Macrophage erythrophagocytosis and iron exocytosis

SUMMARY

Senescent, or damaged, erythrocytes are removed from the blood stream mainly by the macrophage system. Such cells may acquire and store large quantities of the redox-active transition metal iron that, if released together with superoxide and hydrogen peroxide during an oxidative burst, may induce peroxidative reactions with a variety of surrounding substances, e.g., low-density lipoprotein (LDL). In this study we demonstrate 1. the temporary sequestration of iron within the secondary lysosomal apparatus of both established macrophage-like J-774 cells and human monocyte-derived macrophages secondary to the uptake and degradation of native and photo-oxidized (ultraviolet UV light) erythrocytes; and 2. an ensuing development by these cells of a capacity for iron-exocytosis. The binding and uptake by human macrophages and J-774 cells of artificially aged, UV-irradiated erythrocytes were stimulated compared to that of native erythrocytes. The uptake resulted in lysosomal accumulation of iron in a low-molecular weight form, as shown by autometallography. Cells exposed to ferric chloride were used as positive controls. Ensuing exocytosis of iron to the culture medium was demonstrated by atomic absorption spectroscopy. Our findings suggest that macrophage erythrophagocytosis is a useful model for the study of the sequestration of iron within the macrophage acidic vacuolar apparatus, its subsequent exocytosis, and oxidative effect on extracellular LDL.     

A chemiluminescence assay for erythrophagocytosis

A luminol-dependent chemiluminescence assay for the assessment of the phagocytosis of erythrocytes sensitized with anti-D IgG immunoglobulin by mononuclear leukocytes is described. The mononuclear leukocytes were obtained by apheresis enriched by centrifugation through a density gradient and stored in liquid nitrogen before use. The total reaction mixture, consisting of mononuclear leukocytes-luminol-erythrocytes (either anti-D IgG sensitized or unsensitized controls) was 500 μl, light detection was by an LKB 1251 luminometer. Peak luminescence was seen between 35–45 minutes, the reaction being exhausted by 120 minutes. Determination of the reproducibility of the assay gave intra- and inter-assay coefficients of variation of 5% and 13% respectively. We found the chemiluminescent response to be affected by the number of erythrocytes used in the assay and by the composition of the medium in which the cells were resuspended, particularly the pH at the initiation of the assay. We also compared the chemiluminescence assay to a microscopic phagocytic assay and found the results virtually identical. However, the former chemiluminescence assay was much easier to perform, marginally more sensitive, less laborious and eliminated any possibility of subjective error.     

Enhancement of erythrophagocytosis by cyclophosphamide

The effect of cyclophosphamide (Cy) on erythrophagocytosis carried out by peritoneal exudate cells (PEC) was evaluated. The results indicate that the treatment of BALB/c mice with a single high dose of Cy (200 mg/kg) increases the capability of PEC to ingest sensitized sheep red blood cells. Cy not only increases the percentage of PEC with engulfed erythrocytes, but also augments the activity of individual phagocytes. This effect is exerted upon both mononuclear and polymorphonuclear cells and is probably due to the activation of receptors for the Fc fragment of IgG on PEC membranes, as unsensitized sheep erythrocytes are not phagocytized. Considering that Cy is one of the most used alkylating agents in treatment of immunological disorders and cancer chemotherapy, this enhancing effect on phagocytosis may be important in the regulation of host defense mechanisms.     

Model studies of erythrophagocytosis in vitro

Macrophages of the RHS are important for the elimination of aged and altered erythrocytes. An increase in the membrane bound autologous IgG generates a recognition signal in the plasmalemma, which triggers the RBC-phagocytosis. The IgG-receptors are buried in the band 3 proteins of the membrane. Enzymatic degradations or conformational changes of the glycocalyx are accompanied by an expression of these receptors. Similar effects were obtained after alteration of the membrane skeleton (crosslinking of the spectrin). A clustering of IgG-receptors due to interaction of the denatured hemoglobin (Heinz-bodies) with the membrane seems to be unlikely. Exovesiculation represents a process of formation of an intact membrane structure. Prolonged stay of RBC in the spleen can induce membrane altering continued by increased IgG loading.     

Morphometrical studies of erythrophagocytosis in the spleen

The elimination of altered RBC was investigated morphometrically in the rat spleen by determination of the percentage of erythrophagosomes in macrophages. PHZ and diamide treated RBC led to a time dependent increase of the percentage of erythrophagosomes in comparison to normal spleens. The deformability of the target RBC was lowered as revealed by measurements with glass micropipettes. RBC-microvesicles and diamide treated RBC are primarily loaded with IgG and undergo a rapid elimination. PHZ-RBC and cells with a prolonged stay in the spleen are sequestrated by secondary mechanisms. Details of primary and secondary elimination are discussed.     

Final stages of erythrophagocytosis in the sheep placenta

Summary In trophoblastic epithelial cells of the sheep placenta the final stages of erythrocyte breakdown within the lysosomal apparatus were studied at the ultrastructural level.As a result of hemoglobin digestion lysosomes containing hemoglobin-derived pigments (HDP) were formed. The HDP-lysosomes were acid phosphatase-positive, highly electron-dense bodies of round to irregular shape containing whorled membranous formations. The accumulation of these lysosomes in epithelial cells led to fusion resulting in the formation of conglomerates. At the end of the gestation period the amount of HD Plysosomes and their conglomerates markedly increased.In addition to erythrocytes the trophoblastic epithelial cells in the erythrophagocytic regions phagocytosed maternal leukocytes and neighbouring epithelial cells and giant cells.By gradual accumulation of HDP-lysosomes and remnants of phagocytosed cells, highly electron-dense acid phosphatase-positive residual bodies of variable appearance were formed within the epithelial cells.At the end of pregnancy the spaces between juxtaposed villi of the trophoblastic epithelium in the erythrophagocytic zones were occluded by apposition of the epithelial cells. In these occluded regions an increase in highly electron-dense large-sized residual bodies (15–22 m of dimension) occurred as a result of multiple cell phagocytosis in combination with fusion. In these residual bodies the numerous incorporated HDP-lysosomes and the remnants of phagocytosed cells could still be recognized.     

New method to quantify erythrophagocytosis by autologous monocytes.

BACKGROUND: Anemia is the net result of decreased red blood cell (RBC) production and increased removal of RBCs. Replication and maturation of erythroid precursors and RBC lysis can be measured by standardized in vitro methods and surrogate markers, respectively. In contrast, erythrophagocytosis by autologous phagocytes is more difficult to quantify. METHODS: We developed a method to assess erythrophagocytosis by autologous monocytes from 5 ml of whole blood. RBCs were labeled with carboxyfluorescein-diacetate-succinimidyl ester (CFDA-SE) and subsequently coincubated with autologous CD14(+) monocytes. Phagocytosis was quantified using flow cytometry. After standardization, the assay was validated in patients with severe malarial anemia (SMA), a condition that is associated with increased erythrophagocytosis. RESULTS: After labeling, CFDA-SE was stably incorporated into RBCs and no significant leakage leading to contamination of nonlabeled cells was observed. Monocytes ingested opsonized, labeled RBCs seven times more than nonopsonized controls. Erythrophagocytosis was significantly higher in SMA than in healthy controls. CONCLUSIONS: The established assay showed enhanced autoerythrophagocytosis associated with SMA and hence was able to detect clinically relevant erythrophagocytosis. This novel assay is well suited for rapid quantification of in vitro erythrophagocytosis by autologous monocytes.     

Fever,jaundice, and histiocytic erythrophagocytosis: fulminant infection or malignancy?

Some of the problems which we see on the infectious disease consultation service can be quite frustrating. This is one such case. A middle-aged man presented to our medical service with fever and dyspnea. His fulminant downhill course was characterized by anemia, jaundice, hypercalcemia, pulmonary abnormalities, and a lack of responsiveness to conventional antimicrobial therapy. At autopsy, malignant-appearing histiocytes were present in several organs including spleen, lymph nodes, and lung. Histopathological examination of tissues obtained at autopsy confirmed the presence of phagocytized erythrocytes within such histiocytes. This case aptly illustrates the hazy dividing line which sometimes exists between infectious and/or malignant processes which are, at present, still of undetermined etiology.     

Phagosome-lysosome interactions related to erythrophagocytosis in Kupffer cells of fetal rat liver

Kupffer cells of fetal rat liver were examined by ultrastructural cytochemical methods to reveal acid phosphatase (AcPase) activity in lysosomes. Elongated cisternae, 940-1150 A in width containing AcPase reaction product, were identified in these cells. These cisternae were sometimes in continuity with phagosomes containing engulfed erythrocytes. Observations suggest that such cisternae may partly encircle these phagosomes. The relationships of these cisternae to GERL (Golgi Endoplasmic Reticulum Lysosomes) is discussed.     

Role of an oxidative stress in the macrophage dysfunction caused by erythrophagocytosis

A phagocytic challenge with immunoglobulin G (IgG)-coated erythrocytes (EIgGs) has been shown to cause a subsequent depression of macrophage respiratory burst capacity and phagocytic function. The present study evaluated the hypothesis that this macrophage dysfunction is caused by an oxidative stress. An oxidative stress induced by ferric ammonium citrate (FAC) plus cumene hydroperoxide (CHP) caused a depression of macrophage function that was attenuated by antioxidants and iron chelators. In contrast, the same antioxidants and iron chelators did not alter changes caused by a challenge with EIgGs. EIgG challenge caused an increase in lipid peroxidation but failed to deplete glutathione (GSH) or decrease the activity of glyceraldehyde-3-phosphate dehydrogenase (GA-3-PD), suggesting that there was only a slight oxidative stress. Inhibition of the Fc gamma receptor (Fc gammaR) stimulated respiratory burst by removing calcium during the challenge did not attenuate the changes caused by an EIgG challenge. A phagocytic challenge with nonerythrocyte particles, IgG-coated beads (BIgGs), did not depress the respiratory burst capacity but did depress phagocytic function. Fc gammaR expression was depressed following a phagocytic challenge but not an oxidative stress. Thus, an oxidative stress can depress macrophage function, but the dysfunction caused by a phagocytic challenge with EIgGs involves Fc gammaR depletion and the erythrocyte contents rather than an oxidative stress.     

Subcellular localization of iron and heme metabolism related proteins at early stages of erythrophagocytosis

Background

Senescent red blood cells (RBC) are recognized, phagocytosed and cleared by tissue macrophages. During this erythrophagocytosis (EP), RBC are engulfed and processed in special compartments called erythrophagosomes. We previously described that following EP, heme is rapidly degraded through the catabolic activity of heme oxygenase (HO). Extracted heme iron is then either exported or stored by macrophages. However, the cellular localization of the early steps of heme processing and iron extraction during EP remains to be clearly defined.

Methodology/Principal Findings

We took advantage of our previously described cellular model of EP, using bone marrow-derived macrophages (BMDM). The subcellular localization of both inducible and constitutive isoforms of HO (HO-1 and HO-2), of the divalent metal transporters (Nramp1, Nramp2/DMT1, Fpn), and of the recently identified heme transporter HRG-1, was followed by fluorescence and electron microscopy during the earliest steps of EP. We also looked at some ER [calnexin, glucose-6-phosphatase (G6Pase) activity] and lysosomes (Lamp1) markers during EP. In both quiescent and LPS-activated BMDM, Nramp1 and Lamp1 were shown to be strong markers of the erythrophagolysosomal membrane. HRG-1 was also recruited to the erythrophagosome. Furthermore, we observed calnexin labeling and G6Pase activity at the erythrophagosomal membrane, indicating the contribution of ER in this phagocytosis model. In contrast, Nramp2/DMT1, Fpn, HO-1 and HO-2 were not detected at the membrane of erythrophagosomes.

Conclusions/Significance

Our study highlights the subcellular localization of various heme- and iron-related proteins during early steps of EP, thereby suggesting a model for heme catabolism occurring outside the phagosome, with heme likely being transported into the cytosol through HRG1. The precise function of Nramp1 at the phagosomal membrane in this model remains to be determined.     

Development of the embryonic chick phagocytic system: Intraembryonic erythrophagocytosis induced by phenylhydrazine

The intraembryonic reticuloendothelial response to phenylhydrazine-induced hemolytic anemia was studied embryonic chicks (days 13–16) by light and electron microscopy and histochemical and biochemical assays for acid phosphatase. Phenylhydrazine was given on day 13 and tissue taken at 2, 5, and 10 h and at 1, 2, and 3 days after injections. The response varied in the three major reticuloendothelial organs. The spleen first demonstrated an increase in erythrophagocytosis that was accompanied by increased acid phosphatase levels. Erythrophagocytosis occurred primarily in the red pulp resulting in increased numbers of macrophages, increased size of macrophages, and retention of erythrocytes, which together combined to enlarge the spleens. By 2 days after phenylhydrazine injection, greatly enlarged macrophages began to migrate into the venous system, where some erythrophagocytosis continued to occur. The liver was also a major erythroclastic organ in which Kupffer cells became increasingly erythrophagocytic. However, erythrophagocytosis began later than in the spleen, and as measured by acid phosphatase levels, the liver was not as effective in removing damaged erythroid cells. Marrow erythrophagocytosis was only slightly enhanced; however, the marrow responded by increasing its production of red blood cells. Thus, the intraembryonic reticuloendothelial organs of the embryonic chick responded to phenylhydrazine-induced hemolytic anemia in much the same manner as might be expected of the adult bird.     

Uremia associated with erythrophagocytosis by small intestine epithelial cells: a case report

BACKGROUND: Anemia is a frequent finding in patients with uremia due to chronic renal failure. Two factors contribute to the decrease in the red blood cell count and worsen the patient's general status: depression of erythropoiesis and shortening of the red blood cell lifespan. CASE: A novel response mechanism to erythrocyte loss took place in a uremic patient with gastrointestinal hemorrhage. In an autopsy case of an 80-year-old woman dying of uremia, analysis of an intestinal fluid smear revealed small intestine epithelial cells engulfing complete erythrocytes. CONCLUSION: This cytologic finding could account for a potential response mechanism to counteract the massive erythrocyte loss that occurs in hemorrhagic anemia with a uremic background.