Studies on calcium transport and calcium-dependent adenosine triphosphatase activity of erythrocyte membranes in hereditary spherocytosis

Ca2+ influx in normal and spherocytic red cells

The influx of 45Ca2+ into normal red cells and various types of spherocytic red cells was studied after blocking active Ca2+ extrusion by vanadate. The measurements were performed with and without verapamil, a calcium antagonist. The influx of Ca2+ into red cells from unsplenectomized persons was 22 +/- 7 mumol/l packed red cells/h (mean +/- SD), and 17 +/- 7 mumol/l per h when incubated with verapamil. The influx of Ca2+ into red cells from four splenectomized normal controls was of the same magnitude as in the unsplenectomized controls but there was no effect of verapamil on the influx rate. The influx of Ca2+ into red cells from nine splenectomized patients with hereditary spherocytosis (HS) was 27 +/- 9 mumol/l per h without and 24 +/- 9 mumol/l per h with verapamil. In 9 normal red cell samples made spherocytic by thermal damage the corresponding values were 32 +/- 16 and 31 +/- 19 mumol/l per h, respectively. The uptake of Ca2+ in chlorpromazine-induced spherocytic red cells was 20 +/- 4 mumol/l per h without and 19 +/- 5 mumol/l per h with verapamil in 9 experiments. These results indicate that although in HS erythrocytes changes in the cell membrane lead to an increased Ca2+ influx, the slow calcium channels are not affected, whereas in spherocytes induced by thermal damage or by incubation with chlorpromazine the channels are blocked, at least partly.

Increased calcium uptake in the red cells of unsplenectomized patients with hereditary spherocytosis: significant contribution of reticulocytosis

The presence of abnormal calcium (Ca) metabolism in the red cells of hereditary spherocytosis (HS) patients has long been in dispute. Thus, to clarify the discrepancies of experimental results published previously, Ca metabolism in the red cells was investigated in 12 unsplenectomized and 6 splenectomized HS patients. A marked increase of Ca uptake was observed in the ATP-depleted red cells of the unsplenectomized HS patients. The increased red cell Ca uptake was normalized after splenectomy in the same HS patients. The extent of increased Ca uptake was well correlated to the degree of reticulocytosis (p less than 0.001). The observation was confirmed by the fractionation studies of the HS red cells. Ca uptake was not increased in the spherocyte-rich bottom fraction, if reticulocytosis was not present. No significant difference was observed in red cell calcium content between normal and HS patients, neither unsplenectomized nor splenectomized.

The molecular basis of the defect in phosphorylation of spectrin in human hereditary spherocytosis

The molecular basis for the depressed phosphorylation of the smaller polypeptide of spectrin (band 2) in the erythrocytes of patients suffering from hereditary spherocytosis is investigated. Comparison of healthy and spherocytic spectrin polypeptides by controlled proteolysis reveals no abnormality in the degradation pattern or in the sites of phosphorylation. It is concluded that the lesion is a consequence of a defective control of phosphorylation. The defect can be mimicked in healthy cells by the introduction of calcium into the erythrocyte and the possibility that the primary pathological lesion is a deficient control of the calcium content of the erythrocyte is discussed.

Inherited disorders of the red cell membrane skeleton

Current knowledge of red cell membrane structure and function are briefly presented, and the pathophysiology, diagnosis, and treatment of hereditary spherocytosis, hereditary elliptocytosis, and hereditary pyropoikilocytosis are discussed.

Red cell membrane protein phosphorylation in hemolytic anemias and muscular dystrophies

We review our current understanding of membrane phosphorylation in normal and abnormal erythrocytes. The major phosphoproteins in red blood cell (RBC) membranes are spectrin (band 2), bands 3, 2.1, and 4.5, and glycophorin A. At least two protein kinases can be distinguished on the basis of their stimulation by cyclic AMP and salt; they are present both in the membrane and in the cytosol. Analysis of the conflicting data on endogenous membrane-protein phosphorylation in abnormal RBCs indicates a considerable variability of phosphorylation rates which largely depends on the manner of preparation of ghosts and enzyme assay conditions. This variability reflects differences in the partitioning of protein kinases between the membrane and cytosol, the specificity and accessibility of membrane-protein substrates, and reaction kinetics. We select examples of data from several hemolytic anemias to illustrate that precautions are needed to interpret abnormalities of membrane-protein phosphorylation properly; we discuss possible new methodological approaches.

Calcium transport and adenosine triphosphatase activities of erythrocyte membranes in congenital spherocytosis

Calcium transport from red cells was measured in seventeen patients with congenital or hereditary spherocytosis (HS). The efflux remained at a lower level in resealed ghost cells of patients than in normal cells both in the presence and absence of adenosine triphosphate (ATP). We studied the activities of Ca2+,Mg2+-ATPase, ouabain-sensitive Na+,K+-ATPase, Mg2+-ATPase and Ca2+-(spectrin-)ATPase in cell membranes prepared by washing the cells with hypotonic medium. The mean +/-SD Ca2+,Mg2+-ATPase/Mg2+-ATPase of HS patients was 3.34 +/- 1.06, and 2.81 +/- 0.42 in control subjects. Na+,K+-ATPase/Mg2+-ATPase was 2.38 +/- 0.38 in HS cells compared to 2.01 +/- 0.41 in normal cells. Ca2+-ATPase/Mg2+-ATPase of HS membranes was 0.57 +/- 0.18 and the control value 0.43 +/- 0.08. These data indicate calcium retention in the erythrocytes of HS patients in spite of increases in Ca2+,Mg2+-ATPase activity in the majority of patients.