Deformability investigations of erythrocytes stored at different temperatures

The deformability changes of erythrocytes stored at different temperatures were characterized by a filtration procedure. The filterability index (FI) of erythrocytes cryopreserved at either -196 degrees C or -28 degrees C increased (deformability decreased) by about 9% and 40% respectively. For comparison with the cryopreserves the filterability of erythrocytes stored in liquid state at +4 degrees C were investigated. The filterability changes are discussed in comparison with the changes of MCHC during storage.     

Deformability characterization of erythrocytes stored in different resuspension media

The deformability changes of erythrocytes during 35 days of storage in different resuspension media were characterized by a filtration procedure. The filterability of erythrocytes stored in CDS-AG medium decreased drastically, whereas the filterability of erythrocytes stored in SAGM and SAGS medium decreased only slightly. The MCHC change of stored erythrocytes were discussed in relation to filterability effects.     

Further improvement of the ACD-AG protective solution for blood. II. Behavior of the oxygen affinity of preserved blood in ACD-AG medium and in a protective solution with addition of pyruvate and xylitol and elevated Ph values]

The present paper deals with the behaviour of the oxygen transport function as well as the 2.3 DPG and ATP levels of erythrocytes during the storage in an ACD-AG solution. In the ACD-AG blood in P 50 fell from 20mm of Hg to values of 12 mm of Hg within 4 weeks of storage. The 2.3 DPG content had already fallen to values below 10% within a fortnight. Additions of xylitol (10 mM in the blood) and pyruvate (0.3 mM in the blood) will delay the decrease of P 50 and the 2.3 DPG content. Concerning the ATP behaviour there was no significant difference between ACD-AG blood and that with additions of xylitol and pyruvate. Up to a storage of a fortnight stored blood in the ACD-AG solution of xylitol and pyruvate will be equal to ACD-AG fresh blood as far as the parameter of oxygen transport function is concerned.     

ATP-content and shape of erythrocytes during preservation with adenine and nucleosides]

ACD blood with additions of adenine (A, 0.5 mM in blood), ademine + guanosine ((AG, 0.5 mM each) and adenine + guanosine + inosine (IAG, 0.5: 0.5: 18 mM) was stored for 6 weeks at 4 degrees C and the morphological changes in connection with the ATP content were observed. After a storage of 6 weeks 2--3% of the cells were present as diskocytes, 60% as echinocytes, and 40% as spherocytes. The delayed morphological alterations in the ACD-AG blood in comparison with ACD-A blood were also reflected by a higher ATP content of the ACD-AG blood during its storage. The alterations in the form of erythrocytes recorded in the morphological index Im (a subdivision was made according to 6 different stages of form) correlated with the ATP content. The coefficient of correlation amounted to r = 0.85. Thus, Im is a reliable criterium for evaluating possible storage damages of stored erythrocytes.     

Autologous transfusion of erythrocytes with high or low concentration of 2,3-diphosphoglycerate. Survival rate and time and hemoglobin-oxygen affinity]

1. In human erythrocytes the 2.3 DPG concentration was increased three to fourfold of the norm as IPP re-suspension by an incubation time of four hours at 37 degrees C or as ACD-AG blood was lowered below 20% of the norm respectively. After an autologous transfusion the 24 hours' surviving rate and the apparent half survival time of cells as well as the affinity of haemoglobin to oxygen in the total blood were measured. 2. The 24 hours' surviving rate for fresh erythrocytes with increased 2.3 DPG and ATP concentration amounts to 73% and the apparent half survival time amounts to 6 days. If erythrocytes are stored for four weeks as IPP resuspension at 4 degrees C, the 24 hours' surviving rate is 59%. Erythrocytes from fresh ACD-AG blood with lowered 2.3 DPG and a normal ATP concentration have a 24 hours' surviving time of 85% and an apparent half survival time of 24 days. 3. After autologous transfusion of 400 ml of erythrocytes with increased 2.3 DPG concentration the P50 value of the total blood will increase by 3 mm of Hg, after administering 400 ml of erythrocytes with lowered 2.3 DPG concentration it will fall by 1.8 mm of Hg. 4. The findings are discussed in connection with the significance of the changes of affinity of haemoglobin to oxygen produced by 2.3 DPG for the oxygen supply of tissues and under the aspect of using stored blood with increased 2.3 DPG concentration for practical purposes.     

Further improvement of the ACD-AG protective solution for blood. III. Improvement of the oxygen transport function of erythrocytes in sorbitol xylitol pyruvate solutions with elevated Ph]

If the pH value in the ACD or in the ACD-AG storage solution is enhanced, the glucose in the autoclaving with undergo a caramelizing process. For this reason glucose was replaced by sorbite in the storage solutions with a pH value of 6.0 and additions of xylitol and pyruvate. The initial pH value in the blood amounted to 7.3. The content of 2.3 DPG of the erythrocytes remained fully preserved in the blood with sorbitol and additions of xylitol and pyruvate during the first 2 weeks of storage and decreased to 30% only in the third week. There were only slight amounts of 2.3 DPG in the ACD-AG blood at that time of storage. Up to the third week of storage the ATP content of erythrocytes as well as the haemoglobin level in the plasma revealed no essential differences between stored blood with sorbitol and xylitol as a substrate or glucose + xylitol respectively. The quick decrease of the ATP level to zero and the simultaneous strong increase of haemolysis in the sorbitol blood within the fourth week of storage is discussed in connection with a lowering of the NAD/NADH2 quotient. For the purpose of keeping the 2.3 DPG level of erythrocytes a storage solution with sorbite and xylitol (ASCX-AG-Pyr 10mM) seems to be well suited for a storing time of 2---3 weeks at first.     

肠淋巴液引流对失血性休克大鼠红细胞流变性的影响

目的:观察肠淋巴液引流对失血性休克大鼠红细胞流变性指标以及血液黏度的作用。方法:Wistar雄性大鼠均分为假休克组、休克组(复制失血性休克模型)、引流组(复制失血性休克模型,自低血压1 h引流休克肠淋巴液)。在低血压3 h或相应时间,经腹主动脉取血,检测红细胞参数、红细胞电泳、红细胞沉降率(ESR)以及血液黏度,计算红细胞聚集指数、红细胞变形指数。结果:与假休克组比较,休克组红细胞数量、红细胞比积(HCT)、血红蛋白(Hb)、平均红细胞血红蛋白浓度(MCHC)、红细胞电泳率与迁移率、红细胞变形指数、全血黏度、全血低切与高切相对黏度和还原黏度显著降低,休克组平均红细胞体积、红细胞电泳时间、ESR、血沉方程K值与校正K值、红细胞聚集性指数、血浆黏度显著升高;引流组MCHC、红细胞电泳率与迁移率、全血黏度、全血低切与高切还原黏度均显著降低,引流组红细胞体积分布宽度(RDW-SD)显著增加。同时,引流组HCT、RDW-SD、红细胞变形指数、全血黏度、全血低切与高切相对黏度显著高于休克组;ESR、血沉方程K值与校正K值、红细胞聚集性指数、血浆黏度显著低于休克组。结论:休克肠淋巴液引流可改善失血性休克大鼠红细胞流变行为,从而改善血液流变性。     

Viability, ATP and 2,3-DPG content of resuspended erythrocytes during several-week storage in cold

Leukocyte-and thrombocyte-poor packed red cells obtained from ACD or. ACD-AG blood were resuspended to a hematocrit of about 55% and stored at 4 degrees C. The resuspension solution consisted of xylitol, inorganic phosphate, bicarbonate, adenine (A) and guanosine (G) solved in water. In one case glucose, citrate and sucrose were also added, in another one, sorbitol. The 2,3-DPG and the ATP level remained for a longer period in the sorbitol-xylitol-medium than in the glucose-xylitol-medium. The ATP content in the red cell suspension was higher than in packed cells. Higher ATP values were obtained in red blood cells from whole blood with adenine and guanosine. The survival rate of resuspended red blood cells in glucose-AG-citrate-sucrose medium was about 80--85% after 3 weeks of storage and 77% after 6 weeks with a higher range.     

Decreased deformability in aging erythrocytes

Deformability of bovine erythrocytes separated according to density (and age) was estimated by a modified Teitel's filterability test, the centrifugational test of Sirs, and viscosity measurements of cell suspensions. Both youngest and oldest erythrocytes were found to be less deformable than middle-aged cells, a result speaking against any chief role for deformability in the recognition of senescent erythrocytes and their removal from the circulation.     

Influence of bicarbonate on the content of 2,3-DPG (bisdihydroglycerophosphate) in preserved erythrocytes]

Both whole blood in ACD-adenine-guanosine solution (PCV about 36%) and resuspensions of erythrocytes from EDTA-blood (PCV about 80%) were stored at 4 degrees C with an admixture of sodium bicarbonate. To the resuspensions simultaneously were added xylitol and inorganic phosphate. The erythrocyte concentration of 2,3-disphosphoglycerate in whole blood will be preserved the longer the more bicarbonate is added. Compared with whole blood in resuspensions of erythrocytes the preservation of 2,3-DPG is significantly prolonged, probably because xylitol was added. From these results and from literature data it is concluded that bicarbonate is fixed to metabolites of the pentose metabolism. The products of the fixation of bicarbonate may influence the 2,3-DPG metabolism of the erythrocytes.     

Erythrocyte concentrates, low in buffy coat: production, preservation and evaluation of its quality

Buffy coat-poor packed red cells were prepared from fresh ACD-, ACD-AG- and EDTA-blood, than resuspended with a preservation solution, containing glucose, adenine, guanosine, sucrose, citric acid and sodium citrate and stored at 4 degrees C for 6 weeks. The survival rate of resuspended red cells from ACD-AG-blood amounted to 77% after 6 weeks of storage. The ATP content of resuspended red cells was approximately 25% lower than in ACD-AG whole blood during storage caused probably by increased ATP consuming reactions at the red cell membrane. The P2G-content of resuspended red cells from ACD- and ACD-AG-blood decreased above 50% of the normal level during the first week, as fast as in ACD- and ACD-AG whole blood. The P2G-breakdown in red cells from EDTA-blood was delayed for a week due to the higher pH as in CPD blood. Additions of xylitol, inorganic phosphate, and bicarbonate in 6, 5 and 20 mM final concentrations in the red cell suspensions and an increased pH at the same time delayed the breakdown of ATP and P2G. Packed red cells can be administered fast enough at hematocrits to 0.60 that will be achieved by adding 50 to 100 ml preservation solution. Leukocytes and thrombocytes were reduceds to 70 to 80%. With increasing rate of reduction a higher loss of red cells occured. Buffy coat-poor red cell concentrate contains only few microaggregates. It diminishes the risc of febrile transfusion reactions and delays the appearance of alloimmunisation. The circulatory overload of patients is less frequent than after transfusions of red cell resuspensions containing a large resuspension volume.     

The oxygen transport function of the blood and of the erythrocyte concentrate during storage and its importance for blood transfusion

The property of oxygen transport function was investigated in blood which had been stored in solutions of "glugizir" and "zitroglucophosphate" and in erythrocyte concentrates gained from it on the noughth, 7th, 14th und 21st day of storage at -4 +/- 2 degrees C. The parameters of the oxygen binding function (oxygen content of erythrocytes, half time of haemoglobin saturation with oxygen, concentration of organic phosphate [2.3 diphosphoglycerate and adenosine triphosphate] and those of inorganic phosphorus were determined in erythrocytes. During storage for more than 21 days no significant differences could be detected in the property of oxygen transfer between erythrocytes of stored blood and erythrocyte concentrate, with the values for storing in zitroglucophosphate being somewhat higher. Problems of applying all components of donor blood efficiently are discussed. In performing an adequate haemotherapy with blood components the importance of a functional condition of erythrocytes and oxygen balance in the organism of the receiver should be considered. The necessity of transfusing erythrocyte concentrate in the therapy of anaemias of different genesis is emphasized and the differences in applying concentrates in different plasma solutions are referred to. By transfusing concentrates the effectiveness of hemotherapy are elevated and the rate of complications and side-effects of whole blood are diminished.     

Effects of nitric oxide and prostacyclin on deformability and aggregability of red blood cells of rats ex vivo and in vitro.

Although many diseases of the heart and circulatory system have been linked with insufficient deformability and increased aggregability of red blood cells, there are only a few drugs which can modulate these biological functions of erythrocytes. Here, we show evidences that iloprost, stable prostacyclin analogue and SIN-1, active metabolite of molsidomine which spontaneously releases NO, may be sufficient pharmacological tools for modulating red blood cell deformability and aggregability. Deformability of red blood cells was measured by shear stress laser diffractometer (Rheodyn SSD) and expressed in percent of red blood cell deformability index (DI). MA-1 (Myrenne) erythrocyte aggregometer was used for photometric measurements of aggregability in arbitrary units (MEA) of mean extent of aggregation. Experiments were carried out on rats ex vivo and in vitro using whole rat blood or isolated erythrocytes. Ex vivo SIN-1 (infusion 2 mg/kg/min i.v.) and iloprost (bolus injection 10 microg/kg i.v.) significantly improved erythrocyte deformability and aggregability at 5-15 min after administration. L-NAME (10 mg/kg i.v.)- inhibitor of nitric oxide synthase, and aspirin (1 mg/kg i.v.) caused worsening of deformability of erythrocytes in experiments ex vivo. Studies in vitro also revealed improvement of red blood cell deformability and aggregability by SIN-1 (3 microM, 15 min incubation at 22 degrees C) or iloprost (1 microM, 15 min incubation at 22 degrees C) and this phenomenon appeared not only in whole blood but also in isolated red cells. It is concluded that NO- and prostacyclin-induced improvement of red blood cell deformability and aggregability results from direct action of these compounds on erythrocytes. NO-donors and iloprost could be useful in the treatment of disorders of blood fluidity.     

Blood filterability in peripheral obstructive arterial disease

The aim of this paper is to test whether an alteration of blood flow in microcirculation and in particular of red cell deformability is present in chronic arterial occlusive disease. To this end we determined by the method proposed by Reid and Dormandy (J. Clin. Pharmacol. 1976, 29, 855) whole-blood filterability in 18 patients with peripheral vascular disease, in 15 clinically healthy subjects and in 99 subjects without clinical evidence of ischemic pathology displaying one or more vascular risk factors. Blood filterability turned out to be significantly lower in cases of arterial disease that in the controls (p less than 0,001), and we found a constant reduction of blood filterability with the increase of number of risk factors. Comparison of the results obtained in arteriopatics and in controls displaying risk factors shows that though risk factors have an important impact on blood filterability, their presence alone is not enough to explain the reduction of blood filterability which, risk factors being equal, in vascular disease is always significantly lower than in controls. We also found a significant correlation between levels of fibrinogen and reduction of blood filterability.     

Blood filterability in cerebral vascular disease

The aim of this paper is to test whether an alteration of blood flow in microcirculation and in particular of red cell deformability is present in cerebrovascular insufficiency. To this end we determined by the method proposed by Reid and Dormandy (J. Clin. Pharmacol. 1976, 29, 855) whole-blood filterability in 31 patients with cerebrovascular disease, in 15 clinically healthy subjects and in 99 subjects without clinical evidence of ischemic pathology displaying one or more vascular risk factors. Blood filterability turned out to be significantly lower in cases of cerebrovascular disease than in the controls (p less than 0,001), while data about presence of risk factors in cerebrovascular insufficiency and in controls are almost overlapping. Reduction of blood filterability in cerebrovascular disease may therefore be attributed directly to the risk factors associated to the disease, which can significantly reduce red cell deformability. Further we didn't find any significant correlation between blood filterability and levels of fibrinogen, platelets, triglycerides and cholesterol in blood.     

Impaired deformability of erythrocytes in diabetic rat and human: investigation by the nickel-mesh-filtration technique

Comprehensive research to quantify the deformability of erythrocytes in diabetic animals and humans has been lacking. The objective of this study was to compare the impairment of erythrocyte deformability in diabetic rats and patients by use of the same rheologic method. Deformability was investigated in streptozotocin-induced diabetic rats and diabetic patients, by using the highly sensitive and quantitative nickel-mesh-filtration technique. Erythrocyte filterability (whole-cell deformability) was defined as flow rate of hematocrit-adjusted erythrocyte suspension relative to that of saline (%). Hematological and biochemical data for diabetic rats did not differ from those for age-matched control rats except for hyperglycemia and malnutrition. Erythrocyte filterability for diabetic rats was significantly lower than that for control rats (69.4 ± 10.1%, n = 8, compared with 83.1 ± 4.2%, n = 8; p < 0.001). Likewise, erythrocyte filterability for diabetic patients was significantly impaired compared with that for controls (87.6 ± 3.4%, n = 174, compared with 88.6 ± 2.1%, n = 51; p = 0.046). Stepwise multiple regression analysis revealed that this impairment was mostly attributable to associated obesity (BMI, p = 0.029) and glycemic stress (HbA1c(JDS), p = 0.046). We therefore conclude that erythrocyte filterability is commonly impaired in diabetic rats and in humans. Moreover, metabolic risk accumulation further impairs erythrocyte filterability, resulting in derangement of the microcirculation.     

Changes of physiological and biochemical characteristics of rat erythrocytes after blood loss

In experiments of Wistar male rats, changes are studied of erythrocyte hematological, biochemical (activitities of transport ATPases), and rheological properties (capability for aggregation and deformability) 7 days after bloodletting of 12-15 % of the total blood mass. It has been shown that alongside with an elevation of erythrocyte volume and of the number of immature cells - reticulocytes, there was a statistically significant increase of Na,K-ATPase and Ca-ATPase activities in the whole erythrocytes and their membrane preparations - ghosts, the increment of activity in the case of Na,K-ATPase being essentially higher in the whole cells. This indicates the appearance of an enzyme activator inside the erythrocytes. There are also revealed a decrease of firmness of erythrocyte aggregates, a deceleration of spontaneous aggregation, and an increase of index of erythrocyte deformability. The conclusion is made that changes of erythrocyte rheological properties are interconnected with changes of the Na,K-ATPase activity and are directed to optimization of blood circulation in large vessels and capillary network.     

Changes of physiological and biochemical characteristics of rat erythrocytes after blood loss

In experiments on Wistar male rats, changes are studied of erythrocyte hematological, biochemical (activities of transport ATPases), and rheological properties (capability for aggregation and deformability) 7 days after bloodletting of 12–15% of the total blood mass. It has been shown that alongside with an elevation of erythrocyte volume and of the number of immature cells—reticulocytes, there was a statistically significant increase of Na,K-ATPase and Ca-ATPase activities in the whole erythrocytes and in their membrane preparations—ghosts, the increment of activity in the case of Na,K-ATPase being essentially higher in the whole cells. This indicates the appearance of an enzyme activator inside the erythrocytes. There are also revealed a decrease of firmness of erythrocyte aggregates, a deceleration of spontaneous aggregation, and an increase of index of erythrocyte deformability. The conclusion is made that changes of erythrocyte rheological properties are interconnected with changes of the Na,K-ATPase activity and are aimed at optimization of blood circulation in large vessels and capillary network.     

HNE produced by the malaria parasite Plasmodium falciparum generates HNE-protein adducts and decreases erythrocyte deformability

In Plasmodium falciparum-parasitized erythrocytes, hemozoin (HZ) formation was accompanied by enhanced formation of 4-hydroxynonenal (HNE)-protein adducts on the cell surface, reaching in the HZ-rich schizont forms the 16.8-fold amount of control non-parasitized cells. The addition of 1-100 microM exogenous HNE to control non-parasitized cells generated HNE-adducts on surface proteins in amounts similar to those found in schizonts. Parasitized as well as HNE-treated non-parasitized erythrocytes showed decreased cell deformability (measured as decreased filterability through cylindrical-pore filters) related to the amount of HNE adducts. In vivo, the HZ-containing trophozoites and schizonts are phagocytic targets for monocytes/macrophages. The reduced deformability of circulating erythrocytes carrying HNE-adducts may increase their phagocytic elimination. Uncontrolled HNE production by parasitized erythrocytes may additionally modify non-parasitized bystander erythrocytes, induce their phagocytosis, and contribute to malarial anemia, which is predominantly due to the removal of large numbers of indirectly damaged non-parasitized erythrocytes.     

Erythrocyte volume distribution curves: a parameter for evaluating erythrocyte preparations

The volume distribution of erythrocytes in ACD-AG blood and in human erythrocyte concentrations was investigated by means of computer-assisted techniques of hematological analysis. The storage-dependent distribution was described by the content of discrete class areas. Erythrocytes with a volume below 72 fl are only slightly capable of changing their volume. Their condition predisposes them to selection in the receiver's organism. Their percentage amount correlates with the share of cells ineffective of transfusion. The concentration of cells with a volume above 72 fl is discussed with ACD-AG blood (78% on the 42nd day), with CDS-AG erythrocyte concentrate (66% on the 20th day) and with SAG-M erythrocyte concentrate (74% on the 35th day) together with findings about the transfusional survival rate.