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Petkova-Kirova P, Murciano N, Iacono G, Jansen J, Simionato G, Qiao M, Van der Zwaan C, Rotordam MG, John T, Hertz L, Hoogendijk AJ, Becker N, Wagner C, Von Lindern M, Egee S, Van den Akker E, Kaestner L. The Gárdos Channel and Piezo1 Revisited: Comparison between Reticulocytes and Mature Red Blood Cells. Int J Mol Sci 2024; 25:1416. [PMID: 38338693 PMCID: PMC10855361 DOI: 10.3390/ijms25031416] [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: 10/13/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 02/12/2024] Open
Abstract
The Gárdos channel (KCNN4) and Piezo1 are the best-known ion channels in the red blood cell (RBC) membrane. Nevertheless, the quantitative electrophysiological behavior of RBCs and its heterogeneity are still not completely understood. Here, we use state-of-the-art biochemical methods to probe for the abundance of the channels in RBCs. Furthermore, we utilize automated patch clamp, based on planar chips, to compare the activity of the two channels in reticulocytes and mature RBCs. In addition to this characterization, we performed membrane potential measurements to demonstrate the effect of channel activity and interplay on the RBC properties. Both the Gárdos channel and Piezo1, albeit their average copy number of activatable channels per cell is in the single-digit range, can be detected through transcriptome analysis of reticulocytes. Proteomics analysis of reticulocytes and mature RBCs could only detect Piezo1 but not the Gárdos channel. Furthermore, they can be reliably measured in the whole-cell configuration of the patch clamp method. While for the Gárdos channel, the activity in terms of ion currents is higher in reticulocytes compared to mature RBCs, for Piezo1, the tendency is the opposite. While the interplay between Piezo1 and Gárdos channel cannot be followed using the patch clamp measurements, it could be proved based on membrane potential measurements in populations of intact RBCs. We discuss the Gárdos channel and Piezo1 abundance, interdependencies and interactions in the context of their proposed physiological and pathophysiological functions, which are the passing of small constrictions, e.g., in the spleen, and their active participation in blood clot formation and thrombosis.
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Affiliation(s)
- Polina Petkova-Kirova
- Institute of Neurobiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
- Department of Biochemistry, Saarland University, 66123 Saarbrücken, Germany
| | - Nicoletta Murciano
- Nanion Technologies, 80339 Munich, Germany; (N.M.); (M.G.R.); (N.B.)
- Theoretical Medicine and Biosciences, Campus University Hospital, Saarland University, 66421 Homburg, Germany; (J.J.); (M.Q.); (L.H.)
| | - Giulia Iacono
- Department of Hematopoiesis, Sanquin Research, 1066 CX Amsterdam, The Netherlands; (G.I.); (C.V.d.Z.); (A.J.H.); (M.V.L.); (E.V.d.A.)
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Julia Jansen
- Theoretical Medicine and Biosciences, Campus University Hospital, Saarland University, 66421 Homburg, Germany; (J.J.); (M.Q.); (L.H.)
- Department of Experimental Physics, Saarland University, 66123 Saarbrücken, Germany (T.J.); (C.W.)
| | - Greta Simionato
- Department of Experimental Physics, Saarland University, 66123 Saarbrücken, Germany (T.J.); (C.W.)
- Department of Experimental Surgery, Campus University Hospital, Saarland University, 66421 Homburg, Germany
| | - Min Qiao
- Theoretical Medicine and Biosciences, Campus University Hospital, Saarland University, 66421 Homburg, Germany; (J.J.); (M.Q.); (L.H.)
- Department of Experimental Physics, Saarland University, 66123 Saarbrücken, Germany (T.J.); (C.W.)
| | - Carmen Van der Zwaan
- Department of Hematopoiesis, Sanquin Research, 1066 CX Amsterdam, The Netherlands; (G.I.); (C.V.d.Z.); (A.J.H.); (M.V.L.); (E.V.d.A.)
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, 1007 MB Amsterdam, The Netherlands
| | | | - Thomas John
- Department of Experimental Physics, Saarland University, 66123 Saarbrücken, Germany (T.J.); (C.W.)
| | - Laura Hertz
- Theoretical Medicine and Biosciences, Campus University Hospital, Saarland University, 66421 Homburg, Germany; (J.J.); (M.Q.); (L.H.)
- Department of Experimental Physics, Saarland University, 66123 Saarbrücken, Germany (T.J.); (C.W.)
| | - Arjan J. Hoogendijk
- Department of Hematopoiesis, Sanquin Research, 1066 CX Amsterdam, The Netherlands; (G.I.); (C.V.d.Z.); (A.J.H.); (M.V.L.); (E.V.d.A.)
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Nadine Becker
- Nanion Technologies, 80339 Munich, Germany; (N.M.); (M.G.R.); (N.B.)
| | - Christian Wagner
- Department of Experimental Physics, Saarland University, 66123 Saarbrücken, Germany (T.J.); (C.W.)
- Physics and Materials Science Research Unit, University of Luxembourg, L-1511 Luxembourg, Luxembourg
| | - Marieke Von Lindern
- Department of Hematopoiesis, Sanquin Research, 1066 CX Amsterdam, The Netherlands; (G.I.); (C.V.d.Z.); (A.J.H.); (M.V.L.); (E.V.d.A.)
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Stephane Egee
- Biological Station Roscoff, Sorbonne University, CNRS, UMR8227 LBI2M, F-29680 Roscoff, France;
- Laboratory of Excellence GR-Ex, F-75015 Paris, France
| | - Emile Van den Akker
- Department of Hematopoiesis, Sanquin Research, 1066 CX Amsterdam, The Netherlands; (G.I.); (C.V.d.Z.); (A.J.H.); (M.V.L.); (E.V.d.A.)
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Campus University Hospital, Saarland University, 66421 Homburg, Germany; (J.J.); (M.Q.); (L.H.)
- Department of Experimental Physics, Saarland University, 66123 Saarbrücken, Germany (T.J.); (C.W.)
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2
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Allegrini B, NGuyen LD, Mignotet M, Etchebest C, Fenneteau O, Platon J, Lambilliotte A, Guizouarn H, Da Costa L. Next generation sequencing (NGS) interest in deciphering erythrocyte molecular defects' association in red cell disorders: Clinical and erythrocyte phenotypes of patients with mutations inheritance in PIEZO1, Spectrin ß1, RhAG and SLC4A1. Blood Cells Mol Dis 2023; 103:102780. [PMID: 37516005 DOI: 10.1016/j.bcmd.2023.102780] [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: 04/24/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 07/31/2023]
Abstract
We report here an instructive case referred at 16 months-old for exploration of hemolysis without anemia (compensated anemia with reticulocytosis). The biology tests confirmed the hemolysis with increased total and indirect bilirubin. The usual hemolysis diagnosis tests were normal (DAT, G6PD, PK, Hb electrophoresis) except cytology and ektacytometry suggesting an association of multiple red blood cell (RBC) membrane disorders. This led us to propose a molecular screening analysis using targeted-Next Generation Sequencing (t-NGS) with a capture technique on 93 genes involved in RBC and erythropoiesis defects. We identified 4 missense heterozygous allelic variations, all of them were described without any significance (VUS) in the SLC4A1, RhAG, PIEZO1 and SPTB genes. The study of the familial cosegregation and research functional tests allowed to decipher the role of at least two by two genes in the phenotype and the hemolytic disease of this young patient. Specialized t-NGS panel (or virtual exome/genome sequencing) in a disease-referent laboratory and the motivated collaboration of clinicians, biologists and scientists should be the gold standard for improving the diagnosis of the patients affected with RBC diseases or rare inherited anemias.
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Affiliation(s)
- Benoit Allegrini
- Université Côte d'Azur, CNRS, Inserm, Institut Biologie Valrose, Nice, France
| | | | - Morgane Mignotet
- Université Côte d'Azur, CNRS, Inserm, Institut Biologie Valrose, Nice, France
| | - Catherine Etchebest
- Inserm U1134, France; Laboratory of Excellence for RBCs, LABEX GR-Ex, 75015 Paris, France
| | - Odile Fenneteau
- AP-HP, Service Hématologie Biologique, Hôpital R. Debré, Paris, France
| | - Jessica Platon
- HEMATIM EA4666, Université Picardie Jules Vernes, Amiens, France
| | | | - Hélène Guizouarn
- Université Côte d'Azur, CNRS, Inserm, Institut Biologie Valrose, Nice, France; Laboratory of Excellence for RBCs, LABEX GR-Ex, 75015 Paris, France.
| | - Lydie Da Costa
- AP-HP, Service Hématologie Biologique, Hôpital R. Debré, Paris, France; HEMATIM EA4666, Université Picardie Jules Vernes, Amiens, France; Université Paris, Paris, France; Inserm U1134, France
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3
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Stewart GW, Gibson JS, Rees DC. The cation-leaky hereditary stomatocytosis syndromes: A tale of six proteins. Br J Haematol 2023; 203:509-522. [PMID: 37679660 DOI: 10.1111/bjh.19093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
This review concerns a series of dominantly inherited haemolytic anaemias in which the membrane of the erythrocyte 'leaks' the univalent cations, compromising the osmotic stability of the cell. The majority of the conditions are explained by mutations in one of six genes, coding for multispanning membrane proteins of different structure and function. These are: RhAG, coding for an ammonium carrier; SLC4A1, coding for the band 3 anion exchanger; PIEZO1, coding for a mechanosensitive cation channel; GLUT1, coding for a glucose transporter; KCNN4, coding for an internal-calcium-activated potassium channel; and ABCB6, coding for a porphyrin transporter. This review describes the five clinical syndromes associated with genetic defects in these genes and their variable genotype/phenotype relationships.
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Affiliation(s)
- Gordon W Stewart
- Division of Medicine, Faculty of Medical Sciences, University College London, London, UK
| | - John S Gibson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - David C Rees
- Haematological Medicine, Kings College London, London, UK
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4
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Allegrini B, Jedele S, David Nguyen L, Mignotet M, Rapetti-Mauss R, Etchebest C, Fenneteau O, Loubat A, Boutet A, Thomas C, Durin J, Petit A, Badens C, Garçon L, Da Costa L, Guizouarn H. New KCNN4 Variants Associated With Anemia: Stomatocytosis Without Erythrocyte Dehydration. Front Physiol 2022; 13:918620. [PMID: 36003639 PMCID: PMC9393219 DOI: 10.3389/fphys.2022.918620] [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: 04/12/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
The K+ channel activated by the Ca2+, KCNN4, has been shown to contribute to red blood cell dehydration in the rare hereditary hemolytic anemia, the dehydrated hereditary stomatocytosis. We report two de novo mutations on KCNN4, We reported two de novo mutations on KCNN4, V222L and H340N, characterized at the molecular, cellular and clinical levels. Whereas both mutations were shown to increase the calcium sensitivity of the K+ channel, leading to channel opening for lower calcium concentrations compared to WT KCNN4 channel, there was no obvious red blood cell dehydration in patients carrying one or the other mutation. The clinical phenotype was greatly different between carriers of the mutated gene ranging from severe anemia for one patient to a single episode of anemia for the other patient or no documented sign of anemia for the parents who also carried the mutation. These data compared to already published KCNN4 mutations question the role of KCNN4 gain-of-function mutations in hydration status and viability of red blood cells in bloodstream.
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Affiliation(s)
- B. Allegrini
- Université Côte d’Azur, CNRS, INSERM, iBV, Nice, France
| | - S. Jedele
- Université Paris Cité and Université des Antilles, Inserm, BIGR, Paris, France
| | - L. David Nguyen
- Université Paris Cité, Paris, France
- AP-HP, Service d’Hématologie Biologique, Hôpital R. Debré, Paris, France
| | - M. Mignotet
- Université Côte d’Azur, CNRS, INSERM, iBV, Nice, France
| | | | - C. Etchebest
- Université Paris Cité and Université des Antilles, Inserm, BIGR, Paris, France
| | - O. Fenneteau
- AP-HP, Service d’Hématologie Biologique, Hôpital R. Debré, Paris, France
| | - A. Loubat
- Université Côte d’Azur, CNRS, INSERM, iBV, Nice, France
| | - A. Boutet
- Hôpital Saint Nazaire, Saint-Nazaire, France
| | - C. Thomas
- CHU Nantes, Service Oncologie-hématologie et Immunologie Pédiatrique, Nantes, France
| | - J. Durin
- Sorbonne Université, AP-HP, Hôpital Armand Trousseau, Service d'Hématologie Oncologie Pédiatrique, Paris, France
| | - A. Petit
- Sorbonne Université, AP-HP, Hôpital Armand Trousseau, Service d'Hématologie Oncologie Pédiatrique, Paris, France
| | - C. Badens
- Aix Marseille Univ, INSERM, MMG, Marseille, France
- AP-HM, Department of Genetic, Marseille, France
| | - L. Garçon
- Université Picardie Jules Verne, Unité EA4666 Hematim, Amiens, France
- CHU Amiens, Service d'Hématologie Biologique, Amiens, France
| | - L. Da Costa
- Université Paris Cité, Paris, France
- AP-HP, Service d’Hématologie Biologique, Hôpital R. Debré, Paris, France
- Université Picardie Jules Verne, Unité EA4666 Hematim, Amiens, France
| | - H. Guizouarn
- Université Côte d’Azur, CNRS, INSERM, iBV, Nice, France
- *Correspondence: H. Guizouarn,
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5
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Bailey CAR, Farnsworth CW. You've Got to Be K+-idding Me. Clin Chem 2021; 67:567-568. [PMID: 33674840 DOI: 10.1093/clinchem/hvaa205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/06/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Cedric A R Bailey
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
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6
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The prognostic value of Piezo1 in breast cancer patients with various clinicopathological features. Anticancer Drugs 2021; 32:448-455. [PMID: 33559992 DOI: 10.1097/cad.0000000000001049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The effects of piezo-type mechanosensitive ion channel component 1 (Piezo1) in sensing extracellular mechanical stress have been well investigated. Recently, Piezo1's vital role in cancerogenesis has been demonstrated by many studies. Nonetheless, the prognostic value of Piezo1 in cancer still remains unexplored and unclear. This article aims to investigate the prognostic value of Piezo1 in breast cancer. Human Protein Atlas and the Cancer Genome Atlas (TCGA) databases were used to examine Piezo1 expression in different human tissues and human cell lines. The discrepancies of Piezo1 mRNA expression in breast cancer patients with different clinicopathological features were assessed using bc-GenExMiner. The prognostic value of Piezo1 in breast cancer patients was evaluated using Kaplan-Meier plotter. Piezo1 mRNA was extensively expressed in human tissues and cell lines, particularly in breast and cancerous breast cancer cell line MCF7. High Piezo1 expression was found correlated with poor prognosis of breast cancer. Survival analysis further confirmed unfavorable prognosis of high Piezo1 expression in breast cancer patients with lymph node positive, estrogen receptor positive, Grade 2 (Scarff-Bloom-Richardson grading system), luminal A, and human epidermal growth factor receptor 2 overexpression, respectively. This study suggested that Piezo1 can serve as a prognostic indicator of breast cancer.
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7
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Liu H, Bian W, Yang D, Yang M, Luo H. Inhibiting the Piezo1 channel protects microglia from acute hyperglycaemia damage through the JNK1 and mTOR signalling pathways. Life Sci 2020; 264:118667. [PMID: 33127514 DOI: 10.1016/j.lfs.2020.118667] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 01/20/2023]
Abstract
AIM Diabetes is a high-risk factor for neurocognitive dysfunction. Diabetic acute hyperglycaemia accompanied by high osmotic pressure can induce immune cell dysfunction, but its mechanism of action in brain microglia remains unclear. This study aimed to evaluate the role of the mechanically sensitive ion channel Piezo1 in the dysfunction of microglia in acute hyperglycaemia. MATERIALS AND METHODS To construct an in vitro acute hyperglycaemia model using the BV2 microglial cell line, Piezo1 in microglia was inhibited by GsMTx4 and siRNA, and the changes in microglial function were further evaluated. KEY FINDINGS High concentrations of glucose upregulated the expression of Piezo1, led to weakened cell proliferation and migration, and reduced the immune response to inflammatory stimulating factors (Aβ and LPS). Additionally, LPS upregulated Piezo1 in BV2 microglial cultures in vitro. The activation of Piezo1 channels increased the intracellular Ca2+ concentration and reduced the phosphorylation of JNK1 and mTOR. Inhibiting Piezo1 did not affect cell viability at average glucose concentrations but improved acute HCG-induced cell damage and increased the phosphorylation of JNK1 and mTOR, suggesting that the latter modification may be a potential downstream mechanism of Piezo1. SIGNIFICANCE Piezo1 is necessary for microglial damage in acute hyperglycaemia and may become a promising target to treat hyperglycaemic brain injury.
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Affiliation(s)
- Hailin Liu
- Department of Anesthesiology, The Third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330008, China; Jiangxi Key Laboratory of Cancer Metastasis and Precision Treatment, The Third Affiliated Hospital of Nanchang University, Nanchang, China; Graduate School of School of Medicine, Nanchang University, China
| | - Wengong Bian
- Department of Anesthesiology, The Third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330008, China; Jiangxi Key Laboratory of Cancer Metastasis and Precision Treatment, The Third Affiliated Hospital of Nanchang University, Nanchang, China; Graduate School of School of Medicine, Nanchang University, China
| | - Dongxia Yang
- Department of Anesthesiology, The Third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330008, China; Jiangxi Key Laboratory of Cancer Metastasis and Precision Treatment, The Third Affiliated Hospital of Nanchang University, Nanchang, China; Graduate School of School of Medicine, Nanchang University, China
| | - Mingmin Yang
- Department of Anesthesiology, The Third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330008, China
| | - Heguo Luo
- Department of Anesthesiology, The Third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330008, China.
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8
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Guo XW, Lu Y, Zhang H, Huang JQ, Li YW. PIEZO1 might be involved in cerebral ischemia-reperfusion injury through ferroptosis regulation: a hypothesis. Med Hypotheses 2020; 146:110327. [PMID: 33277104 DOI: 10.1016/j.mehy.2020.110327] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/17/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
Stroke is associated with high mortality and extremely high disability rate. Regulating ferroptosis seems to be a promising way to treat ischemic stroke. After stroke, vasogenic edema exerts a mechanical force on surrounding structures, which could activate the mechanosensitive PIEZO1 channel. Our previous research has found that brain cortex PIEZO1 expression was increased in the rat model of middle cerebral artery occlusion (MCAO), and PIEZO1 regulated oxygen-glucose deprivation/reoxygenation (OGD/R) injury in neurons through the calcium signaling. Considering recent studies has identified HIF1α as an essential protein in PIEZO1/calcium signaling, ferroptosis regulation and cerebral ischemia, we herein hypothesize that PIEZO1 might be involved in cerebral ischemia-reperfusion injury through ferroptosis regulation.
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Affiliation(s)
- Xue-Wei Guo
- Postgraduate Training Base of Jinzhou Medical University, the PLA Rocket Force Characteristic Medical Center, Beijing 100088, PR China; Department of Anesthesiology, the PLA Rocket Force Characteristic Medical Center, Beijing 100088, PR China
| | - Yan Lu
- Department of Neurology, the PLA Rocket Force Characteristic Medical Center, Beijing 100088, PR China
| | - Hao Zhang
- Department of Anesthesiology, the PLA Rocket Force Characteristic Medical Center, Beijing 100088, PR China
| | - Jia-Qi Huang
- Postgraduate Training Base of Jinzhou Medical University, the PLA Rocket Force Characteristic Medical Center, Beijing 100088, PR China; Department of Anesthesiology, the PLA Rocket Force Characteristic Medical Center, Beijing 100088, PR China
| | - Yong-Wang Li
- Department of Anesthesiology, the PLA Rocket Force Characteristic Medical Center, Beijing 100088, PR China.
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9
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Guizouarn H, Barshtein G. Editorial: Red Blood Cell Vascular Adhesion and Deformability. Front Physiol 2020; 11:657. [PMID: 32670087 PMCID: PMC7331698 DOI: 10.3389/fphys.2020.00657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/22/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Gregory Barshtein
- Department of Biochemistry, The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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10
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Föller M, Lang F. Ion Transport in Eryptosis, the Suicidal Death of Erythrocytes. Front Cell Dev Biol 2020; 8:597. [PMID: 32733893 PMCID: PMC7360839 DOI: 10.3389/fcell.2020.00597] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022] Open
Abstract
Erythrocytes are among the most abundant cells in mammals and are perfectly adapted to their main functions, i.e., the transport of O2 to peripheral tissues and the contribution to CO2 transport to the lungs. In contrast to other cells, they are fully devoid of organelles. Similar to apoptosis of nucleated cells erythrocytes may enter suicidal death, eryptosis, which is characterized by the presentation of membrane phosphatidylserine on the cell surface and cell shrinkage, hallmarks that are also typical of apoptosis. Eryptosis may be triggered by an increase in the cytosolic Ca2+ concentration, which may be due to Ca2+ influx via non-selective cation channels of the TRPC family. Eryptosis is further induced by ceramide, which sensitizes erythrocytes to the eryptotic effect of Ca2+. Signaling regulating eryptosis further involves a variety of kinases including AMPK, PAK2, cGKI, JAK3, CK1α, CDK4, MSK1/2 and casein kinase. Eryptosis-dependent shrinkage is induced by K+ efflux through Ca2+-activated K+ channel KCa3.1, the Gardos channel. Eryptotic cells are phagocytosed and may adhere to endothelial cells. Eryptosis may help prevent hemolysis since defective erythrocytes usually undergo eryptosis followed by rapid clearance from circulating blood. Excessive eryptosis stimulated by various diseases and xenobiotics may result in anemia and/or impaired microcirculation. This review focuses on the significance and mechanisms of eryptosis as well as on the ion fluxes involved. Moreover, a short summary of further ion transport mechanisms of the erythrocyte membrane is provided.
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Affiliation(s)
- Michael Föller
- Department of Physiology, University of Hohenheim, Stuttgart, Germany
| | - Florian Lang
- Department of Physiology Institute of Physiology, University of Tübingen, Tübingen, Germany
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11
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Guizouarn H, Allegrini B. Erythroid glucose transport in health and disease. Pflugers Arch 2020; 472:1371-1383. [PMID: 32474749 DOI: 10.1007/s00424-020-02406-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 12/14/2022]
Abstract
Glucose transport is intimately linked to red blood cell physiology. Glucose is the unique energy source for these cells, and defects in glucose metabolism or transport activity are associated with impaired red blood cell morphology and deformability leading to reduced lifespan. In vertebrate erythrocytes, glucose transport is mediated by GLUT1 (in humans) or GLUT4 transporters. These proteins also account for dehydroascorbic acid (DHA) transport through erythrocyte membrane. The peculiarities of glucose transporters and the red blood cell pathologies involving GLUT1 are summarized in the present review.
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Affiliation(s)
- Hélène Guizouarn
- Université Côte d'Azur, CNRS, Inserm, Institut de Biologie Valrose, 28 av. Valrose, 06100, Nice, France.
| | - Benoit Allegrini
- Université Côte d'Azur, CNRS, Inserm, Institut de Biologie Valrose, 28 av. Valrose, 06100, Nice, France
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12
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McMahon TJ. Red Blood Cell Deformability, Vasoactive Mediators, and Adhesion. Front Physiol 2019; 10:1417. [PMID: 31803068 PMCID: PMC6873820 DOI: 10.3389/fphys.2019.01417] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 11/01/2019] [Indexed: 01/16/2023] Open
Abstract
Healthy red blood cells (RBCs) deform readily in response to shear stress in the circulation, facilitating their efficient passage through capillaries. RBCs also export vasoactive mediators in response to deformation and other physiological and pathological stimuli. Deoxygenation of RBC hemoglobin leads to the export of vasodilator and antiadhesive S-nitrosothiols (SNOs) and adenosine triphosphate (ATP) in parallel with oxygen transport in the respiratory cycle. Together, these mediated responses to shear stress and oxygen offloading promote the efficient flow of blood cells and in turn optimize oxygen delivery. In diseases including sickle cell anemia and conditions including conventional blood banking, these adaptive functions may be compromised as a result, for example, of limited RBC deformability, impaired mediator formation, or dysfunctional mediator export. Ongoing work, including single cell approaches, is examining relevant mechanisms and remedies in health and disease.
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Affiliation(s)
- Timothy J McMahon
- Durham VA Medical Center, Duke University, Durham, NC, United States
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13
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Knight T, Zaidi AU, Wu S, Gadgeel M, Buck S, Ravindranath Y. Mild erythrocytosis as a presenting manifestation of PIEZO1 associated erythrocyte volume disorders. Pediatr Hematol Oncol 2019; 36:317-326. [PMID: 31298594 DOI: 10.1080/08880018.2019.1637984] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Piezo1, encoded by the gene PIEZO1, is an erythrocytic cellular membrane mechanoactivated cation channel. Mutations have been implicated in erythrocyte volume disorders (EVDs)-especially hereditary xerocytosis (HX)/dehydrated stomatocytosis (DHS). We identified three patients, all with novel PIEZO1 mutations, but only one displaying the HX/DHS phenotype. Retrospective review of three cases. Osmotic gradient red cell deformability (Osmoscan) was assessed via the Technicon Ektacytometer. Red cell band 3 content was estimated using Eosin-5'-Maleimide staining. Patient 1 was evaluated for polycythemia. Osmoscans suggested mild spherocytosis; a novel PIEZO1 mutation (p.Thr1589Ile, exon 35) was identified, causing mild erythrocytosis without hemolytic anemia. Patient 2 was evaluated for macrocytosis/reticulocytosis, normal-to-high hemoglobin, and indirect hyperbilirubinemia. Osmoscans suggested increased cellular hydration; a second novel PIEZO1 mutation (p.Arg1728Cys, exon 37) was identified, resulting in overhydrated stomatocytosis with well-compensated hemolysis. Patient 3 was evaluated for indirect hyperbilirubinemia only. Osmoscans suggested dehydrated stomatocytosis (DHS, xerocytosis); a third novel PIEZO1 mutation (p.Arg2279Cys, exon 47) was identified. All three patients' blood smears demonstrated stomatocytes and spherocytes. EVDs may be underdiagnosed due to the lack of "expected" anemia in a hemolytic disorder; two of three patients had high hemoglobin and red cell counts and one had high normal values for both parameters and the presence of stomatocytes/dehydrated cells lead to identification of causative PIEZO1 mutations. PIEZO1-associated EVDs may be more common than previously suspected and should be included in the diagnostic algorithms for mild erythrocytosis/unexplained jaundice.
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Affiliation(s)
- Tristan Knight
- Division of Pediatric Hematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Detroit , Michigan , USA.,Wayne State University , Detroit , Michigan , USA
| | - Ahmar Urooj Zaidi
- Division of Pediatric Hematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Detroit , Michigan , USA.,Wayne State University , Detroit , Michigan , USA
| | - Shengnan Wu
- Fulgent Diagnostics , Temple City , California , USA
| | - Manisha Gadgeel
- Division of Pediatric Hematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Detroit , Michigan , USA.,Wayne State University , Detroit , Michigan , USA
| | - Steven Buck
- Division of Pediatric Hematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Detroit , Michigan , USA.,Wayne State University , Detroit , Michigan , USA
| | - Yaddanapudi Ravindranath
- Division of Pediatric Hematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Detroit , Michigan , USA.,Wayne State University , Detroit , Michigan , USA
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14
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Iolascon A, Andolfo I, Russo R. Advances in understanding the pathogenesis of red cell membrane disorders. Br J Haematol 2019; 187:13-24. [PMID: 31364155 DOI: 10.1111/bjh.16126] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Hereditary erythrocyte membrane disorders are caused by mutations in genes encoding various transmembrane or cytoskeletal proteins of red blood cells. The main consequences of these genetic alterations are decreased cell deformability and shortened erythrocyte survival. Red blood cell membrane defects encompass a heterogeneous group of haemolytic anaemias caused by either (i) altered membrane structural organisation (hereditary spherocytosis, hereditary elliptocytosis, hereditary pyropoikilocytosis and Southeast Asian ovalocytosis) or (ii) altered membrane transport function (overhydrated hereditary stomatocytosis, dehydrated hereditary stomatocytosis or xerocytosis, familial pseudohyperkalaemia and cryohydrocytosis). Herein we provide a comprehensive review of the recent literature on the molecular genetics of erythrocyte membrane defects and their reported clinical consequences. We also describe the effect of low-expression genetic variants on the high inter- and intra-familial phenotype variability of erythrocyte structural defects.
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Affiliation(s)
- Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies, Federico II" University of Naples, Naples, Italy.,CEINGE - Biotecnologie Avanzate, Naples, Italy
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnologies, Federico II" University of Naples, Naples, Italy.,CEINGE - Biotecnologie Avanzate, Naples, Italy
| | - Roberta Russo
- Department of Molecular Medicine and Medical Biotechnologies, Federico II" University of Naples, Naples, Italy.,CEINGE - Biotecnologie Avanzate, Naples, Italy
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15
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Frederiksen H. Dehydrated hereditary stomatocytosis: clinical perspectives. J Blood Med 2019; 10:183-191. [PMID: 31308777 PMCID: PMC6613601 DOI: 10.2147/jbm.s179764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/14/2019] [Indexed: 12/30/2022] Open
Abstract
Dehydrated hereditary stomatocytosis (DHSt) is a nonimmune congenital hemolytic disorder characterized by red blood cell (RBC) dehydration and lysis. It has been a recognized diagnostic entity for almost 50 years, and autosomal dominant inheritance has long been suspected, but it was not until 2011 that the first genetic alterations were identified. The current study reviews 73 articles published during 1971–2019 and focuses on clinical perspectives of the disease. All but one of the published clinical data in DHSt were either single case reports or case series. From these, it can be seen that patients with DHSt often have fully or partially compensated hemolysis with few symptoms. Despite this, iron overload is an almost universal finding even in patients without or with only sporadic blood transfusions, and this may lead to organ dysfunction. Other severe complications, such as thrombosis and perinatal fluid effusions unrelated to fetal hemoglobin concentration, may also occur. No specific treatment for symptomatic hemolysis exists, and splenectomy should be avoided as it seems to aggravate the risk of thrombosis. Recently, treatment with senicapoc has shown activity against RBC dehydration in vitro; however, it is not known if this translates into relevant clinical effects. In conclusion, despite recent advances in the understanding of pathophysiology in DHSt, options for clinical management have not improved. Entering data into international registries has the potential to fill gaps in knowledge and eventually care of these rare patients.
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16
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Red cell membrane proteins. Hemasphere 2019; 3:HemaSphere-2019-0029. [PMID: 35309774 PMCID: PMC8925656 DOI: 10.1097/hs9.0000000000000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/12/2019] [Indexed: 11/29/2022] Open
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17
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Petkova-Kirova P, Hertz L, Danielczok J, Huisjes R, Makhro A, Bogdanova A, Mañú-Pereira MDM, Vives Corrons JL, van Wijk R, Kaestner L. Red Blood Cell Membrane Conductance in Hereditary Haemolytic Anaemias. Front Physiol 2019; 10:386. [PMID: 31040790 PMCID: PMC6477063 DOI: 10.3389/fphys.2019.00386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/21/2019] [Indexed: 11/18/2022] Open
Abstract
Congenital haemolytic anaemias are inherited disorders caused by red blood cell membrane and cytoskeletal protein defects, deviant hemoglobin synthesis and metabolic enzyme deficiencies. In many cases, although the causing mutation might be known, the pathophysiology and the connection between the particular mutation and the symptoms of the disease are not completely understood. Thus effective treatment is lagging behind. As in many cases abnormal red blood cell cation content and cation leaks go along with the disease, by direct electrophysiological measurements of the general conductance of red blood cells, we aimed to assess if changes in the membrane conductance could be a possible cause. We recorded whole-cell currents from 29 patients with different types of congenital haemolytic anaemias: 14 with hereditary spherocytosis due to mutations in α-spectrin, β-spectrin, ankyrin and band 3 protein; 6 patients with hereditary xerocytosis due to mutations in Piezo1; 6 patients with enzymatic disorders (3 patients with glucose-6-phosphate dehydrogenase deficiency, 1 patient with pyruvate kinase deficiency, 1 patient with glutamate-cysteine ligase deficiency and 1 patient with glutathione reductase deficiency), 1 patient with β-thalassemia and 2 patients, carriers of several mutations and a complex genotype. While the patients with β-thalassemia and metabolic enzyme deficiencies showed no changes in their membrane conductance, the patients with hereditary spherocytosis and hereditary xerocytosis showed largely variable results depending on the underlying mutation.
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Affiliation(s)
| | - Laura Hertz
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany.,Experimental Physics, Saarland University, Saarbrücken, Germany
| | - Jens Danielczok
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany
| | - Rick Huisjes
- Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Asya Makhro
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty, Zurich Center for Integrative Human Physiology (ZIHP), University of Zürich, Zurich, Switzerland
| | - Anna Bogdanova
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty, Zurich Center for Integrative Human Physiology (ZIHP), University of Zürich, Zurich, Switzerland
| | | | - Joan-Lluis Vives Corrons
- Red Blood Cell Defects and Hematopoietic Disorders Unit, Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | - Richard van Wijk
- Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany.,Experimental Physics, Saarland University, Saarbrücken, Germany
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18
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Barcellini W, Zaninoni A, Gregorini AI, Soverini G, Duca L, Fattizzo B, Giannotta JA, Pedrotti P, Vercellati C, Marcello AP, Fermo E, Bianchi P, Cappellini MD. Iron overload in congenital haemolytic anaemias: role of hepcidin and cytokines and predictive value of ferritin and transferrin saturation. Br J Haematol 2019; 185:523-531. [PMID: 30828802 DOI: 10.1111/bjh.15811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/27/2018] [Indexed: 01/19/2023]
Abstract
Iron overload (IO) is poorly investigated in the congenital haemolytic anaemias (CHAs), a heterogeneous group of rare inherited diseases encompassing abnormalities of the erythrocyte membrane and metabolism, and defects of the erythropoiesis. In this study we systematically evaluated routine iron parameters and cardiac and hepatic magnetic resonance imaging, together with erythropoietin, hepcidin, non-transferrin bound iron (NTBI), and cytokine serum levels in patients with different CHAs. We found that 40% of patients had a liver iron concentration (LIC) >4 mg Fe/g dry weight. Hepatic IO was associated with ferritin levels (P = 0·0025), transferrin saturation (TfSat, P = 0·002) and NTBI (P = 0·003). Moreover, ferritin >500 μg/l plus TfSat >60% was demonstrated as the best combination able to identify increased LIC, and TfSat alteration as more important in cases with discordant values. Possible confounding factors, such as transfusions, hepatic disease, metabolic syndrome and hereditary haemochromatosis-associated mutations, had negligible effects on IO. Erythropoietin and hepcidin levels were increased in CHAs compared with controls, correlating with LIC and ferritin, respectively. Regarding cytokines, γ-interferon (IFN-γ) was increased, and both interleukin 6 and IFN-γ levels positively correlated with ferritin and hepcidin levels. Overall, these findings suggest the existence of a vicious cycle between chronic haemolysis, inflammatory response and IO in CHAs.
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Affiliation(s)
- Wilma Barcellini
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna Zaninoni
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna I Gregorini
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giulia Soverini
- Spedali Civili di Brescia - Unità di Ematologia, Brescia, Italy
| | - Lorena Duca
- Dipartimento di Scienze Cliniche e Comunità, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico - Università degli studi di Milano, Milano, Italy
| | - Bruno Fattizzo
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Juri A Giannotta
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Patrizia Pedrotti
- Dipartimento di Cardiologia, Unità di Risonanza Magnetica Cardiaca, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Cristina Vercellati
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna P Marcello
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Elisa Fermo
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Paola Bianchi
- Milano - Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Maria Domenica Cappellini
- Dipartimento di Scienze Cliniche e Comunità, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico - Università degli studi di Milano, Milano, Italy
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19
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Abstract
Supplemental Digital Content is available in the text
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20
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Caulier A, Rapetti-Mauss R, Guizouarn H, Picard V, Garçon L, Badens C. Primary red cell hydration disorders: Pathogenesis and diagnosis. Int J Lab Hematol 2018; 40 Suppl 1:68-73. [DOI: 10.1111/ijlh.12820] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/09/2018] [Indexed: 11/26/2022]
Affiliation(s)
- A. Caulier
- EA HEMATIM; Université Picardie Jules Verne; Amiens France
| | | | - H. Guizouarn
- CNRS, INSERM, IBV; Université Côte d'Azur; Nice France
| | - V. Picard
- Faculté de Pharmacie; Université Paris Sud-Paris Saclay; Chatenay Malabry France
- AP-HP; Département d'Hématologie; Hôpital Bicêtre; Le Kremlin-Bicêtre France
| | - L. Garçon
- EA HEMATIM; Université Picardie Jules Verne; Amiens France
- Service d'Hématologie Biologique; CHU Amiens; Amiens France
| | - C. Badens
- INSERM, MMG; Aix Marseille University; Marseille France
- Laboratoire de Génétique Moléculaire; APHM; Marseille France
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21
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Zaninoni A, Fermo E, Vercellati C, Consonni D, Marcello AP, Zanella A, Cortelezzi A, Barcellini W, Bianchi P. Use of Laser Assisted Optical Rotational Cell Analyzer (LoRRca MaxSis) in the Diagnosis of RBC Membrane Disorders, Enzyme Defects, and Congenital Dyserythropoietic Anemias: A Monocentric Study on 202 Patients. Front Physiol 2018; 9:451. [PMID: 29755372 PMCID: PMC5934481 DOI: 10.3389/fphys.2018.00451] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/10/2018] [Indexed: 01/17/2023] Open
Abstract
Chronic hemolytic anemias are a group of heterogeneous diseases mainly due to abnormalities of red cell (RBC) membrane and metabolism. The more common RBC membrane disorders, classified on the basis of blood smear morphology, are hereditary spherocytosis (HS), elliptocytosis, and hereditary stomatocytoses (HSt). Among RBC enzymopathies, the most frequent is pyruvate kinase (PK) deficiency, followed by glucose-6-phosphate isomerase, pyrimidine 5′ nucleotidase P5′N, and other rare enzymes defects. Because of the rarity and heterogeneity of these diseases, diagnosis may be often challenging despite the availability of a variety of laboratory tests. The ektacytometer laser-assisted optical rotational cell analyser (LoRRca MaxSis), able to assess the RBC deformability in osmotic gradient conditions (Osmoscan analysis), is a useful diagnostic tool for RBC membrane disorders and in particular for the identification of hereditary stomatocytosis. Few data are so far available in other hemolytic anemias. We evaluated the diagnostic power of LoRRca MaxSis in a large series of 140 patients affected by RBC membrane disorders, 37 by enzymopathies, and 16 by congenital diserythropoietic anemia type II. Moreover, nine patients with paroxysmal nocturnal hemoglobinuria (PNH) were also investigated. All the hereditary spherocytoses, regardless the biochemical defect, showed altered Osmoscan curves, with a decreased Elongation Index (EI) max and right shifted Omin; hereditary elliptocytosis (HE) displayed a trapezoidal curve and decreased EImax. Dehydrated hereditary stomatocytosis (DHSt) caused by PIEZO1 mutations was characterized by left-shifted curve, whereas KCNN4 mutations were associated with a normal curve. Congenital diserythropoietic anemia type II and RBC enzymopathies had Osmoscan curve within the normal range except for glucosephosphate isomerase (GPI) deficient cases who displayed an enlarged curve associated with significantly increased Ohyper, offering a new diagnostic tool for this rare enzyme defect. The Osmoscan analysis performed by LoRRca MaxSis represents a useful and feasible first step screening test for specialized centers involved in the diagnosis of hemolytic anemias. However, the results should be interpreted by caution because different factors (i.e., splenectomy or coexistent diseases) may interfere with the analysis; additional tests or molecular investigations are therefore needed to confirm the diagnosis.
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Affiliation(s)
- Anna Zaninoni
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Fermo
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Vercellati
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- UO Epidemiologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna P Marcello
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alberto Zanella
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Agostino Cortelezzi
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Università degli Studi di Milano, Milan, Italy
| | - Wilma Barcellini
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Bianchi
- UOC Oncoematologia, UOS Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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22
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Abstract
Haemochromatosis is defined as systemic iron overload of genetic origin, caused by a reduction in the concentration of the iron regulatory hormone hepcidin, or a reduction in hepcidin-ferroportin binding. Hepcidin regulates the activity of ferroportin, which is the only identified cellular iron exporter. The most common form of haemochromatosis is due to homozygous mutations (specifically, the C282Y mutation) in HFE, which encodes hereditary haemochromatosis protein. Non-HFE forms of haemochromatosis due to mutations in HAMP, HJV or TFR2 are much rarer. Mutations in SLC40A1 (also known as FPN1; encoding ferroportin) that prevent hepcidin-ferroportin binding also cause haemochromatosis. Cellular iron excess in HFE and non-HFE forms of haemochromatosis is caused by increased concentrations of plasma iron, which can lead to the accumulation of iron in parenchymal cells, particularly hepatocytes, pancreatic cells and cardiomyocytes. Diagnosis is noninvasive and includes clinical examination, assessment of plasma iron parameters, imaging and genetic testing. The mainstay therapy is phlebotomy, although iron chelation can be used in some patients. Hepcidin supplementation might be an innovative future approach.
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Affiliation(s)
- Pierre Brissot
- INSERM, Univ. Rennes, INRA, Institut NUMECAN (Nutrition Metabolisms and Cancer) UMR_A 1341, UMR_S 1241, F-35000 Rennes, France
| | - Antonello Pietrangelo
- Division of Internal Medicine 2 and Center for Haemochromatosis, University Hospital of Modena, Modena, Italy
| | - Paul C. Adams
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | | | - Olivier Loréal
- INSERM, Univ. Rennes, INRA, Institut NUMECAN (Nutrition Metabolisms and Cancer) UMR_A 1341, UMR_S 1241, F-35000 Rennes, France
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23
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Jamwal M, Aggarwal A, Sachdeva MUS, Sharma P, Malhotra P, Maitra A, Das R. Overhydrated stomatocytosis associated with a complex RHAG genotype including a novel de novo mutation. J Clin Pathol 2018; 71:648-652. [DOI: 10.1136/jclinpath-2018-205018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/01/2018] [Accepted: 03/02/2018] [Indexed: 11/04/2022]
Abstract
Overhydrated stomatocytosis is a rare autosomal dominant disorder known to cause variably severe haemolytic anaemia due to heterozygous mutations in the RHAG gene. We report a 26-year-old man with recurring jaundice, splenohepatomegaly and mild chronic haemolytic anaemia with significant stomatocytosis. Extensive haemolytic work-up including flow cytometry for eosin-5′-maleimide and CD47 expression levels was carried out. Targeted resequencing revealed two probably causative heterozygous mutations in RHAG (Leu336Ser and Ile149Met) and one heterozygous mutation in ANK1 (Glu1046Lys). RHAG involvement was confirmed by decreased RhAG macrocomplex component indicated by the reduced CD47 expression on erythrocytes. In silico analysis concordantly flagged RHAG:Leu336Ser and ANK1:Glu1046Lys as likely deleterious mutation, whereas RHAG:Ile149Met was reported as likely neutral by PROVEAN. Family screening by Sanger sequencing revealed RHAG:Leu336Ser in a mother and ANK1:Glu1046Lys in a father who were both asymptomatic, excluding them as causative dominant events, thus establishing RHAG:Ile149Met, novel de novo mutation as probably causative. This case illustrates the importance of family screening in interpreting next-generation sequencing (NGS) data, as in silico analysis alone can be misleading. Erudite generation of diagnostic possibilities based on a thorough baseline clinical and laboratory work-up remains as important as ever, even as NGS brings about a paradigm shift in the diagnostic work-up of rare haemolytic anaemias.
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24
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Iolascon A, Andolfo I, Barcellini W, Corcione F, Garçon L, De Franceschi L, Pignata C, Graziadei G, Pospisilova D, Rees DC, de Montalembert M, Rivella S, Gambale A, Russo R, Ribeiro L, Vives-Corrons J, Martinez PA, Kattamis A, Gulbis B, Cappellini MD, Roberts I, Tamary H. Recommendations regarding splenectomy in hereditary hemolytic anemias. Haematologica 2017; 102:1304-1313. [PMID: 28550188 PMCID: PMC5541865 DOI: 10.3324/haematol.2016.161166] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 05/22/2017] [Indexed: 01/19/2023] Open
Abstract
Hereditary hemolytic anemias are a group of disorders with a variety of causes, including red cell membrane defects, red blood cell enzyme disorders, congenital dyserythropoietic anemias, thalassemia syndromes and hemoglobinopathies. As damaged red blood cells passing through the red pulp of the spleen are removed by splenic macrophages, splenectomy is one possible therapeutic approach to the management of severely affected patients. However, except for hereditary spherocytosis for which the effectiveness of splenectomy has been well documented, the efficacy of splenectomy in other anemias within this group has yet to be determined and there are concerns regarding short- and long-term infectious and thrombotic complications. In light of the priorities identified by the European Hematology Association Roadmap we generated specific recommendations for each disorder, except thalassemia syndromes for which there are other, recent guidelines. Our recommendations are intended to enable clinicians to achieve better informed decisions on disease management by splenectomy, on the type of splenectomy and the possible consequences. As no randomized clinical trials, case control or cohort studies regarding splenectomy in these disorders were found in the literature, recommendations for each disease were based on expert opinion and were subsequently critically revised and modified by the Splenectomy in Rare Anemias Study Group, which includes hematologists caring for both adults and children.
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Affiliation(s)
- Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University Federico II Naples, Italy .,CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnology, University Federico II Naples, Italy.,CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Wilma Barcellini
- Oncohematology Unit, IRCCS Ca' Granda Foundation, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Corcione
- Department of General Surgery, Monaldi Hospital A.O.R.N. dei Colli, Naples, Italy
| | - Loïc Garçon
- Service d'Hématologie Biologique, CHU Amiens Picardie, Amiens, France
| | | | - Claudio Pignata
- Department of Translational Medical Sciences, Federico II University of Naples, Italy
| | - Giovanna Graziadei
- Department of Clinical Science and Community Health, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Dagmar Pospisilova
- Department of Pediatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - David C Rees
- Department of Paediatric Haematology, King's College Hospital, King's College London School of Medicine, UK
| | | | - Stefano Rivella
- Department of Pediatrics, Division of Hematology-Oncology, Children's Blood and Cancer Foundation Laboratories, Weill Cornell Medical College, New York, NY, USA; Department of Pediatrics, Division of Hematology, Children's Hospital of Philadelphia, PA, USA
| | - Antonella Gambale
- Department of Molecular Medicine and Medical Biotechnology, University Federico II Naples, Italy.,CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Roberta Russo
- Department of Molecular Medicine and Medical Biotechnology, University Federico II Naples, Italy.,CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Leticia Ribeiro
- Hematology Service, Hospital and University Center of Coimbra (CHUC), Portugal
| | | | | | | | - Beatrice Gulbis
- Department of Clinical Chemistry, Hôpital Erasme, U.L.B., Brussels, Belgium
| | - Maria Domenica Cappellini
- Department of Clinical Science and Community Health, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Irene Roberts
- Department of Paediatrics, Children's Hospital, University of Oxford, John Radcliffe Hospital, UK
| | - Hannah Tamary
- Pediatric Hematology Unit, Schneider Children's Medical Center of Israel, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Israel
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Fermo E, Bogdanova A, Petkova-Kirova P, Zaninoni A, Marcello AP, Makhro A, Hänggi P, Hertz L, Danielczok J, Vercellati C, Mirra N, Zanella A, Cortelezzi A, Barcellini W, Kaestner L, Bianchi P. 'Gardos Channelopathy': a variant of hereditary Stomatocytosis with complex molecular regulation. Sci Rep 2017; 7:1744. [PMID: 28496185 PMCID: PMC5431847 DOI: 10.1038/s41598-017-01591-w] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/31/2017] [Indexed: 11/17/2022] Open
Abstract
The Gardos channel is a Ca2+ sensitive, K+ selective channel present in several tissues including RBCs, where it is involved in cell volume regulation. Recently, mutations at two different aminoacid residues in KCNN4 have been reported in patients with hereditary xerocytosis. We identified by whole exome sequencing a new family with two members affected by chronic hemolytic anemia carrying mutation R352H in the KCNN4 gene. No additional mutations in genes encoding for RBCs cytoskeletal, membrane or channel proteins were detected. We performed functional studies on patients’ RBCs to evaluate the effects of R352H mutation on the cellular properties and eventually on the clinical phenotype. Gardos channel hyperactivation was demonstrated in circulating erythrocytes and erythroblasts differentiated ex-vivo from peripheral CD34+ cells. Pathological alterations in the function of multiple ion transport systems were observed, suggesting the presence of compensatory effects ultimately preventing cellular dehydration in patient’s RBCs; moreover, flow cytometry and confocal fluorescence live-cell imaging showed Ca2+ overload in the RBCs of both patients and hypersensitivity of Ca2+ uptake by RBCs to swelling. Altogether these findings suggest that the ‘Gardos channelopathy’ is a complex pathology, to some extent different from the common hereditary xerocytosis.
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Affiliation(s)
- Elisa Fermo
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna Bogdanova
- Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Polina Petkova-Kirova
- Research Center for Molecular Imaging and Screening, Medical School, Institute for Molecular Cell Biology, Saarland University, Homburg/Saar, Germany
| | - Anna Zaninoni
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna Paola Marcello
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Asya Makhro
- Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Pascal Hänggi
- Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Laura Hertz
- Research Center for Molecular Imaging and Screening, Medical School, Institute for Molecular Cell Biology, Saarland University, Homburg/Saar, Germany
| | - Jens Danielczok
- Research Center for Molecular Imaging and Screening, Medical School, Institute for Molecular Cell Biology, Saarland University, Homburg/Saar, Germany
| | - Cristina Vercellati
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Nadia Mirra
- UOC Pronto soccorso, Pediatria ambulatoriale e DH/MAC. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Alberto Zanella
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Agostino Cortelezzi
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Universita' degli Studi di Milano, Milano, Italy
| | - Wilma Barcellini
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Lars Kaestner
- Experimental Physics, Saarland University, Saarbruecken, Germany.,Theoretical Medicine and Biosciences, Saarland University, Homburg/Saar, Germany
| | - Paola Bianchi
- UOC Oncoematologia, UOS. Fisiopatologia delle Anemie Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
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26
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Abstract
Mutations in the genes encoding the mechanosensitive cation channels PIEZO1 and PIEZO2 are responsible for multiple hereditary human diseases. Loss-of-function mutations in the human PIEZO1 gene cause autosomal recessive congenital lymphatic dysplasia. Gain-of-function mutations in the human PIEZO1 gene cause the autosomal dominant hemolytic anemia, hereditary xerocytosis (also known as dehydrated stomatocytosis). Loss-of-function mutations in the human PIEZO2 gene cause an autosomal recessive syndrome of muscular atrophy with perinatal respiratory distress, arthrogryposis, and scoliosis. Gain-of-function mutations in the human PIEZO2 gene cause three clinical types of autosomal dominant distal arthrogryposis. This chapter will review the hereditary diseases caused by mutations in the PIEZO genes and will discuss additional physiological systems in which PIEZO channel dysfunction may contribute to human disease pathophysiology.
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Affiliation(s)
- S L Alper
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
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