Nanoscale Surface Characterization of Human Erythrocytes by Atomic Force Microscopy: A Critical Review

Deformability of Heterogeneous Red Blood Cells in Aging and Related Pathologies

Aging is interrelated with changes in red blood cell parameters and functionality. In this article, we focus on red blood cells (RBCs) and provide a review of the known changes associated with the characterization of RBC deformability in aging and related pathologies. The biophysical parameters complement the commonly used biochemical parameters and may contribute to a better understanding of the aging process. The power of the deformability measurement approach is well established in clinical settings. Measuring RBCs' deformability has the advantage of relative simplicity, and it reflects the complex effects developing in erythrocytes during aging. However, aging and related pathological conditions also promote heterogeneity of RBC features and have a certain impact on the variance in erythrocyte cell properties. The possible applications of deformability as an early biophysical biomarker of pathological states are discussed, and modulating PIEZO1 as a therapeutic target is suggested. The changes in RBCs' shape can serve as a proxy for deformability evaluation, leveraging single-cell analysis with imaging flow cytometry and artificial intelligence algorithms. The characterization of biophysical parameters of RBCs is in progress in humans and will provide a better understanding of the complex dynamics of aging.

Nanoscale Changes on RBC Membrane Induced by Storage and Ionizing Radiation: A Mini-Review

The storage lesions and the irradiation of blood cellular components for medical procedures in blood banks are events that may induce nanochanges in the membrane of red blood cells (RBCs). Alterations, such as the formation of pores and vesicles, reduce flexibility and compromise the overall erythrocyte integrity. This review discusses the alterations on erythrocytic lipid membrane bilayer through their characterization by confocal scanning microscopy, Raman, scanning electron microscopy, and atomic force microscopy techniques. The interrelated experimental results may address and shed light on the correlation of biomechanical and biochemical transformations induced in the membrane and cytoskeleton of stored and gamma-irradiated RBC. To highlight the main advantages of combining these experimental techniques simultaneously or sequentially, we discuss how those outcomes observed at micro- and nanoscale cell levels are useful as biomarkers of cell aging and storage damage.

Red Blood Cell Stiffness and Adhesion Are Species-Specific Properties Strongly Affected by Temperature and Medium Changes in Single Cell Force Spectroscopy

Besides human red blood cells (RBC), a standard model used in AFM-single cell force spectroscopy (SCFS), little is known about apparent Young's modulus (Ea) or adhesion of animal RBCs displaying distinct cellular features. To close this knowledge gap, we probed chicken, horse, camel, and human fetal RBCs and compared data with human adults serving as a repository for future studies. Additionally, we assessed how measurements are affected under physiological conditions (species-specific temperature in autologous plasma vs. 25 °C in aqueous NaCl solution). In all RBC types, Ea decreased with increasing temperature irrespective of the suspension medium. In mammalian RBCs, adhesion increased with elevated temperatures and scaled with reported membrane sialic acid concentrations. In chicken only adhesion decreased with higher temperature, which we attribute to the lower AE-1 concentration allowing more membrane undulations. Ea decreased further in plasma at every test temperature, and adhesion was completely abolished, pointing to functional cell enlargement by adsorption of plasma components. This halo elevated RBC size by several hundreds of nanometers, blunted the thermal input, and will affect the coupling of RBCs with the flowing plasma. The study evidences the presence of a RBC surface layer and discusses the tremendous effects when RBCs are probed at physiological conditions.

Quantitative phase imaging of erythrocyte in epilepsy patients

The present study focuses on the quantitative phase imaging of erythrocytes with the aim to compare the morphological differences between epilepsy patients under antiepileptic treatment, who have no other disease which may affect the erythrocyte morphology, and the healthy control group. The white light diffraction phase microscopy (WDPM) has been used to obtain the interferogram of the erythrocyte surfaces. The continuous wavelet transform with Paul wavelet has been chosen to calculate the surface profiles from this interferogram image. For the determination of alteration in morphology, besides WDPM, erythrocyte surfaces have been investigated by light microscope and scanning electron microscope. In this way, it has been possible to see the difference in terms of precision and implementation between the most commonly used methods with regard to the quantitative phase imaging. Erythrocytes from all the samples have been examined and displayed in both two- and three-dimensional way. We have observed that erythrocytes of patients with effective antiepileptic blood levels were more affected in morphology than healthy subjects. When we compared the erythrocyte morphological changes of patients who received monotherapy or polytherapy, no difference was observed. In conclusion, antiepileptic drugs (AEDs) cause red blood cell (RBC) morphological changes and a combined usage of WDPM with Paul wavelet and light microscopy methods are very convenient for studying the erythrocyte morphologies on multiple patients.

Imaging live bacteria at the nanoscale: comparison of immobilisation strategies

Atomic force microscopy (AFM) provides an effective, label-free technique enabling the imaging of live bacteria under physiological conditions with nanometre precision. However, AFM is a surface scanning technique, and the accuracy of its performance requires the effective and reliable immobilisation of bacterial cells onto substrates. Here, we compare the effectiveness of various chemical approaches to facilitate the immobilisation of Escherichia coli onto glass cover slips in terms of bacterial adsorption, viability and compatibility with correlative imaging by fluorescence microscopy. We assess surface functionalisation using gelatin, poly-l-lysine, Cell-Tak™, and Vectabond®. We describe how bacterial immobilisation, viability and suitability for AFM experiments depend on bacterial strain, buffer conditions and surface functionalisation. We demonstrate the use of such immobilisation by AFM images that resolve the porin lattice on the bacterial surface; local degradation of the bacterial cell envelope by an antimicrobial peptide (Cecropin B); and the formation of membrane attack complexes on the bacterial membrane.

Alterations to the contents of plasma membrane structural lipids are associated with structural changes and compartmentalization in platelets in hypertension

Arterial hypertension (HTN) can lead to serious organ damage. Several mechanisms have been implicated in the pathogenesis of HTN including constitutive activation of platelets, which increases the risk of aggregation and clot formation. We recently demonstrated the plasma membranes of platelets from patients with HTN exhibit modified structural and physicochemical properties; Raman and Fourier transform infrared by attenuated total reflectance (FTIR-ATR) spectroscopy also indicated lipid content and protein structure alterations. This study aimed to precisely quantify the constituents of the main structural phospholipids and cholesterol in the plasma membranes of platelets from patients with HTN and normotensive individuals. We also assessed the consequence of these alterations on platelet structure and function. Liquid chromatography coupled to triple quadrupole mass spectrometry revealed the plasma membranes of HTN platelets contained less cholesterol and phosphatidylcholine, more phosphatidylserine and phosphatidylethanolamine and had similar sphingosine contents. Atomic force microscopy revealed HTN platelets exhibited increased surface roughness and more pleats. Transmission electron microscopy revealed diminution of the internal membranous structures in HTN platelets. Our findings strongly suggest plasma membrane lipid content alterations-including cholesterol depletion-occur in HTN, and these alterations may induce morphological and physiological abnormalities that participate in the functional changes associated with hypertension.

Biomechanical properties of red blood cells infected by Plasmodium berghei ANKA

Malaria is a pathogenic disease in mammal species and typically causes destruction of red blood cells (RBCs). The malaria-infected RBCs undergoes alterations in morphology and its rheological properties, and the altered rheological properties of RBCs have a significant impact on disease pathophysiology. In this study, we investigated detailed topological and biomechanical properties of RBCs infected with malaria Plasmodium berghei ANKA using atomic force microscopy. Mouse (BALB/c) RBCs were obtained on Days 4, 10, and 14 after infection. We found that malaria-infected RBCs changed significantly in shape. The RBCs maintained a biconcave disk shape until Day 4 after infection and then became lopsided on Day 7 after infection. The central region of RBCs began to swell beginning on Day 10 after infection. More schizont stages were present on Days 10 and 14 compared with on Day 4. The malaria-infected RBCs also showed changes in mechanical properties and the cytoskeleton. The stiffness of infected RBCs increased 4.4-4.6-fold and their cytoskeletal F-actin level increased 18.99-67.85% compared with the control cells. The increase in F-actin depending on infection time was in good agreement with the increased stiffness of infected RBCs. Because more schizont stages were found at a late period of infection at Days 10 and 14, the significant changes in biomechanical properties might contribute to the destruction of RBCs, possibly resulting in the release of merozoites into the blood circulation.

Biomechanical Characterization at the Cell Scale: Present and Prospects

The rapidly growing field of mechanobiology demands for robust and reproducible characterization of cell mechanical properties. Recent achievements in understanding the mechanical regulation of cell fate largely rely on technological platforms capable of probing the mechanical response of living cells and their physico–chemical interaction with the microenvironment. Besides the established family of atomic force microscopy (AFM) based methods, other approaches include optical, magnetic, and acoustic tweezers, as well as sensing substrates that take advantage of biomaterials chemistry and microfabrication techniques. In this review, we introduce the available methods with an emphasis on the most recent advances, and we discuss the challenges associated with their implementation.

Visualization of perforin/gasdermin/complement-formed pores in real cell membranes using atomic force microscopy

Different types of pores ubiquitously form in cell membranes, leading to various types of cell death that profoundly influence the fate of inflammation and the disease status. However, these pores have never truly been visualized to date. Atomic force microscopy (AFM), which is emerging as a powerful tool to analyze the mechanical properties of biomolecules and cells, is actually an excellent imaging platform that allows biological samples to be visualized by probing surface roughness at the level of atomic resolution. Here, membrane pore structures were clearly visualized using AFM. This visualization not only describes the aperture and depth of the pore complexes but also highlights differences among the pores formed by perforin and gasdermins in tumor cell membranes and by complement in immune cell membranes. Additionally, this type of visualization also reveals the dynamic process of pore formation, fusion, and repair.

Ultrastructural changes in red blood cells in aortic dissection patients under extracorporeal circulation: Atomic force microscopy study

PURPOSE

During extracorporeal circulation in heart surgery, blood is exposed to non-physiological conditions, such as high shear stress, foreign surfaces, turbulence, and hypothermia. These factors cause damage to the red blood cells, which is manifested by immediate and delayed hemolysis or some changes in the mechanical properties of red blood cells, defined as sublethal trauma. Unfortunately, sublethal trauma is hard to detect, and there is not enough morphological evidence regarding red blood cell sublethal trauma. In this study, red blood cell sublethal trauma was observed after extracorporeal circulation by describing ultrastructural changes in red blood cell membranes using atomic force microscopy and scanning electron microscopy.

METHODS

Venous blood (2 mL) was collected into heparin tubes from preoperative, intraoperative and postoperative aortic dissection patients for comparison with blood from healthy patients. The red blood cell morphological study (malformations percentage, diameter, height, concavity, and roughness) was performed with scanning electron microscopy and atomic force microscopy.

RESULTS

Scanning electron microscopy and atomic force microscopy imaging analysis revealed that the red blood cell shape changed during extracorporeal circulation and that the red blood cell malformation percentage in the postoperative group was higher than those in the preoperative and intraoperative groups. Most morphological parameters had no obvious changes, except roughness (Ra and Rq) in aortic dissection patients. Atomic force microscopy quantitative analysis indicated that the roughness of red blood cell membranes increased during extracorporeal circulation.

CONCLUSIONS

This study demonstrates that ultrastructural morphological damage occurs to red blood cells membranes due to extracorporeal circulation in aortic dissection patients. In addition, we provided a new parameter (Ra and Rq) to evaluate red blood cell sublethal trauma.

Fractal Dimension of Erythrocyte Membranes: A Highly Useful Precursor for Rapid Morphological Assay

Morphology of erythrocyte membrane has been recognized as an alternative biomarker of several patho-physiological states. Numerous attempts have been made to upgrade the existing method of primitive manual counting, particularly exploring the light scattering properties of erythrocyte. All the techniques are at best semi-empirical and heavily rely on the effectiveness of the statistical correlations. Precisely, this is due to the lack of a non-empirical scale of the so-called "morphological scores". In this article, fractal dimension of erythrocyte membrane has been used to formulate a suitable scoring scale. Subsequently, the rapid experimental output of flow-cytometry has been functionally related to the mean morphological quantifier of the whole cell population via an optimum neural network model (R² = 0.98). Moreover, the fractal dimension has been further demonstrated to be an important parameter in early detection of an abnormal patho-physiological state, even without any noticeable poikilocytic transformation in micrometric domain.

Analyzing the Formation, Morphology, and Integrity of Erythroblastic Islands

The bone marrow is the primary site of erythropoiesis in healthy adult mammals. In the bone marrow, erythroid cells mature within specialized microenvironments termed erythroblastic islands (EBIs). EBIs are multi-cellular clusters comprised of a central macrophage surrounded by red blood cell (erythroid) progenitors. It has been proposed that the central macrophage functions as a "nurse-cell" providing iron, cytokines, and growth factors for the developing erythroid cells. The central macrophage also engulfs and destroys extruded erythroid nuclei. EBIs have recently been shown to play clinically important roles during human hematological disease. The molecular mechanisms regulating this hematopoietic niche are largely unknown. In this chapter, we detail protocols to study isolated EBIs using multiple microscopy platforms. Adhesion molecules regulate cell-cell interactions within the EBI and maintain the integrity of the niche. To improve our understanding of the molecular regulation of erythroid cells in EBIs, we have developed protocols for immuno-gold labeling of erythroid surface antigens to combine with scanning electron microscopy. These protocols have allowed imaging of EBIs at the nanometer scale, offering novel insights into the processes regulating red blood cell production.

Morphological changes in erythrocytes of people with type 2 diabetes mellitus evaluated with atomic force microscopy: A brief review

Prevalence of type 2 diabetes mellitus (T2DM) has been increasing worldwide. Cardiovascular diseases are one of the main causes of death among people with T2DM. Morphological changes in erythrocytes have been associated with higher risk of cardiovascular diseases. Atomic force microscopy (AFM) is a new technique that allows non-invasive imaging of cells and the evaluation of changes in mechanical properties.

AIM

To evaluate by AFM the erythrocytes morphological changes of people with T2DM METHODS: Search was conducted from in PubMed, ScienceDirect, Scielo, and Lilacs. Erythrocyte, type 2 Diabetes Mellitus and, Microscopy, Atomic Force were the keywords used for the search. Papers included were cross-sectional studies performed in humans.

RESULTS

Five of seven articles fulfilled the inclusion criteria. Compared with healthy cells, the erythrocytes from individuals affected by T2DM had morphological changes such as a decreased concave depth, diameter, height and a deformation index, while axial ratio, stiffness, adhesive force, aggregation, and rigidity index were increased. The results regarding the erythrocyte roughness were inconclusive.

CONCLUSIONS

The AFM is an excellent instrument to study the altered erythrocytes of subjects affected by T2DM. Morphology changes in erythrocytes could lead to cardiovascular events, which are major complications in people living with this disease.

Immunoaffinity based methods are superior to kits for purification of prostate derived extracellular vesicles from plasma samples

BACKGROUND

The ability to isolate extracellular vesicles (EVs) such as exosomes or microparticles is an important method that is currently not standardized. While commercially available kits offer purification of EVs from biofluids, such purified EV samples will also contain non-EV entities such as soluble protein and nucleic acids that could confound subsequent experimentation. Ideally, only EVs would be isolated and no soluble protein would be present in the final EV preparation.

METHODS

We compared commercially available EV isolation kits with immunoaffinity purification techniques and evaluated our final EV preparations using atomic force microscopy (AFM) and nanoscale flow cytometry (NFC). AFM is the only modality capable of detecting distinguishing soluble protein from EVs which is important for downstream proteomics approaches. NFC is the only technique capable of quantitating the proportion of target EVs to non-target EVs in the final EV preparation.

RESULTS

To determine enrichment of prostate derived EVs relative to non-target MPs, anti-PSMA (Prostate Specific Membrane Antigen) antibodies were used in NFC. Antibody-based immunoaffinity purification generated the highest quality of prostate derived EV preparations due to the lack of protein and RNA present in the samples. All kits produced poor purity EV preparations that failed to deplete the sample of plasma protein.

CONCLUSIONS

While attractive due to their ease of use, EV purification kits do not provide substantial improvements in isolation of EVs from biofluids such as plasma. Immunoaffinity approaches are more efficient and economical and will also eliminate a significant portion of plasma proteins which is necessary for downstream approaches.