Spherocyte shape transformation and release of tubular nanovesicles in human erythrocytes

Deciphering the Relationship Between Free and Vesicular Hemoglobin in Stored Red Blood Cell Units

Red blood cells (RBCs) release hemoglobin (Hb)-containing extracellular vesicles (EVs) throughout their lifespan in the circulation, and especially during senescence, by spleen-facilitated vesiculation of their membrane. During ex vivo aging under blood bank conditions, the RBCs lose Hb, both in soluble form and inside EVs that accumulate as a part of storage lesion in the supernatant of the unit. Spontaneous hemolysis and vesiculation are increasingly promoted by the storage duration, but little is known about any physiological linkage between them. In the present study, we measured the levels of total extracellular and EV-enclosed Hb (EV-Hb) in units of whole blood (n = 36) or packed RBCs stored in either CPDA-1 (n = 99) or in CPD-SAGM additive solution (n = 46), in early, middle, and late storage. The spectrophotometry data were subjected to statistical analysis to detect possible correlation(s) between storage hemolysis and EV-Hb, as well as the threshold (if any) that determines the area of this dynamic association. It seems that the percentage of EV-Hb is negatively associated with hemolysis levels from middle storage onward by showing low to moderate correlation profiles in all strategies under investigation. Moreover, 0.17% storage hemolysis was determined as the potential cut-off, above which this inverse correlation is evident in non-leukoreduced CPDA units. Notably, RBC units with hemolysis levels > 0.17% are characterized by higher percentage of nanovesicles (<100 nm) over typical microvesicles (100–400 nm) compared with the lower hemolysis counterparts. Our results suggest an ordered loss of Hb during RBC accelerated aging that might fuel targeted research to elucidate its mechanistic basis.

Hemolysis Pathways during Storage of Erythrocytes and Inter-Donor Variability in Erythrocyte Morphology

Background

Red blood cells (RBCs) stored for transfusions can lyse over the course of the storage period. The lysis is traditionally assumed to occur via the formation of spiculated echinocyte forms, so that cells that appear smoother are assumed to have better storage quality. We investigate this hypothesis by comparing the morphological distribution to the hemolysis for samples from different donors.

Methods

Red cell concentrates were obtained from a regional blood bank quality control laboratory. Out of 636 units processed by the laboratory, we obtained 26 high hemolysis units and 24 low hemolysis units for assessment of RBC morphology. The association between the morphology and the hemolysis was tested with the Wilcoxon-Mann-Whitney U test.

Results

Samples with high stomatocyte counts (p = 0.0012) were associated with increased hemolysis, implying that cells can lyse via the formation of stomatocytes.

Conclusion

RBCs can lyse without significant echinocyte formation. Lower degrees of spiculation are not a good indicator of low hemolysis when RBCs from different donors are compared.

On the Role of Curved Membrane Nanodomains, and Passive and Active Skeleton Forces in the Determination of Cell Shape and Membrane Budding

Biological membranes are composed of isotropic and anisotropic curved nanodomains. Anisotropic membrane components, such as Bin/Amphiphysin/Rvs (BAR) superfamily protein domains, could trigger/facilitate the growth of membrane tubular protrusions, while isotropic curved nanodomains may induce undulated (necklace-like) membrane protrusions. We review the role of isotropic and anisotropic membrane nanodomains in stability of tubular and undulated membrane structures generated or stabilized by cyto- or membrane-skeleton. We also describe the theory of spontaneous self-assembly of isotropic curved membrane nanodomains and derive the critical concentration above which the spontaneous necklace-like membrane protrusion growth is favorable. We show that the actin cytoskeleton growth inside the vesicle or cell can change its equilibrium shape, induce higher degree of segregation of membrane nanodomains or even alter the average orientation angle of anisotropic nanodomains such as BAR domains. These effects may indicate whether the actin cytoskeleton role is only to stabilize membrane protrusions or to generate them by stretching the vesicle membrane. Furthermore, we demonstrate that by taking into account the in-plane orientational ordering of anisotropic membrane nanodomains, direct interactions between them and the extrinsic (deviatoric) curvature elasticity, it is possible to explain the experimentally observed stability of oblate (discocyte) shapes of red blood cells in a broad interval of cell reduced volume. Finally, we present results of numerical calculations and Monte-Carlo simulations which indicate that the active forces of membrane skeleton and cytoskeleton applied to plasma membrane may considerably influence cell shape and membrane budding.

Microvesicles in vascular homeostasis and diseases. Position Paper of the European Society of Cardiology (ESC) Working Group on Atherosclerosis and Vascular Biology

Microvesicles are members of the family of extracellular vesicles shed from the plasma membrane of activated or apoptotic cells. Microvesicles were initially characterised by their pro-coagulant activity and described as "microparticles". There is mounting evidence revealing a role for microvesicles in intercellular communication, with particular relevance to hemostasis and vascular biology. Coupled with this, the potential of microvesicles as meaningful biomarkers is under intense investigation. This Position Paper will summarise the current knowledge on the mechanisms of formation and composition of microvesicles of endothelial, platelet, red blood cell and leukocyte origin. This paper will also review and discuss the different methods used for their analysis and quantification, will underline the potential biological roles of these vesicles with respect to vascular homeostasis and thrombosis and define important themes for future research.

CHANGES IN ERYTHROCYTE SURFACE MARKER CD44 DURING HYPOTHERMIC AND LOW TEMPERATURE STORAGE

We studied the changes in surface marker CD44 in erythrocytes, cryopreserved under the protection of glycerol and PEG–1500, or stored in hypothermic conditions. It was shown that during hypothermic storage the CD44 characteristics in erythrocyte suspension were unchanged within 10 days. In cryopreserved erythrocytes a reduction in CD44–positive cells and in the level of expression of the surface marker were marked. Using PEG–1500 resulted in more pronounced change in erythrocyte CD44 characteristics after freeze–thawing in comparison with glycerol. Removal of cryoprotectants and the loss of a part of cells during the washing process led to the restoration of the CD44 characteristics in freeze–thawed erythrocytes suspension which successfully survived after the stresses. The results indicate that revealed changes in cryopreserved erythrocytes cover only a part of the cells, and they are associated with the instability of the population of erythrocytes with altered CD44 characteristics wherethrough after the removal of cryoprotectants with concomitant hemolysis of unstable cells the CD44 parameters in erythrocyte suspensions recovered. The mechanisms underlying the changes in the parameters of the surface marker CD44 in freeze–thawed erythrocyte may be related to the disruption of intermolecular interactions in the membrane under the influence of physical and chemical environmental factors, followed by the membrane vesiculation with the inclusion of the CD44 into the vesicles.

Erythrocyte microparticles can induce kidney vaso-occlusions in a murine model of sickle cell disease

Patients with sickle cell disease suffer from painful crises associated with disseminated vaso-occlusions, increased circulating erythrocyte microparticles (MPs), and thrombospondin-1 (TSP1). MPs are submicron membrane vesicles shed by compromised or activated cells. We hypothesized that TSP1 mediates MP shedding and participates in vaso-occlusions. We injected TSP1 to transgenic SAD mice with sickle cell disease and characterized circulating phosphatidylserine+ MPs by FACS. TSP1 stimulated MPs in plasma and initiated vaso-occlusions within minutes. In vitro, TSP1 triggered rapid erythrocyte conversion into spicule-covered echinocytes, followed by MP shedding. MP shedding was recapitulated by peptides derived from the TSP1 carboxyterminus. We purified MPs shed by erythrocytes in vitro and administered them back to SAD mice. MPs triggered immediate renal vaso-occlusions. In vitro, MPs triggered the production of radical oxygen species by endothelial monolayers, favored erythrocyte adhesion, and induced endothelial apoptosis. MPs also compromised vasodilation in perfused microvessels. These effects were inhibited by saturating MP phosphatidylserine with annexin-V, or with inhibitors of endothelial ROS production. We conclude that TSP1 triggers erythrocyte MP shedding. These MPs induce endothelial injury and facilitate acute vaso-occlusive events in transgenic SAD mice. This work supports a novel concept that toxic erythrocyte MPs may connect sickle cell anemia to vascular disease.

Unusual "erythroid loops" in canine blood smears after viper-bite envenomation

Northern Italy is a habitat for many species of viper; Vipera aspis is responsible for most reported bites of humans and animals. Five dogs of different breeds and ages were presented by their owners to a veterinary clinic in northern Italy between September 2004 and August 2007 with a history of being bitten by a viper within the past 2 hours. On physical examination, all of the dogs were depressed, had pale mucous membranes, and had a painful area consistent with a recent viper bite wound on the nose (2), distal front leg (2), or lip (1). Hemoglobinemia and hemoglobinuria were observed in plasma and urine from all dogs. CBCs were done at the time of presentation, daily for 4 days, and 10 days after presentation in all dogs with the exception of one dog that died after 2 days. All dogs had an acute decrease in HCT within 24 hours of presentation; all dogs had neutrophilia, 3/5 had a mildly toxic left shift, and 4/5 had thrombocytopenia. On Diff-Quik-stained blood smears, moderate numbers of echinocytes, spherocytes, and erythrocyte ghosts were observed. In addition, moderate numbers of unusual erythrocyte membrane-like structures ("erythroid loops") were observed. The loops were annular in shape and sometimes disrupted, appearing as thin pale blue bands. Erythrocyte morphologic abnormalities decreased by day 3 and were no longer observed on day 10. The unique appearance of the erythroid loops together with evidence for intravascular hemolysis and other erythrocyte morphologic changes suggest they may be a consequence of erythrocyte lysis. Echinocytes, spherocytes, and erythrocyte ghosts are known to result from the action of phospholipase in viper venom; however, erythroid loops have not been reported previously and their exact mechanism of formation is unknown.

Force balance and membrane shedding at the red-blood-cell surface

During the aging of the red-blood cell, or under conditions of extreme echinocytosis, membrane is shed from the cell plasma membrane in the form of nanovesicles. We propose that this process is the result of the self-adaptation of the membrane surface area to the elastic stress imposed by the spectrin cytoskeleton, via the local buckling of membrane under increasing cytoskeleton stiffness. This model introduces the concept of force balance as a regulatory process at the cell membrane and quantitatively reproduces the rate of area loss in aging red-blood cells.

Ultrastructural study of echinocytes induced by poly (ethylene glycol)-cholesterol

Poly (ethylene glycol)-cholesterol (PEG-Chol) consists of a hydrophilic PEG and hydrophobic cholesterol moiety. When PEG-Chol was applied to erythrocytes, the reagent quantitatively induced protrusions by exclusively distributing in the outer monolayer of the membrane. This kind of response has been regarded as a general response that reduces the stress of expansion of the outer monolayer. However, the relationship between the membrane architecture and the distribution of such molecules is unknown. In this study, we examined the distribution of tagged PEG-Chol along the shape change pathway. The echinocytic shape was initiated by the initial formation of bumps on the rim of the discoid, which subsequently elongated as protrusions. These protrusions contained aggregates of granular structures, which appeared to accommodate the increase in the outer monolayer area. At higher concentrations, PEG-Chol further induced sphero-echinocytosis that resulted in numerous branched protrusion processes. We found that PEG-Chol was exclusively distributed in these protrusions and, in particular, accumulated at the tips. These results suggested that externally intercalated PEG-Chol was sequestrated from erythrocytes as membrane protrusions through an as-yet-unknown mechanism.