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Igbineweka NE, van Loon JJWA. Gene-environmental influence of space and microgravity on red blood cells with sickle cell disease. NPJ Genom Med 2024; 9:44. [PMID: 39349487 PMCID: PMC11442622 DOI: 10.1038/s41525-024-00427-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/09/2024] [Indexed: 10/02/2024] Open
Abstract
A fundamental question in human biology and for hematological disease is how do complex gene-environment interactions lead to individual disease outcome? This is no less the case for sickle cell disease (SCD), a monogenic disorder of Mendelian inheritance, both clinical course, severity, and treatment response, is variable amongst affected individuals. New insight and discovery often lie between the intersection of seemingly disparate disciplines. Recently, opportunities for space medicine have flourished and have offered a new paradigm for study. Two recent Nature papers have shown that hemolysis and oxidative stress play key mechanistic roles in erythrocyte pathogenesis during spaceflight. This paper reviews existing genetic and environmental modifiers of the sickle cell disease phenotype. It reviews evidence for erythrocyte pathology in microgravity environments and demonstrates why this may be relevant for the unique gene-environment interaction of the SCD phenotype. It also introduces the hematology and scientific community to methodological tools for evaluation in space and microgravity research. The increasing understanding of space biology may yield insight into gene-environment influences and new treatment paradigms in SCD and other hematological disease phenotypes.
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Affiliation(s)
- Norris E Igbineweka
- Imperial College London, Centre for Haematology, Department of Immunology & Inflammation, Commonwealth Building, Hammersmith Campus, Du Cane, London, W12 0NN, UK.
- Department of Haematology, King's College Hospital NHS Foundation Trust Denmark Hill, SE5 9RS, London, UK.
| | - Jack J W A van Loon
- Dutch Experiment Support Center (DESC), Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam Bone Center (ABC), Amsterdam UMC Location VU University Medical Center (VUmc) & Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081, LA Amsterdam, The Netherlands
- European Space Agency (ESA), European Space Research and Technology Centre (ESTEC), TEC-MMG, Keplerlaan 1, 2201, AZ Noordwijk, The Netherlands
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Bolarinwa AB, Oduwole O, Okebe J, Ogbenna AA, Otokiti OE, Olatinwo AT. Antioxidant supplementation for sickle cell disease. Cochrane Database Syst Rev 2024; 5:CD013590. [PMID: 38775255 PMCID: PMC11110109 DOI: 10.1002/14651858.cd013590.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND Sickle cell disease (SCD) refers to a group of genetic disorders characterized by the presence of an abnormal haemoglobin molecule called haemoglobin S (HbS). When subjected to oxidative stress from low oxygen concentrations, HbS molecules form rigid polymers, giving the red cell the typical sickle shape. Antioxidants have been shown to reduce oxidative stress and improve outcomes in other diseases associated with oxidative stress. Therefore, it is important to review and synthesize the available evidence on the effect of antioxidants on the clinical outcomes of people with SCD. OBJECTIVES To assess the effectiveness and safety of antioxidant supplementation for improving health outcomes in people with SCD. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 15 August 2023. SELECTION CRITERIA We included randomized and quasi-randomized controlled trials comparing antioxidant supplementation to placebo, other antioxidants, or different doses of antioxidants, in people with SCD. DATA COLLECTION AND ANALYSIS Two authors independently extracted data, assessed the risk of bias and certainty of the evidence, and reported according to Cochrane methodological procedures. MAIN RESULTS The review included 1609 participants in 26 studies, with 17 comparisons. We rated 13 studies as having a high risk of bias overall, and 13 studies as having an unclear risk of bias overall due to study limitations. We used GRADE to rate the certainty of evidence. Only eight studies reported on our important outcomes at six months. Vitamin C (1400 mg) plus vitamin E (800 mg) versus placebo Based on evidence from one study in 83 participants, vitamin C (1400 mg) plus vitamin E (800 mg) may not be better than placebo at reducing the frequency of crisis (risk ratio (RR) 1.18, 95% confidence interval (CI) 0.64 to 2.18), the severity of pain (RR 1.33, 95% CI 0.40 to 4.37), or adverse effects (AE), of which the most common were headache, nausea, fatigue, diarrhoea, and epigastric pain (RR 0.56, 95% CI 0.31 to 1.00). Vitamin C plus vitamin E may increase the risk of SCD-related complications (acute chest syndrome: RR 2.66, 95% CI 0.77 to 9.13; 1 study, 83 participants), and increase haemoglobin level (median (interquartile range) 90 (81 to 96) g/L versus 93.5 (84 to 105) g/L) (1 study, 83 participants) compared to placebo. However, the evidence for all the above effects is very uncertain. The study did not report on quality of life (QoL) of participants and their caregivers, nor on frequency of hospitalization. Zinc versus placebo Zinc may not be better than placebo at reducing the frequency of crisis at six months (rate ratio 0.62, 95% CI 0.17 to 2.29; 1 study, 36 participants; low-certainty evidence). We are uncertain whether zinc is better than placebo at improving sickle cell-related complications (complete healing of leg ulcers at six months: RR 2.00, 95% CI 0.60 to 6.72; 1 study, 34 participants; very low-certainty evidence). Zinc may be better than placebo at increasing haemoglobin level (g/dL) (MD 1.26, 95% CI 0.44 to 1.26; 1 study, 36 participants; low-certainty evidence). The study did not report on severity of pain, QoL, AE, and frequency of hospitalization. N-acetylcysteine versus placebo N-acetylcysteine (NAC) 1200 mg may not be better than placebo at reducing the frequency of crisis in SCD, reported as pain days (rate ratio 0.99 days, 95% CI 0.53 to 1.84; 1 study, 96 participants; low-certainty evidence). Low-certainty evidence from one study (96 participants) suggests NAC (1200 mg) may not be better than placebo at reducing the severity of pain (MD 0.17, 95% CI -0.53 to 0.87). Compared to placebo, NAC (1200 mg) may not be better at improving physical QoL (MD -1.80, 95% CI -5.01 to 1.41) and mental QoL (MD 2.00, 95% CI -1.45 to 5.45; very low-certainty evidence), reducing the risk of adverse effects (gastrointestinal complaints, pruritus, or rash) (RR 0.92, 95% CI 0.75 to 1.14; low-certainty evidence), reducing the frequency of hospitalizations (rate ratio 0.98, 95% CI 0.41 to 2.38; low-certainty evidence), and sickle cell-related complications (RR 5.00, 95% CI 0.25 to 101.48; very low-certainty evidence), or increasing haemoglobin level (MD -0.18 g/dL, 95% CI -0.40 to 0.04; low-certainty evidence). L-arginine versus placebo L-arginine may not be better than placebo at reducing the frequency of crisis (monthly pain) (RR 0.71, 95% CI 0.26 to 1.95; 1 study, 50 participants; low-certainty evidence). However, L-arginine may be better than placebo at reducing the severity of pain (MD -1.41, 95% CI -1.65 to -1.18; 2 studies, 125 participants; low-certainty evidence). One participant allocated to L-arginine developed hives during infusion of L-arginine, another experienced acute clinical deterioration, and a participant in the placebo group had clinically relevant increases in liver function enzymes. The evidence is very uncertain whether L-arginine is better at reducing the mean number of days in hospital compared to placebo (MD -0.85 days, 95% CI -1.87 to 0.17; 2 studies, 125 participants; very low-certainty evidence). Also, L-arginine may not be better than placebo at increasing haemoglobin level (MD 0.4 g/dL, 95% CI -0.50 to 1.3; 2 studies, 106 participants; low-certainty evidence). No study in this comparison reported on QoL and sickle cell-related complications. Omega-3 versus placebo Very low-certainty evidence shows no evidence of a difference in the risk of adverse effects of omega-3 compared to placebo (RR 1.05, 95% CI 0.74 to 1.48; 1 study, 67 participants). Very low-certainty evidence suggests that omega-3 may not be better than placebo at increasing haemoglobin level (MD 0.36 g/L, 95% CI -0.21 to 0.93; 1 study, 67 participants). The study did not report on frequency of crisis, severity of pain, QoL, frequency of hospitalization, and sickle cell-related complications. AUTHORS' CONCLUSIONS There was inconsistent evidence on all outcomes to draw conclusions on the beneficial and harmful effects of antioxidants. However, L-arginine may be better than placebo at reducing the severity of pain at six months, and zinc may be better than placebo at increasing haemoglobin level. We are uncertain whether other antioxidants are beneficial for SCD. Larger studies conducted on each comparison would reduce the current uncertainties.
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Affiliation(s)
- Abiola B Bolarinwa
- Department of Haematology & Blood Transfusion Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Olabisi Oduwole
- Department of Medical Laboratory Science, Achievers University, Owo, Nigeria
| | - Joseph Okebe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Ann A Ogbenna
- Department of Haematology & Blood Transfusion Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Oluwakemi E Otokiti
- Department of Haematology & Blood Transfusion Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adejoke T Olatinwo
- Department of Haematology & Blood Transfusion Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
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Feugray G, Grall M, Dumesnil C, Brunel V, Benhamou Y, Quillard Muraine M, Billoir P. Lipid and hemolysis parameters predicting acute chest syndrome in adulthood with sickle cell disease. Lipids Health Dis 2024; 23:140. [PMID: 38755670 PMCID: PMC11100209 DOI: 10.1186/s12944-024-02135-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
Sickle cell disease (SCD) is a lifelong blood disorder affecting approximately 100,000 people in the United States and is one of the most common monogenic diseases. A serious complication of SCD is acute chest syndrome (ACS). ACS is a condition with a high rate of morbidity and mortality. The aim of the study was to assess hemolysis and lipid parameters in a cohort of confirmed SCD patients to predict ACS development in the following year.Standard lipid were performed (triglycerides, total cholesterol, high-density cholesterol, low-density cholesterol) panel to calculate of non-HDL-C, large buoyant LDL cholesterol (lbLDL-C) and small dense LDL cholesterol (sdLDL-C) with Sampson equation. Hemolysis and hematologic parameters were also evaluated.Among 91 patients included between September 2018 and June 2021, thirty-seven patients had history of ACS and 6 patients developed ACS during following year. In unadjusted logistic regression, total bilirubin was associated with ACS occurrence (RR: 1.2 [1.05-1.51] p = 0.013). Concerning lipid profile, non-HDL-C (RR: 0.87 [0.0.67-0.99] p = 0.04) and sdLDL-C (RR: 0.78 [0.49-0.96] p = 0.03) were associated with ACS occurrence decrease. C-reactive protein was associated with ACS occurrence (RR: 1.27 [1.065-1.85] p = 0.011).Based on these findings, this study demonstrated that several biomarker easily available can be used at steady state to predict ACS in the following year. The validation of these results are required to ensure the reproducibility of the findings.
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Affiliation(s)
- Guillaume Feugray
- Department of General Biochemistry, Normandie Univ, UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Rouen, F-76000, France.
- Service de Biochimie, Centre hospitalier Universitaire Charles Nicolle, 1 rue de Germont, Rouen, 76031, France.
| | - Maximilien Grall
- Department of Internal Medicine, CHU Rouen, Rouen, F-76000, France
| | - Cécile Dumesnil
- Department of Pediatric Onco-Hematology, CHU Rouen, Rouen, F-76000, France
| | - Valéry Brunel
- Department of General Biochemistry, CHU Rouen, Rouen, F-76000, France
| | - Ygal Benhamou
- Department of Internal Medicine, Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Rouen, F-76000, France
| | - Muriel Quillard Muraine
- Department of General Biochemistry, Normandie Univ, UNIROUEN, INSERM U1404 INSERMU1073 ADEN, CHU Rouen, CIC-CRB, Rouen, F-76000, France
| | - Paul Billoir
- Normandie Univ, UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Vascular Hemostasis Unit, Rouen, F-76000, France
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Hassanzadeh M, Sanat ZM, Khayatian S, Sotoudeheian M, Shahbazian A, Hoseini S. Acute sickle cell hepatopathy: A case report and literature review. J Natl Med Assoc 2024; 116:119-125. [PMID: 38383222 DOI: 10.1016/j.jnma.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/01/2023] [Accepted: 09/30/2023] [Indexed: 02/23/2024]
Abstract
Sickle cell disease (SCD) is an inherited hemoglobinopathy with protean clinical manifestations. The liver could be affected by various SCD-associated complications of an overlapping nature. The clinical presentations of "sickle cell hepatopathy" range from clinically asymptomatic patients to those with life-threatening complications. Herein we report an SCD patient who presented with right upper quadrant abdominal pain and jaundice, eventually diagnosed as a self-limited form of acute sickle cell hepatopathy with overlapping features of acute hepatic crisis and benign intrahepatic cholestasis. Using this patient as an illustration, we will review the spectrum of hepatobiliary presentations in the SCD population.
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Affiliation(s)
- Morteza Hassanzadeh
- Department of Internal Medicine, School of Medicine, Colorectal Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Zahra Momayez Sanat
- Department of Internal Medicine, School of Medicine, Digestive Diseases Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Somayeh Khayatian
- Department of Internal Medicine, School of Medicine, Digestive Diseases Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Amirmasoud Shahbazian
- Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Owen B, Thota K, Krüger T. Numerical investigation of heterogeneous soft particle pairs in inertial microfluidics. SOFT MATTER 2024; 20:887-899. [PMID: 38175527 PMCID: PMC10807000 DOI: 10.1039/d3sm01120h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
The formation of pairs of particles or cells of different types in microfluidic channels can be desired or detrimental in healthcare applications. It is still unclear what role softness heterogeneity plays in the formation of these particle pairs. We use an in-house lattice-Boltzmann-immersed-boundary-finite-element solver to simulate a pair of particles with different softness flowing through a straight channel with a rectangular cross-section under initial conditions representative of a dilute suspension. We find that softness heterogeneity significantly affects the pair dynamics, determining whether a pair will form or not, and determining the lateral and inter-particle equilibrium behaviour in the pair. We also observe close matches between the transient deformation of particles in a linear pair and single particles in isolation. These results further our understanding of pair behaviour, providing a foundation for understanding particle train formation, and open up the potential to develop reduced-order models for particle pair formation based upon the behaviour of single particles.
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Affiliation(s)
- Benjamin Owen
- School of Engineering, Institute for Multiscale Thermofluids, University of Edinburgh, Edinburgh, EH9 3FB, UK.
| | - Krishnaveni Thota
- School of Engineering, Institute for Multiscale Thermofluids, University of Edinburgh, Edinburgh, EH9 3FB, UK.
| | - Timm Krüger
- School of Engineering, Institute for Multiscale Thermofluids, University of Edinburgh, Edinburgh, EH9 3FB, UK.
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Obeagu EI, Ubosi NI, Obeagu GU, Egba SI, Bluth MH. Understanding apoptosis in sickle cell anemia patients: Mechanisms and implications. Medicine (Baltimore) 2024; 103:e36898. [PMID: 38215146 PMCID: PMC10783340 DOI: 10.1097/md.0000000000036898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/18/2023] [Indexed: 01/14/2024] Open
Abstract
Sickle cell anemia (SCA) is a hereditary blood disorder characterized by the presence of abnormal hemoglobin, leading to the formation of sickle-shaped red blood cells. While much research has focused on the molecular and cellular mechanisms underlying the pathophysiology of SCA, recent attention has turned to the role of apoptosis, or programmed cell death, in the disease progression. This review aims to elucidate the intricate mechanisms of apoptosis in SCA patients and explore its implications in disease severity, complications, and potential therapeutic interventions. Different research search engines such as PubMed central, Scopus, Web of Science, Google Scholar, ResearchGate, Academia Edu, etc were utilized in writing this paper. Apoptosis, a highly regulated cellular process, plays a crucial role in maintaining homeostasis by eliminating damaged or dysfunctional cells. In SCA, the imbalance between pro-apoptotic and anti-apoptotic signals contributes to increased erythrocyte apoptosis, exacerbating anemia and vaso-occlusive crises. Various factors, including oxidative stress, inflammation, and altered cell signaling pathways, converge to modulate the apoptotic response in SCA. Furthermore, the interaction between apoptotic cells and the vascular endothelium contributes to endothelial dysfunction, promoting the pathogenesis of vasculopathy and organ damage seen in SCA patients. In conclusion, unraveling the complexities of apoptosis in SCA provides valuable insights into the disease pathophysiology and offers novel avenues for therapeutic interventions.
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Affiliation(s)
| | - Nwanganga Ihuoma Ubosi
- Department of Public Health Sciences, Faculty of Health Sciences, National Open University of Nigeria, Headquarters, Jabi, Abuja, Nigeria
| | | | - Simeon Ikechukwu Egba
- Department of Biochemistry, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria
| | - Martin H. Bluth
- Department of Pathology, Division of Blood Transfusion Medicine, Maimonides Medical Center, Brooklyn, NY, USA
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Kelly S. Logistics, risks, and benefits of automated red blood cell exchange for patients with sickle cell disease. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2023; 2023:646-652. [PMID: 38066846 PMCID: PMC10905321 DOI: 10.1182/hematology.2023000498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Red blood cell (RBC) transfusions treat and prevent severe complications of sickle cell disease (SCD) and can be delivered as a simple or exchange transfusion. During an exchange, some of the patient's abnormal hemoglobin (Hb) S (HbS) RBCs are removed. An apheresis device can accomplish an automated RBC exchange, simultaneously removing patient's RBCs while returning other blood components along with normal RBCs. Automated RBC exchange is therefore an isovolemic transfusion that can efficiently decrease HbS RBCs while limiting iron loading and hyperviscosity. However, specialized equipment, trained personnel, appropriate vascular access, and increased RBC exposure are required compared to simple or manual RBC exchange. Therefore, risks and benefits must be balanced to make individualized decisions for patients with SCD who require transfusion.
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Affiliation(s)
- Shannon Kelly
- UCSF Benioff Children's Hospital Oakland, Oakland, CA
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Williams DC, Wood DK. High-throughput quantification of red blood cell deformability and oxygen saturation to probe mechanisms of sickle cell disease. Proc Natl Acad Sci U S A 2023; 120:e2313755120. [PMID: 37983504 PMCID: PMC10691249 DOI: 10.1073/pnas.2313755120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023] Open
Abstract
The complex, systemic pathology of sickle cell disease is driven by multiple mechanisms including red blood cells (RBCs) stiffened by polymerized fibers of deoxygenated sickle hemoglobin. A critical step toward understanding the pathologic role of polymer-containing RBCs is quantifying the biophysical changes in these cells in physiologically relevant oxygen environments. We have developed a microfluidic platform capable of simultaneously measuring single RBC deformability and oxygen saturation under controlled oxygen and shear stress. We found that RBCs with detectable amounts of polymer have decreased oxygen affinity and decreased deformability. Surprisingly, the deformability of the polymer-containing cells is oxygen-independent, while the fraction of these cells increases as oxygen decreases. We also find that some fraction of these cells is present at most physiologic oxygen tensions, suggesting a role for these cells in the systemic pathologies. Additionally, the ability to measure these pathological cells should provide clearer targets for evaluating therapies.
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Affiliation(s)
- Dillon C. Williams
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN55455
| | - David K. Wood
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN55455
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Giannaki A, Georgatzakou HΤ, Fortis SP, Anastasiadi AT, Pavlou EG, Nomikou EG, Drandaki MP, Kotsiafti A, Xydaki A, Fountzoula C, Papageorgiou EG, Tzounakas VL, Kriebardis AG. Stratification of β Sβ + Compound Heterozygotes Based on L-Glutamine Administration and RDW: Focusing on Disease Severity. Antioxidants (Basel) 2023; 12:1982. [PMID: 38001835 PMCID: PMC10669421 DOI: 10.3390/antiox12111982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Sickle cell disease (SCD) is heterogeneous in terms of manifestation severity, even more so when in compound heterozygosity with beta-thalassemia. The aim of the present study was to stratify βSβ+ patient blood samples in a severity-dependent manner. Blood from thirty-two patients with HbS/β-thalassemia compound heterozygosity was examined for several parameters (e.g., hemostasis, inflammation, redox equilibrium) against healthy controls. Additionally, SCD patients were a posteriori (a) categorized based on the L-glutamine dose and (b) clustered into high-/low-RDW subgroups. The patient cohort was characterized by anemia, inflammation, and elevated coagulation. Higher-dose administration of L-glutamine was associated with decreased markers of inflammation and oxidation (e.g., intracellular reactive oxygen species) and an altered coagulation profile. The higher-RDW group was characterized by increased hemolysis, elevated markers of inflammation and stress erythropoiesis, and oxidative phenomena (e.g., membrane-bound hemoglobin). Moreover, the levels of hemostasis parameters (e.g., D-Dimers) were greater compared to the lower-RDW subgroup. The administration of higher doses of L-glutamine along with hydroxyurea seems to attenuate several features in SCD patients, probably by enhancing antioxidant power. Moreover, anisocytosis may alter erythrocytes' coagulation processes and hemolytic propensity. This results in the disruption of the redox and pro-/anti-inflammatory equilibria, creating a positive feedback loop by inducing stress erythropoiesis and, thus, the occurrence of a mixed erythrocyte population.
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Affiliation(s)
- Aimilia Giannaki
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Hara Τ. Georgatzakou
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Sotirios P. Fortis
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Alkmini T. Anastasiadi
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
- Department of Biochemistry, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Efthimia G. Pavlou
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
- Blood Bank and Hemophilia Unit, Hippokration Hospital, 11527 Athens, Greece;
| | - Efrosyni G. Nomikou
- Blood Bank and Hemophilia Unit, Hippokration Hospital, 11527 Athens, Greece;
| | - Maria P. Drandaki
- Thalassemia and Sickle Cell Unit, Expertise Center of Hemoglobinopathies and Their Complications, Hippokration General Hospital, 11527 Athens, Greece; (M.P.D.); (A.K.); (A.X.)
| | - Angeliki Kotsiafti
- Thalassemia and Sickle Cell Unit, Expertise Center of Hemoglobinopathies and Their Complications, Hippokration General Hospital, 11527 Athens, Greece; (M.P.D.); (A.K.); (A.X.)
| | - Aikaterini Xydaki
- Thalassemia and Sickle Cell Unit, Expertise Center of Hemoglobinopathies and Their Complications, Hippokration General Hospital, 11527 Athens, Greece; (M.P.D.); (A.K.); (A.X.)
| | - Christina Fountzoula
- Laboratory of Chemistry, Biochemistry and Cosmetic Science (ChemBiochemCosm), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece;
| | - Effie G. Papageorgiou
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
| | - Vassilis L. Tzounakas
- Department of Biochemistry, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Anastasios G. Kriebardis
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece; (A.G.); (H.T.G.); (S.P.F.); (A.T.A.); (E.G.P.); (E.G.P.)
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Fay ME, Oshinowo O, Iffrig E, Fibben KS, Caruso C, Hansen S, Musick JO, Valdez JM, Azer SS, Mannino RG, Choi H, Zhang DY, Williams EK, Evans EN, Kanne CK, Kemp ML, Sheehan VA, Carden MA, Bennett CM, Wood DK, Lam WA. iCLOTS: open-source, artificial intelligence-enabled software for analyses of blood cells in microfluidic and microscopy-based assays. Nat Commun 2023; 14:5022. [PMID: 37596311 PMCID: PMC10439163 DOI: 10.1038/s41467-023-40522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 07/28/2023] [Indexed: 08/20/2023] Open
Abstract
While microscopy-based cellular assays, including microfluidics, have significantly advanced over the last several decades, there has not been concurrent development of widely-accessible techniques to analyze time-dependent microscopy data incorporating phenomena such as fluid flow and dynamic cell adhesion. As such, experimentalists typically rely on error-prone and time-consuming manual analysis, resulting in lost resolution and missed opportunities for innovative metrics. We present a user-adaptable toolkit packaged into the open-source, standalone Interactive Cellular assay Labeled Observation and Tracking Software (iCLOTS). We benchmark cell adhesion, single-cell tracking, velocity profile, and multiscale microfluidic-centric applications with blood samples, the prototypical biofluid specimen. Moreover, machine learning algorithms characterize previously imperceptible data groupings from numerical outputs. Free to download/use, iCLOTS addresses a need for a field stymied by a lack of analytical tools for innovative, physiologically-relevant assays of any design, democratizing use of well-validated algorithms for all end-user biomedical researchers who would benefit from advanced computational methods.
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Affiliation(s)
- Meredith E Fay
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Oluwamayokun Oshinowo
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Elizabeth Iffrig
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Kirby S Fibben
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Christina Caruso
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Scott Hansen
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Jamie O Musick
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - José M Valdez
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Sally S Azer
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Robert G Mannino
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Hyoann Choi
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Dan Y Zhang
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Evelyn K Williams
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Erica N Evans
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Celeste K Kanne
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Melissa L Kemp
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Vivien A Sheehan
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Marcus A Carden
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Carolyn M Bennett
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - David K Wood
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Wilbur A Lam
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA.
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA.
- Winship Cancer Institute of Emory University, Atlanta, GA, USA.
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA.
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11
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An L, Ji F, Zhao E, Liu Y, Liu Y. Measuring cell deformation by microfluidics. Front Bioeng Biotechnol 2023; 11:1214544. [PMID: 37434754 PMCID: PMC10331473 DOI: 10.3389/fbioe.2023.1214544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
Microfluidics is an increasingly popular method for studying cell deformation, with various applications in fields such as cell biology, biophysics, and medical research. Characterizing cell deformation offers insights into fundamental cell processes, such as migration, division, and signaling. This review summarizes recent advances in microfluidic techniques for measuring cellular deformation, including the different types of microfluidic devices and methods used to induce cell deformation. Recent applications of microfluidics-based approaches for studying cell deformation are highlighted. Compared to traditional methods, microfluidic chips can control the direction and velocity of cell flow by establishing microfluidic channels and microcolumn arrays, enabling the measurement of cell shape changes. Overall, microfluidics-based approaches provide a powerful platform for studying cell deformation. It is expected that future developments will lead to more intelligent and diverse microfluidic chips, further promoting the application of microfluidics-based methods in biomedical research, providing more effective tools for disease diagnosis, drug screening, and treatment.
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Affiliation(s)
- Ling An
- School of Engineering, Dali University, Dali, Yunnan, China
| | - Fenglong Ji
- School of Textile Materials and Engineering, Wuyi University, Jiangmen, Guangdong, China
| | - Enming Zhao
- School of Engineering, Dali University, Dali, Yunnan, China
| | - Yi Liu
- School of Engineering, Dali University, Dali, Yunnan, China
| | - Yaling Liu
- Department of Bioengineering, Lehigh University, Bethlehem, PA, United States
- Department of Mechanical Engineering and Mechanics, Lehigh University, Bethlehem, PA, United States
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12
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Han K, Ma S, Sun J, Xu M, Qi X, Wang S, Li L, Li X. In silico modeling of patient-specific blood rheology in type 2 diabetes mellitus. Biophys J 2023; 122:1445-1458. [PMID: 36905122 PMCID: PMC10147843 DOI: 10.1016/j.bpj.2023.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/16/2022] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Increased blood viscosity in type 2 diabetes mellitus (T2DM) is a risk factor for the development of insulin resistance and diabetes-related vascular complications; however, individuals with T2DM exhibit heterogeneous hemorheological properties, including cell deformation and aggregation. Using a multiscale red blood cell (RBC) model with key parameters derived from patient-specific data, we present a computational study of the rheological properties of blood from individual patients with T2DM. Specifically, one key model parameter, which determines the shear stiffness of the RBC membrane (μ) is informed by the high-shear-rate blood viscosity of patients with T2DM. At the same time, the other, which contributes to the strength of the RBC aggregation interaction (D0), is derived from the low-shear-rate blood viscosity of patients with T2DM. The T2DM RBC suspensions are simulated at different shear rates, and the predicted blood viscosity is compared with clinical laboratory-measured data. The results show that the blood viscosity obtained from clinical laboratories and computational simulations are in agreement at both low and high shear rates. These quantitative simulation results demonstrate that the patient-specific model has truly learned the rheological behavior of T2DM blood by unifying the mechanical and aggregation factors of the RBCs, which provides an effective way to extract quantitative predictions of the rheological properties of the blood of individual patients with T2DM.
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Affiliation(s)
- Keqin Han
- State Key Laboratory of Fluid Power and Mechatronic Systems, Department of Engineering Mechanics, and Center for X-Mechanics, Zhejiang University, Hangzhou, China
| | - Shuhao Ma
- State Key Laboratory of Fluid Power and Mechatronic Systems, Department of Engineering Mechanics, and Center for X-Mechanics, Zhejiang University, Hangzhou, China
| | - Jiehui Sun
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Miao Xu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Xiaojing Qi
- State Key Laboratory of Fluid Power and Mechatronic Systems, Department of Engineering Mechanics, and Center for X-Mechanics, Zhejiang University, Hangzhou, China
| | - Shuo Wang
- State Key Laboratory of Fluid Power and Mechatronic Systems, Department of Engineering Mechanics, and Center for X-Mechanics, Zhejiang University, Hangzhou, China
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China.
| | - Xuejin Li
- State Key Laboratory of Fluid Power and Mechatronic Systems, Department of Engineering Mechanics, and Center for X-Mechanics, Zhejiang University, Hangzhou, China; The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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13
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Hareendranath S, Sathian SP. Dynamic response of red blood cells in health and disease. SOFT MATTER 2023; 19:1219-1230. [PMID: 36688330 DOI: 10.1039/d2sm01090a] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The viscoelastic response of the red blood cells (RBCs) affected by hematological disorders become severely impaired by the altered biophysical and morphological properties. These include traits like reduced deformability, increased membrane viscosity, and change in cell shape, causing substantial changes in the overall hemodynamics. RBCs, by virtue of their highly elastic membrane and low bending rigidity, exhibit complex dynamics when exposed to cyclic, transient forces in the microcirculation. Here, we employ mesoscopic numerical simulations based on the dissipative particle dynamics (DPD) framework to explore the dynamics of healthy, schizont stage malaria-infected and type 2 diabetes mellitus affected RBCs subjected to external time-dependent loads. The paper focuses on the imposition and cessation of external forcing on the cells of two different typologies, saw-tooth cyclic wave loading and sudden loads in the form of creep and relaxation phenomena. The effects of varying the rate of stress and the applied stress magnitude were investigated. Our simulations disclosed unique shape transitions of the hysteresis curves at varied loading rates. A careful analysis reveals a critical threshold of half cycle time of the from wherein the deformation of all cells observed, healthy or otherwise, falls under the nearly reversible deformation regime displaying minimal energy dissipation. Finally, we also examined the individual effects of the different constitutive and geometric characteristics attributed to the pathological cells and observed interesting recovery dynamics of spherocytes and cells having high shear moduli. The distinguished deformation behaviour of healthy and diseased cells could establish external force as a valuable initial biomarker.
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Affiliation(s)
- Sainath Hareendranath
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai 600036, India.
| | - Sarith P Sathian
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai 600036, India.
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14
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Mohanto N, Park YJ, Jee JP. Current perspectives of artificial oxygen carriers as red blood cell substitutes: a review of old to cutting-edge technologies using in vitro and in vivo assessments. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2023; 53:153-190. [PMID: 35935469 PMCID: PMC9344254 DOI: 10.1007/s40005-022-00590-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/02/2022] [Indexed: 01/06/2023]
Abstract
Background Several circumstances such as accidents, surgery, traumatic hemorrhagic shock, and other causalities cause major blood loss. Allogenic blood transfusion can be resuscitative for such conditions; however, it has numerous ambivalent effects, including supply shortage, needs for more time, cost for blood grouping, the possibility of spreading an infection, and short shelf-life. Hypoxia or ischemia causes heart failure, neurological problems, and organ damage in many patients. To address this emergent medical need for resuscitation and to treat hypoxic conditions as well as to enhance oxygen transportation, researchers aspire to achieve a robust technology aimed to develop safe and feasible red blood cell substitutes for effective oxygen transport. Area covered This review article provides an overview of the formulation, storage, shelf-life, clinical application, side effects, and current perspectives of artificial oxygen carriers (AOCs) as red blood cell substitutes. Moreover, the pre-clinical (in vitro and in vivo) assessments for the evaluation of the efficacy and safety of oxygen transport through AOCs are key considerations in this study. With the most significant technologies, hemoglobin- and perfluorocarbon-based oxygen carriers as well as other modern technologies, such as synthetically produced porphyrin-based AOCs and oxygen-carrying micro/nanobubbles, have also been elucidated. Expert opinion Both hemoglobin- and perfluorocarbon-based oxygen carriers are significant, despite having the latter acting as safeguards; they are cost-effective, facile formulations which penetrate small blood vessels and remove arterial blockages due to their nano-size. They also show better biocompatibility and longer half-life circulation than other similar technologies.
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Affiliation(s)
- Nijaya Mohanto
- College of Pharmacy, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452 Republic of Korea
| | - Young-Joon Park
- College of Pharmacy, Ajou University, Suwon, Gyeonggi, Republic of Korea
| | - Jun-Pil Jee
- College of Pharmacy, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452 Republic of Korea
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15
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Sickle Cell Disease Pathophysiology and Related Molecular and Biophysical Biomarkers. Hematol Oncol Clin North Am 2022; 36:1077-1095. [DOI: 10.1016/j.hoc.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Ibrahim A, Muhammad SA. Antioxidant-Rich Nutraceutical as a Therapeutic Strategy for Sickle Cell Disease. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022:1-10. [PMID: 36069788 DOI: 10.1080/27697061.2022.2108930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/23/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
Sickle cell disease (SCD) is a genetically inherited disease in which the "SS" individual possesses two copies of the abnormal beta-globin gene. This disease is one of the most dominant genetic diseases in the world. SCD is marked by the propensity of red cell hemoglobin to polymerize and distort the red cell from a biconcave disk shape into a sickle shape, resulting in a typical vaso-occlusive episode and accelerated hemolysis. Plants are rich sources of bioactive compounds that are promising anti-sickling agents to scavenge free radicals, thereby ensuring oxidative balance. The current review highlights the potential therapeutic benefits of antioxidant-rich nutraceutical in the treatment and management of sickle cell disease. The anti-sickling potential of nutraceutical is attributed to the presence of antioxidant bioactive chemicals such as alkaloids, polyphenols, vitamins, and minerals, which acts as scavengers of free radicals that prevent oxidative damage of the hemoglobin and prevent hemolysis, facilitating longer erythrocyte lifespan. The challenges of current therapies for SCD and future directions are also discussed.KEY TEACHING POINTSSickle cell disease is a genetically inherited disease in which SS individuals possess two copies of the abnormal beta-globin gene.Oxidative stress contributes to the pathophysiology of secondary dysfunction in sickle cell patients.Antioxidants can play a vital role in maintaining a balance between oxidant and antioxidant defense systems.Nutraceutical rich in antioxidants such as alkaloids, polyphenols, vitamins, and minerals is potential therapeutic agents for sickle cell disease.An antioxidant-rich nutraceutical may act to reduce vaso-occlusive crises.
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Affiliation(s)
- Abdulwasiu Ibrahim
- Department of Biochemistry and Molecular Biology, Usmanu Danfodiyo University, Sokoto, Nigeria
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17
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Palomarez A, Jha M, Medina Romero X, Horton RE. Cardiovascular consequences of sickle cell disease. BIOPHYSICS REVIEWS 2022; 3:031302. [PMID: 38505276 PMCID: PMC10903381 DOI: 10.1063/5.0094650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/11/2022] [Indexed: 03/21/2024]
Abstract
Sickle cell disease (SCD) is an inherited blood disorder caused by a single point mutation within the beta globin gene. As a result of this mutation, hemoglobin polymerizes under low oxygen conditions causing red blood cells to deform, become more adhesive, and increase in rigidity, which affects blood flow dynamics. This process leads to enhanced red blood cell interactions with the endothelium and contributes to vaso-occlusion formation. Although traditionally defined as a red blood cell disorder, individuals with SCD are affected by numerous clinical consequences including stroke, painful crisis episodes, bone infarctions, and several organ-specific complications. Elevated cardiac output, endothelium activation along with the sickling process, and the vaso-occlusion events pose strains on the cardiovascular system. We will present a review of the cardiovascular consequences of sickle cell disease and show connections with the vasculopathy related to SCD. We will also highlight biophysical properties and engineering tools that have been used to characterize the disease. Finally, we will discuss therapies for SCD and potential implications on SCD cardiomyopathy.
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Affiliation(s)
- Alexis Palomarez
- Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, Texas 77204, USA
| | - Manisha Jha
- Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, Texas 77204, USA
| | - Ximena Medina Romero
- Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, Texas 77204, USA
| | - Renita E. Horton
- Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, Texas 77204, USA
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18
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Man Y, An R, Monchamp K, Sekyonda Z, Kucukal E, Federici C, Wulftange WJ, Goreke U, Bode A, Sheehan VA, Gurkan UA. OcclusionChip: A functional microcapillary occlusion assay complementary to ektacytometry for detection of small-fraction red blood cells with abnormal deformability. Front Physiol 2022; 13:954106. [PMID: 36091387 PMCID: PMC9452903 DOI: 10.3389/fphys.2022.954106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022] Open
Abstract
Red blood cell (RBC) deformability is a valuable hemorheological biomarker that can be used to assess the clinical status and response to therapy of individuals with sickle cell disease (SCD). RBC deformability has been measured by ektacytometry for decades, which uses shear or osmolar stress. However, ektacytometry is a population based measurement that does not detect small-fractions of abnormal RBCs. A single cell-based, functional RBC deformability assay would complement ektacytometry and provide additional information. Here, we tested the relative merits of the OcclusionChip, which measures RBC deformability by microcapillary occlusion, and ektacytometry. We tested samples containing glutaraldehyde-stiffened RBCs for up to 1% volume fraction; ektacytometry detected no significant change in Elongation Index (EI), while the OcclusionChip showed significant differences in Occlusion Index (OI). OcclusionChip detected a significant increase in OI in RBCs from an individual with sickle cell trait (SCT) and from a subject with SCD who received allogeneic hematopoietic stem cell transplant (HSCT), as the sample was taken from normoxic (pO2:159 mmHg) to physiologic hypoxic (pO2:45 mmHg) conditions. Oxygen gradient ektacytometry detected no difference in EI for SCT or HSCT. These results suggest that the single cell-based OcclusionChip enables detection of sickle hemoglobin (HbS)-related RBC abnormalities in SCT and SCD, particularly when the HbS level is low. We conclude that the OcclusionChip is complementary to the population based ektacytometry assays, and providing additional sensitivity and capacity to detect modest abnormalities in red cell function or small populations of abnormal red cells.
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Affiliation(s)
- Yuncheng Man
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Ran An
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Karamoja Monchamp
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
- Division of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Zoe Sekyonda
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Erdem Kucukal
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Chiara Federici
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
- Division of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - William J. Wulftange
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Utku Goreke
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Allison Bode
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
- Division of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Vivien A. Sheehan
- Aflac Cancer & Blood Disorders Center Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, United States
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
- *Correspondence: Umut A. Gurkan,
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19
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Automated measurement of cell mechanical properties using an integrated dielectrophoretic microfluidic device. iScience 2022; 25:104275. [PMID: 35602969 PMCID: PMC9114521 DOI: 10.1016/j.isci.2022.104275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/24/2022] Open
Abstract
Cell mechanics is closely related to and interacts with cellular functions, which has the potential to be an effective biomarker to indicate disease onset and progression. Although several techniques have been developed for measuring cell mechanical properties, the issues of limited measurement data and biological significance because of complex and labor-intensive manipulation remain to be addressed, especially for the dielectrophoresis-based approach that is difficult to utilize flow measurement techniques. In this work, a dielectrophoresis-based solution is proposed to automatically obtain mass cellular mechanical data by combining a designed microfluidic device integrated the functions of cell capture, dielectrophoretic stretching, and cell release and an automatic control scheme. Experiments using human umbilical vein endothelial cells and breast cells revealed the automation capability of this device. The proposed method provides an effective way to address the low-throughput problem of dielectrophoresis-based cell mechanical property measurements, which enhance the biostatistical significance for cellular mechanism studies. Cell capture, dielectrophoretic stretching, and release in one microfluidic chip Automatic measurement scheme to realize circularly measurement Automatic acquisition of large amounts of cell mechanical properties data Significant advances in dielectrophoretic measurement of cell mechanical properties
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20
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Olagunju MO, Loschwitz J, Olubiyi OO, Strodel B. Multiscale
MD
simulations of wild‐type and sickle hemoglobin aggregation. Proteins 2022; 90:1811-1824. [DOI: 10.1002/prot.26352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/02/2022] [Accepted: 04/20/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Maryam O. Olagunju
- Institute of Biological Information Processing Structural Biochemistry, Forschungszentrum Jülich Jülich Germany
| | - Jennifer Loschwitz
- Institute of Biological Information Processing Structural Biochemistry, Forschungszentrum Jülich Jülich Germany
- Institute of Theoretical and Computational Chemistry, Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Olujide O. Olubiyi
- Institute of Biological Information Processing Structural Biochemistry, Forschungszentrum Jülich Jülich Germany
- Department of Pharmaceutical and Medicinal Chemistry, College of Pharmacy Afe Babalola University Ado‐Ekiti Nigeria
- Institute of Drug Research and Development, Bogoro Centre Afe Babalola University Ado‐Ekiti Nigeria
| | - Birgit Strodel
- Institute of Biological Information Processing Structural Biochemistry, Forschungszentrum Jülich Jülich Germany
- Institute of Theoretical and Computational Chemistry, Heinrich Heine University Düsseldorf Düsseldorf Germany
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Growth of Laser-Induced Microbubbles inside Capillary Tubes Affected by Gathered Light-Absorbing Particles. MICROMACHINES 2022; 13:mi13050740. [PMID: 35630207 PMCID: PMC9145415 DOI: 10.3390/mi13050740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 12/03/2022]
Abstract
Microbubbles have important applications in optofluidics. The generation and growth of microbubbles is a complicated process in microfluidic channels. In this paper, we use a laser to irradiate light-absorbing particles to generate microbubbles in capillary tubes and investigate the factors affecting microbubble size. The results show that the key factor is the total area of the light-absorbing particles gathered at the microbubble bottom. The larger the area of the particles at bottom, the larger the size of the microbubbles. Furthermore, the area is related to capillary tube diameter. The larger the diameter of the capillary tube, the more particles gathered at the bottom of the microbubbles. Numerical simulations show that the Marangoni convection is stronger in a capillary tube with a larger diameter, which can gather more particles than that in a capillary tube with a smaller diameter. The calculations show that the particles in contact with the microbubbles will be in a stable position due to the surface tension force.
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Feugray G, Kasonga F, Grall M, Benhamou Y, Bobée-Schneider V, Buchonnet G, Daliphard S, Le Cam Duchez V, Lahary A, Billoir P. Assessment of Reticulocyte and Erythrocyte Parameters From Automated Blood Counts in Vaso-Occlusive Crisis on Sickle Cell Disease. Front Med (Lausanne) 2022; 9:858911. [PMID: 35492334 PMCID: PMC9044919 DOI: 10.3389/fmed.2022.858911] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/21/2022] [Indexed: 12/18/2022] Open
Abstract
Sickle cell disease is a complex genetic disease involving cell adhesion between red blood cells, white blood cells, platelets and endothelial cells, inducing painful vaso-occlusive crisis (VOC). We assessed reticulocyte and erythrocyte parameters in a cohort of confirmed SCD patients, and investigated whether a combination of these routine laboratory biomarkers of haemolysis could be used to predict VOC development. Reticulocyte and erythrocyte parameters were evaluated using the Sysmex XN-9000 analyser. A total of 98 patients with SCD were included, 72 in steady state and 26 in VOC. Among the 72 patients in steady state, 22 developed a VOC in the following year (median: 3 months [2-6]). The following parameters were increased in SCD patients with VOC development compared to SCD patients without VOC development in the following year: reticulocyte count (94.6 109/L [67.8-128] vs. 48.4 109/L [24.9-87.5]), immature reticulocyte count (259 109/L [181-334] vs. 152 109/L [129-208]) reticulocyte/immature reticulocyte fraction (IRF) ratio (6.63 109/(L*%) [4.67-9.56] vs. 4.94 109/(L*%) [3.96-6.61]), and medium fluorescence reticulocytes (MFR) (19.9% [17.4-20.7] vs. 17.1% [15.95-19.75]). The association of a reticulocyte count of >189.4 109/L and an MFR of >19.75% showed a sensitivity of 81.8% and a specificity of 88% to predict VOC development in the following year. Based on our findings, a combination of routine laboratory biomarkers, as reticulocyte count, immature reticulocyte count and fluorescent reticulocyte fraction at steady state, could be used to predict VOC development in SCD.
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Affiliation(s)
- Guillaume Feugray
- General Biochemistry, Normandie Univ, Rouen University, INSERM U1096, CHU Rouen, Rouen, France
| | | | | | - Ygal Benhamou
- Department of Internal Medecine, Normandie Univ, Rouen University, INSERM U1096, CHU Rouen, Rouen, France
| | | | | | | | - Véronique Le Cam Duchez
- Normandie Univ, Rouen University, INSERM U1096, CHU Rouen, Vascular Hemostasis Unit, Rouen, France
| | | | - Paul Billoir
- Normandie Univ, Rouen University, INSERM U1096, CHU Rouen, Vascular Hemostasis Unit, Rouen, France
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Zhang W, Cui N, Su F, Wang Y, Yang B, Sun Y, Guan W, Kuang H, Wang Q. Comprehensive Metabolomics and Network Pharmacology to Explore the Mechanism of 5-Hydroxymethyl Furfural in the Treatment of Blood Deficiency Syndrome. Front Pharmacol 2022; 12:811331. [PMID: 35310893 PMCID: PMC8931835 DOI: 10.3389/fphar.2021.811331] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Radix Rehmanniae (RR, from Radix Rehmanniae (Gaertn.) DC.) is a natural medicine used in traditional Chinese medicine (TCM) since ancient times for the treatment of blood disorders. RR is steamed to get Rehmanniae Radix Praeparata (RP), which has a tonic effect on blood; the content of 5-hydromethylfurfural (5-HMF) increases more than four times after steaming. Studies have shown that 5-HMF has positive pharmacological effects on cardiovascular and hematological disorders. This study aimed to explore and verify the impact of 5-HMF on rats with chemotherapy-induced blood deficiency syndrome (BDS). Rats were given cyclophosphamide (CP) and acetophenhydrazine (APH) to induce BDS, the coefficients of some organs (liver, spleen, and kidney) were measured, and a routine blood test examined the coefficients of several peripheral blood cells. Metabolomics and network pharmacology were combined to find important biomarkers, targets, and pathways. Western blot was used to detect the expression of CYP17A1 and HSD3B1 proteins in the spleen. All these findings suggested that the 5-HMF significantly increased the number of peripheral blood cells and reversed splenomegaly in rats. In addition, 5-HMF upregulated CYP17A1 and HSD3B1 protein expression in splenic tissues. Also, 5-HMF ameliorated chemotherapy-induced BDS in rats, and its therapeutic mechanism might depend on steroid hormone biosynthesis and other pathways. It acts on blood deficiency via multiple targets and pathways, which is unique to Chinese medicine.
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Affiliation(s)
- Wensen Zhang
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
| | - Na Cui
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
| | - Fazhi Su
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
| | - Yangyang Wang
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
| | - Bingyou Yang
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
| | - Yanping Sun
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
| | - Wei Guan
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
| | - Haixue Kuang
- Key Laboratory of Basic and Application Research of Beiyao (Heilongjiang University of Chinese Medicine), Ministry of Education, Harbin, China
- *Correspondence: Haixue Kuang, ; Qiuhong Wang,
| | - Qiuhong Wang
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangdong, China
- *Correspondence: Haixue Kuang, ; Qiuhong Wang,
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25
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Praljak N, Iram S, Goreke U, Singh G, Hill A, Gurkan UA, Hinczewski M. Integrating deep learning with microfluidics for biophysical classification of sickle red blood cells adhered to laminin. PLoS Comput Biol 2021; 17:e1008946. [PMID: 34843453 PMCID: PMC8659663 DOI: 10.1371/journal.pcbi.1008946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/09/2021] [Accepted: 11/19/2021] [Indexed: 12/02/2022] Open
Abstract
Sickle cell disease, a genetic disorder affecting a sizeable global demographic, manifests in sickle red blood cells (sRBCs) with altered shape and biomechanics. sRBCs show heightened adhesive interactions with inflamed endothelium, triggering painful vascular occlusion events. Numerous studies employ microfluidic-assay-based monitoring tools to quantify characteristics of adhered sRBCs from high resolution channel images. The current image analysis workflow relies on detailed morphological characterization and cell counting by a specially trained worker. This is time and labor intensive, and prone to user bias artifacts. Here we establish a morphology based classification scheme to identify two naturally arising sRBC subpopulations-deformable and non-deformable sRBCs-utilizing novel visual markers that link to underlying cell biomechanical properties and hold promise for clinically relevant insights. We then set up a standardized, reproducible, and fully automated image analysis workflow designed to carry out this classification. This relies on a two part deep neural network architecture that works in tandem for segmentation of channel images and classification of adhered cells into subtypes. Network training utilized an extensive data set of images generated by the SCD BioChip, a microfluidic assay which injects clinical whole blood samples into protein-functionalized microchannels, mimicking physiological conditions in the microvasculature. Here we carried out the assay with the sub-endothelial protein laminin. The machine learning approach segmented the resulting channel images with 99.1±0.3% mean IoU on the validation set across 5 k-folds, classified detected sRBCs with 96.0±0.3% mean accuracy on the validation set across 5 k-folds, and matched trained personnel in overall characterization of whole channel images with R2 = 0.992, 0.987 and 0.834 for total, deformable and non-deformable sRBC counts respectively. Average analysis time per channel image was also improved by two orders of magnitude (∼ 2 minutes vs ∼ 2-3 hours) over manual characterization. Finally, the network results show an order of magnitude less variance in counts on repeat trials than humans. This kind of standardization is a prerequisite for the viability of any diagnostic technology, making our system suitable for affordable and high throughput disease monitoring.
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MESH Headings
- Anemia, Sickle Cell/blood
- Anemia, Sickle Cell/diagnostic imaging
- Biophysical Phenomena
- Computational Biology
- Deep Learning
- Diagnosis, Computer-Assisted/statistics & numerical data
- Erythrocyte Deformability/physiology
- Erythrocytes, Abnormal/classification
- Erythrocytes, Abnormal/pathology
- Erythrocytes, Abnormal/physiology
- Hemoglobin, Sickle/chemistry
- Hemoglobin, Sickle/metabolism
- High-Throughput Screening Assays/statistics & numerical data
- Humans
- Image Interpretation, Computer-Assisted/statistics & numerical data
- In Vitro Techniques
- Lab-On-A-Chip Devices/statistics & numerical data
- Laminin/metabolism
- Microfluidics/statistics & numerical data
- Neural Networks, Computer
- Protein Multimerization
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Affiliation(s)
- Niksa Praljak
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
- Department of Physics, Cleveland State University, Cleveland, Ohio, United States of America
| | - Shamreen Iram
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Utku Goreke
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Gundeep Singh
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ailis Hill
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Michael Hinczewski
- Department of Physics, Case Western Reserve University, Cleveland, Ohio, United States of America
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Kanne CK, Nebor D, Pochron M, Oksenberg D, Sheehan VA. Rheological Impact of GBT1118 Cessation in a Sickle Mouse Model. Front Physiol 2021; 12:742784. [PMID: 34630162 PMCID: PMC8497897 DOI: 10.3389/fphys.2021.742784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
In sickle cell disease (SCD), higher whole blood viscosity is a risk factor for vaso-occlusive crisis, avascular necrosis, and proliferative retinopathy. Blood viscosity is strongly impacted by hemoglobin (Hb) levels and red blood cell (RBC) deformability. Voxelotor is a hemoglobin S (HbS) polymerization inhibitor with anti-sickling properties that increases the Hb affinity for oxygen, thereby reducing HbS polymerization. In clinical trials, voxelotor increased Hb by an average of 1g/dl, creating concern that this rise in Hb could increase viscosity, particularly when the drug was cleared. To investigate this potential rebound hyperviscosity effect, we treated SCD mice with GBT1118, a voxelotor analog, and stopped the treatment to determine the effect on blood viscosity and RBC deformability under a range of oxygen concentrations. GBT1118 treatment increased Hb, improved RBC deformability by increasing the elongation index under normoxic (EImax) and hypoxic conditions (EImin), and decreased the point of sickling (PoS) without increasing blood viscosity. The anti-sickling effects and improvement of RBC deformability balanced the effect of increased Hb such that there was no increase in blood viscosity. Forty-eight hours after ceasing GBT1118, Hb declined from the rise induced by treatment, viscosity did not increase, and EImin remained elevated compared to control animals. Hb and PoS were not different from control animals, suggesting a return to native oxygen affinity and clearance of the drug. RBC deformability did not return to baseline, suggesting some residual rheological improvement. These data suggest that concerns regarding viscosity rise above pre-treatment levels upon sudden cessation of voxelotor are not warranted.
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Affiliation(s)
- Celeste K. Kanne
- Aflac Cancer & Blood Disorders Center Children’s Healthcare of Atlanta, School of Medicine, Emory University, Atlanta, GA, United States
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, TX, United States
| | - Danitza Nebor
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, TX, United States
| | - Mira Pochron
- Global Blood Therapeutics, South, San Francisco, CA, United States
| | - Donna Oksenberg
- Global Blood Therapeutics, South, San Francisco, CA, United States
| | - Vivien A. Sheehan
- Aflac Cancer & Blood Disorders Center Children’s Healthcare of Atlanta, School of Medicine, Emory University, Atlanta, GA, United States
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, TX, United States
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27
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Harp KO, Botchway F, Dei-Adomakoh Y, Wilson MD, Mubasher M, Adjei AA, Thompson WE, Stiles JK, Driss A. Analysis of clinical presentation, hematological factors, self-reported bed net usage, and malaria burden in sickle cell disease patients. EClinicalMedicine 2021; 39:101045. [PMID: 34386757 PMCID: PMC8342910 DOI: 10.1016/j.eclinm.2021.101045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Sickle cell anemia (SCA) is a severe monogenic disorder, caused by single nucleotide mutations in the hemoglobin (Hb) gene, that is prevalent in malaria endemic regions of the world. Sickle cell trait (SCT) individuals carry only one of the mutated alleles and were shown to be protected against malaria. However, defining the relative contribution of hematological, clinical, and environmental factors to the overall burden of malaria in individuals with hemoglobinopathies such as SCA has been challenging. METHODS We hypothesized that hematological differences, clinical presentations, and self-reported bed net usage among Plasmodium-infected and uninfected individuals may govern overall malaria burden in individuals with sickle cell disease (SCD). We conducted a cross-sectional study in Ghana from 2014 to 2019 and described clinical presentations, hematological characteristics, and bed net use based on a comprehensive questionnaire. Hematological characteristics were compared using a parametric or nonparametric ANOVA, pending if data passed D'Agostino & Pearson normality test. When comparing only two Hb genotypes hematological characteristics a Mann-Whitney U-test were used. Logistic regressions and Chi-squared tests were used to compare questionnaire responses between Hb genotypes. All statistical significance was set at p < 0.05. FINDINGS Multiple hematological parameters were significantly (p < 0.05) altered depending on sickle cell genotype and/or malaria status. When compared to other Hb genotypes, SCA individuals with or without malaria had significantly (p < 0.05) higher WBC and platelets counts and lower Hb levels. While the sickle cell genotype may affect malaria severity, SCT and SCA participants were found to significantly (p < 0.007) use bet nets more than HbAA participants. INTERPRETATIONS Our findings can be utilized to enhance national guidelines for reducing the incidence of malaria especially among individuals with SCD, SCT protection and health disparities among hemoglobinopathies. FUNDING This study was supported by the National Institute for Health.
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Affiliation(s)
- Keri Oxendine Harp
- Department of Physiology, Morehouse School of Medicine, 720 Westview Dr. SW, Atlanta GA 30310, USA
| | - Felix Botchway
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | | | - Michael D. Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Mohamed Mubasher
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Andrew A. Adjei
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Winston E. Thompson
- Department of Physiology, Morehouse School of Medicine, 720 Westview Dr. SW, Atlanta GA 30310, USA
| | - Jonathan K. Stiles
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Adel Driss
- Department of Physiology, Morehouse School of Medicine, 720 Westview Dr. SW, Atlanta GA 30310, USA
- Corresponding author.
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Sahu T, Verma HK, Ganguly S, Sinha M, Sinha R. Common, But Neglected: A Comprehensive Review of Leg Ulcers in Sickle Cell Disease. Adv Skin Wound Care 2021; 34:423-431. [PMID: 34260420 DOI: 10.1097/01.asw.0000755924.12513.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compile available evidence to better understand the management of leg ulcers in sickle cell disease (SCD), as well as describe potential therapeutic steps that may be required to improve the quality of life of patients with SCD leg ulcers. DATA SOURCES MEDLINE, PubMed, EMBASE, and Web of Science databases. STUDY SELECTION A comprehensive search was conducted to retrieve relevant studies using the keywords "sickle cell disease and leg ulcer," "ulcer treatments, diagnosis and sickle cell," and "wound sickle cell." Studies published through July 2020 were included. DATA EXTRACTION Two independent authors selected all studies that assessed the relationship between leg ulcer and SCD identified from online databases. DATA SYNTHESIS The authors have summarized updated information on pathophysiology (vasculopathy linked to chronic hemolysis and endothelial dysfunction), diagnosis, and available treatment options to unravel the dermohematologic connection between leg ulcers and SCD. CONCLUSIONS It is the authors' hope that this detailed discussion of the information available on leg ulcers and SCD will lead to a better appreciation of this clinical problem by the clinicians and researchers and in turn have a long-term positive effect on the quality of life of patients with SCD. Researchers should design new trials considering these insights and potential therapeutic approaches based on current knowledge.
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Affiliation(s)
- Tarun Sahu
- Tarun Sahu, PhD, is Research Fellow, Department of Physiology, All India Institute of Medical Sciences, Raipur, India. Henu Kumar Verma, PhD, is Researcher, Stem Cell Laboratory, Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy. At the All India Institute of Medical Sciences, Satyaki Ganguly, MD, DNB, is Associate Professor, Department of Dermatology; Meenakshi Sinha, PhD, is Associate Professor, Department of Physiology; and Ramanjan Sinha, PhD, is Professor and Head, Department of Physiology. The authors have disclosed no financial relationships related to this article. Submitted August 26, 2020; accepted in revised form October 22, 2020
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Anurogo D, Yuli Prasetyo Budi N, Thi Ngo MH, Huang YH, Pawitan JA. Cell and Gene Therapy for Anemia: Hematopoietic Stem Cells and Gene Editing. Int J Mol Sci 2021; 22:ijms22126275. [PMID: 34200975 PMCID: PMC8230702 DOI: 10.3390/ijms22126275] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/23/2022] Open
Abstract
Hereditary anemia has various manifestations, such as sickle cell disease (SCD), Fanconi anemia, glucose-6-phosphate dehydrogenase deficiency (G6PDD), and thalassemia. The available management strategies for these disorders are still unsatisfactory and do not eliminate the main causes. As genetic aberrations are the main causes of all forms of hereditary anemia, the optimal approach involves repairing the defective gene, possibly through the transplantation of normal hematopoietic stem cells (HSCs) from a normal matching donor or through gene therapy approaches (either in vivo or ex vivo) to correct the patient’s HSCs. To clearly illustrate the importance of cell and gene therapy in hereditary anemia, this paper provides a review of the genetic aberration, epidemiology, clinical features, current management, and cell and gene therapy endeavors related to SCD, thalassemia, Fanconi anemia, and G6PDD. Moreover, we expound the future research direction of HSC derivation from induced pluripotent stem cells (iPSCs), strategies to edit HSCs, gene therapy risk mitigation, and their clinical perspectives. In conclusion, gene-corrected hematopoietic stem cell transplantation has promising outcomes for SCD, Fanconi anemia, and thalassemia, and it may overcome the limitation of the source of allogenic bone marrow transplantation.
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Affiliation(s)
- Dito Anurogo
- International PhD Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (D.A.); (N.Y.P.B.); (M.-H.T.N.)
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Makassar, Makassar 90221, Indonesia
| | - Nova Yuli Prasetyo Budi
- International PhD Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (D.A.); (N.Y.P.B.); (M.-H.T.N.)
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Mai-Huong Thi Ngo
- International PhD Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (D.A.); (N.Y.P.B.); (M.-H.T.N.)
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yen-Hua Huang
- International PhD Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (D.A.); (N.Y.P.B.); (M.-H.T.N.)
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Research Center of Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Center for Reproductive Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Comprehensive Cancer Center, Taipei Medical University, Taipei 11031, Taiwan
- Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei 11031, Taiwan
- PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: (Y.-H.H.); (J.A.P.); Tel.: +886-2-2736-1661 (ext. 3150) (Y.-H.H.); +62-812-9535-0097 (J.A.P.)
| | - Jeanne Adiwinata Pawitan
- Department of Histology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
- Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
- Stem Cell and Tissue Engineering Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
- Correspondence: (Y.-H.H.); (J.A.P.); Tel.: +886-2-2736-1661 (ext. 3150) (Y.-H.H.); +62-812-9535-0097 (J.A.P.)
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Abstract
PURPOSE OF REVIEW This review summarizes the significant biophysical and rheological aspects of red blood cell physiology and pathophysiology in relation to recent advances in microfluidic biomarker assays and emerging targeted or curative intent therapies. RECENT FINDINGS Alterations in red cell biophysical properties and blood rheology have been associated with numerous hematologic and circulatory disorders. Recent advances in biomarker assays enable effective assessment of these biophysical and rheological properties in normoxia or physiological hypoxia in a clinically meaningful way. There are emerging targeted or curative therapies that aim to improve red cell pathophysiology, especially in the context of inherited hemoglobin disorders, such as sickle cell disease. SUMMARY Red cell pathophysiology can be therapeutically targeted and the improvements in membrane and cellular biophysics and blood rheology can now be feasibly assessed via new microfluidic biomarker assays. Recent advances provide a new hope and novel treatment options for major red cell ailments, including inherited hemoglobin disorders, membrane disorders, and other pathologies of the red cell, such as malaria.
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Affiliation(s)
- Umut A. Gurkan
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH 44106, USA
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH 44106, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
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Shafrin J, Thom HHZ, Keeney E, Gaunt DM, Zhao LM, Bhor M, Rizio AA, Bronté-Hall L, Shah N. The impact of vaso-occlusive crises and disease severity on quality of life and productivity among patients with sickle cell disease in the US. Curr Med Res Opin 2021; 37:761-768. [PMID: 33686891 DOI: 10.1080/03007995.2021.1897556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM Sickle cell disease (SCD) is a lifelong blood disorder affecting approximately 100,000 individuals in the United States (US). A number of new treatments have recently become available to improve SCD clinical outcomes, but it is unclear how treatment innovations that reduce disease severity could affect patients' humanistic and economic outcomes. METHODS AND MATERIALS To answer this question, an online survey of US adult residents with a self-reported SCD diagnosis was conducted. Humanistic outcomes based on health-related quality of life (HRQoL)) were assessed during and outside of vaso-occlusive crises (VOCs). Economic outcomes were measured by annual household income and whether the respondent received disability insurance. RESULTS Among the 301 respondents completing the survey, average age was 34.4 years and 73.4% were female. Average HRQoL, measured using health utilities, were 0.311 (95% CI: 0.286, 0.337) during a VOC and 0.738 (0.720, 0.756) not during a VOC. The likelihood of claiming disability insurance was correlated with more frequent VOCs (0 VOCs: 12% vs. ≥4 VOCs: 47%, p = .002) and disease severity (Severity Class II: 16% vs. Severity Class III: 39%, p = .03). There was a weak relationship between VOC frequency and household income (0 VOCs: $47,488 vs. ≥4 VOCs: $34,569, p = .06) and no evidence of a relationship between disease severity class and income (Severity Class II: $42,443 vs. Severity Class III: $36,842, p = .29). CONCLUSION In conclusion, disease severity, strongly predicted worse self-reported HRQoL, moderately predicted increased likelihood of collecting disability insurance, and weakly predicted lower household income levels.
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Affiliation(s)
| | - Howard H Z Thom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Edna Keeney
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Daisy M Gaunt
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Menaka Bhor
- Novartis Pharmaceutical Company, East Hanover, NJ, USA
| | | | | | - Nirmish Shah
- Hematology, Duke University School of Medicine, Durham, NC, USA
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The Mystery of Red Blood Cells Extracellular Vesicles in Sleep Apnea with Metabolic Dysfunction. Int J Mol Sci 2021; 22:ijms22094301. [PMID: 33919065 PMCID: PMC8122484 DOI: 10.3390/ijms22094301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/12/2022] Open
Abstract
Sleep is very important for overall health and quality of life, while sleep disorder has been associated with several human diseases, namely cardiovascular, metabolic, cognitive, and cancer-related alterations. Obstructive sleep apnea (OSA) is the most common respiratory sleep-disordered breathing, which is caused by the recurrent collapse of the upper airway during sleep. OSA has emerged as a major public health problem and increasing evidence suggests that untreated OSA can lead to the development of various diseases including neurodegenerative diseases. In addition, OSA may lead to decreased blood oxygenation and fragmentation of the sleep cycle. The formation of free radicals or reactive oxygen species (ROS) can emerge and react with nitric oxide (NO) to produce peroxynitrite, thereby diminishing the bioavailability of NO. Hypoxia, the hallmark of OSA, refers to a decline of tissue oxygen saturation and affects several types of cells, playing cell-to-cell communication a vital role in the outcome of this interplay. Red blood cells (RBCs) are considered transporters of oxygen and nutrients to the tissues, and these RBCs are important interorgan communication systems with additional functions, including participation in the control of systemic NO metabolism, redox regulation, blood rheology, and viscosity. RBCs have been shown to induce endothelial dysfunction and increase cardiac injury. The mechanistic links between changes of RBC functional properties and cardiovascular are largely unknown. Extracellular vesicles (EVs) are secreted by most cell types and released in biological fluids both under physiological and pathological conditions. EVs are involved in intercellular communication by transferring complex cargoes including proteins, lipids, and nucleic acids from donor cells to recipient cells. Advancing our knowledge about mechanisms of RBC-EVs formation and their pathophysiological relevance may help to shed light on circulating EVs and to translate their application to clinical practice. We will focus on the potential use of RBC-EVs as valuable diagnostic and prognostic biomarkers and state-specific cargoes, and possibilities as therapeutic vehicles for drug and gene delivery. The use of RBC-EVs as a precision medicine for the diagnosis and treatment of the patient with sleep disorder will improve the prognosis and the quality of life in patients with cardiovascular disease (CVD).
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Single laser trapping for optical folding and rotation of red blood cells in sickle cell disease in response to hydroxyurea treatment. Biochem Biophys Res Commun 2021; 554:222-228. [PMID: 33823382 DOI: 10.1016/j.bbrc.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 11/20/2022]
Abstract
Optical folding and rotation behavior of red blood cells (RBCs) in polarized laser tweezers are considerably important for understanding the biophysical and biomechanical properties using the fast probing method. Here, a dual-mode polarized single-laser tweezers technique with distinct principal axes exhibiting different polarization states is presented and designed to investigate the deformation, optical folding, and rotation of single living cells with one measurement. RBC optical folding and rotation speed are measured in patients with sickle cell disease (SCD), including follow up of patients after hydroxyurea (HU) treatment for at least three months. Folding angle and rotation speed are significantly lower in patients with SCD and do not significantly differ in patients treated by HU compared with the healthy control group. The RBC folding angle and rotation speed in patients treated with HU drug increase linearly at lower laser powers and rapidly at higher powers, and increase much slowly in patients not treated with HU. The difference in the folding angle and rotation speed of RBCs could be useful for drug response in SCD or predicting pain crisis in SCD.
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Evers TMJ, Holt LJ, Alberti S, Mashaghi A. Reciprocal regulation of cellular mechanics and metabolism. Nat Metab 2021; 3:456-468. [PMID: 33875882 PMCID: PMC8863344 DOI: 10.1038/s42255-021-00384-w] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/12/2021] [Indexed: 12/12/2022]
Abstract
Metabolism and mechanics are intrinsically intertwined. External forces, sensed through the cytoskeleton or distortion of the cell and organelles, induce metabolic changes in the cell. The resulting changes in metabolism, in turn, feed back to regulate every level of cell biology, including the mechanical properties of cells and tissues. Here we examine the links between metabolism and mechanics, highlighting signalling pathways involved in the regulation and response to cellular mechanosensing. We consider how forces and metabolism regulate one another through nanoscale molecular sensors, micrometre-scale cytoskeletal networks, organelles and dynamic biomolecular condensates. Understanding this cross-talk will create diagnostic and therapeutic opportunities for metabolic disorders such as cancer, cardiovascular pathologies and obesity.
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Affiliation(s)
- Tom M J Evers
- Medical Systems Biophysics and Bioengineering, Leiden Academic Centre for Drug Research, Faculty of Science, Leiden University, Leiden, the Netherlands
| | - Liam J Holt
- Institute for Systems Genetics, New York University Langone Health, New York, NY, USA
| | - Simon Alberti
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | - Alireza Mashaghi
- Medical Systems Biophysics and Bioengineering, Leiden Academic Centre for Drug Research, Faculty of Science, Leiden University, Leiden, the Netherlands.
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Harp KO, Botchway F, Dei-Adomakoh Y, Wilson MD, Hood JL, Adjei AA, Stiles JK, Driss A. Hemoglobin Genotypes Modulate Inflammatory Response to Plasmodium Infection. Front Immunol 2020; 11:593546. [PMID: 33424841 PMCID: PMC7786007 DOI: 10.3389/fimmu.2020.593546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022] Open
Abstract
In 2018, 228 million cases and 405,000 malaria-associated deaths were reported worldwide with a majority being in Africa. A wide range of factors, including parasitemia, host immunity, inflammatory responses to infection, and host hemoglobin genotype, mediate the severity of malaria. Among the hemoglobinopathies, hemoglobin S (HbS) is caused by a single amino acid substitution of Glutamic Acid replaced by Valine at the sixth position of the beta-globin chain (E6V). Hemoglobin C (HbC) on the other hand, involves a single amino acid substitution of Glutamic Acid by a Lysine (E6K), which has received the most attention. These substitutions alter the stability of Hb leading to wide-ranging hematological disorders. The homozygous state of hemoglobin S (HbSS) results in sickle cell anemia (SCA) whereas the heterozygous state (HbAS) results in sickle cell trait (SCT). Both mutations are reported to mediate the reduction in the severity and fatality of Plasmodium falciparum malaria. The mechanism underlying this protection is poorly understood. Since both malaria and sickle cell disease (SCD) are associated with the destruction of erythrocytes and widespread systemic inflammation, identifying which inflammatory factor(s) mediate susceptibility of individuals with different hemoglobin genotypes to Plasmodium infection could result in the discovery of new predictive markers and interventions against malaria or SCD severity. We hypothesized that hemoglobin genotypes modulate the inflammatory response to Plasmodium infection. We conducted a cross-sectional study in Ghana, West Africa, between 2014 and 2019 to ascertain the relationships between blood inflammatory cytokines, Plasmodium infection, and hemoglobin genotype. A total of 923 volunteers were enrolled in the study. A total of 74, age and sex-matched subjects were identified with various genotypes including HbAS, HbAC, HbSS, HbSC, HbCC, or HbAA. Complete blood counts and serum inflammatory cytokine expression levels were assessed. The results indicate that differential expression of CXCL10, TNF-α, CCL2, IL-8, and IL-6 were tightly linked to hemoglobin genotype and severity of Plasmodium infection and that these cytokine levels may be predictive for susceptibility to severe malaria or SCD severity.
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Affiliation(s)
- Keri Oxendine Harp
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA, United States
| | - Felix Botchway
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | | | - Michael D Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joshua L Hood
- Department of Pharmacology and Toxicology & the James Graham Brown Cancer Center & the Hepatobiology and Toxicology COBRE, University of Louisville, School of Medicine, Louisville, KY, United States
| | - Andrew A Adjei
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Jonathan K Stiles
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, United States
| | - Adel Driss
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA, United States
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Bazzi MS, Valdez JM, Barocas VH, Wood DK. An Experimental-Computational Approach to Quantify Blood Rheology in Sickle Cell Disease. Biophys J 2020; 119:2307-2315. [PMID: 33096079 PMCID: PMC7732763 DOI: 10.1016/j.bpj.2020.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/02/2020] [Accepted: 10/13/2020] [Indexed: 02/08/2023] Open
Abstract
In sickle cell disease, aberrant blood flow due to oxygen-dependent changes in red cell biomechanics is a key driver of pathology. Most studies to date have focused on the potential role of altered red cell deformability and blood rheology in precipitating vaso-occlusive crises. Numerous studies, however, have shown that sickle blood flow is affected even at high oxygen tensions, suggesting a potentially systemic role for altered blood flow in driving pathologies, including endothelial dysfunction, ischemia, and stroke. In this study, we applied a combined experimental-computation approach that leveraged an experimental platform that quantifies sickle blood velocity fields under a range of oxygen tensions and shear rates. We computationally fitted a continuum model to our experimental data to generate physics-based parameters that capture patient-specific rheological alterations. Our results suggest that sickle blood flow is altered systemically, from the arterial to the venous circulation. We also demonstrated the application of this approach as a tool to design patient-specific transfusion regimens. Finally, we demonstrated that patient-specific rheological parameters can be combined with patient-derived vascular models to identify patients who are at higher risk for cerebrovascular complications such as aneurysm and stroke. Overall, this study highlights that sickle blood flow is altered systemically, which can drive numerous pathologies, and this study demonstrates the potential utility of an experimentally parameterized continuum model as a predictive tool for patient-specific care.
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Affiliation(s)
- Marisa S Bazzi
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - José M Valdez
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Victor H Barocas
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - David K Wood
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota.
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Paul R, Zhou Y, Nikfar M, Razizadeh M, Liu Y. Quantitative absorption imaging of red blood cells to determine physical and mechanical properties. RSC Adv 2020; 10:38923-38936. [PMID: 33240491 PMCID: PMC7685304 DOI: 10.1039/d0ra05421f] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022] Open
Abstract
Red blood cells or erythrocytes, constituting 40 to 45 percent of the total volume of human blood are vesicles filled with hemoglobin with a fluid-like lipid bilayer membrane connected to a 2D spectrin network. The shape, volume, hemoglobin mass, and membrane stiffness of RBCs are important characteristics that influence their ability to circulate through the body and transport oxygen to tissues. In this study, we show that a simple two-LED set up in conjunction with standard microscope imaging can accurately determine the physical and mechanical properties of single RBCs. The Beer-Lambert law and undulatory motion dynamics of the membrane have been used to measure the total volume, hemoglobin mass, membrane tension coefficient, and bending modulus of RBCs. We also show that this method is sensitive enough to distinguish between the mechanical properties of RBCs during morphological changes from a typical discocyte to echinocytes and spherocytes. Measured values of the tension coefficient and bending modulus are 1.27 × 10-6 J m-2 and 7.09 × 10-2 J for discocytes, 4.80 × 10-6 J m-2 and 7.70 × 10-20 J for echinocytes, and 9.85 × 10-6 J m-2 and 9.69 × 10-20 J for spherocytes, respectively. This quantitative light absorption imaging reduces the complexity related to the quantitative imaging of the biophysical and mechanical properties of a single RBC that may lead to enhanced yet simplified point of care devices for analyzing blood cells.
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Affiliation(s)
- Ratul Paul
- Department of Mechanical Engineering and Mechanics, Lehigh UniversityBethlehemPennsylvania 18015USA
| | - Yuyuan Zhou
- Department of Bioengineering, Lehigh UniversityBethlehemPennsylvania 18015USA
| | - Mehdi Nikfar
- Department of Mechanical Engineering and Mechanics, Lehigh UniversityBethlehemPennsylvania 18015USA
| | - Meghdad Razizadeh
- Department of Mechanical Engineering and Mechanics, Lehigh UniversityBethlehemPennsylvania 18015USA
| | - Yaling Liu
- Department of Mechanical Engineering and Mechanics, Lehigh UniversityBethlehemPennsylvania 18015USA
- Department of Bioengineering, Lehigh UniversityBethlehemPennsylvania 18015USA
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Katayama K, Tsunemi T, Miyazaki K, Uoto K, Yoshioka R, Terashima H, Terakawa M, Yamashiro K, Haruyama M, Maeda H, Makino T. Design, synthesis, and optimization of a series of 2-azaspiro[3.3]heptane derivatives as orally bioavailable fetal hemoglobin inducers. Bioorg Med Chem Lett 2020; 30:127425. [PMID: 32717372 DOI: 10.1016/j.bmcl.2020.127425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/08/2020] [Accepted: 07/16/2020] [Indexed: 12/18/2022]
Abstract
Pharmacological reactivation of the γ-globin gene for the production of fetal hemoglobin (HbF) is a promising approach for the management of β-thalassemia and sickle cell disease (SCD). We conducted a phenotypic screen in human erythroid progenitor cells to identify molecules that could induce HbF, which resulted in identification of the hit compound 1. Exploration of structure-activity relationships and optimization of ADME properties led to 2-azaspiro[3.3]heptane derivative 18, which is more rigid and has a unique structure. In vivo using cynomolgus monkeys, compound 18 induced a significant dose-dependent increase in globin switching, with developable properties. Moreover, compound 18 showed no genotoxic effects and was much safer than hydroxyurea. These findings could facilitate the development of effective new therapies for the treatment of β-hemoglobinopathies, including SCD.
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Affiliation(s)
- Katsushi Katayama
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan.
| | - Tomoyuki Tsunemi
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Kazuo Miyazaki
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Kouichi Uoto
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Ryosuke Yoshioka
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Hideki Terashima
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Maki Terakawa
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Kyoko Yamashiro
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Munetada Haruyama
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Hiroaki Maeda
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Tomohiro Makino
- Asubio Pharma Co. Ltd, 6-4-3 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
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Foy BH, Gonçalves BP, Higgins JM. Unraveling Disease Pathophysiology with Mathematical Modeling. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2020; 15:371-394. [PMID: 31977295 DOI: 10.1146/annurev-pathmechdis-012419-032557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Modeling has enabled fundamental advances in our understanding of the mechanisms of health and disease for centuries, since at least the time of William Harvey almost 500 years ago. Recent technological advances in molecular methods, computation, and imaging generate optimism that mathematical modeling will enable the biomedical research community to accelerate its efforts in unraveling the molecular, cellular, tissue-, and organ-level processes that maintain health, predispose to disease, and determine response to treatment. In this review, we discuss some of the roles of mathematical modeling in the study of human physiology and pathophysiology and some challenges and opportunities in general and in two specific areas: in vivo modeling of pulmonary function and in vitro modeling of blood cell populations.
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Affiliation(s)
- Brody H Foy
- Center for Systems Biology and Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA; .,Department of Systems Biology, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Bronner P Gonçalves
- Center for Systems Biology and Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA; .,Department of Systems Biology, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - John M Higgins
- Center for Systems Biology and Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA; .,Department of Systems Biology, Harvard Medical School, Boston, Massachusetts 02115, USA
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40
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Modelling of Red Blood Cell Morphological and Deformability Changes during In-Vitro Storage. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Storage lesion is a critical issue facing transfusion treatments, and it adversely affects the quality and viability of stored red blood cells (RBCs). RBC deformability is a key indicator of cell health. Deformability measurements of each RBC unit are a key challenge in transfusion medicine research and clinical haematology. In this paper, a numerical study, inspired from the previous research for RBC deformability and morphology predictions, is conducted for the first time, to investigate the deformability and morphology characteristics of RBCs undergoing storage lesion. This study investigates the evolution of the cell shape factor, elongation index and membrane spicule details, where applicable, of discocyte, echinocyte I, echinocyte II, echinocyte III and sphero-echinocyte morphologies during 42 days of in-vitro storage at 4 °C in saline-adenine-glucose-mannitol (SAGM). Computer simulations were performed to investigate the influence of storage lesion-induced membrane structural defects on cell deformability and its recoverability during optical tweezers stretching deformations. The predicted morphology and deformability indicate decreasing quality and viability of stored RBCs undergoing storage lesion. The loss of membrane structural integrity due to the storage lesion further degrades the cell deformability and recoverability during mechanical deformations. This numerical approach provides a potential framework to study the RBC deformation characteristics under varying pathophysiological conditions for better diagnostics and treatments.
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41
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Zhang X, Caruso C, Lam WA, Graham MD. Flow-induced segregation and dynamics of red blood cells in sickle cell disease. PHYSICAL REVIEW FLUIDS 2020; 5:053101. [PMID: 34095646 PMCID: PMC8174308 DOI: 10.1103/physrevfluids.5.053101] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Blood flow in sickle cell disease (SCD) can substantially differ from normal blood flow due to significant alterations in the physical properties of the red blood cells (RBCs). Chronic complications, such as inflammation of the endothelial cells lining blood vessel walls, are associated with SCD, for reasons that are unclear. Here, detailed boundary integral simulations are performed to investigate an idealized model flow flow in SCD, a binary suspension of flexible biconcave discoidal fluid-filled capsules and stiff curved prolate capsules that represent healthy and sickle RBCs, respectively, subjected to pressure-driven flow in a planar slit. The stiff component is dilute. The key observation is that, unlike healthy RBCs that concentrate around the center of the channel and form an RBC-depleted layer (i.e. cell-free layer) next to the walls, sickle cells are largely drained from the bulk of the suspension and aggregate inside the cell-free layer, displaying strong margination. These cells are found to undergo a rigid-body-like rolling orbit near the walls. A binary suspension of flexible biconcave discoidal capsules and stiff straight (non-curved) prolate capsules is also considered for comparison, and the curvature of the stiff component is found to play a minor role in the behavior. Additionally, by considering a mixture of flexible and stiff biconcave discoids, we reveal that rigidity difference by itself is sufficient to induce the segregation behavior in a binary suspension. Furthermore, the additional shear stress on the walls induced by the presence of cells is computed for the various cases. Compared to the small fluctuations in wall shear stress for a suspension of healthy RBCs, large local peaks in wall shear stress are observed for the binary suspensions, due to the proximity of the marginated stiff cells to the walls. This effect is most marked for the straight prolate capsules. As endothelial cells are known to mechanotransduce physical forces such as aberrations in shear stress and convert them to physiological processes such as activation of inflammatory signals, these results may aid in understanding mechanisms for endothelial dysfunction associated with SCD.
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Affiliation(s)
- Xiao Zhang
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, WI 53706-1691
| | - Christina Caruso
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA 30322
| | - Wilbur A. Lam
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA 30322
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA 30332
- Winship Cancer Institute, Emory University, Atlanta, GA 30322
- Parker H. Petit Institute of Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332
| | - Michael D. Graham
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, WI 53706-1691
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Bolarinwa AB, Oduwole O, Okebe J, Ogbenna AA, Otokiti OE, Olatinwo AT. Antioxidant supplementation for sickle cell disease. Hippokratia 2020. [DOI: 10.1002/14651858.cd013590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Abiola B Bolarinwa
- Department of Haematology & Blood Transfusion Medicine; Lagos University Teaching Hospital; Lagos Nigeria
| | - Olabisi Oduwole
- Department of Medical Laboratory Science; Achievers University; Owo Nigeria
| | - Joseph Okebe
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine; Banjul Gambia
| | - Ann A Ogbenna
- Department of Haematology & Blood Transfusion Medicine; College of Medicine, University of Lagos; Lagos Nigeria
| | - Oluwakemi E Otokiti
- Department of Haematology & Blood Transfusion Medicine; Lagos University Teaching Hospital; Lagos Nigeria
| | - Adejoke T Olatinwo
- Department of Haematology & Blood Transfusion; Lagos University Teaching Hospital; Lagos Nigeria
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Sharma S, Kulkarni C, Kulkarni MM, Ali R, Porwal K, Chattopadhyay N, Tewari D, Verma S. Tripeptide-induced modulation of mesenchymal stem cell biomechanics stimulates proliferation and wound healing. Chem Commun (Camb) 2020; 56:3043-3046. [PMID: 32048649 DOI: 10.1039/c9cc10043a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We demonstrate the ability of two tripeptides to promote proliferation and modulate the mechanical properties of human mesenchymal stem cells (hMSCs). Notably, Young's modulus of peptide-treated hMSCs was found to be ∼2 fold higher compared to the control group. These peptides promoted wound healing in hMSCs, without stimulating osteogenic and adipogenic differentiation, thus showing high potential in vascular tissue engineering applications.
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Affiliation(s)
- Swati Sharma
- Department of Chemistry, Indian Institute of Technology Kanpur, Kanpur 208016, India.
| | - Chirag Kulkarni
- Endocrinology Division, CSIR-Central Drug Research Institute, Jankipuram Extension, Sitapur Road, Lucknow 226031, India
| | - Manish M Kulkarni
- Centre for Nanoscience, Indian Institute of Technology Kanpur, Kanpur 208016, India.
| | - Rafat Ali
- Department of Chemistry, Indian Institute of Technology Kanpur, Kanpur 208016, India.
| | - Konica Porwal
- Endocrinology Division, CSIR-Central Drug Research Institute, Jankipuram Extension, Sitapur Road, Lucknow 226031, India
| | - Naibedya Chattopadhyay
- Endocrinology Division, CSIR-Central Drug Research Institute, Jankipuram Extension, Sitapur Road, Lucknow 226031, India
| | - Deepshikha Tewari
- Centre for Nanoscience, Indian Institute of Technology Kanpur, Kanpur 208016, India.
| | - Sandeep Verma
- Department of Chemistry, Indian Institute of Technology Kanpur, Kanpur 208016, India.
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Geekiyanage NM, Sauret E, Saha SC, Flower RL, Gu YT. Deformation behaviour of stomatocyte, discocyte and echinocyte red blood cell morphologies during optical tweezers stretching. Biomech Model Mechanobiol 2020; 19:1827-1843. [PMID: 32100179 DOI: 10.1007/s10237-020-01311-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 02/17/2020] [Indexed: 12/22/2022]
Abstract
The red blood cell (RBC) deformability is a critical aspect, and assessing the cell deformation characteristics is essential for better diagnostics of healthy and deteriorating RBCs. There is a need to explore the connection between the cell deformation characteristics, cell morphology, disease states, storage lesion and cell shape-transformation conditions for better diagnostics and treatments. A numerical approach inspired from the previous research for RBC morphology predictions and for analysis of RBC deformations is proposed for the first time, to investigate the deformation characteristics of different RBC morphologies. The present study investigates the deformability characteristics of stomatocyte, discocyte and echinocyte morphologies during optical tweezers stretching and provides the opportunity to study the combined contribution of cytoskeletal spectrin network and the lipid-bilayer during RBC deformation. The proposed numerical approach predicts agreeable deformation characteristics of the healthy discocyte with the analogous experimental observations and is extended to further investigate the deformation characteristics of stomatocyte and echinocyte morphologies. In particular, the computer simulations are performed to investigate the influence of direct stretching forces on different equilibrium cell morphologies on cell spectrin link extensions and cell elongation index, along with a parametric analysis on membrane shear modulus, spectrin link extensibility, bending modulus and RBC membrane-bead contact diameter. The results agree with the experimentally observed stiffer nature of stomatocyte and echinocyte with respect to a healthy discocyte at experimentally determined membrane characteristics and suggest the preservation of relevant morphological characteristics, changes in spectrin link densities and the primary contribution of cytoskeletal spectrin network on deformation behaviour of stomatocyte, discocyte and echinocyte morphologies during optical tweezers stretching deformation. The numerical approach presented here forms the foundation for investigations into deformation characteristics and recoverability of RBCs undergoing storage lesion.
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Affiliation(s)
- N M Geekiyanage
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - E Sauret
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
| | - S C Saha
- University of Technology Sydney (UTS), Ultimo, NSW, Australia
| | - R L Flower
- Research and Development, Australian Red Cross Lifeblood, Brisbane, QLD, Australia
| | - Y T Gu
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, QLD, Australia
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Olubiyi OO, Olagunju MO, Strodel B. Rational Drug Design of Peptide-Based Therapies for Sickle Cell Disease. Molecules 2019; 24:E4551. [PMID: 31842406 PMCID: PMC6943517 DOI: 10.3390/molecules24244551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 11/16/2022] Open
Abstract
Sickle cell disease (SCD) is a group of inherited disorders affecting red blood cells, which is caused by a single mutation that results in substitution of the amino acid valine for glutamic acid in the sixth position of the β-globin chain of hemoglobin. These mutant hemoglobin molecules, called hemoglobin S, can polymerize upon deoxygenation, causing erythrocytes to adopt a sickled form and to suffer hemolysis and vaso-occlusion. Until recently, only two drug therapies for SCD, which do not even fully address the manifestations of SCD, were approved by the United States (US) Food and Drug Administration. A third treatment was newly approved, while a monoclonal antibody preventing vaso-occlusive crises is also now available. The complex nature of SCD manifestations provides multiple critical points where drug discovery efforts can be and have been directed. These notwithstanding, the need for new therapeutic approaches remains high and one of the recent efforts includes developments aimed at inhibiting the polymerization of hemoglobin S. This review focuses on anti-sickling approaches using peptide-based inhibitors, ranging from individual amino acid dipeptides investigated 30-40 years ago up to more promising 12- and 15-mers under consideration in recent years.
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Affiliation(s)
- Olujide O. Olubiyi
- Institute of Complex Systems: Structural Biochemistry, Forschungszentrum Jülich, 52425 Jülich, Germany; (M.O.O.); (B.S.)
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
| | - Maryam O. Olagunju
- Institute of Complex Systems: Structural Biochemistry, Forschungszentrum Jülich, 52425 Jülich, Germany; (M.O.O.); (B.S.)
| | - Birgit Strodel
- Institute of Complex Systems: Structural Biochemistry, Forschungszentrum Jülich, 52425 Jülich, Germany; (M.O.O.); (B.S.)
- Institute of Theoretical and Computational Chemistry, Heinrich Heine University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
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Ye T, Shi H, Phan-Thien N, Lim CT. The key events of thrombus formation: platelet adhesion and aggregation. Biomech Model Mechanobiol 2019; 19:943-955. [PMID: 31754949 DOI: 10.1007/s10237-019-01262-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/11/2019] [Indexed: 01/20/2023]
Abstract
Thrombus formation is a complex, dynamic and multistep process, involving biochemical reactions, mechanical stimulation, hemodynamics, and so on. In this study, we concentrate on its two crucial steps: (i) platelets adhered to a vessel wall, or simply platelet adhesion, and (ii) platelets clumping and arrested to the adherent platelets, named platelet aggregation. We report the first direct simulation of three modes of platelet adhesion, detachment, rolling adhesion and firm adhesion, as well as the formation, disintegration, arrestment and consolidation of platelet plugs. The results show that the bond dissociation in the detachment mode is mainly attributed to a high probability of rupturing bonds, such that any existing bond can be quickly ruptured and all bonds would be completely broken. In the rolling adhesion, however, it is mainly attributed to the strong traction from the shear flow or erythrocytes, causing that the bonds are ruptured at the trailing edge of the platelet. The erythrocytes play an important role in platelet activities, such as the formation, disintegration, arrestment and consolidation of platelet plugs. They exert an aggregate force on platelets, a repulsion at a near distance but an attraction at a far distance to the platelets. This aggregate force can promote platelets to form a plug and/or bring along a part of a platelet plug causing its disintegration. It also greatly influences the arrestment and consolidation of platelet plugs, together with the adhesive force from the thrombus.
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Affiliation(s)
- Ting Ye
- School of Mathematics, Jilin University, Qianjin Ave. 2699, Changchun, 130012, China.
| | - Huixin Shi
- School of Mathematics, Jilin University, Qianjin Ave. 2699, Changchun, 130012, China
| | - Nhan Phan-Thien
- Department of Mechanical Engineering, National University of Singapore, Singapore, 117576, Singapore
| | - Chwee Teck Lim
- Department of Mechanical Engineering, National University of Singapore, Singapore, 117576, Singapore
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Zhang X, Lam WA, Graham MD. Dynamics of deformable straight and curved prolate capsules in simple shear flow. PHYSICAL REVIEW FLUIDS 2019; 4:043103. [PMID: 31777765 PMCID: PMC6880959 DOI: 10.1103/physrevfluids.4.043103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This work investigates the motion of neutrally-buoyant, slightly deformable straight and curved prolate fluid-filled capsules in unbounded simple shear flow at zero Reynolds number using direct simulations. The curved capsules serve as a model for the typical crescent-shaped sickle red blood cells in sickle cell disease (SCD). The effects of deformability and curvature on the dynamics are revealed. We show that with low deformability, straight prolate spheroidal capsules exhibit tumbling in the shear plane as their unique asymptotically stable orbit. This result contrasts with that for rigid spheroids, where infinitely many neutrally stable Jeffery orbits exist. The dynamics of curved prolate capsules are more complicated due to a combined effect of deformability and curvature. At short times, depending on the initial orientation, slightly deformable curved prolate capsules exhibit either a Jeffery-like motion such as tumbling or kayaking, or a non-Jeffery-like behavior in which the director (end-to-end vector) of the capsule crosses the shear-gradient plane back and forth. At long times, however, a Jeffery-like quasiperiodic orbit is taken regardless of the initial orientation. We further show that the average of the long-time trajectory can be well approximated using the analytical solution for Jeffery orbits with an effective orbit constant C eff and aspect ratio ℓ eff. These parameters are useful for characterizing the dynamics of curved capsules as a function of given deformability and curvature. As the capsule becomes more deformable or curved, C eff decreases, indicating a shift of the orbit towards log-rolling motion, while ℓ eff increases weakly as the degree of curvature increases but shows negligible dependency on deformability. These features are not changed substantially as the viscosity ratio between the inner and outer fluids is changed from 1 to 5. As cell deformability, cell shape, and cell-cell interactions are all pathologically altered in blood disorders such as SCD, these results will have clear implications on improving our understanding of the pathophysiology of hematologic disease.
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Affiliation(s)
- Xiao Zhang
- Department of Chemical and Biological Engineering University of Wisconsin-Madison, Madison, WI 53706-1691
| | - Wilbur A. Lam
- Wallace H. Coulter Department of Biomedical Engineering Emory University and Georgia Institute of Technology, Atlanta, GA 30332
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta Emory University School of Medicine, Atlanta, GA 30322
- Winship Cancer Institute Emory University, Atlanta, GA 30322
- Parker H. Petit Institute of Bioengineering and Bioscience Georgia Institute of Technology, Atlanta, GA 30332
| | - Michael D. Graham
- Department of Chemical and Biological Engineering University of Wisconsin-Madison, Madison, WI 53706-1691
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Wang S, Guo H, Li Y, Li X. Penetration of nanoparticles across a lipid bilayer: effects of particle stiffness and surface hydrophobicity. NANOSCALE 2019; 11:4025-4034. [PMID: 30768108 DOI: 10.1039/c8nr09381d] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The cellular uptake of nanoparticles (NPs) has drawn significant attention due to their great importance and potential in drug delivery, bioimaging, and specific targeting. Here, we conduct a computational study on the translocation process of soft nanoparticles with different elasticities and surface hydrophobicities through a lipid bilayer membrane. It is shown that the translocation abilities of hydrophilic NPs can be enhanced by increasing their stiffness, while the penetrability of hydrophobic NPs is weakened by increasing the particle stiffness. The free energy analysis indicates that rigid hydrophilic NPs and soft hydrophobic NPs encounter lower energy barriers during penetration. In direct translocation, different deformation modes are observed for NPs with different surface hydrophobicities during cellular internalization. Further, deformation analysis demonstrates that hydrophilic NPs are flattened in the membrane plane, while hydrophobic NPs are elongated along the membrane norm during penetration. We conclude that the elasticity of NPs has an obvious impact on their ability to penetrate across the lipid bilayer membrane through different morphological responses of hydrophilic and hydrophobic NPs. These results shed light on the coupled effects of particle elasticity and surface hydrophobicity on the cellular uptake of elastic NPs, which may provide useful guidelines for designing effective nanocarrier systems for drug delivery.
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Affiliation(s)
- Shuo Wang
- Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering (State Key Laboratory of Ocean Engineering, MOE Key Laboratory of Hydrodynamics), Shanghai Jiao Tong University, Shanghai 200240, P. R. China.
| | - Hui Guo
- Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yinfeng Li
- Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering (State Key Laboratory of Ocean Engineering, MOE Key Laboratory of Hydrodynamics), Shanghai Jiao Tong University, Shanghai 200240, P. R. China.
| | - Xuejin Li
- Department of Engineering Mechanics and Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, Zhejiang University, Hangzhou 310027, P. R. China.
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Guruprasad P, Mannino RG, Caruso C, Zhang H, Josephson CD, Roback JD, Lam WA. Integrated automated particle tracking microfluidic enables high-throughput cell deformability cytometry for red cell disorders. Am J Hematol 2019; 94:189-199. [PMID: 30417938 DOI: 10.1002/ajh.25345] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 12/17/2022]
Abstract
Investigating individual red blood cells (RBCs) is critical to understanding hematologic diseases, as pathology often originates at the single-cell level. Many RBC disorders manifest in altered biophysical properties, such as deformability of RBCs. Due to limitations in current biophysical assays, there exists a need for high-throughput analysis of RBC deformability with single-cell resolution. To that end, we present a method that pairs a simple in vitro artificial microvasculature network system with an innovative MATLAB-based automated particle tracking program, allowing for high-throughput, single-cell deformability index (sDI) measurements of entire RBC populations. We apply our technology to quantify the sDI of RBCs from healthy volunteers, Sickle cell disease (SCD) patients, a transfusion-dependent beta thalassemia major patient, and in stored packed RBCs (pRBCs) that undergo storage lesion over 4 weeks. Moreover, our system can also measure cell size for each RBC, thereby enabling 2D analysis of cell deformability vs cell size with single cell resolution akin to flow cytometry. Our results demonstrate the clear existence of distinct biophysical RBC subpopulations with high interpatient variability in SCD as indicated by large magnitude skewness and kurtosis values of distribution, the "shifting" of sDI vs RBC size curves over transfusion cycles in beta thalassemia, and the appearance of low sDI RBC subpopulations within 4 days of pRBC storage. Overall, our system offers an inexpensive, convenient, and high-throughput method to gauge single RBC deformability and size for any RBC population and has the potential to aid in disease monitoring and transfusion guidelines for various RBC disorders.
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Affiliation(s)
- Puneeth Guruprasad
- Wallace H. Coulter Department of Biomedical Engineering; Georgia Institute of Technology and Emory University; Atlanta Georgia
| | - Robert G. Mannino
- Wallace H. Coulter Department of Biomedical Engineering; Georgia Institute of Technology and Emory University; Atlanta Georgia
- Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta, Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia
| | - Christina Caruso
- Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta, Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia
| | | | - Cassandra D. Josephson
- Department of Pathology and Laboratory Medicine; Emory University School of Medicine, Center for Transfusion and Cellular Therapies; Atlanta Georgia
| | - John D. Roback
- Department of Pathology and Laboratory Medicine; Emory University School of Medicine, Center for Transfusion and Cellular Therapies; Atlanta Georgia
| | - Wilbur A. Lam
- Wallace H. Coulter Department of Biomedical Engineering; Georgia Institute of Technology and Emory University; Atlanta Georgia
- Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta, Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia
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Deng Y, Papageorgiou DP, Chang HY, Abidi SZ, Li X, Dao M, Karniadakis GE. Quantifying Shear-Induced Deformation and Detachment of Individual Adherent Sickle Red Blood Cells. Biophys J 2018; 116:360-371. [PMID: 30612714 DOI: 10.1016/j.bpj.2018.12.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/26/2018] [Accepted: 12/10/2018] [Indexed: 02/02/2023] Open
Abstract
Vaso-occlusive crisis, a common painful complication of sickle cell disease, is a complex process triggered by intercellular adhesive interactions among blood cells and the endothelium in all human organs (e.g., the oxygen-rich lung as well as hypoxic systems such as liver and kidneys). We present a combined experimental-computational study to quantify the adhesive characteristics of sickle mature erythrocytes (SMEs) and irreversibly sickled cells (ISCs) under flow conditions mimicking those in postcapillary venules. We employed an in vitro microfluidic cell adherence assay, which is coated uniformly with fibronectin. We investigated the adhesion dynamics of SMEs and ISCs in pulsatile flow under well-controlled hypoxic conditions, inferring the cell adhesion strength by increasing the flow rate (or wall shear stress (WSS)) until the onset of cell detachment. In parallel, we performed simulations of individual SMEs and ISCs under shear. We introduced two metrics to quantify the adhesion process, the cell aspect ratio (AR) as a function of WSS and its rate of change (the dynamic deformability index). We found that the AR of SMEs decreases significantly with the increase of WSS, consistent between the experiments and simulations. In contrast, the AR of ISCs remains constant in time and independent of the flow rate. The critical WSS value for detaching a single SME in oxygenated state is in the range of 3.9-5.5 Pa depending on the number of adhesion sites; the critical WSS value for ISCs is lower than that of SMEs. Our simulations show that the critical WSS value for SMEs in deoxygenated state is above 6.2 Pa (multiple adhesion sites), which is greater than their oxygenated counterparts. We investigated the effect of cell shear modulus on the detachment process; we found that for the same cell adhesion spring constant, the higher shear modulus leads to an earlier cell detachment from the functionalized surface. These findings may aid in the understanding of individual roles of sickle cell types in sickle cell disease vaso-occlusion.
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Affiliation(s)
- Yixiang Deng
- Division of Applied Mathematics, Brown University, Providence, Rhode Island; School of Engineering, Brown University, Providence, Rhode Island
| | - Dimitrios P Papageorgiou
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Hung-Yu Chang
- Division of Applied Mathematics, Brown University, Providence, Rhode Island
| | - Sabia Z Abidi
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts; Department of Bioengineering, Rice University, Houston, Texas
| | - Xuejin Li
- Division of Applied Mathematics, Brown University, Providence, Rhode Island; Department of Engineering Mechanics, Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, Zhejiang University, Hangzhou, People's Republic of China.
| | - Ming Dao
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
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