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Bertocchio JP, Genetet S, Da Costa L, Walsh SB, Knebelmann B, Galimand J, Bessenay L, Guitton C, De Lafaille R, Vargas-Poussou R, Eladari D, Mouro-Chanteloup I. Red Blood Cell AE1/Band 3 Transports in Dominant Distal Renal Tubular Acidosis Patients. Kidney Int Rep 2020; 5:348-357. [PMID: 32154456 PMCID: PMC7056926 DOI: 10.1016/j.ekir.2019.12.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/26/2019] [Accepted: 12/31/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction Anion exchanger 1 (AE1) (SLC4A1 gene product) is a membrane protein expressed in both kidney and red blood cells (RBCs): it exchanges extracellular bicarbonate (HCO3–) for intracellular chloride (Cl–) and participates in acid−base homeostasis. AE1 mutations in kidney α-intercalated cells can lead to distal renal tubular acidosis (dRTA). In RBC, AE1 (known as band 3) is also implicated in membrane stability: deletions can cause South Asian ovalocytosis (SAO). Methods We retrospectively collected clinical and biological data from patients harboring dRTA due to a SLC4A1 mutation and analyzed HCO3– and Cl– transports (by stopped-flow spectrophotometry) and expression (by flow cytometry, fluorescence activated cell sorting, and Coomassie blue staining) in RBCs, as well as RBC membrane stability (ektacytometry). Results Fifteen patients were included. All experience nephrolithiasis and/or nephrocalcinosis, 2 had SAO and dRTA (dRTA SAO+), 13 dominant dRTA (dRTA SAO−). The latter did not exert specific RBC membrane anomalies. Both HCO3– and Cl– transports were lower in patients with dRTA SAO+ than in those with dRTA SAO− or controls. Using 3 different extracellular probes, we report a decreased expression (by 52%, P < 0.05) in dRTA SAO+ patients by fluorescence activated cell sorting, whereas total amount of protein was not affected. Conclusion Band 3 transport function and expression in RBCs from dRTA SAO− patients is normal. However, in SAO RBCs, impaired conformation of AE1/band 3 corresponds to an impaired function. Thus, the driver of acid−base defect during dominant dRTA is probably an impaired membrane expression.
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Affiliation(s)
- Jean-Philippe Bertocchio
- Renal and Metabolic Diseases Unit, Assistance Publique-Hôpitaux de Paris, European Georges Pompidou Hospital, Paris, France.,Faculty of Medicine, Paris Descartes University, Paris, France.,Reference Center for Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Genito-urinary Medical Oncology and Research Department, MD Anderson Cancer Center, Houston, Texas, USA
| | - Sandrine Genetet
- UMR_S1134, Integrated Red Globule Biology (IRGB), Inserm, University of Paris, Paris, France.,Team 1, Physiology of Normal and Pathologic Red Blood Cell, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - Lydie Da Costa
- UMR_S1134, Integrated Red Globule Biology (IRGB), Inserm, University of Paris, Paris, France.,UMR_S1134, Inserm, Paris, France.,Service d'Hématologie Biologique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Stephen B Walsh
- Department of Renal Medicine, University College of London, London, UK
| | - Bertrand Knebelmann
- Nephrology Department, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France
| | - Julie Galimand
- Service d'Hématologie Biologique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Lucie Bessenay
- Pediatrics Department, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Corinne Guitton
- Pediatrics Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Renaud De Lafaille
- Nephrology Department, University Hospital of Bordeaux, Bordeaux, Aquitaine, France
| | - Rosa Vargas-Poussou
- Reference Center for Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM), Unité Mixte de Recherche UMRS1138, Cordeliers Research Center, Paris, France.,Genetics Department, Assistance Publique-Hôpitaux de Paris, European Georges Pompidou Hospital, Paris, France
| | - Dominique Eladari
- Renal and Metabolic Diseases Department, CHU de la Réunion, Felix Guyon Hospital, Saint Denis, France.,INSERM, UMRS 1283-European Genomic Institute for Diabetes, Lille, France
| | - Isabelle Mouro-Chanteloup
- UMR_S1134, Integrated Red Globule Biology (IRGB), Inserm, University of Paris, Paris, France.,Team 1, Physiology of Normal and Pathologic Red Blood Cell, Institut National de la Transfusion Sanguine (INTS), Paris, France
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De Vecchis D, Reithmeier RAF, Kalli AC. Molecular Simulations of Intact Anion Exchanger 1 Reveal Specific Domain and Lipid Interactions. Biophys J 2019; 117:1364-1379. [PMID: 31540709 PMCID: PMC6818359 DOI: 10.1016/j.bpj.2019.08.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/30/2019] [Accepted: 08/22/2019] [Indexed: 12/23/2022] Open
Abstract
Anion exchanger 1 (AE1) is responsible for the exchange of bicarbonate and chloride across the erythrocyte plasma membrane. Human AE1 consists of a cytoplasmic and a membrane domain joined by a 33-residue flexible linker. Crystal structures of the individual domains have been determined, but the intact AE1 structure remains elusive. In this study, we use molecular dynamics simulations and modeling to build intact AE1 structures in a complex lipid bilayer that resembles the native erythrocyte plasma membrane. AE1 models were evaluated using available experimental data to provide an atomistic view of the interaction and dynamics of the cytoplasmic domain, the membrane domain, and the connecting linker in a complete model of AE1 in a lipid bilayer. Anionic lipids were found to interact strongly with AE1 at specific amino acid residues that are linked to diseases and blood group antigens. Cholesterol was found in the dimeric interface of AE1, suggesting that it may regulate subunit interactions and anion transport.
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Affiliation(s)
- Dario De Vecchis
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | | | - Antreas C Kalli
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom; Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, United Kingdom.
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Da Costa L, Suner L, Galimand J, Bonnel A, Pascreau T, Couque N, Fenneteau O, Mohandas N. Diagnostic tool for red blood cell membrane disorders: Assessment of a new generation ektacytometer. Blood Cells Mol Dis 2015; 56:9-22. [PMID: 26603718 DOI: 10.1016/j.bcmd.2015.09.001] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 12/14/2022]
Abstract
Inherited red blood cell (RBC) membrane disorders, such as hereditary spherocytosis, elliptocytosis and hereditary ovalocytosis, result from mutations in genes encoding various RBC membrane and skeletal proteins. The RBC membrane, a composite structure composed of a lipid bilayer linked to a spectrin/actin-based membrane skeleton, confers upon the RBC unique features of deformability and mechanical stability. The disease severity is primarily dependent on the extent of membrane surface area loss. RBC membrane disorders can be readily diagnosed by various laboratory approaches that include RBC cytology, flow cytometry, ektacytometry, electrophoresis of RBC membrane proteins and genetics. The reference technique for diagnosis of RBC membrane disorders is the osmotic gradient ektacytometry. However, in spite of its recognition as the reference technique, this technique is rarely used as a routine diagnosis tool for RBC membrane disorders due to its limited availability. This may soon change as a new generation of ektacytometer has been recently engineered. In this review, we describe the workflow of the samples shipped to our Hematology laboratory for RBC membrane disorder analysis and the data obtained for a large cohort of French patients presenting with RBC membrane disorders using a newly available version of the ektacytomer.
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Affiliation(s)
- Lydie Da Costa
- AP-HP, Service d'Hématologie Biologique, Hôpital R. Debré, Paris F-75019, France; Univ Paris Diderot, Sorbonne Paris Cité, Paris F-75010, France; INSERM U1149, CRI, Faculté de Médecine Bichat-Claude Bernard, F-75019, France; Laboratoire d'Excellence GR-Ex, France.
| | - Ludovic Suner
- AP-HP, Service d'Hématologie Biologique, Hôpital R. Debré, Paris F-75019, France
| | - Julie Galimand
- AP-HP, Service d'Hématologie Biologique, Hôpital R. Debré, Paris F-75019, France
| | - Amandine Bonnel
- AP-HP, Service d'Hématologie Biologique, Hôpital R. Debré, Paris F-75019, France
| | - Tiffany Pascreau
- AP-HP, Service d'Hématologie Biologique, Hôpital R. Debré, Paris F-75019, France
| | - Nathalie Couque
- AP-HP, Département de Génétique, Hôpital R. Debré, Paris F-75019, France
| | - Odile Fenneteau
- AP-HP, Service d'Hématologie Biologique, Hôpital R. Debré, Paris F-75019, France
| | - Narla Mohandas
- Red Cell physiology laboratory, New York Blood Center (NYBC), New York, USA
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Da Costa L, Galimand J, Fenneteau O, Mohandas N. Hereditary spherocytosis, elliptocytosis, and other red cell membrane disorders. Blood Rev 2013; 27:167-78. [PMID: 23664421 DOI: 10.1016/j.blre.2013.04.003] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hereditary spherocytosis and elliptocytosis are the two most common inherited red cell membrane disorders resulting from mutations in genes encoding various red cell membrane and skeletal proteins. Red cell membrane, a composite structure composed of lipid bilayer linked to spectrin-based membrane skeleton is responsible for the unique features of flexibility and mechanical stability of the cell. Defects in various proteins involved in linking the lipid bilayer to membrane skeleton result in loss in membrane cohesion leading to surface area loss and hereditary spherocytosis while defects in proteins involved in lateral interactions of the spectrin-based skeleton lead to decreased mechanical stability, membrane fragmentation and hereditary elliptocytosis. The disease severity is primarily dependent on the extent of membrane surface area loss. Both these diseases can be readily diagnosed by various laboratory approaches that include red blood cell cytology, flow cytometry, ektacytometry, electrophoresis of the red cell membrane proteins, and mutational analysis of gene encoding red cell membrane proteins.
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Affiliation(s)
- Lydie Da Costa
- AP-HP, Service d'Hématologie Biologique, Hôpital R. Debré, Paris, F-75019, France.
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Bolton-Maggs PHB, Langer JC, Iolascon A, Tittensor P, King MJ. Guidelines for the diagnosis and management of hereditary spherocytosis--2011 update. Br J Haematol 2011; 156:37-49. [PMID: 22055020 DOI: 10.1111/j.1365-2141.2011.08921.x] [Citation(s) in RCA: 222] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Guidelines on hereditary spherocytosis (HS) published in 2004 (Bolton-Maggs et al, 2004) are here replaced to reflect changes in current opinion on the surgical management, (particularly the indications for concomitant splenectomy with cholecystectomy in children with mild HS, and concomitant cholecystectomy with splenectomy in those with asymptomatic gallstones). Further potential long term hazards of splenectomy are now recognised. Advances have been made in our understanding of the biochemistry of the red cell membrane which underpins the choice of tests. Biochemical assays of membranes proteins and genetic analysis may be indicated (rarely) to diagnose atypical cases. The diagnostic value of the eosin-5-maleimide (EMA) binding test has been validated in a number of studies with understanding of its limitations.
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Abstract
Hereditary spherocytosis is a common inherited disorder that is characterised by anaemia, jaundice, and splenomegaly. It is reported worldwide and is the most common inherited anaemia in individuals of northern European ancestry. Clinical severity is variable with most patients having a well-compensated haemolytic anaemia. Some individuals are asymptomatic, whereas others have severe haemolytic anaemia requiring erythrocyte transfusion. The primary lesion in hereditary spherocytosis is loss of membrane surface area, leading to reduced deformability due to defects in the membrane proteins ankyrin, band 3, beta spectrin, alpha spectrin, or protein 4.2. Many isolated mutations have been identified in the genes encoding these membrane proteins; common hereditary spherocytosis-associated mutations have not been identified. Abnormal spherocytes are trapped and destroyed in the spleen and this is the main cause of haemolysis in this disorder. Common complications are cholelithiasis, haemolytic episodes, and aplastic crises. Splenectomy is curative but should be undertaken only after careful assessment of the risks and benefits.
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Affiliation(s)
- Silverio Perrotta
- Department of Paediatrics, Second University of Naples, Naples, Italy
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Bolton-Maggs PHB, Stevens RF, Dodd NJ, Lamont G, Tittensor P, King MJ. Guidelines for the diagnosis and management of hereditary spherocytosis. Br J Haematol 2004; 126:455-74. [PMID: 15287938 DOI: 10.1111/j.1365-2141.2004.05052.x] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hereditary spherocytosis (HS) is a heterogeneous group of disorders with regard to clinical severity, protein defects and mode of inheritance. It is relatively common in Caucasian populations; most affected individuals have mild or only moderate haemolysis. There is usually a family history, and a typical clinical and laboratory picture so that the diagnosis is often easily made without additional laboratory tests. Atypical cases may require measurement of erythrocyte membrane proteins to clarify the nature of the membrane disorder and in the absence of a family history, occasionally molecular genetic analysis will help to determine whether inheritance is recessive or non-dominant. It is particularly important to rule out stomatocytosis where splenectomy is contraindicated because of the thrombotic risk. Mild HS can be managed without folate supplements and does not require splenectomy. Moderately and severely affected individuals are likely to benefit from splenectomy, which should be performed after the age of 6 years and with appropriate counselling about the infection risk. In all cases careful dialogue between doctor, patient and the family is essential. Laparoscopic surgery, when performed by experienced surgeons, can result in a shorter hospital stay and less pain.
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