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Alexy T, Detterich J, Connes P, Toth K, Nader E, Kenyeres P, Arriola-Montenegro J, Ulker P, Simmonds MJ. Physical Properties of Blood and their Relationship to Clinical Conditions. Front Physiol 2022; 13:906768. [PMID: 35874542 PMCID: PMC9298661 DOI: 10.3389/fphys.2022.906768] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/14/2022] [Indexed: 02/03/2023] Open
Abstract
It has been long known that blood health heavily influences optimal physiological function. Abnormalities affecting the physical properties of blood have been implicated in the pathogenesis of various disorders, although the exact mechanistic links between hemorheology and clinical disease manifestations remain poorly understood. Often overlooked in current medical practice, perhaps due to the promises offered in the molecular and genetic era, the physical properties of blood which remain a valuable and definitive indicator of circulatory health and disease. Bridging this gap, the current manuscript provides an introduction to hemorheology. It reviews the properties that dictate bulk and microcirculatory flow by systematically dissecting the biomechanics that determine the non-Newtonian behavior of blood. Specifically, the impact of hematocrit, the mechanical properties and tendency of red blood cells to aggregate, and various plasma factors on blood viscosity will be examined. Subsequently, the manner in which the physical properties of blood influence hemodynamics in health and disease is discussed. Special attention is given to disorders such as sickle cell disease, emphasizing the clinical impact of severely abnormal blood rheology. This review expands into concepts that are highly topical; the relation between mechanical stress and intracellular homeostasis is examined through a contemporary cell-signaling lens. Indeed, accumulating evidence demonstrates that nitric oxide is not only transported by erythrocytes, but is locally produced by mechanically-sensitive enzymes, which appears to have intracellular and potentially extracellular effects. Finally, given the importance of shear forces in the developing field of mechanical circulatory support, we review the role of blood rheology in temporary and durable mechanical circulatory support devices, an increasingly utilized method of life support. This review thus provides a comprehensive overview for interested trainees, scientists, and clinicians.
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Affiliation(s)
- Tamas Alexy
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, United States
| | - Jon Detterich
- Department of Pediatrics, Division of Cardiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Philippe Connes
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
| | - Kalman Toth
- First Department of Medicine, Division of Cardiology, Medical School, University of Pecs, Pecs, Hungary
| | - Elie Nader
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
| | - Peter Kenyeres
- First Department of Medicine, Division of Cardiology, Medical School, University of Pecs, Pecs, Hungary
| | - Jose Arriola-Montenegro
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, United States
| | - Pinar Ulker
- Department of Physiology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Michael J Simmonds
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
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2
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Luo M, Chen Y, Cheng Y, Li N, Qing H. Association between hematocrit and the 30-day mortality of patients with sepsis: A retrospective analysis based on the large-scale clinical database MIMIC-IV. PLoS One 2022; 17:e0265758. [PMID: 35324947 PMCID: PMC8947025 DOI: 10.1371/journal.pone.0265758] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
This research sought to ascertain the relationship between hematocrit (HCT) and mortality in patients with sepsis. Methods: A retrospective analysis was conducted on the clinical data of septic patients who were hospitalized between 2008 and 2019 in an advanced academic medical center in Boston, Massachusetts, registered in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, We analyzed basic information including gender, age, race, and types of the first admission, laboratory indicators including HCT, platelets, white blood cells, albumin, bilirubin, hemoglobin, and serum creatinine, and 30-day mortality. A Cox proportional hazards regression model was utilized to analyze the relationship between HCT and 30-day mortality in patients with sepsis. Results: This research recruited 2057 patients who met the research requirements from 2008 to 2019. According to the HCT level, it was classified into the low HCT level, the regular HCT level, and the high HCT level. The 30-day mortality rate was 62.6%, 27.5%, and 9.9% for patients with the low HCT level, the regular HCT level, and the high HCT level, respectively (p < 0.05). The multivariate Cox proportional hazard regression model analysis displayed that compared with patients with the regular HCT level, the 30-day mortality of patients with the low HCT level increased by 58.9% (hazard ratio = 1.589, 95% confidence interval (CI) = 1.009–2.979, p < 0.05). Conclusion: The low HCT level is an independent risk factor for the increase of the 30-day mortality in patients with sepsis and can be used as a significant predictor of the clinical outcome of sepsis.
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Affiliation(s)
- Mengdi Luo
- ICU, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
| | - Yang Chen
- ICU, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
| | - Yuan Cheng
- ICU, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
| | - Na Li
- Southwest Jiaotong University, Chengdu, Sichuan, China
| | - He Qing
- ICU, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
- * E-mail:
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Nader E, Nougier C, Boisson C, Poutrel S, Catella J, Martin F, Charvet J, Girard S, Havard‐Guibert S, Martin M, Rezigue H, Desmurs‐Clavel H, Renoux C, Joly P, Guillot N, Bertrand Y, Hot A, Dargaud Y, Connes P. Increased blood viscosity and red blood cell aggregation in patients with COVID-19. Am J Hematol 2022; 97:283-292. [PMID: 34939698 DOI: 10.1002/ajh.26440] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 12/11/2022]
Abstract
The aim of this study was to (1) analyze blood viscosity, red blood cell (RBC) deformability, and aggregation in hospitalized patients with Coronavirus disease 19 (COVID-19); (2) test the associations between impaired blood rheology and blood coagulation; and (3) test the associations between impaired blood rheology and several indicators of clinical severity. A total of 172 patients with COVID-19, hospitalized in COVID-unit of the Internal Medicine Department (Lyon, France) participated in this study between January and May 2021. Clinical parameters were collected for each patient. Routine hematological/biochemical parameters, blood viscosity, RBC deformability and aggregation, and RBC senescence markers were measured on the first day of hospitalization. A control group of 38 healthy individuals was constituted to compare the blood rheological and RBC profile. Rotational thromboelastography was performed in 76 patients to study clot formation dynamics. Our study demonstrated that patients with COVID-19 had increased blood viscosity despite lower hematocrit than healthy individuals, as well as increased RBC aggregation. In-vitro experiments demonstrated a strong contribution of plasma fibrinogen in this RBC hyper-aggregation. RBC aggregation correlated positively with clot firmness, negatively with clot formation time, and positively with the length of hospitalization. Patients with oxygen supplementation had higher RBC aggregation and blood viscosity than those without, and patients with pulmonary lesions had higher RBC aggregation and enhanced coagulation than those without. This study is the first to demonstrate blood hyper-viscosity and RBC hyper-aggregation in a large cohort of patients with COVID-19 and describe associations with enhanced coagulation and clinical outcomes.
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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 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Christophe Nougier
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
| | - Camille Boisson
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est Hospices Civils de Lyon Lyon France
| | - Solene Poutrel
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
| | - Judith Catella
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
| | - Fiona Martin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Juliette Charvet
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Sandrine Girard
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
| | - Salomé Havard‐Guibert
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Marie Martin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Hamdi Rezigue
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
| | - Helene Desmurs‐Clavel
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
- GEMMAT, Groupe d'Etude Multidisciplinaire en Maladies Thrombotiques, Lyon, France 4 Service de Medecine Intensive Reanimation Hopital Edouard Herriot Lyon France
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Biochimie et Biologie Moléculaire, 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 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est Hospices Civils de Lyon Lyon France
| | - Nicolas Guillot
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
| | - Yves Bertrand
- Institut d'Hématologique et d'Oncologique Pédiatrique Hospices Civils de Lyon Lyon France
| | - Arnaud Hot
- Service de Médecine Interne, Hôpital Edouard Herriot Hospices Civils de Lyon Lyon France
| | - Yesim Dargaud
- Laboratoire d'Hématologie, Groupement Hospitalier Est Hospices Civils de Lyon Lyon France
- GEMMAT, Groupe d'Etude Multidisciplinaire en Maladies Thrombotiques, Lyon, France 4 Service de Medecine Intensive Reanimation Hopital Edouard Herriot Lyon France
- Unite d'Hemostase Clinique Hopital Cardiologique Louis Pradel, Lyon, France 6 UR4609 Hemostase & Thrombose Universite Claude Bernard Lyon 1 Lyon France
- UR4609 Hemostase & Thrombose Universite Claude Bernard Lyon 1 Lyon France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell Université Claude Bernard Lyon 1 Villeurbanne France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
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Maruyama T, Hieda M, Mawatari S, Fujino T. Rheological Abnormalities in Human Erythrocytes Subjected to Oxidative Inflammation. Front Physiol 2022; 13:837926. [PMID: 35283782 PMCID: PMC8905344 DOI: 10.3389/fphys.2022.837926] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/31/2022] [Indexed: 12/26/2022] Open
Abstract
Erythrocytes are oxygen carriers and exposed to redox cycle in oxygenation and deoxygenation of hemoglobin. This indicates that circulating erythrocytes are vulnerable to the oxidative injury occurring under the imbalance of redox homeostasis. In this review article, two topics are presented concerning the human erythrocytes exposed to the oxidative inflammation including septic and sterile conditions. First, we demonstrate rheological derangement of erythrocytes subjected to acute oxidative injury caused by exogenous generators of reactive oxygen species (ROS). Erythrocyte filterability as whole-cell deformability has been estimated by the gravity-based nickel mesh filtration technique in our laboratory and was dramatically impaired in a time-dependent manner after starting exposure to the ROS generators, that is associated with concurrent progression of membrane protein degradation, phospholipid peroxidation, erythrocyte swelling, methemoglobin formation, and oxidative hemolysis. Second, we introduce an impairment of erythrocyte filterability confirmed quantitatively in diabetes mellitus and hypertension of animal models and patients under treatment. Among the cell geometry, internal viscosity, and membrane property as the three major determinants of erythrocyte deformability, erythrocyte membrane alteration is supposed to be the primary cause of this impairment in these lifestyle-related diseases associated with persistent oxidative inflammation. Excessive ROS trigger the inflammatory responses and reduce the erythrocyte membrane fluidity. Oxidative inflammation increasing erythrocyte membrane rigidity underlies the impaired systemic microcirculation, which is observed in diabetic and/or hypertensive patients. On the other hand, elevated internal viscosity caused by sickle hemoglobin polymerization is a primary cause of impaired erythrocyte filterability in sickle cell disease (SCD). However, oxidative inflammation is also involved in the pathophysiology of SCD. The physiologic level of ROS acts as signaling molecules for adaptation to oxidative environment, but the pathological level of ROS induces suicidal erythrocyte death (eryptosis). These findings provide further insight into the ROS-related pathophysiology of many clinical conditions.
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Affiliation(s)
- Toru Maruyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Michinari Hieda
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shiro Mawatari
- Institute of Rheological Function of Foods Co., Ltd., Hisayama, Japan
| | - Takehiko Fujino
- Institute of Rheological Function of Foods Co., Ltd., Hisayama, Japan
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5
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Brun JF, Varlet-Marie E, Myzia J, Raynaud de Mauverger E, Pretorius E. Metabolic Influences Modulating Erythrocyte Deformability and Eryptosis. Metabolites 2021; 12:4. [PMID: 35050126 PMCID: PMC8778269 DOI: 10.3390/metabo12010004] [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: 11/29/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 12/17/2022] Open
Abstract
Many factors in the surrounding environment have been reported to influence erythrocyte deformability. It is likely that some influences represent reversible changes in erythrocyte rigidity that may be involved in physiological regulation, while others represent the early stages of eryptosis, i.e., the red cell self-programmed death. For example, erythrocyte rigidification during exercise is probably a reversible physiological mechanism, while the alterations of red blood cells (RBCs) observed in pathological conditions (inflammation, type 2 diabetes, and sickle-cell disease) are more likely to lead to eryptosis. The splenic clearance of rigid erythrocytes is the major regulator of RBC deformability. The physicochemical characteristics of the surrounding environment (thermal injury, pH, osmolality, oxidative stress, and plasma protein profile) also play a major role. However, there are many other factors that influence RBC deformability and eryptosis. In this comprehensive review, we discuss the various elements and circulating molecules that might influence RBCs and modify their deformability: purinergic signaling, gasotransmitters such as nitric oxide (NO), divalent cations (magnesium, zinc, and Fe2+), lactate, ketone bodies, blood lipids, and several circulating hormones. Meal composition (caloric and carbohydrate intake) also modifies RBC deformability. Therefore, RBC deformability appears to be under the influence of many factors. This suggests that several homeostatic regulatory loops adapt the red cell rigidity to the physiological conditions in order to cope with the need for oxygen or fuel delivery to tissues. Furthermore, many conditions appear to irreversibly damage red cells, resulting in their destruction and removal from the blood. These two categories of modifications to erythrocyte deformability should thus be differentiated.
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Affiliation(s)
- Jean-Frédéric Brun
- UMR CNRS 9214-Inserm U1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles-PHYMEDEXP, Unité D’explorations Métaboliques (CERAMM), Département de Physiologie Clinique, Université de Montpellier, Hôpital Lapeyronie-CHRU de Montpellier, 34295 Montpellier, France; (J.M.); (E.R.d.M.)
| | - Emmanuelle Varlet-Marie
- UMR CNRS 5247-Institut des Biomolécules Max Mousseron (IBMM), Laboratoire du Département de Physicochimie et Biophysique, UFR des Sciences Pharmaceutiques et Biologiques, Université de Montpellier, 34090 Montpellier, France;
| | - Justine Myzia
- UMR CNRS 9214-Inserm U1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles-PHYMEDEXP, Unité D’explorations Métaboliques (CERAMM), Département de Physiologie Clinique, Université de Montpellier, Hôpital Lapeyronie-CHRU de Montpellier, 34295 Montpellier, France; (J.M.); (E.R.d.M.)
| | - Eric Raynaud de Mauverger
- UMR CNRS 9214-Inserm U1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles-PHYMEDEXP, Unité D’explorations Métaboliques (CERAMM), Département de Physiologie Clinique, Université de Montpellier, Hôpital Lapeyronie-CHRU de Montpellier, 34295 Montpellier, France; (J.M.); (E.R.d.M.)
| | - Etheresia Pretorius
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, Private Bag X1 MATIELAND, Stellenbosch 7602, South Africa;
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6
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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: 165] [Impact Index Per Article: 33.0] [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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7
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Effects of crystalloids and colloids on microcirculation, central venous oxygen saturation, and central venous-to-arterial carbon dioxide gap in a rabbit model of hemorrhagic shock. J Anesth 2018; 33:108-117. [DOI: 10.1007/s00540-018-2594-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 11/30/2018] [Indexed: 10/27/2022]
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8
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Ko E, Youn JM, Park HS, Song M, Koh KH, Lim CH. Early red blood cell abnormalities as a clinical variable in sepsis diagnosis. Clin Hemorheol Microcirc 2018; 70:355-363. [DOI: 10.3233/ch-180430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Eunji Ko
- Department of Anaesthesiology and Pain Medicine, Korea University, Seoul, Republic of Korea
| | - Jung Min Youn
- College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hyung Sun Park
- Department of Anaesthesiology and Pain Medicine, Korea University, Seoul, Republic of Korea
| | - Myeongjin Song
- Department of Biomedical Engineering, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyung Hee Koh
- Department of Anaesthesiology and Pain Medicine, Korea University, Seoul, Republic of Korea
| | - Choon hak Lim
- Department of Anaesthesiology and Pain Medicine, Korea University, Seoul, Republic of Korea
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9
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Gyawali P, Ziegler D, Cailhier JF, Denault A, Cloutier G. Quantitative Measurement of Erythrocyte Aggregation as a Systemic Inflammatory Marker by Ultrasound Imaging: A Systematic Review. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1303-1317. [PMID: 29661483 DOI: 10.1016/j.ultrasmedbio.2018.02.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/21/2018] [Accepted: 02/28/2018] [Indexed: 06/08/2023]
Abstract
This systematic review is aimed at answering two questions: (i) Is erythrocyte aggregation a useful biomarker in assessing systemic inflammation? (ii) Does quantitative ultrasound imaging provide the non-invasive option to measure erythrocyte aggregation in real time? The search was executed through bibliographic electronic databases CINAHL, EMB Review, EMBASE, MEDLINE, PubMed and the grey literature. The majority of studies correlated elevated erythrocyte aggregation with inflammatory blood markers for several pathologic states. Some studies used "erythrocyte aggregation" as an established marker of systemic inflammation. There were limited but promising articles regarding the use of quantitative ultrasound spectroscopy to monitor erythrocyte aggregation. Similarly, there were limited studies that used other ultrasound techniques to measure systemic inflammation. The quantitative measurement of erythrocyte aggregation has the potential to be a routine clinical marker of inflammation as it can reflect the cumulative inflammatory dynamics in vivo, is relatively simple to measure, is cost-effective and has a rapid turnaround time. Technologies like quantitative ultrasound spectroscopy that can measure erythrocyte aggregation non-invasively and in real time may offer the advantage of continuous monitoring of the inflammation state and, thus, may help in rapid decision making in a critical care setup.
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Affiliation(s)
- Prajwal Gyawali
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada
| | - Daniela Ziegler
- Documentation Center, University of Montreal Hospital, Montréal, Québec, Canada
| | - Jean-François Cailhier
- University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada; Department of Medicine, University of Montreal, Montréal, Québec, Canada
| | - André Denault
- University of Montreal Hospital, Montreal, Québec, Canada; Montreal Heart Institute, Montreal, Québec, Canada; Department of Anesthesiology, University of Montreal, Montréal, Québec, Canada
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada; Department of Radiology, Radio-Oncology and Nuclear Medicine, Montréal, Québec, Canada; Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada.
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The Effect of Sepsis on the Erythrocyte. Int J Mol Sci 2017; 18:ijms18091932. [PMID: 28885563 PMCID: PMC5618581 DOI: 10.3390/ijms18091932] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 08/31/2017] [Accepted: 09/04/2017] [Indexed: 12/25/2022] Open
Abstract
Sepsis induces a wide range of effects on the red blood cell (RBC). Some of the effects including altered metabolism and decreased 2,3-bisphosphoglycerate are preventable with appropriate treatment, whereas others, including decreased erythrocyte deformability and redistribution of membrane phospholipids, appear to be permanent, and factors in RBC clearance. Here, we review the effects of sepsis on the erythrocyte, including changes in RBC volume, metabolism and hemoglobin's affinity for oxygen, morphology, RBC deformability (an early indicator of sepsis), antioxidant status, intracellular Ca2+ homeostasis, membrane proteins, membrane phospholipid redistribution, clearance and RBC O₂-dependent adenosine triphosphate efflux (an RBC hypoxia signaling mechanism involved in microvascular autoregulation). We also consider the causes of these effects by host mediated oxidant stress and bacterial virulence factors. Additionally, we consider the altered erythrocyte microenvironment due to sepsis induced microvascular dysregulation and speculate on the possible effects of RBC autoxidation. In future, a better understanding of the mechanisms involved in sepsis induced erythrocyte pathophysiology and clearance may guide improved sepsis treatments. Evidence that small molecule antioxidants protect the erythrocyte from loss of deformability, and more importantly improve septic patient outcome suggest further research in this area is warranted. While not generally considered a critical factor in sepsis, erythrocytes (and especially a smaller subpopulation) appear to be highly susceptible to sepsis induced injury, provide an early warning signal of sepsis and are a factor in the microvascular dysfunction that has been associated with organ dysfunction.
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