New insights into regulation of erythrocyte shape

How the spleen reshapes and retains young and old red blood cells: A computational investigation

The spleen, the largest secondary lymphoid organ in humans, not only fulfils a broad range of immune functions, but also plays an important role in red blood cell’s (RBC) life cycle. Although much progress has been made to elucidate the critical biological processes involved in the maturation of young RBCs (reticulocytes) as well as removal of senescent RBCs in the spleen, the underlying mechanisms driving these processes are still obscure. Herein, we perform a computational study to simulate the passage of RBCs through interendothelial slits (IES) in the spleen at different stages of their lifespan and investigate the role of the spleen in facilitating the maturation of reticulocytes and in clearing the senescent RBCs. Our simulations reveal that at the beginning of the RBC life cycle, intracellular non-deformable particles in reticulocytes can be biomechanically expelled from the cell upon passage through IES, an insightful explanation of why this peculiar “pitting” process is spleen-specific. Our results also show that immature RBCs shed surface area by releasing vesicles after crossing IES and progressively acquire the biconcave shape of mature RBCs. These findings likely explain why RBCs from splenectomized patients are significantly larger than those from nonsplenectomized subjects. Finally, we show that at the end of their life span, senescent RBCs are not only retained by IES due to reduced deformability but also become susceptible to mechanical lysis under shear stress. This finding supports the recent hypothesis that transformation into a hemolyzed ghost is a prerequisite for phagocytosis of senescent RBCs. Altogether, our computational investigation illustrates critical biological processes in the spleen that cannot be observed in vivo or in vitro and offer insights into the role of the spleen in the RBC physiology.

The spleen, the largest secondary lymphoid organ in humans, not only fulfils a broad range of immune functions, but also plays an important role in red blood cell (RBC) life cycle. In this study, we perform a computational study to simulate the passage of RBCs through interendothelial slits (IES) in the spleen at different stages of their lifespan, a critical biological process that cannot be observed in humans. Our simulation results illustrate a specific role of spleen in shaping young RBCs, which points to a probable missing step in current in vitro RBC culture protocols that fail to generate a majority of typical biconcave RBCs. Our results also reveal that intra-splenic mechanical constraints likely contribute to the final clearance and elimination of aged RBCs. Altogether, we demonstrate that our computational model can provide mechanistic rationales for experimental studies, offer insights into the role of the spleen in the RBC physiology and help the optimization of in vitro RBC culture techniques.

Near-Newtonian Blood Behavior - Is It Good to Be a Camel?

From a certain level of exercise-intensity onward, hematocrit increases in horses, which brings more oxygen carriers into the bloodstream. Camels, however, when used in competitive racing could be even in need of iron supplementation and blood transfusions due to a severe reduction of their available hematocrit compared to their resting hematocrit. Since the extrinsic and intrinsic mechanical properties of camel erythrocytes (RBC) are so different compared to RBCs of other mammals, the question arises whether this observation might be a response to endurance exercise aiming at keeping the RBC count low. Rheometry indicated dromedary camel blood to behave almost Newtonian, which is unique amongst mammals. Shear thinning did increase with the hematocrit, but remained marginal compared to horses. As a result, camel whole blood viscosity (WBV) exceeded horse WBV at high shear rates, an effect, which was significantly augmented when the packed cell volume (PCV) was increased. Therefore, in camels any infusion of RBCs into the bloodstream can increase the cardiac work and the energy input into the endothelium more effectively, which should generate vascular remodeling in the long term. Yielding, however, was completely absent in camel blood, confirming low cohesion between its components at quasi-static flow. Camel blood remained a viscous liquid without a threshold even at unphysiologically high PCVs. This can help to washout lactate when camels start to dehydrate and might contribute to the sustained working ability of these animals. The subtle pseudoplastic behavior and the high viscosity contrast across the RBC membrane point to weak coupling between blood flow and red cell behavior. We predict that RBCs flow as separate entities and can show various types of motion, which can lead to friction instead of being collectively aligned to the flow direction. In comparison to horses, this behavior will become relevant at higher RBC counts in front of flow obstacles and possibly cause vascular remodeling if the PCV rises during strenuous exercise, a matter that should be avoided.

Hereditary red cell membrane disorders and laboratory diagnostic testing

This overview describes two groups of nonimmune hereditary hemolytic anemias caused by defects in membrane proteins located in distinct layers of the red cell membrane. Hereditary spherocytosis (HS), hereditary elliptocytosis (HE), and hereditary pyropoikilocytosis (HPP) represent disorders of the red cell cytoskeleton. Hereditary stomatocytoses represents disorders of cation permeability in the red cell membrane. The current laboratory screening tests for HS are the osmotic fragility test, acid glycerol lysis time test (AGLT), cryohemolysis test, and eosin-5'-maleimide (EMA)-binding test. For atypical HS, SDS-polyacrylamide gel electrophoresis of erythrocyte membrane proteins is carried out to confirm the diagnosis. The diagnosis of HE/HPP is based on abnormal red cell morphology and the detection of protein 4.1R deficiency or spectrin variants using gel electrophoresis. None of screening tests can detect all HS cases. Some testing centers (a survey of 25 laboratories) use a combination of tests (e.g., AGLT and EMA). No specific screening test for hereditary stomatocytoses is available. The preliminary diagnosis is based on presenting a compensated hemolytic anemia, macrocytosis, and a temperature or time dependent pseudohyperkalemia in some patients. Both the EMA-binding test and the osmotic fragility test may help in differential diagnosis of HS and hereditary stomatocytosis.

Single particle electron microscopy analysis of the bovine anion exchanger 1 reveals a flexible linker connecting the cytoplasmic and membrane domains

Anion exchanger 1 (AE1) is the major erythrocyte membrane protein that mediates chloride/bicarbonate exchange across the erythrocyte membrane facilitating CO₂ transport by the blood, and anchors the plasma membrane to the spectrin-based cytoskeleton. This multi-protein cytoskeletal complex plays an important role in erythrocyte elasticity and membrane stability. An in-frame AE1 deletion of nine amino acids in the cytoplasmic domain in a proximity to the membrane domain results in a marked increase in membrane rigidity and ovalocytic red cells in the disease Southeast Asian Ovalocytosis (SAO). We hypothesized that AE1 has a flexible region connecting the cytoplasmic and membrane domains, which is partially deleted in SAO, thus causing the loss of erythrocyte elasticity. To explore this hypothesis, we developed a new non-denaturing method of AE1 purification from bovine erythrocyte membranes. A three-dimensional (3D) structure of bovine AE1 at 2.4 nm resolution was obtained by negative staining electron microscopy, orthogonal tilt reconstruction and single particle analysis. The cytoplasmic and membrane domains are connected by two parallel linkers. Image classification demonstrated substantial flexibility in the linker region. We propose a mechanism whereby flexibility of the linker region plays a critical role in regulating red cell elasticity.

Red blood cell shape and fluctuations: cytoskeleton confinement and ATP activity

We review recent theoretical work that analyzes experimental measurements of the shape and fluctuations of red blood cells. Particular emphasis is placed on the role of the cytoskeleton and cell elasticity and we contrast the situation of elastic cells with that of fluid-filled vesicles. In red blood cells (RBCs), the cytoskeleton consists of a two-dimensional network of spectrin proteins. Our analysis of the wave vector and frequency dependence of the fluctuation spectrum of RBCs indicates that the spectrin network acts as a confining potential that reduces the fluctuations of the lipid bilayer membrane. However, since the cytoskeleton is only sparsely connected to the bilayer, one cannot regard the composite cytoskeleton membrane as a polymerized object with a shear modulus. The sensitivity of RBC fluctuations and shapes to ATP concentration may reflect the transient defects induced in the cytoskeleton network by ATP.

The how, when, and why of the aging signals appearing on the human erythrocyte membrane: an atomic force microscopy study of surface roughness

We recently developed an atomic force microscopy-based protocol to use the roughness of the plasma membrane of erythrocytes (red blood cells, RBCs) as a morphological parameter, independently from the cell shape, to investigate the membrane-skeleton integrity in healthy and pathological cells. Here we apply the method to investigate a complex physiological phenomenon, the RBCs aging, that plays a major role in the regulation of the RBCs' turnover. The aging, monitored morphologically and biochemically, has been accelerated and modulated by preventing oxidative stresses as well as the effects of proteases and divalent cations, and by artificially consuming the intracellular adenosine triphosphate. The collected data evidence that the progression of aging causes a drastic decrease of the measured roughness that is diagnostic of a progressive, adenosine triphosphate-dependent alteration of the membrane-skeleton properties. Finally, the degree of reversibility of such effects has been investigated as a function of aging time, enabling the detection of irreversible transformation in the RBCs' structure and metabolism.

The role of GLUT1 in the sugar-induced dielectric response of human erythrocytes

We propose a key role for the glucose transporter 1 (GLUT1) in mediating the observed changes in the dielectric properties of human erythrocyte membranes as determined by dielectric spectroscopy. Cytochalasin B, a GLUT1 transport inhibitor, abolished the membrane capacitance changes in glucose-exposed red cells. Surprisingly, D-fructose, known to be transported primarily by GLUT5, exerted similar membrane capacitance changes at increasing D-fructose concentrations. In order to evaluate whether the glucose-mediated membrane capacitance changes originated directly from intracellularly bound adenosine triphosphate (ATP) or other components of the glycolysis process, we studied the dielectric responses of swollen erythrocytes with a decreased ATP content and of nucleotide-filled ghosts. Resealed ghosts containing physiological concentrations of ATP yielded the same glucose-dependent capacitance changes as biconcave intact red blood cells, further supporting the finding that ATP is the effector of the glucose-mediated dielectric response where the ATP concentration is also the mediating factor in swollen red blood cells. The results suggest that ATP binding to GLUT1 elicits a membrane capacitance change that increases with the applied concentration gradient of D-glucose. A simplified model of the membrane capacitance alteration with glucose uptake is proposed.

Evaluation of erythrocyte shape and status by laser interference microscopy

The area, thickness, and volume of erythrocytes of different types (discocytes, stomatocytes, and echinocytes) from normal subjects and coronary patients were studied by laser interference microscopy. Increase of pH value leading to the stomatocyte-discocyte-echinocyte transformations resulted in a slight decrease of cell volume. In coronary patients, erythrocyte had larger area and volume and exhibited increased aggregation capacity compared to erythrocytes from controls. The results recommend laser interference microscopy as an adequate method for erythrocyte evaluation in laboratory diagnostic measurements.

Active elastic network: cytoskeleton of the red blood cell

In red blood cells there is a cortical cytoskeleton; a two-dimensional elastic network of membrane-attached proteins. We describe, using a simple model, how the metabolic activity of the cell, through the consumption of ATP, controls the stiffness of this elastic network. The unusual mechanical property of active strain softening is described and compared to experimental data. As a by-product of this activity there is also an active contribution to the amplitude of membrane fluctuations. We model this membrane as a field of independent "curvature motors," and calculate the spectrum of active fluctuations. We find that the active cytoskeleton contributes to the amplitude of the membrane height fluctuations at intermediate wavelengths, as observed experimentally.

Theoretical model of reticulocyte to erythrocyte shape transformation

A theoretical model describing the kinetics of reticulocyte shape transformation was developed. The model considers the evolution of a simple cellular shape under transmembrane pressure difference, and proposes a four-parameter axisymmetric approximation of the cell surface. The mathematical analysis considers plasma membrane tension in the plane of bilayer leaflets, membrane spontaneous curvature and transmembrane transport of water. Cytoskeleton dilatational and shear rigidity, and the energetic barrier preventing the decrease of cell volume below a certain minimum are also incorporated. The set of adequate physical assumptions allowed for formulation of the equation for free energy of the investigated system. Computer simulations of cell shape changes, down to the state of free energy minimum, together with estimation of the time needed for the resulting transport of water, revealed a complex, three-phase picture of temporal alterations in cellular geometry with a wide spectrum of final results, and led to propose a standard model of reticulocyte-erythrocyte transformation. According to the model, both cell volume and surface undergo changes, and the work of the pressure, initially accumulated in the cytoskeleton, is consumed for local bending of the cell membrane. Further simulations with modified initial shape or parameters of the standard model show the trajectories of system evolution and help in better understanding the conditions for the erythro-, sphero-, ovalo-, stomato-, and leptoidal metamorphosis of maturing red blood cells. The stability of the final biconcave shape was also verified. Spherogenic modifications were discussed in the context of spherocytosis. Future development of the model was proposed.

Alkaline hemolysis fragility is dependent on cell shape: Results from a morphology tracker

BACKGROUND

The morphometric analysis of red blood cells (RBCs) is an important area of study and has been performed previously for fixed samples. We present a novel method for the analysis of morphologic changes of live erythrocytes as a function of time. We use this method to extract information on alkaline hemolysis fragility. Many other toxins lyse cells by membrane poration, which has been studied by averaging over cell populations. However, no quantitative data are available for changes in the morphology of individual cells during membrane poration-driven hemolysis or for the relation between cell shape and fragility.

METHODS

Hydroxide, a porating agent, was generated in a microfluidic enclosure containing RBCs in suspension. Automatic cell recognition, tracking, and morphometric measurements were done by using a custom image analysis program. Cell area and circular shape factor (CSF) were measured over time for individual cells. Implementations were developed in MATLAB and on Kestrel, a parallel computer that affords higher speed that approaches real-time processing.

RESULTS

The average CSF went through a first period of fast increase, corresponding to the conversion of discocytes to spherocytes under internal osmotic pressure, followed by another period of slow increase until the fast lysis event. For individual cells, the initial CSF was shown to be inversely correlated to cell lifetime (linear regression factor R=0.44), with discocytes surviving longer than spherocytes. The inflated cell surface area to volume ratio was also inversely correlated to lifetime (R=0.43) but not correlated to the CSF. Lifetime correlated best to the ratio of cell inflation volume (Vfinal-Vinitial) to surface area (R=0.65).

CONCLUSIONS

RBCs inflate at a rate proportional to their surface area, in agreement with a constant flux model, and lyse after attaining a spherical morphology. Spherical RBCs display increased alkaline hemolysis fragility (shorter lifetimes), providing an explanation for the increased osmotic fragility of RBCs from patients who have spherocytosis.

Red blood cell membrane fluctuations and shape controlled by ATP-induced cytoskeletal defects

We show theoretically how adenosine 5'-triphosphate (ATP)-induced dynamic dissociations of spectrin filaments (from each other and from the membrane) in the cytoskeleton network of red blood cells (RBC) can explain in a unified manner both the measured fluctuation amplitude as well as the observed shape transformations as a function of intracellular ATP concentration. Static defects can be induced by external stresses such as those present when RBCs pass through small capillaries. We suggest that the partially freed actin at these defect sites may explain the activation of the CFTR membrane-bound protein and the subsequent release of ATP by RBCs subjected to deformations. Our theoretical predictions can be tested by experiments that measure the correlation between variations in the binding of actin to spectrin, the activity of CFTR, and the amount of ATP released.

A basis of the acanthocytosis in inherited and acquired disorders

Acanthocytosis refers to the transformation of the normal biconcave disc erythrocyte into one with a few irregularly shaped external projections distributed unevenly at its membrane surface. It is associated with a variety of inherited and acquired disorders. A relationship between the acanthocytosis in chorea-acanthocytosis and an alteration of Band 3, the anion exchange protein, has been previously suggested. We have previously proposed a mechanism of erythrocyte shape control in which decrease and increase of the ratio of the outward-facing (Band 3(o)) and inward-facing (Band 3(i)) conformations of Band 3 contracts and relaxes the membrane skeleton, thus promoting echinocytosis and stomatocytosis, respectively. The equilibrium Band 3(o)/Band 3(i) ratio is determined by the Donnan equilibrium ratio of anions and protons, increasing with the increase of the Donnan ratio. Based on the evidence suggesting that the acanthocyte and echinocyte are interrelated, the mechanism could explain by a decrease of the Donnan ratio the occurrence of acanthocytes in pyruvate kinase and pyrimidine 5'-nucleotidase deficiencies, dehydrated hereditary stomatocytocytosis, In(Lu) phenotype, chorea-acanthocytosis, and McLeod phenotype. Consistent with the proposed mechanism indicating that the membrane skeleton is an important determinant of the erythrocyte shape, is the alteration of its conformation in chorea-acanthocytosis, McLeod phenotype and Fanconi's anemia. In agreement with the proposed mechanism indicating that Band 3 conformation controls the erythrocyte shape are the occurrence of an acanthocytosis in individuals expressing the rare Band 3 HT variant and of alterations of Band 3 properties in chorea-acanthocytosis and In(Lu) phenotype. The observations that the lipid composition or organization are normal in chorea-acanthocytosis and McLeod phenotype are supportive of the proposed mechanism since it postulates that the lipid bilayer has a secondary role in determining the erythrocyte shape. The acanthocytoses in alcoholic cirrhosis and abetalipoproteinemia are accompanied by significant increases of the cholesterol level and of the ratio of sphingomyelin and glycerophospholipids, respectively. However, they could occur by a change of the Band 3 conformation since cholesterol binds specifically to Band 3 and inhibits its anion transport activity, and that sphingomyelin potentiates this inhibition. Thus, the acanthocytosis could involve an alteration of the Band 3 conformation.

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

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