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Connes P. Blood rheology and vascular function in sickle cell trait and sickle cell disease: From pathophysiological mechanisms to clinical usefulness. Clin Hemorheol Microcirc 2024; 86:9-27. [PMID: 38073384 DOI: 10.3233/ch-238122] [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] [Indexed: 02/24/2024]
Abstract
Sickle cell disease (SCD) is an autosomal recessive disorder. Although the molecular mechanisms at the origin of SCD have been well characterized, its clinical expression is highly variable. SCD is characterized by blood rheological abnormalities, increased inflammation and oxidative stress, and vascular dysfunction. Individuals with only one copy of the mutated β-globin gene have sickle cell trait (SCT) and are usually asymptomatic. The first part of this review focuses on the biological responses of SCT carriers during exercise and on the effects of combined SCT and diabetes on vascular function, several biomarkers and clinical complications. The second part of the review focuses on SCD and shows that the magnitude of red blood cell (RBC) rheological alterations is highly variable from one patient to another, and this variability reflects the clinical and hematological variability: patients with the less deformable RBCs have high hemolytic rate and severe anemia, and are prone to develop leg ulcers, priapism, cerebral vasculopathy, glomerulopathy or pulmonary hypertension. In contrast, SCD patients characterized by the presence of more deformable RBCs (but still rigid) are less anemic and may exhibit increased blood viscosity, which increases the risk for vaso-occlusive events. Several genetic and cellular factors may modulate RBC deformability in SCD: co-existence of α-thalassemia, fetal hemoglobin level, oxidative stress, the presence of residual mitochondria into mature RBCs, the activity of various non-selective cationic ion channels, etc. The last part of this review presents the effects of hydroxyurea and exercise training on RBC rheology and other biomarkers in SCD.
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Affiliation(s)
- Philippe Connes
- Laboratory LIBM EA7424, University of Lyon 1, "Vascular Biology and Red Blood Cell" Team, Lyon, France
- Laboratory of Excellence Labex GR-Ex, Paris, France
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2
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Connes P, Renoux C, Joly P, Nader E. Vascular pathophysiology of sickle cell disease. Presse Med 2023; 52:104202. [PMID: 37944640 DOI: 10.1016/j.lpm.2023.104202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/05/2023] [Indexed: 11/12/2023] Open
Abstract
Sickle cell disease (SCD) is an hereditary disorder characterized by the production of an abnormal hemoglobin called hemoglobin S (HbS). HbS may polymerize in deoxygenated conditions, which leads to red blood cell (RBC) sickling. Sickled RBCs are more rigid and fragile, and prone to lysis. SCD patients exhibit various acute and/or chronic complications, which may affect several organs. The clinical presentation of SCD is highly variable from one patient to another and cannot be only explained by RBC sickling. Increased blood viscosity, caused by the presence of RBCs with abnormal deformability and aggregation, may increase vascular resistance and increase the risk of acute and chronic vascular complications. Chronic hemolysis results in decreased nitric oxide (NO) bioavailability which may compromise vasodilation and participate to the development of chronic vasculopathy. Furthermore, chronic hemolysis is responsible for increased inflammation and oxidative stress, which affect the vascular system and may promote the adhesion of circulating cells to endothelial cells. Extracellular vesicles and especially RBC microparticles (massively released in the context of SCD) are also at the origin of vascular damages and increased white blood cells adhesion to the endothelium, which may trigger vaso-occlusive crisis and other vascular-related complications. This review highlights the fact that SCD should not only be considered as a hematological disorder but also as a vascular disease.
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Affiliation(s)
- Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, France; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, France; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France; Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, France; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France; Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, France; Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
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3
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Song A, Wen AQ, Wen YE, Dzieciatkowska M, Kellems RE, Juneja HS, D'Alessandro A, Xia Y. p97 dysfunction underlies a loss of quality control of damaged membrane proteins and promotes oxidative stress and sickling in sickle cell disease. FASEB J 2022; 36:e22246. [PMID: 35405035 DOI: 10.1096/fj.202101500rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/19/2022] [Accepted: 02/23/2022] [Indexed: 11/11/2022]
Abstract
Sickling is the central pathogenic process of sickle cell disease (SCD), one of the most prevalent inherited hemolytic disorders. Having no easy access to antioxidants in the cytosol, elevated levels of reactive oxygen species (ROS) residing at the plasma membrane in sickle red blood cells (sRBCs) easily oxidize membrane proteins and thus contribute to sickling. Although the ubiquitin-proteasome system (UPS) is essential to rapidly clear ROS-damaged membrane proteins and maintain cellular homeostasis, the function and regulatory mechanism of the UPS for their clearance in sRBCs remains unidentified. Elevated levels of polyubiquitinated membrane-associated proteins in human sRBCs are reported here. High throughput and untargeted proteomic analyses of membrane proteins immunoprecipitated by ubiquitin antibodies detected elevated levels of ubiquitination of a series of proteins including cytoskeletal proteins, transporters, ROS-related proteins, and UPS machinery components in sRBCs. Polyubiquitination of membrane-associated catalase was increased in sRBCs, associated with decreased catalase activity and elevated ROS. Surprisingly, shuttling of p97 (ATP-dependent valosin-containing chaperone protein), a key component of the UPS to shuttle polyubiquitinated proteins from the membrane to cytosol for proteasomal degradation, was significantly impaired, resulting in significant accumulation of p97 along with polyubiquitinated proteins in the membrane of human sRBCs. Functionally, inhibition of p97 directly promoted accumulation of polyubiquitinated membrane-associated proteins, excessive ROS levels, and sickling in response to hypoxia. Overall, we revealed that p97 dysfunction underlies impaired UPS and contributes to oxidative stress in sRBCs.
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Affiliation(s)
- Anren Song
- Department of Biochemistry and Molecular Biology, the University of Texas McGovern Medical School, Houston, Texas, USA
| | - Alexander Q Wen
- Department of Biochemistry and Molecular Biology, the University of Texas McGovern Medical School, Houston, Texas, USA.,University of California at San Diego, La Jolla, California, USA
| | - Y Edward Wen
- Department of Biochemistry and Molecular Biology, the University of Texas McGovern Medical School, Houston, Texas, USA.,University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Rodney E Kellems
- Department of Biochemistry and Molecular Biology, the University of Texas McGovern Medical School, Houston, Texas, USA.,Graduate Program in Biochemistry and Cell Biology, University of Texas MD Anderson UTHealth Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Harinder S Juneja
- Department of Internal Medicine, Divison of Hematology, the University of Texas McGovern Medical School, Houston, Texas, USA
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Yang Xia
- Department of Biochemistry and Molecular Biology, the University of Texas McGovern Medical School, Houston, Texas, USA.,Graduate Program in Biochemistry and Cell Biology, University of Texas MD Anderson UTHealth Graduate School of Biomedical Sciences, Houston, Texas, USA
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4
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Nader E, Garnier Y, Connes P, Romana M. Extracellular Vesicles in Sickle Cell Disease: Plasma Concentration, Blood Cell Types Origin Distribution and Biological Properties. Front Med (Lausanne) 2021; 8:728693. [PMID: 34490315 PMCID: PMC8417591 DOI: 10.3389/fmed.2021.728693] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/30/2021] [Indexed: 01/08/2023] Open
Abstract
Prototype of monogenic disorder, sickle cell disease (SCD) is caused by a unique single mutation in the β-globin gene, leading to the production of the abnormal hemoglobin S (HbS). HbS polymerization in deoxygenated condition induces the sickling of red blood cells (RBCs), which become less deformable and more fragile, and thus prone to lysis. In addition to anemia, SCD patients may exhibit a plethora of clinical manifestations ranging from acute complications such as the frequent and debilitating painful vaso-occlusive crisis to chronic end organ damages. Several interrelated pathophysiological processes have been described, including impaired blood rheology, increased blood cell adhesion, coagulation, inflammation and enhanced oxidative stress among others. During the last two decades, it has been shown that extracellular vesicles (EVs), defined as cell-derived anucleated particles delimited by a lipid bilayer, and comprising small EVs (sEVs) and medium/large EVs (m/lEVs); are not only biomarkers but also subcellular actors in SCD pathophysiology. Plasma concentration of m/lEVs, originated mainly from RBCs and platelets (PLTs) but also from the other blood cell types, is higher in SCD patients than in healthy controls. The concentration and the density of externalized phosphatidylserine of those released from RBCs may vary according to clinical status (crisis vs. steady state) and treatment (hydroxyurea). Besides their procoagulant properties initially described, RBC-m/lEVs may promote inflammation through their effects on monocytes/macrophages and endothelial cells. Although less intensely studied, sEVs plasma concentration is increased in SCD and these EVs may cause endothelial damages. In addition, sEVs released from activated PLTs trigger PLT-neutrophil aggregation involved in lung vaso-occlusion in sickle mice. Altogether, these data clearly indicate that EVs are both biomarkers and bio-effectors in SCD, which deserve further studies.
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Affiliation(s)
- Elie Nader
- Laboratoire Inter-Universitaire de Biologie de la Motricité EA7424, Team "Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge, PRES Sorbonne, Paris, France
| | - Yohann Garnier
- Laboratoire d'Excellence du Globule Rouge, PRES Sorbonne, Paris, France.,Université des Antilles, UMR_S1134, BIGR, Pointe-à-Pitre, France.,Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France
| | - Philippe Connes
- Laboratoire Inter-Universitaire de Biologie de la Motricité EA7424, Team "Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge, PRES Sorbonne, Paris, France
| | - Marc Romana
- Laboratoire d'Excellence du Globule Rouge, PRES Sorbonne, Paris, France.,Université des Antilles, UMR_S1134, BIGR, Pointe-à-Pitre, France.,Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France
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5
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Connes P, Möckesch B, Tudor Ngo Sock E, Hardy-Dessources MD, Reminy K, Skinner S, Billaud M, Nader E, Tressieres B, Etienne-Julan M, Guillot N, Lemonne N, Hue O, Romana M, Antoine-Jonville S. Oxidative stress, inflammation, blood rheology, and microcirculation in adults with sickle cell disease: Effects of hydroxyurea treatment and impact of sickle cell syndrome. Eur J Haematol 2021; 106:800-807. [PMID: 33629431 DOI: 10.1111/ejh.13607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 12/16/2022]
Abstract
Inflammation and oxidative stress play a key role in the pathophysiology of sickle cell disease (SCD). However, the potential influence of different sickle genotypes, or hydroxyurea (HU) treatment, on these factors remains poorly documented. The present study compared several plasma markers of inflammation and oxidative stress, as well as microvascular function, between patients with sickle SC disease (HbSC, n = 19) and patients with sickle cell anemia (HbSS) under hydroxyurea (HU) treatment (n = 16), or not (n = 13). Hemorheological parameters and levels of inflammatory (IL-6, IL-8, IFN-γ, MCP-1, MIP-1β, TNF-α) and oxidative stress (AOPP, MDA, MPO) markers were determined. Peripheral microcirculatory cutaneous blood flow and immediate microvascular response to local heat were evaluated using laser Doppler flowmetry. Oxidative stress and inflammation were lower in HbSC patients and HbSS patients under HU therapy compared to HbSS patients not treated with HU. Blood viscosity was higher in HbSC than in HbSS patients treated with or not with HU. Vasodilation response of the cutaneous microcirculation to heat stress was higher in HbSS patients receiving HU treatment. Our results clearly established that both sickle cell genotype and HU treatment modulate inflammation and oxidative stress.
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Affiliation(s)
- Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Lyon 1 (COMUE Lyon), Equipe "Biologie Vasculaire et du Globule Rouge", Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Berenike Möckesch
- EA "ACTES": Adaptation, Climat Tropical, Exercice et Santé, Université des Antilles, Pointe-à-Pitre, France
| | - Emilienne Tudor Ngo Sock
- EA "ACTES": Adaptation, Climat Tropical, Exercice et Santé, Université des Antilles, Pointe-à-Pitre, France
| | - Marie-Dominique Hardy-Dessources
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, UMR_S1134, BIGR Inserm, Pointe-à-Pitre, France.,Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France
| | - Karen Reminy
- EA "ACTES": Adaptation, Climat Tropical, Exercice et Santé, Université des Antilles, Pointe-à-Pitre, France
| | - Sarah Skinner
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Lyon 1 (COMUE Lyon), Equipe "Biologie Vasculaire et du Globule Rouge", Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Marie Billaud
- Unité Transversale de la Drépanocytose, CHU de la Guadeloupe, Pointe-à-Pitre, France
| | - Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Lyon 1 (COMUE Lyon), Equipe "Biologie Vasculaire et du Globule Rouge", Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Benoit Tressieres
- Centre d'Investigation Clinique Antilles Guyane, Pointe-à-Pitre, France
| | - Maryse Etienne-Julan
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, UMR_S1134, BIGR Inserm, Pointe-à-Pitre, France.,Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Unité Transversale de la Drépanocytose, CHU de la Guadeloupe, Pointe-à-Pitre, France
| | - Nicolas Guillot
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Lyon 1 (COMUE Lyon), Equipe "Biologie Vasculaire et du Globule Rouge", Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Nathalie Lemonne
- Unité Transversale de la Drépanocytose, CHU de la Guadeloupe, Pointe-à-Pitre, France
| | - Olivier Hue
- EA "ACTES": Adaptation, Climat Tropical, Exercice et Santé, Université des Antilles, Pointe-à-Pitre, France
| | - Marc Romana
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, UMR_S1134, BIGR Inserm, Pointe-à-Pitre, France.,Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France
| | - Sophie Antoine-Jonville
- EA "ACTES": Adaptation, Climat Tropical, Exercice et Santé, Université des Antilles, Pointe-à-Pitre, France.,Université d'Avignon, LAPEC EA4278, Avignon, France
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6
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Vona R, Sposi NM, Mattia L, Gambardella L, Straface E, Pietraforte D. Sickle Cell Disease: Role of Oxidative Stress and Antioxidant Therapy. Antioxidants (Basel) 2021; 10:antiox10020296. [PMID: 33669171 PMCID: PMC7919654 DOI: 10.3390/antiox10020296] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022] Open
Abstract
Sickle cell disease (SCD) is the most common hereditary disorder of hemoglobin (Hb), which affects approximately a million people worldwide. It is characterized by a single nucleotide substitution in the β-globin gene, leading to the production of abnormal sickle hemoglobin (HbS) with multi-system consequences. HbS polymerization is the primary event in SCD. Repeated polymerization and depolymerization of Hb causes oxidative stress that plays a key role in the pathophysiology of hemolysis, vessel occlusion and the following organ damage in sickle cell patients. For this reason, reactive oxidizing species and the (end)-products of their oxidative reactions have been proposed as markers of both tissue pro-oxidant status and disease severity. Although more studies are needed to clarify their role, antioxidant agents have been shown to be effective in reducing pathological consequences of the disease by preventing oxidative damage in SCD, i.e., by decreasing the oxidant formation or repairing the induced damage. An improved understanding of oxidative stress will lead to targeted antioxidant therapies that should prevent or delay the development of organ complications in this patient population.
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Affiliation(s)
- Rosa Vona
- Biomarkers Unit, Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (R.V.); (N.M.S.); (L.G.)
| | - Nadia Maria Sposi
- Biomarkers Unit, Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (R.V.); (N.M.S.); (L.G.)
| | - Lorenza Mattia
- Department of Clinical and Molecular Medicine, “La Sapienza” University, 00161 Rome, Italy;
- Endocrine-Metabolic Unit, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Lucrezia Gambardella
- Biomarkers Unit, Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (R.V.); (N.M.S.); (L.G.)
| | - Elisabetta Straface
- Biomarkers Unit, Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (R.V.); (N.M.S.); (L.G.)
- Correspondence: ; Tel.: +39-064-990-2443; Fax: +39-064-990-3690
| | - Donatella Pietraforte
- Core Facilities, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy;
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7
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Gbotosho OT, Kapetanaki MG, Kato GJ. The Worst Things in Life are Free: The Role of Free Heme in Sickle Cell Disease. Front Immunol 2021; 11:561917. [PMID: 33584641 PMCID: PMC7873693 DOI: 10.3389/fimmu.2020.561917] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022] Open
Abstract
Hemolysis is a pathological feature of several diseases of diverse etiology such as hereditary anemias, malaria, and sepsis. A major complication of hemolysis involves the release of large quantities of hemoglobin into the blood circulation and the subsequent generation of harmful metabolites like labile heme. Protective mechanisms like haptoglobin-hemoglobin and hemopexin-heme binding, and heme oxygenase-1 enzymatic degradation of heme limit the toxicity of the hemolysis-related molecules. The capacity of these protective systems is exceeded in hemolytic diseases, resulting in high residual levels of hemolysis products in the circulation, which pose a great oxidative and proinflammatory risk. Sickle cell disease (SCD) features a prominent hemolytic anemia which impacts the phenotypic variability and disease severity. Not only is circulating heme a potent oxidative molecule, but it can act as an erythrocytic danger-associated molecular pattern (eDAMP) molecule which contributes to a proinflammatory state, promoting sickle complications such as vaso-occlusion and acute lung injury. Exposure to extracellular heme in SCD can also augment the expression of placental growth factor (PlGF) and interleukin-6 (IL-6), with important consequences to enthothelin-1 (ET-1) secretion and pulmonary hypertension, and potentially the development of renal and cardiac dysfunction. This review focuses on heme-induced mechanisms that are implicated in disease pathways, mainly in SCD. A special emphasis is given to heme-induced PlGF and IL-6 related mechanisms and their role in SCD disease progression.
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Affiliation(s)
- Oluwabukola T. Gbotosho
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Maria G. Kapetanaki
- Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Gregory J. Kato
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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8
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Nader E, Romana M, Guillot N, Fort R, Stauffer E, Lemonne N, Garnier Y, Skinner SC, Etienne-Julan M, Robert M, Gauthier A, Cannas G, Antoine-Jonville S, Tressières B, Hardy-Dessources MD, Bertrand Y, Martin C, Renoux C, Joly P, Grau M, Connes P. Association Between Nitric Oxide, Oxidative Stress, Eryptosis, Red Blood Cell Microparticles, and Vascular Function in Sickle Cell Anemia. Front Immunol 2020; 11:551441. [PMID: 33250889 PMCID: PMC7672038 DOI: 10.3389/fimmu.2020.551441] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022] Open
Abstract
Chronic hemolysis, enhanced oxidative stress, and decreased nitric oxide (NO) bioavailability promote vasculopathy in sickle cell anemia (SCA). Oxidative stress and NO are known to modulate eryptosis in healthy red blood cells (RBCs); however, their role in SCA eryptosis and their impact on the genesis of RBC-derived microparticles (RBC-MPs) remains poorly described. RBC-MPs could play a role in vascular dysfunction in SCA. The aims of this study were to evaluate the roles of oxidative stress and NO in eryptosis and RBC-MPs release, and to determine whether RBC-MPs could be involved in vascular dysfunction in SCA. Markers of eryptosis and oxidative stress, plasma RBC-MPs concentration and arterial stiffness were compared between SCA and healthy (AA) individuals. In-vitro experiments were performed to test: 1) the effects of oxidative stress (antioxidant: n-acetylcysteine (NAC); pro-oxidant: cumene hydroperoxide) and NO (NO donor: sodium nitroprusside (SNP); NO-synthase inhibitor (L-NIO)) on eryptosis, RBC deformability and RBC-MP genesis; 2) the effects of SCA/AA-RBC-MPs on human aortic endothelial cell (HAEC) inflammatory phenotype and TLR4 pathway. Eryptosis, RBC-MPs, oxidative stress and arterial stiffness were increased in SCA. NAC increased RBC deformability and decreased eryptosis and RBC-MPs release, while cumene did the opposite. SNP increased RBC deformability and limited eryptosis, but had no effect on RBC-MPs. L-NIO did not affect these parameters. Arterial stiffness was correlated with RBC-MPs concentration in SCA. RBC-MPs isolated directly from SCA blood increased adhesion molecules expression and the production of cytokines by HAEC compared to those isolated from AA blood. TLR4 inhibition alleviated these effects. Our data show that oxidative stress could promote eryptosis and the release of RBC-MPs that are potentially involved in macrovascular dysfunction in SCA.
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Affiliation(s)
- Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Marc Romana
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, Pointe-à-Pitre, France.,Université de Paris, Paris, France
| | - Nicolas Guillot
- Laboratoire Carmen Inserm, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France
| | - Romain Fort
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Emeric Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Nathalie Lemonne
- Unité Transversale de la Drépanocytose, Hôpital de Pointe-á-Pitre, Hôpital Ricou, Guadeloupe, France
| | - Yohann Garnier
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, Pointe-à-Pitre, France.,Université de Paris, Paris, France
| | - Sarah Chambers Skinner
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Maryse Etienne-Julan
- Unité Transversale de la Drépanocytose, Hôpital de Pointe-á-Pitre, Hôpital Ricou, Guadeloupe, France
| | | | - Alexandra Gauthier
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Giovanna Cannas
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | - Benoît Tressières
- Centre Investigation Clinique Antilles Guyane, 1424 Inserm, Academic Hospital of Pointe-á-Pitre, Pointe-á-Pitre, Guadeloupe, France
| | - Marie-Dominique Hardy-Dessources
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, Pointe-à-Pitre, France.,Université de Paris, Paris, France
| | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Cyril Martin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies érythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies érythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Marijke Grau
- Molecular and Cellular Sport Medicine, Deutsche Sporthochschule Köln, Köln, Germany
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France, Paris, France
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9
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Gueye Tall F, Martin C, Ndour EHM, Faes C, Déme Ly I, Pialoux V, Connes P, Gueye PM, Ndiaye Diallo R, Renoux C, Diagne I, Diop PA, Cissé A, Sall PL, Joly P. Influence of Oxidative Stress Biomarkers and Genetic Polymorphisms on the Clinical Severity of Hydroxyurea-Free Senegalese Children with Sickle Cell Anemia. Antioxidants (Basel) 2020; 9:antiox9090863. [PMID: 32937882 PMCID: PMC7555380 DOI: 10.3390/antiox9090863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/16/2022] Open
Abstract
Oxidative stress would play a role in the pathophysiology of sickle cell anemia (SCA). We tested the impact of common SCA genetic modifiers (alpha-thalassemia, G6PD deficiency, HbF quantitative trait loci; QTL) and pro/antioxidant genes polymorphisms (SOD2 rs4880, XO rs207454, MPO rs233322) on oxidative stress biomarkers (AOPP, MDA, MPO, XO, MnSOD, CAT, GPx) and clinical severity in 301 Senegalese SCA hydroxyurea-free children at steady-state (median age 9.1 years, sex ratio H/F = 1.3). Plasma oxidative stress biomarkers were compared with those of a control group (AA). CAT activity, AOPP, and MDA levels were higher in SCA than in AA individuals while XO, GPX, and MnSOD activities were lower. The presence of alpha-thalassemia decreased MDA level and MPO activity but no effect of the HbF QTL or G6PD deficiency was observed. SCA children who experienced their first hospitalized complication before 3 years old had higher MnSOD and CAT activities than the other children while those with no hospitalized VOC in the previous 2 years presented higher GPX activity. Age of the first hospitalized complication and AOPP levels were affected by the MPO rs2333227 SNP. Our results suggest that alpha-thalassemia modulates oxidative stress in SCA, presumably because of a reduction in the MPO activity.
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Affiliation(s)
- Fatou Gueye Tall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Cyril Martin
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
| | - El hadji Malick Ndour
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Camille Faes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
| | - Indou Déme Ly
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
- Service Universitaire de Pédiatrie-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal;
| | - Vincent Pialoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
| | - Papa Madieye Gueye
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Rokhaya Ndiaye Diallo
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- UF Biochimie des Pathologies Erythrocytaires, Laboratoire de Biochimie et Biologie Moleculaire Grand-Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 69500 Bron, France
| | - Ibrahima Diagne
- Service Universitaire de Pédiatrie-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal;
- UFR des Sciences de la Santé–Universite Gaston Berger, Saint-Louis 32002, Senegal
| | - Pape Amadou Diop
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Aynina Cissé
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Philomène Lopez Sall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
- UF Biochimie des Pathologies Erythrocytaires, Laboratoire de Biochimie et Biologie Moleculaire Grand-Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 69500 Bron, France
- Correspondence:
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11
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Bolarinwa AB, Oduwole O, Okebe J, Ogbenna AA, Otokiti OE, Olatinwo AT. Antioxidant supplementation for sickle cell disease. Hippokratia 2020. [DOI: 10.1002/14651858.cd013590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Abiola B Bolarinwa
- Department of Haematology & Blood Transfusion Medicine; Lagos University Teaching Hospital; Lagos Nigeria
| | - Olabisi Oduwole
- Department of Medical Laboratory Science; Achievers University; Owo Nigeria
| | - Joseph Okebe
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine; Banjul Gambia
| | - Ann A Ogbenna
- Department of Haematology & Blood Transfusion Medicine; College of Medicine, University of Lagos; Lagos Nigeria
| | - Oluwakemi E Otokiti
- Department of Haematology & Blood Transfusion Medicine; Lagos University Teaching Hospital; Lagos Nigeria
| | - Adejoke T Olatinwo
- Department of Haematology & Blood Transfusion; Lagos University Teaching Hospital; Lagos Nigeria
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12
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Nader E, Romana M, Connes P. The Red Blood Cell-Inflammation Vicious Circle in Sickle Cell Disease. Front Immunol 2020; 11:454. [PMID: 32231672 PMCID: PMC7082402 DOI: 10.3389/fimmu.2020.00454] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/27/2020] [Indexed: 12/31/2022] Open
Abstract
Sickle cell disease (SCD) is a genetic disease caused by a single mutation in the β-globin gene, leading to the production of an abnormal hemoglobin called hemoglobin S (HbS), which polymerizes under deoxygenation, and induces the sickling of red blood cells (RBCs). Sickled RBCs are very fragile and rigid, and patients consequently become anemic and develop frequent and recurrent vaso-occlusive crises. However, it is now evident that SCD is not only a RBC rheological disease. Accumulating evidence shows that SCD is also characterized by the presence of chronic inflammation and oxidative stress, participating in the development of chronic vasculopathy and several chronic complications. The accumulation of hemoglobin and heme in the plasma, as a consequence of enhanced intravascular hemolysis, decreases nitric oxide bioavailability and enhances the production of reactive oxygen species (ROS). Heme and hemoglobin also represent erythrocytic danger-associated molecular pattern molecules (eDAMPs), which may activate endothelial inflammation through TLR-4 signaling and promote the development of complications, such as acute chest syndrome. It is also suspected that heme may activate the innate immune complement system and stimulate neutrophils to release neutrophil extracellular traps. A large amount of microparticles (MPs) from various cellular origins (platelets, RBCs, white blood cells, endothelial cells) is also released into the plasma of SCD patients and participate in the inflammation and oxidative stress in SCD. In turn, this pro-inflammatory and oxidative stress environment further alters the RBC properties. Increased pro-inflammatory cytokine concentrations promote the activation of RBC NADPH oxidase and, thus, raise the production of intra-erythrocyte ROS. Such enhanced oxidative stress causes deleterious damage to the RBC membrane and further alters the deformability of the cells, modifying their aggregation properties. These RBC rheological alterations have been shown to be associated to specific SCD complications, such as leg ulcers, priapism, and glomerulopathy. Moreover, RBCs positive for the Duffy antigen receptor for chemokines may be very sensitive to various inflammatory molecules that promote RBC dehydration and increase RBC adhesiveness to the vascular wall. In summary, SCD is characterized by a vicious circle between abnormal RBC rheology and inflammation, which modulates the clinical severity of patients.
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Affiliation(s)
- Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Marc Romana
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, UMR_S1134, BIGR, Pointe-à-Pitre, France.,Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
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13
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Öztaş Y, Boşgelmez İİ. Oxidative stress in sickle cell disease and emerging roles for antioxidants in treatment strategies. Pathology 2020. [DOI: 10.1016/b978-0-12-815972-9.00006-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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14
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Caprari P, Massimi S, Diana L, Sorrentino F, Maffei L, Materazzi S, Risoluti R. Hemorheological Alterations and Oxidative Damage in Sickle Cell Anemia. Front Mol Biosci 2019; 6:142. [PMID: 31867341 PMCID: PMC6904369 DOI: 10.3389/fmolb.2019.00142] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/20/2019] [Indexed: 01/21/2023] Open
Abstract
Sickle cell anemia (SCA) is the most common hereditary disorder of hemoglobin (Hb) characterized by a mutation in the β globin gene, which leads to synthesis of HbS a hemoglobin which, under hypoxic conditions, gels and leading to the sickling of the red blood cells (RBC). The dehydration of the RBC increases the concentration of the intracellular Hb with an increase in the internal viscosity and consequently a decrease in the erythrocyte deformability. Sickle red blood cells due to their difficulty to flow through the microcirculation cause frequent vaso-occlusive episodes, tissue ischemia, and infarctions. Moreover, the reduced RBC deformability causes cell fragility leading to hemolysis and recently a key role of hemolysis and oxidative stress in the development of vascular dysfunction has been demonstrated. The aim of this study was to evaluate the hemorheological profiles of patients with SCA in order to point out new indices of vascular impairment, and to characterize the membrane oxidative damage of sickled RBC. Blood viscosities, erythrocyte aggregation, and viscoelastic profiles of SCA patients were determined, and the RBC oxidative damage was investigated by comparing metabolic capability and RBC membrane proteins from SCA patients with and without transfusion dependence. The hemorheological profile of SCA subjects demonstrated high blood viscosity, increased RBC aggregation, and decreased RBC deformability. These impaired flow properties were associated with RBC membrane protein oxidation, with degradation of spectrin and increased membrane-bound globin. The comparison between SCA patients with and without transfusion dependence showed metabolic and structural RBC oxidative damage significantly different.
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Affiliation(s)
- Patrizia Caprari
- National Centre for the Control and Evaluation of Medicine, IstitutoSuperiore di Sanità, Rome, Italy
| | - Sara Massimi
- National Centre for the Control and Evaluation of Medicine, IstitutoSuperiore di Sanità, Rome, Italy
| | - Loretta Diana
- National Centre for the Control and Evaluation of Medicine, IstitutoSuperiore di Sanità, Rome, Italy
| | | | - Laura Maffei
- Thalassemia Unit, S. Eugenio Hospital, Rome, Italy
| | | | - Roberta Risoluti
- Department of Chemistry, Sapienza University of Rome, Rome, Italy
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15
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Nader E, Skinner S, Romana M, Fort R, Lemonne N, Guillot N, Gauthier A, Antoine-Jonville S, Renoux C, Hardy-Dessources MD, Stauffer E, Joly P, Bertrand Y, Connes P. Blood Rheology: Key Parameters, Impact on Blood Flow, Role in Sickle Cell Disease and Effects of Exercise. Front Physiol 2019; 10:1329. [PMID: 31749708 PMCID: PMC6842957 DOI: 10.3389/fphys.2019.01329] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/04/2019] [Indexed: 01/07/2023] Open
Abstract
Blood viscosity is an important determinant of local flow characteristics, which exhibits shear thinning behavior: it decreases exponentially with increasing shear rates. Both hematocrit and plasma viscosity influence blood viscosity. The shear thinning property of blood is mainly attributed to red blood cell (RBC) rheological properties. RBC aggregation occurs at low shear rates, and increases blood viscosity and depends on both cellular (RBC aggregability) and plasma factors. Blood flow in the microcirculation is highly dependent on the ability of RBC to deform, but RBC deformability also affects blood flow in the macrocirculation since a loss of deformability causes a rise in blood viscosity. Indeed, any changes in one or several of these parameters may affect blood viscosity differently. Poiseuille's Law predicts that any increase in blood viscosity should cause a rise in vascular resistance. However, blood viscosity, through its effects on wall shear stress, is a key modulator of nitric oxide (NO) production by the endothelial NO-synthase. Indeed, any increase in blood viscosity should promote vasodilation. This is the case in healthy individuals when vascular function is intact and able to adapt to blood rheological strains. However, in sickle cell disease (SCD) vascular function is impaired. In this context, any increase in blood viscosity can promote vaso-occlusive like events. We previously showed that sickle cell patients with high blood viscosity usually have more frequent vaso-occlusive crises than those with low blood viscosity. However, while the deformability of RBC decreases during acute vaso-occlusive events in SCD, patients with the highest RBC deformability at steady-state have a higher risk of developing frequent painful vaso-occlusive crises. This paradox seems to be due to the fact that in SCD RBC with the highest deformability are also the most adherent, which would trigger vaso-occlusion. While acute, intense exercise may increase blood viscosity in healthy individuals, recent works conducted in sickle cell patients have shown that light cycling exercise did not cause dramatic changes in blood rheology. Moreover, regular physical exercise has been shown to decrease blood viscosity in sickle cell mice, which could be beneficial for adequate blood flow and tissue perfusion.
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Affiliation(s)
- Elie Nader
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Sarah Skinner
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Marc Romana
- Laboratory of Excellence GR-Ex, Paris, France.,Biologie Intégrée du Globule Rouge, Université de Paris, UMR_S1134, BIGR, INSERM, F-75015, Paris, France.,Biologie Intégrée du Globule Rouge, The Université des Antilles, UMR_S1134, BIGR, F- 97157, Pointe-a-Pitre, France
| | - Romain Fort
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Département de Médecine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Nathalie Lemonne
- Unité Transversale de la Drépanocytose, Hôpital de Pointe-a-Pitre, Hôpital Ricou, Pointe-a-Pitre, France
| | - Nicolas Guillot
- Laboratoire Carmen INSERM 1060, INSA Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France
| | - Alexandra Gauthier
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | | | - Céline Renoux
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Laboratoire de Biochimie et de Biologie Moleìculaire, UF de Biochimie des Pathologies Eìrythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Marie-Dominique Hardy-Dessources
- Laboratory of Excellence GR-Ex, Paris, France.,Biologie Intégrée du Globule Rouge, Université de Paris, UMR_S1134, BIGR, INSERM, F-75015, Paris, France.,Biologie Intégrée du Globule Rouge, The Université des Antilles, UMR_S1134, BIGR, F- 97157, Pointe-a-Pitre, France
| | - Emeric Stauffer
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Philippe Joly
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France.,Laboratoire de Biochimie et de Biologie Moleìculaire, UF de Biochimie des Pathologies Eìrythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Yves Bertrand
- d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Philippe Connes
- Laboratory LIBM EA7424, Team "Vascular Biology and Red Blood Cell", University of Lyon 1, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
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Connes P, Renoux C, Romana M, Abkarian M, Joly P, Martin C, Hardy-Dessources MD, Ballas SK. Blood rheological abnormalities in sickle cell anemia. Clin Hemorheol Microcirc 2018; 68:165-172. [PMID: 29614630 DOI: 10.3233/ch-189005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This review focuses on the contribution of abnormal blood rheology in the pathophysiology of sickle cell anemia (SCA). SCA is characterized by a reduction of red blood cell (RBC) deformability but this reduction is very heterogeneous among patients. Recent works have shown that patients with the lowest RBC deformability (measured by ektacytometry) have enhanced hemolysis and would be more prone to develop several complications such as priapism, leg ulcers and glomerulopathy. In contrast, patients with the highest deformability, and not under hydroxyurea therapy, seem to develop more frequently vaso-occlusive like events. Although less studied, RBC aggregation properties are very different between SCA and healthy individuals and it was demonstrated that increased RBC aggregates strength could be involved in some complications. Finally, several studies have established that the vascular system of SCA patients could not fully compensate any increase in blood viscosity because of the loss of vascular reactivity, which may result in vaso-occlusive crises.
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Affiliation(s)
- Philippe Connes
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Institut Universitaire de France, Paris, France
| | - Céline Renoux
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Laboratoire de biochimie des pathologies érythrocytaires, Centre de Biologie Est, Hospices Civils de Lyon, France
| | - Marc Romana
- Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-à-Pitre, 97157 Pointe-à-Pitre, Guadeloupe
| | - Manouk Abkarian
- CNRS UMR 5048, Université de Montpellier, Centre de Biochimie Structurale, 34090 Montpellier, France
| | - Philippe Joly
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Laboratoire de biochimie des pathologies érythrocytaires, Centre de Biologie Est, Hospices Civils de Lyon, France
| | - Cyril Martin
- Laboratoire LIBM EA7424, Team"Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, 69100 Villeurbanne, France.,Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France
| | - Marie-Dominique Hardy-Dessources
- Laboratory of Excellence GR-Ex « The red cell: from genesis to death », PRES Sorbonne Paris Cité, 75015, Paris, France.,Inserm UMR 1134, Hôpital Ricou, CHU de Pointe-à-Pitre, 97157 Pointe-à-Pitre, Guadeloupe
| | - Samir K Ballas
- Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Renoux C, Joly P, Faes C, Mury P, Eglenen B, Turkay M, Yavas G, Yalcin O, Bertrand Y, Garnier N, Cuzzubbo D, Gauthier A, Romana M, Möckesch B, Cannas G, Antoine-Jonville S, Pialoux V, Connes P. Association between Oxidative Stress, Genetic Factors, and Clinical Severity in Children with Sickle Cell Anemia. J Pediatr 2018; 195:228-235. [PMID: 29449005 DOI: 10.1016/j.jpeds.2017.12.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/13/2017] [Accepted: 12/08/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To investigate the associations between several sickle cell disease genetic modifiers (beta-globin haplotypes, alpha-thalassemia, and glucose-6-phosphate dehydrogenase deficiency) and the level of oxidative stress and to evaluate the association between oxidative stress and the rates of vaso-occlusive events. STUDY DESIGN Steady-state oxidative and nitrosative stress markers, biological variables, genetic modulators, and vaso-occlusive crisis events requiring emergency admissions were measured during a 2-year period in 62 children with sickle cell anemia (58 SS and 4 Sβ0). Twelve ethnic-matched children without sickle cell anemia also participated as healthy controls (AA) for oxidative and nitrosative stress level measurement. RESULTS Oxidative and nitrosative stress were greater in patients with sickle cell anemia compared with control patients, but the rate of vaso-occlusive crisis events in sickle cell anemia was not associated with the level of oxidative stress. The presence of alpha-thalassemia, but not glucose-6-phosphate dehydrogenase deficiency or beta-globin haplotype, modulated the level of oxidative stress in children with sickle cell anemia. CONCLUSION Mild hemolysis in children with alpha-thalassemia may limit oxidative stress and could explain the protective role of alpha-thalassemia in hemolysis-related sickle cell complications.
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Affiliation(s)
- Céline Renoux
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Department of Biochemistry on Red Blood Cell Disease, Biologie Est Center, Hospices Civils de Lyon, Lyon, France
| | - Philippe Joly
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Department of Biochemistry on Red Blood Cell Disease, Biologie Est Center, Hospices Civils de Lyon, Lyon, France
| | - Camille Faes
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Pauline Mury
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Buse Eglenen
- School of Medicine, Koç University, Istanbul, Turkey
| | - Mine Turkay
- School of Medicine, Koç University, Istanbul, Turkey
| | - Gokce Yavas
- School of Medicine, Koç University, Istanbul, Turkey
| | - Ozlem Yalcin
- School of Medicine, Koç University, Istanbul, Turkey
| | - Yves Bertrand
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Nathalie Garnier
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Daniela Cuzzubbo
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Alexandra Gauthier
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, Lyon, France
| | - Marc Romana
- Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; UMR Inserm 1134, Ricou Hospital, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe
| | - Berenike Möckesch
- Laboratory ACTES EA3596, University of French West Indies, Pointe-à-Pitre, Guadeloupe
| | - Giovanna Cannas
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; Internal Medicine, Hématology, Edouard Herriot Hospital, Lyon, France
| | | | - Vincent Pialoux
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; French University Institute (IUF), Paris, France
| | - Philippe Connes
- Inter-University Laboratory of Human Movement Biology (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Team, University Claude Bernard Lyon, Villeurbanne, France; Laboratory of Excellence on Red Blood Cell (Labex GR-Ex), PRES Sorbonne, Paris, France; French University Institute (IUF), Paris, France.
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