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Sickle cell rheology is determined by polymer fraction–not cell morphology
Author(s) -
Hiruma Hiroyuki,
Noguchi Constance Tom,
Uyesaka Nobuhiro,
Hasegawa Setsuo,
BlanchetteMackie E. Joan,
Schechter Alan N.,
Rodgers Griffin P.
Publication year - 1995
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830480105
Subject(s) - intracellular , hemoglobin , cell , biophysics , deoxygenation , sickle cell trait , chemistry , hemoglobinopathy , polymer , microcirculation , sickle cell anemia , red blood cell , oxygen , oxygenation , rheology , filtration (mathematics) , size exclusion chromatography , biology , biochemistry , immunology , materials science , medicine , hemolytic anemia , enzyme , disease , organic chemistry , catalysis , statistics , mathematics , composite material
Sickle cell disease pathophysiology is mediated by acute and chronic impairment of cell flexibility due to the formation of intracellular sickle hemoglobin (Hb S) polymer as cells are partially deoxygenated in the microcirculation. We have recently developed a method to measure the relationship between the formation of intracellular polymerized Hb S and cell filtration. In this study, we have used this method to examine whether sickle cell morphology, independent of Hb S polymer fraction, had an effect on cell rheology. We primarily use sickle trait (AS) and Hb S‐β + ‐thalassemia (S‐β + ‐thal) erythrocytes with low hemoglobin F levels, which have normal membranes and few or no dense cells, to remove these confounding effects. We find that the relationship between filtration and the percentages of each “type” of morphological deformation of AS erythrocytes was different from that of the S‐β + ‐thal erythrocytes. In addition, we find that while the filtration of AS erythrocytes as a function of oxygen saturation was similar, whether measured during deoxygenation or reoxygenation, the relationship between the percentages of each type of deformed erythrocyte and oxygen saturation demonstrated hysteresis during oxygenation‐deoxygenation experiments. Transmission electron microscopy, for both elongated and irregularly shaped cells, showed that similarly distorted cells could have very different amounts and alignment of polymer. These results suggests that cell morphology per se is not strongly related to filtration, whereas calculated intracellular Hb S polymer fraction predicts loss of filtration of AS and S‐β + ‐thal erythrocytes well. Measured or calculated polymer fraction values would appear to be a better parameter for the study of sickle cell disease pathophysiology and response to treatment than cell morphology studies. ©1995 Wiley‐Liss, Inc.