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Hernández CA, Peikert K, Qiao M, Darras A, de Wilde JRA, Bos J, Leibowitz M, Galea I, Wagner C, Rab MAE, Walker RH, Hermann A, van Beers EJ, van Wijk R, Kaestner L. Osmotic gradient ektacytometry - a novel diagnostic approach for neuroacanthocytosis syndromes. Front Neurosci 2024; 18:1406969. [PMID: 39091345 PMCID: PMC11292800 DOI: 10.3389/fnins.2024.1406969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/15/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction The unique red blood cell (RBC) properties that characterize the rare neuroacanthocytosis syndromes (NAS) have prompted the exploration of osmotic gradient ektacytometry (Osmoscan) as a diagnostic tool for these disorders. In this exploratory study, we assessed if Osmoscans can discriminate NAS from other neurodegenerative diseases. Methods A comprehensive assessment was conducted using Osmoscan on a diverse group of patients, including healthy controls (n = 9), neuroacanthocytosis syndrome patients (n = 6, 2 VPS13A and 4 XK disease), Parkinson's disease patients (n = 6), Huntington's disease patients (n = 5), and amyotrophic lateral sclerosis patients (n = 4). Concurrently, we collected and analyzed RBC indices and patients' characteristics. Results Statistically significant changes were observed in NAS patients compared to healthy controls and other conditions, specifically in osmolality at minimal elongation index (Omin), maximal elongation index (EImax), the osmolality at half maximal elongation index in the hyperosmotic part of the curve (Ohyper), and the width of the curve close to the osmolality at maximal elongation index (Omax-width). Discussion This study represents an initial exploration of RBC properties from NAS patients using osmotic gradient ektacytometry. While specific parameters exhibited differences, only Ohyper and Omax-width yielded 100% specificity for other neurodegenerative diseases. Moreover, unique correlations between Osmoscan parameters and RBC indices in NAS versus controls were identified, such as osmolality at maximal elongation index (Omax) vs. mean cellular hemoglobin content (MCH) and minimal elongation index (EImin) vs. red blood cell distribution width (RDW). Given the limited sample size, further studies are essential to establish diagnostic guidelines based on these findings.
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Affiliation(s)
- Carolina A. Hernández
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, trecht University, Utrecht, Netherlands
| | - Kevin Peikert
- Translational Neurodegeneration Section “Albrecht Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, Rostock, Germany
- United Neuroscience Campus Lund-Rostock (UNC), Rostock, Germany
| | - Min Qiao
- Dynamics of Fluids, Experimental Physics, Saarland University, Saarbrücken, Germany
- Heoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg, Germany
| | - Alexis Darras
- Dynamics of Fluids, Experimental Physics, Saarland University, Saarbrücken, Germany
| | - Jonathan R. A. de Wilde
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, trecht University, Utrecht, Netherlands
| | - Jennifer Bos
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, trecht University, Utrecht, Netherlands
| | - Maya Leibowitz
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ian Galea
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Christian Wagner
- Dynamics of Fluids, Experimental Physics, Saarland University, Saarbrücken, Germany
- Physics and Materials Science Research Unit, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Minke A. E. Rab
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, trecht University, Utrecht, Netherlands
- Department of Hematology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ruth H. Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States
- Department of Neurology, Mount Sinai School of Medicine, New York City, NY, United States
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Eduard J. van Beers
- Center for Benign Hematology, Thrombosis and Hemostasis - Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Richard van Wijk
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, trecht University, Utrecht, Netherlands
| | - Lars Kaestner
- Dynamics of Fluids, Experimental Physics, Saarland University, Saarbrücken, Germany
- Heoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg, Germany
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2
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Rao H, Wang M, Wu Y, Wu Y, Han C, Yan C, Zhang L, Wang J, Liu Y. In vitro investigation of the mechanics of fixed red blood cells based on optical trap micromanipulation and image analysis. BIOMEDICAL OPTICS EXPRESS 2024; 15:3783-3794. [PMID: 38867786 PMCID: PMC11166448 DOI: 10.1364/boe.523702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 06/14/2024]
Abstract
Erythrocyte deformability correlates with various diseases. Single-cell measurements via optical tweezers (OTs) enable quantitative exploration but may encounter inaccuracies due to erythrocyte life cycle mixing. We present a three-step methodology to address these challenges. Firstly, density gradient centrifugation minimizes erythrocyte variations. Secondly, OTs measure membrane shear force across layers. Thirdly, MATLAB analyzes dynamic cell areas. Results combined with membrane shear force data reveal erythrocyte deformational capacity. To further characterize the deformability of diseased erythrocytes, the experiments used glutaraldehyde-fixed erythrocytes to simulate diseased cells. OTs detect increased shear modulus, while image recognition indicates decreased deformation. The integration of OTs and image recognition presents a comprehensive approach to deformation analysis, introducing novel ideas and methodologies for investigating erythrocytic lesions.
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Affiliation(s)
- Hongtao Rao
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Meng Wang
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Yinglian Wu
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Ying Wu
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Caiqin Han
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Changchun Yan
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Le Zhang
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Jingjing Wang
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
| | - Ying Liu
- Jiangsu Key Laboratory of Advanced Laser Materials and Devices, School of Physics and Electronic Engineering, Jiangsu Normal University, Xuzhou, China
- Xuzhou College of Industrial Technology, Xuzhou, China
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3
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Diaz-del-Pino S, Trelles-Martinez R, González-Fernández F, Guil N. Artificial intelligence to assist specialists in the detection of haematological diseases. Heliyon 2023; 9:e15940. [PMID: 37215889 PMCID: PMC10195887 DOI: 10.1016/j.heliyon.2023.e15940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/24/2023] Open
Abstract
Artificial intelligence, particularly the growth of neural network research and development, has become an invaluable tool for data analysis, offering unrivalled solutions for image generation, natural language processing, and personalised suggestions. In the meantime, biomedicine has been presented as one of the pressing challenges of the 21st century. The inversion of the age pyramid, the increase in longevity, and the negative environment due to pollution and bad habits of the population have led to a necessity of research in the methodologies that can help to mitigate and fight against these changes. The combination of both fields has already achieved remarkable results in drug discovery, cancer prediction or gene activation. However, challenges such as data labelling, architecture improvements, interpretability of the models and translational implementation of the proposals still remain. In haematology, conventional protocols follow a stepwise approach that includes several tests and doctor-patient interactions to make a diagnosis. This procedure results in significant costs and workload for hospitals. In this paper, we present an artificial intelligence model based on neural networks to support practitioners in the identification of different haematological diseases using only rutinary and inexpensive blood count tests. In particular, we present both binary and multiclass classification of haematological diseases using a specialised neural network architecture where data is studied and combined along it, taking into account the clinical knowledge of the problem, obtaining results up to 96% accuracy for the binary classification experiment. Furthermore, we compare this method against traditional machine learning algorithms such as gradient boosting decision trees and transformers for tabular data. The use of these machine learning techniques could reduce the cost and decision time and improve the quality of life for both specialists and patients while producing more precise diagnoses.
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Affiliation(s)
| | | | | | - Nicolas Guil
- Computer Architecture Department, University of Malaga, Spain
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4
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Bhalla N, Bhargav A, Yadav SK, Singh AK. Allogeneic hematopoietic stem cell transplantation to cure sickle cell disease: A review. Front Med (Lausanne) 2023; 10:1036939. [PMID: 36910492 PMCID: PMC9995916 DOI: 10.3389/fmed.2023.1036939] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/24/2023] [Indexed: 02/25/2023] Open
Abstract
Sickle cell disease (SCD) had first been mentioned in the literature a century ago. Advancement in the molecular basis of the pathophysiology of the disease opens the door for various therapeutic options. Though life-extending treatments are available for treating patients with SCD, allogeneic hematopoietic stem cell transplantation (HSCT) is the only option as of yet. A major obstacle before HSCT to cure patients with SCD is the availability of donors. Matched sibling donors are available only for a small percentage of patients. To expand the donor pool, different contrasting approaches of allogeneic HSCT like T-cell replete and deplete have been tested. None of those tested approaches have been without the risk of GvHD and graft rejection. Other limitations such as transplantation-related infections and organ dysfunction caused by the harsh conditioning regimen need to be addressed on a priority basis. In this review, we will discuss available allogeneic HSCT approaches to cure SCD, as well as recent advancements to make the approach safer. The center of interest is using megadose T-cell-depleted bone marrow in conjugation with donor-derived CD8 veto T cells to achieve engraftment and tolerance across MHC barriers, under reduced intensity conditioning (RIC). This approach is in phase I/II clinical trial at the MD Anderson Cancer Centre and is open to patients with hemoglobinopathies.
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Affiliation(s)
- Nishka Bhalla
- Centre for Stem Cell Research, Christian Medical College, Vellore, Tamilnadu, India
| | - Anjali Bhargav
- Centre for Stem Cell Research, Christian Medical College, Vellore, Tamilnadu, India
| | | | - Aloukick Kumar Singh
- Centre for Stem Cell Research, Christian Medical College, Vellore, Tamilnadu, India
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5
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Recktenwald SM, Lopes MGM, Peter S, Hof S, Simionato G, Peikert K, Hermann A, Danek A, van Bentum K, Eichler H, Wagner C, Quint S, Kaestner L. Erysense, a Lab-on-a-Chip-Based Point-of-Care Device to Evaluate Red Blood Cell Flow Properties With Multiple Clinical Applications. Front Physiol 2022; 13:884690. [PMID: 35574449 PMCID: PMC9091344 DOI: 10.3389/fphys.2022.884690] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
In many medical disciplines, red blood cells are discovered to be biomarkers since they "experience" various conditions in basically all organs of the body. Classical examples are diabetes and hypercholesterolemia. However, recently the red blood cell distribution width (RDW), is often referred to, as an unspecific parameter/marker (e.g., for cardiac events or in oncological studies). The measurement of RDW requires venous blood samples to perform the complete blood cell count (CBC). Here, we introduce Erysense, a lab-on-a-chip-based point-of-care device, to evaluate red blood cell flow properties. The capillary chip technology in combination with algorithms based on artificial neural networks allows the detection of very subtle changes in the red blood cell morphology. This flow-based method closely resembles in vivo conditions and blood sample volumes in the sub-microliter range are sufficient. We provide clinical examples for potential applications of Erysense as a diagnostic tool [here: neuroacanthocytosis syndromes (NAS)] and as cellular quality control for red blood cells [here: hemodiafiltration (HDF) and erythrocyte concentrate (EC) storage]. Due to the wide range of the applicable flow velocities (0.1-10 mm/s) different mechanical properties of the red blood cells can be addressed with Erysense providing the opportunity for differential diagnosis/judgments. Due to these versatile properties, we anticipate the value of Erysense for further diagnostic, prognostic, and theragnostic applications including but not limited to diabetes, iron deficiency, COVID-19, rheumatism, various red blood cell disorders and anemia, as well as inflammation-based diseases including sepsis.
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Affiliation(s)
| | - Marcelle G. M. Lopes
- Experimental Physics, Saarland University, Saarbruecken, Germany
- Cysmic GmbH, Saarbruecken, Germany
| | - Stephana Peter
- Experimental Physics, Saarland University, Saarbruecken, Germany
- Theoretical Medicine and Biosciences, Saarland University, Saarbruecken, Germany
| | - Sebastian Hof
- Experimental Physics, Saarland University, Saarbruecken, Germany
- Theoretical Medicine and Biosciences, Saarland University, Saarbruecken, Germany
| | - Greta Simionato
- Experimental Physics, Saarland University, Saarbruecken, Germany
- Institute for Clinical and Experimental Surgery, Saarland University, Campus University Hospital, Homburg, Germany
| | - Kevin Peikert
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, Rostock, Germany
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, Rostock, Germany
- DZNE, Deutsches Zentrum für Neurodegenerative Erkrankungen, Research Site Rostock/Greifswald, Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, Rostock, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-University, Munich, Germany
| | | | - Hermann Eichler
- Institute for Clinical Hemostaseology and Transfusion Medicine, Saarland University and Saarland University Hospital, Homburg, Germany
| | - Christian Wagner
- Experimental Physics, Saarland University, Saarbruecken, Germany
- Department of Physics and Materials Science, University of Luxembourg, Luxembourg City, Luxembourg
| | - Stephan Quint
- Experimental Physics, Saarland University, Saarbruecken, Germany
- Cysmic GmbH, Saarbruecken, Germany
| | - Lars Kaestner
- Experimental Physics, Saarland University, Saarbruecken, Germany
- Theoretical Medicine and Biosciences, Saarland University, Saarbruecken, Germany
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6
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Quintana-Bustamante O, Fañanas-Baquero S, Dessy-Rodriguez M, Ojeda-Pérez I, Segovia JC. Gene Editing for Inherited Red Blood Cell Diseases. Front Physiol 2022; 13:848261. [PMID: 35418876 PMCID: PMC8995967 DOI: 10.3389/fphys.2022.848261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/28/2022] [Indexed: 11/24/2022] Open
Abstract
Today gene therapy is a real therapeutic option to address inherited hematological diseases that could be beneficial for thousands of patients worldwide. Currently, gene therapy is used to treat different monogenic hematological pathologies, including several red blood cell diseases such as β-thalassemia, sickle cell disease and pyruvate kinase deficiency. This approach is based on addition gene therapy, which consists of the correction of hematopoietic stem cells (HSCs) using lentiviral vectors, which integrate a corrected version of the altered gene. Lentivirally-corrected HSCs generate healthy cells that compensate for the deficiency caused by genetic mutations. Despite its successful results, this approach lacks both control of the integration of the transgene into the genome and endogenous regulation of the therapeutic gene, both of which are important aspects that might be a cause for concern. To overcome these limitations, gene editing is able to correct the altered gene through more precise and safer approaches. Cheap and easy-to-design gene editing tools, such as the CRISPR/Cas9 system, allow the specific correction of the altered gene without affecting the rest of the genome. Inherited erythroid diseases, such as thalassemia, sickle cell disease and Pyruvate Kinase Deficiency, have been the test bed for these gene editing strategies, and promising results are currently being seen. CRISPR/Cas9 system has been successfully used to manipulate globin regulation to re-activate fetal globin chains in adult red blood cells and to compensate for hemoglobin defects. Knock-in at the mutated locus to express the therapeutic gene under the endogenous gene regulatory region has also been accomplished successfully. Thanks to the lessons learned from previous lentiviral gene therapy research and trials, gene editing for red blood cell diseases is rapidly moving from its proof-of-concept to its first exciting results in the clinic. Indeed, patients suffering from β-thalassemia and sickle cell disease have already been successfully treated with gene editing, which will hopefully inspire the use of gene editing to cure erythroid disorders and many other inherited diseases in the near future.
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Affiliation(s)
- Oscar Quintana-Bustamante
- Hematopoietic Innovative Therapies Division, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Unidad Mixta de Terapias Avanzadas, Madrid, Spain
| | - Sara Fañanas-Baquero
- Hematopoietic Innovative Therapies Division, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Unidad Mixta de Terapias Avanzadas, Madrid, Spain
| | - Mercedes Dessy-Rodriguez
- Hematopoietic Innovative Therapies Division, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Unidad Mixta de Terapias Avanzadas, Madrid, Spain
| | - Isabel Ojeda-Pérez
- Hematopoietic Innovative Therapies Division, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Unidad Mixta de Terapias Avanzadas, Madrid, Spain
| | - Jose-Carlos Segovia
- Hematopoietic Innovative Therapies Division, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Unidad Mixta de Terapias Avanzadas, Madrid, Spain
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Obergrussberger A, Rinke-Weiß I, Goetze TA, Rapedius M, Brinkwirth N, Becker N, Rotordam MG, Hutchison L, Madau P, Pau D, Dalrymple D, Braun N, Friis S, Pless SA, Fertig N. The suitability of high throughput automated patch clamp for physiological applications. J Physiol 2021; 600:277-297. [PMID: 34555195 DOI: 10.1113/jp282107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/16/2021] [Indexed: 01/18/2023] Open
Abstract
Although automated patch clamp (APC) devices have been around for many years and have become an integral part of many aspects of drug discovery, high throughput instruments with gigaohm seal data quality are relatively new. Experiments where a large number of compounds are screened against ion channels are ideally suited to high throughput APC, particularly when the amount of compound available is low. Here we evaluate different APC approaches using a variety of ion channels and screening settings. We have performed a screen of 1920 compounds on GluN1/GluN2A NMDA receptors for negative allosteric modulation using both the SyncroPatch 384 and FLIPR. Additionally, we tested the effect of 36 arthropod venoms on NaV 1.9 using a single 384-well plate on the SyncroPatch 384. As an example for mutant screening, a range of acid-sensing ion channel variants were tested and the success rate increased through fluorescence-activated cell sorting (FACS) prior to APC experiments. Gigaohm seal data quality makes the 384-format accessible to recording of primary and stem cell-derived cells on the SyncroPatch 384. We show recordings in voltage and current clamp modes of stem cell-derived cardiomyocytes. In addition, the option of intracellular solution exchange enabled investigations into the effects of intracellular Ca2+ and cAMP on TRPC5 and HCN2 currents, respectively. Together, these data highlight the broad applicability and versatility of APC platforms and also outlines some limitations of the approach. KEY POINTS: High throughput automated patch clamp (APC) can be used for a variety of applications involving ion channels. Lower false positive rates were achieved using automated patch clamp versus a fluorometric imaging plate reader (FLIPR) in a high throughput compound screen against NMDA receptors. Genetic variants and mutations can be screened on a single 384-well plate to reduce variability of experimental parameters. Intracellular solution can be perfused to investigate effects of ions and second messenger systems without the need for excised patches. Primary cells and stem cell-derived cells can be used on high throughput APC with reasonable success rates for cell capture, voltage clamp measurements and action potential recordings in current clamp mode.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Nina Braun
- Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | | | - Stephan A Pless
- Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
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Simionato G, van Wijk R, Quint S, Wagner C, Bianchi P, Kaestner L. Rare Anemias: Are Their Names Just Smoke and Mirrors? Front Physiol 2021; 12:690604. [PMID: 34177628 PMCID: PMC8222994 DOI: 10.3389/fphys.2021.690604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/17/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Greta Simionato
- Institute for Clinical and Experimental Surgery, Campus University Hospital, Saarland University, Homburg, Germany.,Experimental Physics, Dynamics of Fluids Group, Saarland University, Saarbrücken, Germany
| | - Richard van Wijk
- Central Diagnostic Laboratory - Research, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Stephan Quint
- Experimental Physics, Dynamics of Fluids Group, Saarland University, Saarbrücken, Germany.,Cysmic GmbH, Saarbrücken, Germany
| | - Christian Wagner
- Experimental Physics, Dynamics of Fluids Group, Saarland University, Saarbrücken, Germany.,Physics and Materials Science Research Unit, University of Luxembourg, Luxembourg, Luxembourg
| | - Paola Bianchi
- Fondazione Instituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico Milano, Unità Operativa Complessa Ematologia, Unità Operativa Semplice Fisiopatologia delle Anemie, Milan, Italy
| | - Lars Kaestner
- Experimental Physics, Dynamics of Fluids Group, Saarland University, Saarbrücken, Germany.,Theoretical Medicine and Biosciences, Campus University Hospital, Saarland University, Homburg, Germany
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An R, Huang Y, Man Y, Valentine RW, Kucukal E, Goreke U, Sekyonda Z, Piccone C, Owusu-Ansah A, Ahuja S, Little JA, Gurkan UA. Emerging point-of-care technologies for anemia detection. LAB ON A CHIP 2021; 21:1843-1865. [PMID: 33881041 PMCID: PMC8875318 DOI: 10.1039/d0lc01235a] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Anemia, characterized by low blood hemoglobin level, affects about 25% of the world's population with the heaviest burden borne by women and children. Anemia leads to impaired cognitive development in children, as well as high morbidity and early mortality among sufferers. Anemia can be caused by nutritional deficiencies, oncologic treatments and diseases, and infections such as malaria, as well as inherited hemoglobin or red cell disorders. Effective treatments are available for anemia upon early detection and the treatment method is highly dependent on the cause of anemia. There is a need for point-of-care (POC) screening, early diagnosis, and monitoring of anemia, which is currently not widely accessible due to technical challenges and cost, especially in low- and middle-income countries where anemia is most prevalent. This review first introduces the evolution of anemia detection methods followed by their implementation in current commercially available POC anemia diagnostic devices. Then, emerging POC anemia detection technologies leveraging new methods are reviewed. Finally, we highlight the future trends of integrating anemia detection with the diagnosis of relevant underlying disorders to accurately identify specific root causes and to facilitate personalized treatment and care.
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Affiliation(s)
- Ran An
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Yuning Huang
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Yuncheng Man
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Russell W Valentine
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Erdem Kucukal
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Utku Goreke
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Zoe Sekyonda
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Connie Piccone
- Department of Pediatric Hematology, Carle Foundation Hospital, Urbana, IL, USA
| | - Amma Owusu-Ansah
- Department of Pediatrics, Division of Hematology and Oncology, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Sanjay Ahuja
- Department of Pediatrics, Division of Hematology and Oncology, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Jane A Little
- Division of Hematology & UNC Blood Research Center, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Umut A Gurkan
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA. and Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
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10
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Simionato G, Hinkelmann K, Chachanidze R, Bianchi P, Fermo E, van Wijk R, Leonetti M, Wagner C, Kaestner L, Quint S. Red blood cell phenotyping from 3D confocal images using artificial neural networks. PLoS Comput Biol 2021; 17:e1008934. [PMID: 33983926 PMCID: PMC8118337 DOI: 10.1371/journal.pcbi.1008934] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/01/2021] [Indexed: 12/15/2022] Open
Abstract
The investigation of cell shapes mostly relies on the manual classification of 2D images, causing a subjective and time consuming evaluation based on a portion of the cell surface. We present a dual-stage neural network architecture for analyzing fine shape details from confocal microscopy recordings in 3D. The system, tested on red blood cells, uses training data from both healthy donors and patients with a congenital blood disease, namely hereditary spherocytosis. Characteristic shape features are revealed from the spherical harmonics spectrum of each cell and are automatically processed to create a reproducible and unbiased shape recognition and classification. The results show the relation between the particular genetic mutation causing the disease and the shape profile. With the obtained 3D phenotypes, we suggest our method for diagnostics and theragnostics of blood diseases. Besides the application employed in this study, our algorithms can be easily adapted for the 3D shape phenotyping of other cell types and extend their use to other applications, such as industrial automated 3D quality control.
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Affiliation(s)
- Greta Simionato
- Department of Experimental Physics, Saarland University, Campus E2.6, Saarbrücken, Germany
- Institute for Clinical and Experimental Surgery, Saarland University, Campus University Hospital, Homburg, Germany
| | - Konrad Hinkelmann
- Department of Experimental Physics, Saarland University, Campus E2.6, Saarbrücken, Germany
| | - Revaz Chachanidze
- Department of Experimental Physics, Saarland University, Campus E2.6, Saarbrücken, Germany
- CNRS, University Grenoble Alpes, Grenoble INP, LRP, Grenoble, France
| | - Paola Bianchi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Elisa Fermo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Richard van Wijk
- Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marc Leonetti
- CNRS, University Grenoble Alpes, Grenoble INP, LRP, Grenoble, France
| | - Christian Wagner
- Department of Experimental Physics, Saarland University, Campus E2.6, Saarbrücken, Germany
- Physics and Materials Science Research Unit, University of Luxembourg, Luxembourg City, Luxembourg
| | - Lars Kaestner
- Department of Experimental Physics, Saarland University, Campus E2.6, Saarbrücken, Germany
- Theoretical Medicine and Biosciences, Saarland University, Campus University Hospital, Homburg, Germany
| | - Stephan Quint
- Department of Experimental Physics, Saarland University, Campus E2.6, Saarbrücken, Germany
- Cysmic GmbH, Saarland University, Saarbrücken, Germany
- * E-mail:
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11
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van Cromvoirt AM, Fenk S, Sadafi A, Melnikova EV, Lagutkin DA, Dey K, Petrushanko IY, Hegemann I, Goede JS, Bogdanova A. Donor Age and Red Cell Age Contribute to the Variance in Lorrca Indices in Healthy Donors for Next Generation Ektacytometry: A Pilot Study. Front Physiol 2021; 12:639722. [PMID: 33737886 PMCID: PMC7960761 DOI: 10.3389/fphys.2021.639722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/01/2021] [Indexed: 01/17/2023] Open
Abstract
The ability of red blood cells (RBCs) to transport gases, their lifespan as well as their rheological properties invariably depend on the deformability, hydration, and membrane stability of these cells, which can be measured by Laser optical rotational red cell analyser (Lorrca® Maxsis, RR Mechatronics). The osmoscan mode of Lorrca is currently used in diagnosis of rare anemias in clinical laboratories. However, a broad range of normal values for healthy subjects reduces the sensitivity of this method for diagnosis of mild disease phenotype. In this pilot study, we explored the impact of age and gender of 45 healthy donors, as well as RBC age on the Lorrca indices. Whereas gender did not affect the Lorrca indices in our study, the age donors had a profound effect on the O_hyper parameter. To study the impact of RBC age on the osmoscan parameters, we have isolated low (L)-, medium (M)-, or high (H)- density fractions enriched with young, mature, and senescent RBCs, respectively, and evaluated the influence of RBC age-related properties, such as density, morphology, and redox state, on the osmoscan indices. As before, O_hyper was the most sensitive parameter, dropping markedly with an increase in RBC density and age. Senescence was associated with a decrease in deformability (EI_max) and tolerability to low and high osmolatites (Area). L-fraction was enriched with reticulocytes and cells with high projected area and EMA staining, but also contained a small number of cells small in projected area and most likely, terminally senescent. L-fraction was on average slightly less deformable than mature cells. The cells from the L-fraction produced more oxidants and NO than all other fractions. However, RBCs from the L-fraction contained maximal levels of reduced thiols compared to other fractions. Our study suggests that reference values for O_hyper should be age-stratified, and, most probably, corrected for the average RBC age. Further multi-center study is required to validate these suggestions before implementing them into clinical practice.
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Affiliation(s)
- Ankie M van Cromvoirt
- Red Blood Cell Research Group, Vetsuisse Faculty, Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Simone Fenk
- Red Blood Cell Research Group, Vetsuisse Faculty, Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Ario Sadafi
- Helmholtz Zentrum München - German Research Center for Environmental Health, Munich, Germany.,Computer Aided Medical Procedures, Technische Universität München, Munich, Germany
| | - Elizaveta V Melnikova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Denis A Lagutkin
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Kuntal Dey
- Red Blood Cell Research Group, Vetsuisse Faculty, Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Irina Yu Petrushanko
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Inga Hegemann
- Department of Medical Oncology and Hematology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Jeroen S Goede
- Division of Oncology and Hematology, Kantonsspital Winterthur, Winterthur, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Anna Bogdanova
- Red Blood Cell Research Group, Vetsuisse Faculty, Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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12
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Fermo E, Vercellati C, Bianchi P. Screening tools for hereditary hemolytic anemia: new concepts and strategies. Expert Rev Hematol 2021; 14:281-292. [PMID: 33543663 DOI: 10.1080/17474086.2021.1886919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Hereditary hemolytic anemias are a group of rare and heterogeneous disorders due to abnormalities in structure, metabolism, and transport functions of erythrocytes; they may overlap in clinical and hematological features making differential diagnosis difficult, particularly in mild and atypical forms. AREAS COVERED In the present review, the main tools currently adopted in routine hematologic investigation for the diagnosis of hereditary hemolytic anemias are described, together with the new diagnostic approaches that are being to be developed in the next future. Available recommendations in this field together with a systematic review through MEDLINE, EMBASE, and PubMED for publications in English from 2000 to 2020 in regards to diagnostic aspects of hereditary hemolytic anemias have been considered. EXPERT OPINION The recent development of specific molecules and treatments for hereditary hemolytic anemias and the increased interest in translational research raised the attention on differential diagnosis and the demand for novel diagnostic assays and devices. Automatic blood cell analyzers, omic-approaches including NGS technologies, and development of new automated tools based on artificial neural networks definitely represent the future strategies in this field.
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Affiliation(s)
- Elisa Fermo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, UOC Ematologia, UOS Fisiopatologia Delle Anemie, Milan, Italy
| | - Cristina Vercellati
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, UOC Ematologia, UOS Fisiopatologia Delle Anemie, Milan, Italy
| | - Paola Bianchi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, UOC Ematologia, UOS Fisiopatologia Delle Anemie, Milan, Italy
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13
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Wang J, Hertz L, Ruppenthal S, El Nemer W, Connes P, Goede JS, Bogdanova A, Birnbaumer L, Kaestner L. Lysophosphatidic Acid-Activated Calcium Signaling Is Elevated in Red Cells from Sickle Cell Disease Patients. Cells 2021; 10:456. [PMID: 33672679 PMCID: PMC7924404 DOI: 10.3390/cells10020456] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/15/2022] Open
Abstract
(1) Background: It is known that sickle cells contain a higher amount of Ca2+ compared to healthy red blood cells (RBCs). The increased Ca2+ is associated with the most severe symptom of sickle cell disease (SCD), the vaso-occlusive crisis (VOC). The Ca2+ entry pathway received the name of Psickle but its molecular identity remains only partly resolved. We aimed to map the involved Ca2+ signaling to provide putative pharmacological targets for treatment. (2) Methods: The main technique applied was Ca2+ imaging of RBCs from healthy donors, SCD patients and a number of transgenic mouse models in comparison to wild-type mice. Life-cell Ca2+ imaging was applied to monitor responses to pharmacological targeting of the elements of signaling cascades. Infection as a trigger of VOC was imitated by stimulation of RBCs with lysophosphatidic acid (LPA). These measurements were complemented with biochemical assays. (3) Results: Ca2+ entry into SCD RBCs in response to LPA stimulation exceeded that of healthy donors. LPA receptor 4 levels were increased in SCD RBCs. Their activation was followed by the activation of Gi protein, which in turn triggered opening of TRPC6 and CaV2.1 channels via a protein kinase Cα and a MAP kinase pathway, respectively. (4) Conclusions: We found a new Ca2+ signaling cascade that is increased in SCD patients and identified new pharmacological targets that might be promising in addressing the most severe symptom of SCD, the VOC.
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Affiliation(s)
- Jue Wang
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, USA;
| | - Laura Hertz
- Theoretical Medicine and Biosciences, Saarland University, 66421 Homburg, Germany;
- Experimental Physics, Dynamics of Fluids, Saarland University, 66123 Saarbrücken, Germany;
| | - Sandra Ruppenthal
- Experimental Physics, Dynamics of Fluids, Saarland University, 66123 Saarbrücken, Germany;
- Gynaecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, 66421 Homburg, Germany
| | - Wassim El Nemer
- Etablissement Français du Sang PACA-Corse, Aix Marseille Université, EFS, CNRS, ADES, 13005 Marseille, France;
- Laboratoire d’Excellence GR-Ex, 75015 Paris, France;
| | - Philippe Connes
- Laboratoire d’Excellence GR-Ex, 75015 Paris, France;
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Teal, University Claude Bernard Lyon 1, 69008 Lyon, France
| | - Jeroen S. Goede
- Division of Oncology and Hematology, Kantonsspital Winterthur, CH-8401 Winterthur, Switzerland;
| | - Anna Bogdanova
- Red Blood Cell Research Group, Institute of Veterinary Physiology, University of Zürich, CH-8057 Zürich, Switzerland;
| | - Lutz Birnbaumer
- Institute of Biomedical Research (BIOMED), Catholic University of Argentina, C1107AFF Buenos Aires, Argentina;
- Laboratory of Neurobiology, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Saarland University, 66421 Homburg, Germany;
- Experimental Physics, Dynamics of Fluids, Saarland University, 66123 Saarbrücken, Germany;
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14
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Abstract
The application of artificial intelligence (AI) in hematology it not new at all. However, it increasingly becomes part of the measurement of hematological parameters and subsequently also influences decision making. Here some examples are provided where well established parameters could be exploited better, if data are not reduced to single values but instead the entire data generation process is considered. Furthermore applications of artificial neural networks (ANN), point of care (PoC) devices and the internet of things (IoT) are discussed. Beside all the technical advancements human judgement will remain the last decision.
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15
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Bogdanova A, Kaestner L. Early Career Scientists' Guide to the Red Blood Cell - Don't Panic! Front Physiol 2020; 11:588. [PMID: 32903637 PMCID: PMC7438720 DOI: 10.3389/fphys.2020.00588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/11/2020] [Indexed: 12/15/2022] Open
Abstract
Why should we take interest in studying red blood cells? This mini review attempts to answer this question and highlights the problems that authors find most appealing in this dynamic research area. It addresses the early career scientists who are just starting their independent journey and facing tough times. Despite unlimited access to information, the exponential development of computational and intellectual powers, and the seemingly endless possibilities open to talented and ambitious early career researchers, they soon realize that the pressure of imminent competition for financial support is hard. They have to hit deadlines, produce data, publish, report, teach, manage, lead groups, and remain loving family members at the same time. Are these countless hardships worth it? We think they are. Despite centuries of research, red blood cells remain a mysterious and fascinating study objects. These cells bring together experts within the family of the European Red Cell Society and beyond. We all share our joy for the unknown and excitement in understanding how red cells function and what they tell us about the microenvironments and macroenvironments they live in. This review is an invitation to our colleagues to join us on our quest.
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Affiliation(s)
- Anna Bogdanova
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany.,Experimental Physics, Saarland University, Saarbrücken, Germany
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