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van Dijk MJ, van Oirschot BA, Harrison AN, Recktenwald SM, Qiao M, Stommen A, Cloos AS, Vanderroost J, Terrasi R, Dey K, Bos J, Rab MAE, Bogdanova A, Minetti G, Muccioli GG, Tyteca D, Egée S, Kaestner L, Molday RS, van Beers EJ, van Wijk R. A novel missense variant in ATP11C is associated with reduced red blood cell phosphatidylserine flippase activity and mild hereditary hemolytic anemia. Am J Hematol 2023; 98:1877-1887. [PMID: 37671681 DOI: 10.1002/ajh.27088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023]
Abstract
Adenosine Triphosphatase (ATPase) Phospholipid Transporting 11C gene (ATP11C) encodes the major phosphatidylserine (PS) flippase in human red blood cells (RBCs). Flippases actively transport phospholipids (e.g., PS) from the outer to the inner leaflet to establish and maintain phospholipid asymmetry of the lipid bilayer of cell membranes. This asymmetry is crucial for survival since externalized PS triggers phagocytosis by splenic macrophages. Here we report on pathophysiological consequences of decreased flippase activity, prompted by a patient with hemolytic anemia and hemizygosity for a novel c.2365C > T p.(Leu789Phe) missense variant in ATP11C. ATP11C protein expression was strongly reduced by 58% in patient-derived RBC ghosts. Furthermore, functional characterization showed only 26% PS flippase activity. These results were confirmed by recombinant mutant ATP11C protein expression in HEK293T cells, which was decreased to 27% compared to wild type, whereas PS-stimulated ATPase activity was decreased by 57%. Patient RBCs showed a mild increase in PS surface exposure when compared to control RBCs, which further increased in the most dense RBCs after RBC storage stress. The increase in PS was not due to higher global membrane content of PS or other phospholipids. In contrast, membrane lipid lateral distribution showed increased abundance of cholesterol-enriched domains in RBC low curvature areas. Finally, more dense RBCs and subtle changes in RBC morphology under flow hint toward alterations in flow behavior of ATP11C-deficient RBCs. Altogether, ATP11C deficiency is the likely cause of hemolytic anemia in our patient, thereby underlining the physiological role and relevance of this flippase in human RBCs.
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Affiliation(s)
- Myrthe J van Dijk
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Center for Benign Hematology, Thrombosis and Hemostasis-Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Brigitte A van Oirschot
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alexander N Harrison
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
| | | | - Min Qiao
- Department of Experimental Physics, Saarland University, Saarbrücken, Germany
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany
| | - Amaury Stommen
- CELL Unit and PICT Platform, de Duve Institute, UCLouvain, Brussels, Belgium
| | - Anne-Sophie Cloos
- CELL Unit and PICT Platform, de Duve Institute, UCLouvain, Brussels, Belgium
| | | | - Romano Terrasi
- Bioanalysis and Pharmacology of Bioactive Lipids Research Group, Louvain Drug Research Institute, UCLouvain, Brussels, Belgium
| | - Kuntal Dey
- Red Blood Cell Group, Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Jennifer Bos
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Minke A E Rab
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Hematology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anna Bogdanova
- Red Blood Cell Group, Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Giampaolo Minetti
- Department of Biology and Biotechnology "L. Spallanzani", Laboratories of Biochemistry, University of Pavia, Pavia, Italy
| | - Giulio G Muccioli
- Bioanalysis and Pharmacology of Bioactive Lipids Research Group, Louvain Drug Research Institute, UCLouvain, Brussels, Belgium
| | - Donatienne Tyteca
- CELL Unit and PICT Platform, de Duve Institute, UCLouvain, Brussels, Belgium
| | - Stéphane Egée
- UMR 8227 CNRS-Sorbonne Université, Station Biologique de Roscoff, Roscoff, France
| | - Lars Kaestner
- Department of Experimental Physics, Saarland University, Saarbrücken, Germany
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany
| | - Robert S Molday
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
| | - Eduard J van Beers
- Center for Benign Hematology, Thrombosis and Hemostasis-Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Richard van Wijk
- Central Diagnostic Laboratory-Research, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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van Dijk MJ, de Wilde JRA, Bartels M, Kuo KHM, Glenthøj A, Rab MAE, van Beers EJ, van Wijk R. Activation of pyruvate kinase as therapeutic option for rare hemolytic anemias: Shedding new light on an old enzyme. Blood Rev 2023; 61:101103. [PMID: 37353463 DOI: 10.1016/j.blre.2023.101103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/25/2023]
Abstract
Novel developments in therapies for various hereditary hemolytic anemias reflect the pivotal role of pyruvate kinase (PK), a key enzyme of glycolysis, in red blood cell (RBC) health. Without PK catalyzing one of the final steps of the Embden-Meyerhof pathway, there is no net yield of adenosine triphosphate (ATP) during glycolysis, the sole source of energy production required for proper RBC function and survival. In hereditary hemolytic anemias, RBC health is compromised and therefore lifespan is shortened. Although our knowledge on glycolysis in general and PK function in particular is solid, recent advances in genetic, molecular, biochemical, and metabolic aspects of hereditary anemias have improved our understanding of these diseases. These advances provide a rationale for targeting PK as therapeutic option in hereditary hemolytic anemias other than PK deficiency. This review summarizes the knowledge, rationale, (pre)clinical trials, and future advances of PK activators for this important group of rare diseases.
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Affiliation(s)
- Myrthe J van Dijk
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Center for Benign Hematology, Thrombosis and Hemostasis - Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Jonathan R A de Wilde
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Marije Bartels
- Center for Benign Hematology, Thrombosis and Hemostasis - Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Kevin H M Kuo
- Division of Hematology, University of Toronto, Toronto, ON, Canada
| | - Andreas Glenthøj
- Danish Red Blood Center, Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Minke A E Rab
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Hematology, Erasmus Medical Center Rotterdam, the Netherlands
| | - Eduard J van Beers
- Center for Benign Hematology, Thrombosis and Hemostasis - Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Richard van Wijk
- Department of Central Diagnostic Laboratory - Research, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
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Andolfo I, Monaco V, Cozzolino F, Rosato BE, Marra R, Cerbone V, Pinto VM, Forni GL, Unal S, Iolascon A, Monti M, Russo R. Proteome alterations in erythrocytes with PIEZO1 gain-of-function mutations. Blood Adv 2023; 7:2681-2693. [PMID: 36595486 PMCID: PMC10333744 DOI: 10.1182/bloodadvances.2022008673] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023] Open
Abstract
Gain-of-function mutations in PIEZO1 cause dehydrated hereditary stomatocytosis (DHS) or hereditary xerocytosis, an autosomal dominant hemolytic anemia characterized by high reticulocyte count, a tendency to macrocytosis, and mild jaundice, as well as by other variably penetrant clinical features, such as perinatal edema, severe thromboembolic complications after splenectomy, and hepatic iron overload. PIEZO1 mutations in DHS lead to slowed inactivation kinetics of the ion channel and/or facilitation of channel opening in response to physiological stimuli. To characterize the alterations of red blood cell proteome in patients with mutated PIEZO1, we used a differential approach to compare the proteome of patients with DHS (16 patients from 13 unrelated ancestries) vs healthy individuals. We identified new components in the regulation of the complex landscape of erythrocytes ion and volume balance mediated by PIEZO1. Specifically, the main impaired processes in patients with DHS were ion homeostasis, transmembrane transport, regulation of vesicle-mediated transport, and the proteasomal catabolic process. Functional assays demonstrated coexpression of PIEZO1 and band 3 when PIEZO1 was activated. Moreover, the alteration of the vesicle-mediated transport was functionally demonstrated by an increased vesiculation rate in patients with DHS compared with healthy controls. This finding also provides an explanation of the pathogenetic mechanism underlying the increased thrombotic rate observed in these patients. Finally, the newly identified proteins, involved in the intracellular signaling pathways altered by PIEZO1 mutations, could be used in the future as potential druggable targets in DHS.
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Affiliation(s)
- Immacolata Andolfo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
| | - Vittoria Monaco
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
- Dipartimento di Scienze Chimiche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Flora Cozzolino
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
- Dipartimento di Scienze Chimiche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Barbara Eleni Rosato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
| | - Roberta Marra
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
| | | | - Valeria Maria Pinto
- Centro della Microcitemia, delle Anemie Congenite e dei Disordini del Metabolismo del Ferro, EO Ospedali Galliera, Genoa, Italy
| | - Gian Luca Forni
- Centro della Microcitemia, delle Anemie Congenite e dei Disordini del Metabolismo del Ferro, EO Ospedali Galliera, Genoa, Italy
| | - Sule Unal
- Research Center for Fanconi Anemia and Other Inherited Bone Marrow Failure Syndromes, Department of Pediatric Hematology, Hacettepe University, Ankara, Turkey
| | - Achille Iolascon
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
| | - Maria Monti
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
- Dipartimento di Scienze Chimiche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Roberta Russo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
- CEINGE Biotecnologie Avanzate, Franco Salvatore, Napoli, Italy
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Hertz L, Flormann D, Birnbaumer L, Wagner C, Laschke MW, Kaestner L. Evidence of in vivo exogen protein uptake by red blood cells: a putative therapeutic concept. Blood Adv 2023; 7:1033-1039. [PMID: 36490356 PMCID: PMC10036505 DOI: 10.1182/bloodadvances.2022008404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/31/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022] Open
Abstract
For some molecular players in red blood cells (RBCs), the functional indications and molecular evidence are discrepant. One such protein is transient receptor potential channel of canonical subfamily, member 6 (TRPC6). Transcriptome analysis of reticulocytes revealed the presence of TRPC6 in mouse RBCs and its absence in human RBCs. We transfused TRPC6 knockout RBCs into wild-type mice and performed functional tests. We observed the "rescue" of TRPC6 within 10 days; however, the "rescue" was slower in splenectomized mice. The latter finding led us to mimic the mechanical challenge with the cantilever of an atomic force microscope and simultaneously carry out imaging by confocal (3D) microscopy. We observed the strong interaction of RBCs with the opposed surface at around 200 pN and the formation of tethers. The results of both the transfusion experiments and the atomic force spectroscopy suggest mechanically stimulated protein transfer to RBCs as a protein source in the absence of the translational machinery. This protein transfer mechanism has the potential to be utilized in therapeutic contexts, especially for hereditary diseases involving RBCs, such as hereditary xerocytosis or Gárdos channelopathy.
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Affiliation(s)
- Laura Hertz
- Theoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg, Germany
| | - Daniel Flormann
- Dynamics of Fluids, Experimental Physics, Saarland University, Saarbruecken, Germany
| | - Lutz Birnbaumer
- Institute of Biomedical Research (BIOMED), Catholic University of Argentina, Buenos Aires, Argentina
- Laboratory of Signal Transduction, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Christian Wagner
- Dynamics of Fluids, Experimental Physics, Saarland University, Saarbruecken, Germany
- Physics and Materials Science Research Unit, University of Luxembourg, Luxembourg City, Luxembourg
| | - Matthias W. Laschke
- Medical Faculty, Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg, Germany
- Dynamics of Fluids, Experimental Physics, Saarland University, Saarbruecken, Germany
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van Vuren AJ, van Wijk R, van Beers EJ, Marx JJ. Liver Iron Retention Estimated from Utilization of Oral and Intravenous Radioiron in Various Anemias and Hemochromatosis in Humans. Int J Mol Sci 2020; 21:ijms21031077. [PMID: 32041196 PMCID: PMC7037197 DOI: 10.3390/ijms21031077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/28/2020] [Accepted: 02/04/2020] [Indexed: 01/19/2023] Open
Abstract
Patients with hereditary hemochromatosis and non-transfusion-dependent hereditary anemia develop predominantly liver iron-overload. We present a unique method allowing quantification of liver iron retention in humans during first-pass of 59Fe-labeled iron through the portal system, using standard ferrokinetic techniques measuring red cell iron uptake after oral and intravenous 59Fe administration. We present data from patients with iron deficiency (ID; N = 47), hereditary hemochromatosis (HH; N = 121) and non-transfusion-dependent hereditary anemia (HA; N = 40). Mean mucosal iron uptake and mucosal iron transfer (±SD) were elevated in patients with HH (59 ± 18%, 80 ± 15% respectively), HA (65 ± 17%, 74 ± 18%) and ID (84 ± 14%, 94 ± 6%) compared to healthy controls (43 ± 19%, 64 ± 18%) (p < 0.05) resulting in increased iron retention after 14 days compared to healthy controls in all groups (p < 0.01). The fraction of retained iron utilized for red cell production was 0.37 ± 0.17 in untreated HA, 0.55 ± 0.20 in untreated HH and 0.99 ± 0.22 in ID (p < 0.01). Interestingly, compared to red blood cell iron utilization after oral iron administration, red blood cell iron utilization was higher after injection of transferrin-bound iron in HA and HH. Liver iron retention was considerably higher in HH and HA compared to ID. We hypothesize that albumin serves as a scavenger of absorbed Fe(II) for delivering albumin-bound Fe(III) to hepatocytes.
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Affiliation(s)
- Annelies J. van Vuren
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Richard van Wijk
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Eduard J. van Beers
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
- Correspondence: ; Tel.: +31-88-755-84-50
| | - Joannes J.M. Marx
- Departments of Haematology and Internal Medicine, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
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Abstract
Significant advances have been made in diagnosis and clinical management of inherited red cell membrane disorders that result in hemolytic anemia. Membrane structural defects lead to hereditary spherocytosis (HS) and hereditary elliptocytosis (HE), whereas altered membrane transport function accounts for hereditary xerocytosis (HX) and hereditary overhydrated stomatocytosis (OHS). The degrees of membrane loss and resultant increases in cell sphericity determine the severity of anemia in HS and HE, and splenectomy leads to amelioration of anemia by increasing the circulatory red cell life span. Alterations in cell volume as a result of disordered membrane cation permeability account for reduced life span red cells in HX and OHS. Importantly, splenectomy is not beneficial in these 2 membrane transport disorders and is not recommended because it is ineffective and may lead to an increased risk of life-threatening thrombosis. Rational approaches are now available for the diagnosis and management of these inherited red cell disorders, and these will be discussed in this review.
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MESH Headings
- Anemia, Hemolytic, Congenital/genetics
- Anemia, Hemolytic, Congenital/metabolism
- Anemia, Hemolytic, Congenital/pathology
- Anemia, Hemolytic, Congenital/therapy
- Elliptocytosis, Hereditary/genetics
- Elliptocytosis, Hereditary/metabolism
- Elliptocytosis, Hereditary/pathology
- Elliptocytosis, Hereditary/therapy
- Erythrocyte Membrane/genetics
- Erythrocyte Membrane/metabolism
- Erythrocyte Membrane/pathology
- Humans
- Hydrops Fetalis/genetics
- Hydrops Fetalis/metabolism
- Hydrops Fetalis/pathology
- Hydrops Fetalis/therapy
- Risk Factors
- Spherocytosis, Hereditary/genetics
- Spherocytosis, Hereditary/metabolism
- Spherocytosis, Hereditary/pathology
- Spherocytosis, Hereditary/therapy
- Thrombosis/genetics
- Thrombosis/metabolism
- Thrombosis/pathology
- Thrombosis/therapy
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Shmukler BE, Vandorpe DH, Rivera A, Auerbach M, Brugnara C, Alper SL. Dehydrated stomatocytic anemia due to the heterozygous mutation R2456H in the mechanosensitive cation channel PIEZO1: a case report. Blood Cells Mol Dis 2013; 52:53-4. [PMID: 23973043 DOI: 10.1016/j.bcmd.2013.07.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 07/22/2013] [Accepted: 07/23/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Boris E Shmukler
- Renal Division and Division of Molecular and Vascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
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Abstract
Piezo ion channels have been found to be essential for mechanical responses in cells. These channels were first shown to exist in Neuro2A cells, and the gene was identified by siRNAs that diminished the mechanical response. Piezo channels are approximately 2500 amino acids long, have between 24-32 transmembrane regions, and appear to assemble into tetramers and require no other proteins for activity. They have a reversal potential around 0 mV and show voltage dependent inactivation. The channel is constitutively active in liposomes, indicating that no cytoskeletal elements are required. Heterologous expression of the Piezo protein can create mechanical sensitivity in otherwise insensitive cells. Piezo1 currents in outside-out patches were blocked by the extracellular MSC inhibitor peptide GsMTx4. Both enantiomeric forms of GsMTx4 inhibited channel activity in a manner similar to endogenous mechanical channels. Piezo1 can adopt a tonic (non-inactivating) form with repeated stimulation. The transition to the non-inactivating form generally occurs in large groups of channels, indicating that the channels exist in domains, and once the domain is compromised, the members simultaneously adopt new properties. Piezo proteins are associated with physiological responses in cells, such as the reaction to noxious stimulus of Drosophila larvae. Recent work measuring cell crowding, shows that Piezo1 is essential for the removal of extra cells without apoptosis. Piezo1 mutations have also been linked to the pathological response of red blood cells in a genetic disease called Xerocytosis. These finding suggest that Piezo1 is a key player in cells' responses to mechanical stimuli.
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Affiliation(s)
- Shameem Mahmood
- Department of Paediatric Haematology, King's College London School of Medicine, King's College Hospital, Denmark Hill, London
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Abstract
An infant with Hb SE disease is reported. He was clinically well. Review of the literature shows that patients aged 18 and younger are usually well. On the other hand, more than half of those aged 20 and older developed sickling-related complications, including potentially life-threatening acute chest syndrome. These patients have 60-65% Hb S, similar to the percent Hb S in patients with Hb S/beta(+)-thalassemia. Their hematological features and clinical course appear to parallel those of Hb S/beta(+)-thalassemia. Patients have variable levels of anemia, and some develop clinical complications. With population migrations and increasing racial intermarriages, Hb SE disease is expected to be encountered more often around the globe. Patients with Hb SE disease should be followed and managed in a similar fashion as those with Hb S/beta(+)-thalassemia, and treated appropriately when they develop sickling-related symptoms and complications.
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MESH Headings
- Adult
- Anemia, Hemolytic, Congenital/genetics
- Anemia, Hemolytic, Congenital/metabolism
- Anemia, Hemolytic, Congenital/pathology
- Anemia, Hemolytic, Congenital/therapy
- Child
- Female
- Hemoglobin E/genetics
- Hemoglobin E/metabolism
- Hemoglobin, Sickle/genetics
- Hemoglobin, Sickle/metabolism
- Humans
- Infant
- Infant, Newborn
- Male
- Mutation/genetics
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Affiliation(s)
- David Masiello
- The Center of Excellence in Sickle Cell Disease, Department of Medicine, School of Medicine, Boston University, Boston, MA, USA
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Xu HG, Fang JP, Huang SL, Zhou DH, Chen C, Huang K, Li Y. [Risk factors and treatment of hemorrhagic cystitis in children after hematopoietic stem cell transplantation]. Zhonghua Er Ke Za Zhi 2006; 44:126-30. [PMID: 16624030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVE Hemorrhagic cystitis (HC) is one of the common complications of hematopoietic stem cell transplantation (HSCT), which causes significant pain, prolongs hospitalization, and occasionally results in renal failure and death. This study aimed at investigating the incidence, risk factors, and outcome of HC in children post umbilical cord blood transplantation (UCBT) and peripheral blood stem cell transplantation (PBSCT). METHODS From October 1998 to June the clinical records of 53 pediatric patients (aged 2-18 years with median age of 7.5 years) in our HCST center who underwent UCBT (n = 37) and PBSCT (n = 16) were retrospectively analyzed. Thirty out of 53 patients were diagnosed as hereditary hemolytic anemia (56.6%), and the others as haematological malignancies (43.4%): of whom 8 had acute lymphoblastic leukemia, 12 acute myeloid leukemia, 2 chronic myeloid leukemia and 1 non-hodgkin lymphoma. Conditioning regimen varied according to disease and clinical status, however based on cyclophosphamide (CTX, 120-200 mg/kg) and busulphan (BU, 12-16 mg/kg) in the cohort. Total body irradiation (TBI) or total lymphoid irradiation was added in 7 patients respectively. The patients were divided into regular treatment group (RTG) with 15 cases who received hyperhydration, alkalinizing, diuresis and Mesna during CTX infusion and prostaglandin E1 (PGE1) group (PEG) with 38 cases who received hyperhydration, alkalinizing, diuresis and Mesna plus prostaglandin E1 (0.03 microg/kg.h). The risk factors of HC were examined by univariate and multivariate analysis. RESULTS In all, 11 of the 53 transplanted patients developed HC (21%) with a median onset time of day +15 (rage day +2 - +25). HC was classified as early in 4 (36%) and late in 7 (64%), and scored as grade Iin 2 cases (18%), grade II in 4 (36%) and grade III in 5 (46%). There was no significant difference between RTG and PEG in the incidence of HC, however, the incidence was much higher in the group of patients who were > or = 6 years old, positive group of graft-versus-host disease (GVHD) and group of cytomegalovirus (CMV) infection than that in the group of patients who were < 6 years of age (32% vs. 8%, P < 0.05), negative group of GVHD (35% vs. 7%, P < 0.05) and CMV non-infected group (62% vs. 13%, P < 0.05), respectively. Furthermore, by multivariate analysis, > or = 6 years old (OR = 3.53, P < 0.05) and CMV infection (OR = 4.31, P < 0.05) were significant risk factors for HC. Three of 11 patients were treated with bladder irrigation. All patients recovered from HC in a median 12.8 days (range 2-53 days). CONCLUSION Older age (> or = 6 years) as well as CMV infection were the risk factors of HC. Both hyperhydration and Mesna were effective in preventing HC, while addition of PGE1 could not reduce the incidence of HC. The prognosis of HC in children post HSCT was satisfactory.
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Affiliation(s)
- Hong-gui Xu
- Department of Pediatrics, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510120, China
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12
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Abstract
The hereditary stomatocytoses are mostly accounted for by genetic disorders of red cell membrane permeability to monovalent cations. These conditions, all very rare, are comprised of a hemolytic anemia, frequently macrocytosis, and the presence of abnormally shaped red blood cells. The key test for diagnosis is osmotic gradient ektacytometry, which measures the osmotic resistance and hydration of the red blood cell; the curve depicting the temperature dependence of the cation leak is also important. Syndromes include familial pseudohyperkalemia (FP), which is devoid of hematological features, dehydrated hereditary stomatocytosis (DHS), and overhydrated hereditary stomatocytosis (OHS). Some forms of DHS may be a pleiotropic, showing pseudohyperkalemia and/or perinatal edema. Perinatal edema, if not properly treated, may be lethal but may also resolve spontaneously prior to or shortly after birth and never reappear. Hereditary cryohydrocytosis, type 1 (CHC 1) is characterized by a dramatic resumption of the leak in vitro as the temperature approaches 0 degrees C; cell hydration seems unaltered. In OHS, stomatin, a membrane protein, is sharply reduced; however, this is a secondary event and the primarily mutated protein remains unknown. Hereditary cryohydrocytosis, type 2 (CHC 2) presents similar to OHS, except that the leak dramatically increases close to 0 degrees C. In addition, hematological manifestations are associated with neurological disorders. Of critical practical importance is that splenectomy in DHS or OHS causes thromboembolic events that may be fatal. The genes involved in hereditary stomatocytoses have yet to be identified. Apart from the 16q24-qter locus, related to subsets of DHS and FP, and a chromosome 2 locus assigned to a single case of FP, gene mapping has been difficult. The eventual discovery of individual genes will clarify complicated classification of the stomatocytoses, now based solely on phenotype.
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MESH Headings
- Anemia, Hemolytic, Congenital/diagnosis
- Anemia, Hemolytic, Congenital/genetics
- Anemia, Hemolytic, Congenital/metabolism
- Anemia, Hemolytic, Congenital/therapy
- Blood Proteins/genetics
- Blood Proteins/metabolism
- Cations, Monovalent/metabolism
- Cell Membrane Permeability/genetics
- Cell Membrane Permeability/physiology
- Chromosomes, Human, Pair 16/genetics
- Chromosomes, Human, Pair 2/genetics
- Erythrocytes, Abnormal/metabolism
- Exons/genetics
- Female
- Humans
- Hyperkalemia/genetics
- Hyperkalemia/metabolism
- Male
- Membrane Proteins/genetics
- Membrane Proteins/metabolism
- Potassium/metabolism
- RNA Precursors/genetics
- RNA Precursors/metabolism
- RNA Splicing/genetics
- Sodium/metabolism
- Splenectomy/mortality
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Affiliation(s)
- Jean Delaunay
- Service d'Hématologie, d'Immunologie et de Cytogénétique, Hôpital de Bicêtre, Faculté de Médecine Paris-Sud, INSERM U-473, 84 rue du Général-Leclerc, 94273 Le Kremlin-Bicêtre, France
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13
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Branca R, Costa E, Rocha S, Coelho H, Quintanilha A, Cabeda JM, Santos-Silva A, Barbot J. Coexistence of congenital red cell pyruvate kinase and band 3 deficiency. ACTA ACUST UNITED AC 2004; 26:297-300. [PMID: 15279669 DOI: 10.1111/j.1365-2257.2004.00617.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The authors report the case of a 9-year-old Caucasian girl, born in northern Portugal, with chronic nonspherocytic haemolytic anaemia and without family history of anaemia. The aethiological study of this anaemia revealed pyruvate kinase deficiency (PKD), because of two previously described mutations (426Arg-->Trp and 510Arg-->Gln). Since the blood smear revealed features not fully compatible with PKD diagnosis, additional tests were performed for the propositus and her parents, namely red blood cell membrane protein analysis. A decrease in proteins band 3 (15%) and 4.2 (18%) was found in the propositus. Her father presented only a decrease in band 3 (11%). Coexistence of PKD and erythrocyte membrane proteins deficiency in the same patient is very uncommon. Our findings suggest that a careful blood smear observation may lead to the identification of a combined deficiency in erythrocyte membrane proteins and enzymopathies.
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MESH Headings
- Anemia, Hemolytic, Congenital/etiology
- Anemia, Hemolytic, Congenital/genetics
- Anemia, Hemolytic, Congenital/metabolism
- Anion Exchange Protein 1, Erythrocyte/deficiency
- Anion Exchange Protein 1, Erythrocyte/genetics
- Anion Exchange Protein 1, Erythrocyte/metabolism
- Child
- DNA Mutational Analysis
- Erythrocytes/enzymology
- Erythrocytes/metabolism
- Exons
- Family Health
- Female
- Hematologic Tests
- Heterozygote
- Humans
- Point Mutation
- Pyruvate Kinase/deficiency
- Pyruvate Kinase/genetics
- Pyruvate Kinase/metabolism
- Pyruvate Metabolism, Inborn Errors/complications
- Pyruvate Metabolism, Inborn Errors/genetics
- Pyruvate Metabolism, Inborn Errors/metabolism
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Affiliation(s)
- R Branca
- Serviço de Hematologia, Hospital de Crianças Maria Pia, Porto, Portugal.
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14
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Martínez Nadal S, Alcorta Loyola I, Estella Aguado J, Rives Sola S, Toll Costa T. [Autoimmune hemolytic anemia with complement-positive direct antiglobulin test]. An Pediatr (Barc) 2003; 59:294-6. [PMID: 12975121 DOI: 10.1016/s1695-4033(03)78181-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Autoimmune hemolytic anemia (AIHI) is an infrequent disease in the pediatric age group. Its diagnosis is given by the direct antiglobulin test (DAT) or Coombs' test, which determines which type of globulin (IgG or complement) is the cause of the hemolysis. The type of globulin involved determines the etiology of AIHI, which is usually confirmed by positive results of other laboratory investigations such as cold agglutinin determination or the Donath-Landsteiner test. We present three cases of AIHI. DAT was positive to complement with diverse etiology: warm antibody with IgG-negative DAT, cold agglutinins associated with infectious mononucleosis, and Doth-Landsteiner antibodies. In all patients, empirical treatment with corticosteroids was initiated. The treatment was withdrawn or continued, depending on the final etiology of AIHI.
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Affiliation(s)
- S Martínez Nadal
- Servicio de Pediatría, Hospital Universitari Sant Joan de Déu, Universidad de Barcelona, España
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15
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Haines PG, Crawley C, Chetty MC, Jarvis H, Coles SE, Fisher J, Nicolaou A, Stewart GW. Familial pseudohyperkalaemia Chiswick: a novel congenital thermotropic variant of K and Na transport across the human red cell membrane. Br J Haematol 2001; 112:469-74. [PMID: 11167849 DOI: 10.1046/j.1365-2141.2001.02564.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two families with inherited abnormalities in Na and K transport across the red cell membrane are described. Both presented with 'pseudohyperkalaemia' as a result of loss of K from the red cells on storage at room temperature. Routine haematology was essentially normal, except for macrocytosis in one family. Studies of the temperature dependence of the passive leak to K showed a novel shoulder pattern with a minimum at 25 degrees C, a maximum at 10 degrees C, followed by a further fall. As in other cases of red cell-based pseudohyperkalaemia, the abnormal temperature dependence of this 'leak' flux could be held to account for the loss of K from the cells at room temperature. These cases represent a novel variant of the temperature dependence of the passive leak of K and Na across the red cell membrane, and can be classified as a mild, non-haemolytic form of the group known as the hereditary stomatocytosis and allied disorders'.
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Affiliation(s)
- P G Haines
- Department of Medicine, University College London, Rayne Institute, UK
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16
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Abstract
The conditions known as 'hereditary stomatocytosis and allied syndromes' comprise a group of dominantly inherited human haemolytic anaemias characterized by a plasma membrane 'leak' to the univalent cations Na and K, an example of a small but growing group of diseases where pathology can be directly attributed to abnormal membrane transport. A number of case reports in the different variants have alluded to temperature-related phenomena, including loss of K on storage at room temperature (giving 'pseudohyperkalaemia') and lysis of cells when stored in the cold ('cryohydrocytosis'). This review collects together published studies of these temperature effects, which show very major differences in the 'leak' K transport. Two main variations on normal emerge: a 'shallow slope' type, in which the flux shows an abnormally low dependence on temperature in the range 37-20 degrees C, and 'high minimum', in which the minimum in this flux, which occurs in normal cells at 8 degrees C, is shifted up to 23 degrees C. These temperature studies provide a powerful method for phenotypic characterization.
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Affiliation(s)
- Suzanne E Coles
- Department of Medicine, University College London, Rayne InstituteUniversity Street, London WC1E 6JJ, UK. Fax: (+ 44) (0)171 2096211; E-mail:
| | - Gordon W Stewart
- Department of Medicine, University College London, Rayne InstituteUniversity Street, London WC1E 6JJ, UK. Fax: (+ 44) (0)171 2096211; E-mail:
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17
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Coles SE, Chetty MC, Ho MM, Nicolaou A, Kearney JW, Wright SD, Stewart GW. Two British families with variants of the 'cryohydrocytosis' form of hereditary stomatocytosis. Br J Haematol 1999; 105:1055-65. [PMID: 10554820 DOI: 10.1046/j.1365-2141.1999.01444.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe two British families with similar, dominantly-inherited, temperature-related variants of hereditary stomatocytosis, consistent with the original description of 'cryohydrocytosis'. The cells show a 5-6-fold increase in passive permeability at 37 degrees C with abnormal intracellular Na and K levels at 15-20 and 60-65 mmol/(l cells) respectively. Marked temperature effects were evident: lysis of red cells on storage in the cold was blatant and when whole heparinized blood was stored at room temperature, K accumulated in the plasma, producing 'pseudohyperkalaemia'. Studies of the temperature dependence of passive permeability showed that the minimum in the passive permeability, which is seen in normal cells at 8-10 degrees C, was shifted up to 23 degrees C in these abnormal cells, such that the permeability at 0 degrees C exceeded that at 37 degrees C. The abnormal temperature dependence in these genetically abnormal red cells strongly resembles that seen in normal cells when suspended in media in which either Na or Cl has been replaced by an organic cation or anion: it could be said these cells had a genetic mutation that somehow rendered the cell resistant to the stabilizing action of NaCl at low temperatures.
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Affiliation(s)
- S E Coles
- Department of Medicine, University College London, Rayne Institute
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18
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Abstract
A family with an unusual form of hereditary stomatocytosis is described. The affected members showed a mild, dominantly-inherited, haemolytic anaemia with intracellular Na and K levels of 41-48 and 44-53 mmol/(l cells) respectively. This anaemia was associated with marked 'pseudohyperkalaemia': that is, loss of K from red cells on storage at room temperature. At 37 degrees C, 'leak' tracer flux rates (assessed as the ouabain + bumetanide-resistant K fluxes) showed a roughly 5-fold acceleration compared to normal, and an abnormal temperature dependence with a shallow slope between 37 and 20 degrees C (mean Q10 (ratio of reaction rates at temperature T and T - 10) over this interval, 1.6; normal 2.2). The pseudohyperkalaemia could be attributed to the disparity between pump and leak at 20 degrees C. This is an identical mechanism to that previously shown for the haemato logically trivial condition, 'familial pseudohyperkalaemia. No protein or lipid abnormality was found in the membrane of these cells.
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Affiliation(s)
- S E Coles
- Department of Medicine, University College London, Rayne Institute
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19
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Abstract
A discussion of a 5-year-old child with congenital hemolytic anemia and severe hypotonia caused by triosephosphate (TPI) deficiency is presented. The complexities in the diagnosis and management of this condition is discussed and the relevant literature is reviewed.
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Affiliation(s)
- R E Linarello
- Department of Pediatrics, LSU School of Medicine, New Oreleans 70112, USA
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20
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Wang D, Mentzer WC, Cameron T, Johnson RM. Purification of band 7.2b, a 31-kDa integral phosphoprotein absent in hereditary stomatocytosis. J Biol Chem 1991; 266:17826-31. [PMID: 1655727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A 31-kDa human erythrocyte integral protein, band 7.2b, has been purified to better than 95% homogeneity. The polypeptide was found to be insoluble in most detergents and was isolated in denatured form by gel filtration in the presence of sodium dodecyl sulfate and preparative electrophoresis. In intact erythrocytes that were equilibrated with 32Pi, band 7.2b was phosphorylated in response to exogenous dibutyryl cAMP. The peptide is also palmitylated, as shown by its incorporation of radioactivity when intact erythrocytes were incubated with [9,10-3H]palmitic acid. Antisera to band 7.2b were raised in rabbits, and these antibodies cross-react with 31-kDa polypeptides in human liver and kidney. Immunoblots of red cells from a number of other species were negative, with the exception of a cross-reacting 23-kDa polypeptide in rat erythrocyte membranes. Band 7.2b was absent in erythrocyte membranes from an individual with overhydrated hereditary stomatocytes.
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Affiliation(s)
- D Wang
- Department of Biochemistry, Wayne Street University, Detroit, Michigan 48201
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21
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Boivin P, Galand C. [Iron overload in congenital hemolytic anemia caused by pyruvate kinase deficiency. A major late complication]. Presse Med 1990; 19:1087-90. [PMID: 2141411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Twelve patients (5 women and 7 men, aged from 19 to 54 years) presenting with congenital, non-spherocytic haemolytic anaemia due to erythrocyte pyruvate kinase (PK) deficiency were investigated for systemic iron overload 18 to 27 years after the diagnosis was made. One patient had, beside PK deficiency, idiopathic haemochromatosis demonstrated by the HLA A3 and B14 markers. Another, 21-year old male patient had received more than 100 blood transfusions. In both patients, blood ferritin levels were as high as 5,584 and 9,665 g/litre respectively. Among the remaining 10 patients, 9 had biochemical signs of iron overload, such as high serum iron levels, reduced total siderophilin saturation capacity and blood ferritin levels of about 1,500 g/litre. Hepatic histology could be obtained from 5 patients and showed significant iron overload with cirrhosis in one case and clear-cut portal fibrosis in 3 cases. In all but the patient with multiple transfusions the iron overload was unrelated to transfusions, being present in their absence, usually during the 3rd and 4th decades of their life. The finding of iron overload requires preventive measures such as limitation of transfusions and elimination of iron by deferoxamine therapy.
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Affiliation(s)
- P Boivin
- INSERM U. 160, Association Claude Bernard et Service d'Hématologie clinique de l'Hôpital Beaujon, Clichy
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22
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Garbarz M, Lecomte MC, Féo C, Devaux I, Picat C, Lefebvre C, Galibert F, Gautero H, Bournier O, Galand C. Hereditary pyropoikilocytosis and elliptocytosis in a white French family with the spectrin alpha I/74 variant related to a CGT to CAT codon change (Arg to His) at position 22 of the spectrin alpha I domain. Blood 1990; 75:1691-8. [PMID: 2328319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We describe a white French family in which 12 subjects presented with hereditary elliptocytosis (HE) or hereditary pyropoikilocytosis (HPP). Eight of these subjects were shown to be heterozygous for a spectrin (Sp) alpha I/74 variant, as demonstrated by analysis of partial tryptic digestion fragments of spectrin. This abnormal peptide pattern was associated with a decreased ability of Sp dimers to self-associate. In this kindred, in which four generations were available for study, the clinical expression varied from mild HE to HPP with an intermediate status of hemolytic HE. The severity of the disease appeared to be correlated both with the estimated amount of variant Sp (42% to 65%) and the excess of Sp dimers found in the membrane (30% to 51%, with a normal value of 3.7% +/- 1.6%). Reassociation studies using isolated Sp alpha and beta chains from an affected patient and an unaffected control subject showed that the Sp alpha I/74 Kd abnormal tryptic peptide resulted from a defect in the Sp alpha chain. Partial amino acid sequencing showed that the Sp alpha I/74 Kd peptide resulted from cleavage at lysine residue 42 of the Sp alpha I/80 Kd domain. Knowledge of the exon/intron organization of the human alpha Sp gene allowed us to amplify by the polymerase chain reaction the second exon of the alpha Sp gene in total cellular DNA of the HPP proposita. The amplified fragment was subcloned and sequenced. We found a G to A base substitution in the 22nd codon (CAT for CGT), which changes the normal arginine to a histidine. Hybridization of amplified DNAs with allele-specific oligonucleotides corresponding to the normal and mutant sequences confirmed the presence of the mutation in six other HE and HPP members of the family. The identification of this mutation at the DNA level confirmed the transmission of the same molecular defect in Sp through four generations but with different patterns of clinical expression.
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Affiliation(s)
- M Garbarz
- INSERM U.160, Association Claude Bernard, Hôpital Beaujon, Clichy, France
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23
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Saltman P. Oxidative stress: a radical view. Semin Hematol 1989; 26:249-56. [PMID: 2554506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- P Saltman
- Department of Biology, University of California San Diego, La Jolla 92093
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24
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Fukuda MN, Klier G, Yu J, Scartezzini P. Anomalous clustering of underglycosylated band 3 in erythrocytes and their precursor cells in congenital dyserythropoietic anemia type II. Blood 1986; 68:521-9. [PMID: 3730615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Congenital dyserythropoietic anemia type II (CDA II or HEMPAS) is a genetic anemia caused by membrane abnormality. Our previous studies indicated that in HEMPAS, erythrocytes band 3 and band 4.5 are not glycosylated by polylactosaminoglycans. The present study was aimed at determining how such underglycosylated band 3 behaves in erythrocyte membranes. By using anti-band 3 antibodies, immunogold electron microscopy revealed that band 3s are clustered in HEMPAS erythrocyte membranes. By freeze-fracture electron microscopy, band 3s were also seen as lightly clumped intramembrane particles on a protoplasmic fracture face. Erythrocyte precursor cells stained by anti-band 3 antibodies showed that band 3s are present in the cytoplasmic area of the reticulocytes as scattered single particles. However, in young erythrocytes in which intracellular membranes are almost degenerated, band 3s were clustered in the cytoplasmic area of the cell. These observations suggest that band 3s cluster before they are incorporated into the plasma membranes of HEMPAS erythrocytes. In contrast to band 3, glycophorin A detected by anti-glycophorin A antibodies did not show a noticeable difference between normal and HEMPAS. Such a clustering of band 3 may cause abnormal localization of band 3-associated proteins and may thus result in the macroscopic membrane abnormality seen in HEMPAS erythrocytes.
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25
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Kuratsuji T, Lee JY, Takahashi E, Shiro H, Yamada K, Miyashima K, Sugihara H, Yawata Y. [A case of congenital stomatocytosis with normal sodium fluxes, normal enzyme activities of red cells, but with increased osmotic fragility of red cells]. Rinsho Ketsueki 1986; 27:338-43. [PMID: 3016363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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26
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Sassa S, Drummond GS, Bernstein SE, Kappas A. Long-term administration of massive doses of Sn-protoporphyrin in anemic mutant mice (sphha/sphha). J Exp Med 1985; 162:864-76. [PMID: 3839840 PMCID: PMC2187816 DOI: 10.1084/jem.162.3.864] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The effects of long-term administration of very large doses of Sn-protoporphyrin on hematological indices, histological changes, plasma bilirubin levels, tissue heme oxygenase activity, and activities of heme biosynthetic enzymes, were examined in genetically anemic mutant mice with hemolytic anemia (sphha/sphha). Long-term weekly treatment with Sn-protoporphyrin (100 mumol/kg body weight for 32 wk) did not alter hematological indices, histological findings, or enzyme activities related to heme biosynthesis, even though it resulted in sustained decreases in microsomal heme oxygenase activity in the liver, kidney, and spleen, and a prolonged decrease in plasma bilirubin concentration. Inhibition of heme oxygenase did not alter the level of cytochrome P-450 in the liver and the kidney. The results indicate that long-term treatment with massive doses of Sn-protoporphyrin suppresses bilirubin formation but does not produce significant histopathological changes or appreciably interfere with heme synthesis, in this strain of genetically anemic mice. These findings provide further support for the idea that suppression of heme degradation to bile pigment by the inhibition of heme oxygenase may prove useful to the prevention of severe hyperbilirubinemia in humans.
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27
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Sakalová A, Rotrekl B, Hrubisko M, Hammerová T, Randusková A, Gazová S, Geso L, Nosková J, Kanderová B. [Congenital hemolytic anemias due to defects in glycolysis and the hexose monophosphate shunt and their incidence in Slovakia]. BRATISL MED J 1984; 82:1438-50. [PMID: 6509341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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28
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Trotman BW, Lakshminarayanaiah N, Bernstein SE, Kaplan SA, Margulies C. Interaction of hemolysis and genotype on ionized calcium in bile of mice with hemolysis-induced gallstones. Gastroenterology 1984; 87:1127-30. [PMID: 6383935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
In this study, we used an ion-selective membrane electrode to measure ionized calcium in hepatic bile of control +/+ mice and nb/nb mice with hereditary hemolytic anemia. We found that biliary concentrations of ionized, bound, and total calcium were significantly higher (p less than 0.001) and magnesium was significantly lower (p less than 0.001) in nb/nb mice than in control +/+ mice. To separate the hemolytic process from genotypic influences, we transplanted genetically defective bone marrow from nb/nb mice into histocompatible nonhemolytic recipients (W/Wv). After successful engraftment, transplanted W/Wv mice had significantly higher biliary concentrations of ionized calcium than their untreated W/Wv counterparts (p less than 0.001); but bound and total calcium and magnesium concentrations were not different from untreated W/Wv controls. When compared with nb/nb mice, transplanted W/Wv mice had lower ionized calcium (p less than 0.001) and higher bound calcium concentrations (p less than 0.001) in their biles. These data indicate that ionized calcium in hepatic bile is significantly influenced by genotypic factors and subsequently increased in chronic hemolysis; and further, that increased ionized calcium in bile of mice with hemolysis is a risk factor, but of limited predictive value for hemolysis-induced gallstone formation.
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29
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Tani K, Fujii H, Miwa S, Imanaka F, Kuramoto A, Ishikawa H. Phosphofructokinase deficiency associated with congenital nonspherocytic hemolytic anemia and mild myopathy: biochemical and morphological studies on the muscle. TOHOKU J EXP MED 1983; 141:287-93. [PMID: 6228037 DOI: 10.1620/tjem.141.287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Enzymatic and electron microscopical studies were performed on the muscle of a proband with phosphofructokinase deficiency. Enzymatic studies showed that muscle phosphofructokinase activity of the proband was decreased to about a half of normal. This enzyme was quite thermolabile and had low affinity for fructose 6-phosphate. Electron microscopical studies showed the accumulation of glycogen granules beneath the sarcolemma and between the myofibrils in spite of a lack of accumulation of the intermediates before the step of phosphofructokinase. The proband's clinical symptoms, i.e., hemolytic anemia and myopathy, were considered to be due to the unstable, mutant, muscle-type phosphofructokinase in the red blood cells and muscle.
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30
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Cazzola M, Barosi G, Bergamaschi G, Dezza L, Palestra P, Polino G, Ramella S, Spriano P, Ascari E. Iron loading in congenital dyserythropoietic anaemias and congenital sideroblastic anaemias. Br J Haematol 1983; 54:649-54. [PMID: 6871111 DOI: 10.1111/j.1365-2141.1983.tb02145.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The relationship between body iron status, degree of anaemia, erythroid expansion, age and sex has been studied in eight patients with congenital dyserythropoietic anaemia (CDA) and two patients with congenital sideroblastic anaemia, who had received no or very few blood transfusions and no medicinal iron during the course of their illness. All patients had increased iron stores. Iron load was mild in three women in the reproductive age and severe in two men, in middle age, who had evidence of parenchymal organ dysfunction. Iron loading, as judged by the plasma ferritin concentration, was independent of the degree of anaemia while it was closely related to the patient's age and the degree of increase in the total erythropoietic activity. It is concluded that patients with CDA or congenital sideroblastic anaemia are at high risk of developing haemochromatosis in middle age. Prophylactic phlebotomy or iron chelation therapy should be considered for such patients.
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31
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Palek J, Lux SE. Red cell membrane skeletal defects in hereditary and acquired hemolytic anemias. Semin Hematol 1983; 20:189-224. [PMID: 6353590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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32
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Abstract
The nb/nb mouse with hereditary hemolytic anemia provides an animal model for the study of pigment gallstone disease. We measured glycoprotein synthesis and secretion in gallbladder neck and fundus of 6-month-old mice without stones, and in 12-month old mice with and without stones in order to determine the effect of age and presence or absence of stones on mucin release. We observed that the gallbladder necks of 12-month-old nb/nb mice with pigment stones secreted more 3H-glucosamine-labeled glycoprotein (68.2 dpm per microgram protein) than did the gallbladder necks of mice without pigment stones (31.1 dpm per microgram protein). When expressed as a percentage of total glycoprotein synthesis in the gallbladder neck, secretion of glycoprotein was 23.4% in 6-month-old hemolytic mice and 28.7% in 12-month-old hemolytic mice without pigment stones. However, in the presence of pigment stones, the percentage of secreted glycoprotein rose to 4.08%, which differed significantly from both 6-month-old (p < 0.02) and 12-month-old mice without stones (p < 0.05). Our results suggest that the presence of gallstones in nb/nb mice was associated with a localized increase in glycoprotein release from gallbladder neck. The mechanism for this increase may be precipitation of pigment-mucin concentrations in the gallbladder neck glands which has been previously described in this animal model.
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Affiliation(s)
- J T LaMont
- Evans Memorial Department of Clinical Research and Section of Gastroenterology, University Hospital, Boston University Medical Center, Massachusetts 02118, USA
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33
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Vel'tishchev IE. [Clinical aspects of hereditary disorders of the structure and function of biological membranes]. Klin Med (Mosk) 1982; 60:32-8. [PMID: 6757572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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34
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Faruqui S, Abraham A, Berenfeld MR, Gabuzda TG. Normal serum ferritin levels in a patient with HEMPAS syndrome and iron overload. Am J Clin Pathol 1982; 78:97-101. [PMID: 7102612 DOI: 10.1093/ajcp/78.1.97] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Serum ferritin levels in a patient with HEMPAS syndrome (hereditary erythroblastic multinuclearity associated with positive acidified serum test) were correlated with body iron stores directly measured on spleen and liver biopsy specimens as well as by quantitative serial phlebotomy. Normal serum ferritin concentrations were found in the presence of a moderate excess in iron stores (approximately 6-12 times normal). They temporarily increased after transfusion and splenectomy with a prompt return to the normal range. As repeated phlebotomies over a period of nine months depleted the excess iron stores, the serum ferritin ultimately decreased to a subnormal concentration. The serum ferritin concentration was not a reliable index of increased body iron stores in this iron overloaded patient, but did reflect their depletion by serial phlebotomy.
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Smith JE. Animal models of human erythrocyte metabolic abnormalities. Clin Haematol 1981; 10:239-51. [PMID: 6111407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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36
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Noël D, Duron F, Thomas M. [Hemochromatosis and puryvate kinase deficiency (author's transl)]. Ann Med Interne (Paris) 1979; 130:679-83. [PMID: 539687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A 25-year-old man with familial pyruvate kinase (PK) deficiency who have been given only 6 transfusions during his lifetime died of cardiac failure from hemochromatosis (HC). This previously unreported association of PK and HC deficiency does not appear to be fortuitous but to be related to possible early hemolysis and intramedullary destruction, features of ineffective erythropoiesis. The role of splenectomy in the progression of the HC could, as in some thalassemias, be an unfavourable factor. Serum iron levels should therefore be measured during the course of AHPK.
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Valentine WN. The Stratton Lecture. Hemolytic anemia and inborn errors of metabolism. Blood 1979; 54:549-59. [PMID: 572716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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38
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Sassa S, Kappas A, Bernstein SE, Alvares AP. Heme biosynthesis and drug metabolism in mice with hereditary hemolytic anemia. Heme oxygenase induction as an adaptive response for maintaining cytochrome P-450 in chronic hemolysis. J Biol Chem 1979; 254:729-35. [PMID: 762094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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39
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Schröter W, Gahr M, Wonneberger B. [Pyrivate kinase deficiency. II. Biochemical studies (author's transl)]. Monatsschr Kinderheilkd (1902) 1977; 125:713-9. [PMID: 19696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pyruvate kinase deficiency was studied biochemically in ten homozygous and seven heterozygous individuals who previously had been examined clinically and hematologically (see part I). In crude hemolysates some properties of the deficient enzymes were found to be altered. The pH optimum was shifted towards the alkaline range, and the thermal optimum was found between 17 and 27 degrees Cinstead of between 37 und 47 degrees C. The abnormal enzymes were much less stable than normal pyruvate Kinase (PK), and more susceptible to inhibition by adenosinetriphosphate. The affinity to adenosinediphosphate was normal in all cases whereas the affinity to phosphoenolpyruvate was either normal (two cases/, increased (two cases) or slightly decreased (six cases). Fructosediphosphate activated the abnormal enzymes by a factor of 1.5--18 and simultaneously transformed the sigmoidal affinity curve with phosphoenolpyruvate into the hyperbolic curve known for the normal enzyme. The consumption of glucose and the formation of lactate were higher in PK deficient erythrocytes than in normal cells but lower than in erythrocyte populations with similar reticulocyte counts. The formation of 2,3-diphosphoglycerate was markedly increased, whereas its breakdown was low. A close relation between the degree of reticulocytosis and the impairment of glucose metabolism was found. In patients with high reticulocyte counts, i.e. in the splenectomized patients, the highest concentrations of glucose-6-phosphate, phosphoenolpyruvate, 3-phosphoglycerate and 2,3-diphosphoglycerate as well as a high formation and a low breakdown of 2,3-diphosphoglycerate and a deficit in lactate formation were found. In heterozygotes, small increases of the concentration of glucose-6-phosphate, phosphoenolpyruvate and 3-phosphoglycerate were demonstrated. Our results support the conclusion that PK deficiency is mainly a disorder of the reticulocytes. Their metabolism grossly deteriorates within the venous sinuses of the spleen. Splenectomy improves the clinical course because this critical area of microcirculation with a highly unfavourable metabolic milieu is eliminated.
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Abstract
This article discusses the production, transport, and excretion of bilirubin in the newborn period. The causes, significance, and treatment of unconjugated and conjugated hyperbilirubinemia are different; and because this is so, it is important to review the main causes and management of unconjugated hyperbilirubinemia. Conjugated hyperbilirubinemia in the newborn period could be either due to hepatocellular dysfunction or extrahepatic biliary obstruction. There are several recent advances in early differentiation and management of these two entities.
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Idel'son LI, Benisovich VI, Levachev MM. [A case of hereditary hemolytic anemia caused by a disorder in the fatty acid composition of erythrocyte membranes with signs of increased erythrocyte complement sensitivity]. Probl Gematol Pereliv Krovi 1976; 21:43-7. [PMID: 959187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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42
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Shevchenko NS, Krylov VI, Vinogradov AF, Petrushina AD, Sosnovskiĭ VG. [Metabolism of plasma and erythrocyte neutral lipids, cholesterol and its esters and also phospholipids in children with several blood diseases]. Probl Gematol Pereliv Krovi 1976; 21:11-6. [PMID: 986652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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43
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Mentzer WC, Smith WB, Goldstone J, Shohet SB. Hereditary stomatocytosis: membrane and metabolism studies. Blood 1975; 46:659-69. [PMID: 1174702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
A defect in the protein kinase-mediated phosphorylation of erythrocyte membrane proteins, previously unrecognized in stomatocytosis, was discovered in a boy with hereditary stomatocytosis and severe hemolytic anemia. The high-sodium, low-potassium erythrocytes of this patient were remarkably permeable to both sodium and potassium. The rate of ouabain-inhibitable active cation transport was more than ten times normal and was sustained by an increase of similar magnitude in glycolysis. The deformability in vitro of fresh stomatocytes was reduced and deteriorated further after a brief period of incubation with glucose. Ferrokinetic studies showed that these rigid cells were sequestered by the spleen. When stomatocytes were deprived of glucose in vitro, ATP depletion and ATPase cation pump failure rapidly ensued. Because of their permeability defect, such depleted cells rapidly became swollen and lysed. Prolonged entrapment in acidic, hypoglycemic regions of the spleen would recapitulate these unfavorable events in vivo. In this regard, splenectomy was followed by an improvement in erythrocyte survival, although evidence of continuing hemolysis was obtained.
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MESH Headings
- Abnormalities, Multiple
- Anemia, Hemolytic, Congenital/metabolism
- Anemia, Hemolytic, Congenital/surgery
- Biological Transport
- Bone Marrow Diseases/genetics
- Cations, Monovalent
- Cell Membrane Permeability
- Cell Survival
- Child, Preschool
- Erythrocytes, Abnormal/metabolism
- Erythrocytes, Abnormal/pathology
- Female
- Genetics, Medical
- Humans
- Infant, Newborn
- Male
- Micropore Filters
- Osmotic Fragility
- Potassium/blood
- Pregnancy
- Sodium/blood
- Splenectomy
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Adverse effects of antidepressant drugs. Med Lett Drugs Ther 1975; 17:3-4. [PMID: 1109185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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45
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Schrier SL. Editorial: Water content of erythrocytes. N Engl J Med 1974; 291:526-7. [PMID: 4277450 DOI: 10.1056/nejm197409052911011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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47
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Queisser W. [The combined application of cytophotometric and autoradiographic methods in the study of the proliferation of normal and distrubed human haemopoietic cell systems (author's transl)]. Klin Wochenschr 1973; 51:687-94. [PMID: 4589266 DOI: 10.1007/bf01468356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Kreimer-Birnbaum M, Bannerman RM, Russell ES, Bernstein SE. Pyrrole pigments in normal and congenitally anaemic mice (+:+, W-W v , ha-ha, nb-nb, mk-mk, f-f and sla-Y). Comp Biochem Physiol A Comp Physiol 1972; 43:21-30. [PMID: 4404581 DOI: 10.1016/0300-9629(72)90464-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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49
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Selwyn JG. Recollections of the years 1951-54. Br J Haematol 1972; 23:Suppl:17-8. [PMID: 4567189 DOI: 10.1111/j.1365-2141.1972.tb03499.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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50
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May A, Huehns ER. The control of oxygen affinity of red cells with Hb-Shepherds Bush. Clin Sci (Lond) 1972; 42:10P. [PMID: 5058560 DOI: 10.1042/cs042010pa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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