salicylate and salicylamide are due to their phenolic character mediating a molecular hydrophobicity. According to the bilayer couple hypothesis this would lead to an insertion into the red blood cells outer plasma bilayer leaflet. The extension induced here would cause a positive membrane bending leading to echinocytic shapes and the observed loss of red blood cell fluidity. In contrast, the hydrophilic aspirin would penetrate and thus not affect the red blood cell plasma membrane.

Extensive electroporation abolishes experimentally induced shape transformations of erythrocytes: a consequence of phospholipid symmetrization?

As shown in earlier work (M.M. Henszen et al., Mol. Membr. Biol. 14 (1997) 195-204), exposure of erythrocytes to single brief electric field pulses (5-7 kV cm(-1)) enhances the transbilayer mobility of phospholipids and produces echinocytes which can subsequently be transformed into stomatocytes in an ATP-dependent process. These shape transformations arise from partly reversible changes of the transbilayer disposition of phospholipids, in agreement with the bilayer couple concept. Extensive membrane modification by repetitive (</=20) field pulses followed by 20 h incubation at 37 degrees C is now shown to produce discocytic cells which are resistant to many established shape-transforming treatments, including (A) single electric field pulses, Ca(2+) incorporation and exposure to membrane active amphiphiles, but also (B) metabolic depletion, binding of band 3 ligands, alkaline pH and contact with glass surfaces. The suppression of type A effects can readily be interpreted by a complete symmetrization of the phospholipids in extensively field pulse-modified cells which prevents shape transformations related to the asymmetric disposition of the phospholipids. This symmetrization could be further substantiated by more direct determinations of the transbilayer distribution of phospholipids. Suppression of shape transformations of type B may indicate an involvement of phospholipid asymmetry in these processes on a yet unknown mechanistic basis. Alternatively we discuss field pulse-induced alterations of the disposition of peripheral proteins or of the conformation of integral membrane proteins as mechanisms interfering with shape transformations of type B.

Micropipette aspiration of human erythrocytes induces echinocytes via membrane phospholipid translocation

When a discocytic erythrocyte (RBC) was partially aspirated into a 1.5-microns glass pipette with a high negative aspiration pressure (delta P = -3.9 kPa), held in the pipette for 30 s (holding time, th), and then released, it underwent a discocyte-echinocyte shape transformation. The degree of shape transformation increased with an increase in th. The echinocytes recovered spontaneously to discocytes in approximately 10 min, and there was no significant difference in recovery time at 20.9 degrees C, 29.5 degrees C, and 37.4 degrees C, respectively. At 11 degrees C the recovery time was significantly elevated to 40.1 +/- 6.7 min. At 20.9 degrees C the shape recovery time varied directly with the isotropic RBC tension induced by the pipetting. Sodium orthovanadate (vanadate, 200 microM), which inhibits the phospholipid translocase, blocks the shape recovery. Chlorpromazine (CP, 25 microM) reversed the pipette-induced echinocytic shape to discocytic in < 2 min, and the RBC became a spherostomatocyte-II after another 30 min. It was hypothesized that the increase in cytosolic pressure during the pipette aspiration induced an isotropic tension in the RBC membrane followed by a net inside-to-outside membrane lipid translocation. After a sudden release of the aspiration pressure the cytosolic pressure and the membrane tension normalized immediately, but the translocated phospholipids remained temporarily "trapped" in the outer layer, causing an area excess and hence the echinocytic shape. The phospholipid translocase activity, when not inhibited by vanadate, caused a gradual return of the translocated phospholipids to the inner layer, and the RBC shape recovered with time.