Zusammenfassung
Die rheologischen Eigenschaften der Erythrozyten von 14 Patienten mit EisenmangelanÄmie wurden mit Filtration der Zellen durch Polycarbonatfilter mit einer Porengrö\e von 5Μm und ViskositÄtsmessungen an Erythrozytensuspensionen mit einem HÄmatokrit von 80 % untersucht. Die Erythrozyten der Patienten passierten die Filterporen langsamer als die Zellen der Kontrollen. Die verminderte Verformbarkeit der Erythrozyten der Patienten war ausschlie\lich durch ein ungünstiges VerhÄltnis von ZelloberflÄche zum Volumen der mikrozytÄren Zellen bedingt. ViskositÄtsmessungen an Ghost-Suspensionen der Patienten ergeben eine normale MembranflexibilitÄt. Als Ausdruck einer erhöhten HÄmoglobinfluiditÄt im Inneren der intakten Zellen war der HÄmoglobingehalt in isolierten Erythrozytenmembranen vermindert. WÄhrend die ViskositÄt in Erythrozytensuspensionen der Patienten bei niedrigen Schergraden gering erhöht war, lag sie bei mittleren und hohen Schergraden im Streubereich der Kontrollen. Wir vermuten, da\ die bei niedrigen Schergraden aufgrund der Mikrozytose verminderte Verformbarkeit bei höheren Schergraden aufgrund der erhöhten HÄmoglobinfluiditÄt im Inneren der Zellen nicht lÄnger nachweisbar ist. Es wird diskutiert, ob dieser Mechanismus auch in vivo Bedeutung haben kann.
Die in vitro verminderte Verformbarkeit der Erythrozyten erklÄrt die verkürzte überlebenszeit der Erythrozyten der Patienten in vivo.
Summary
The rheological properties of erythrocytes of 14 patients with iron deficiency anemia were studied by filtration of cells through polycarbonate filters with a nominal pore diameter of 5 Μm and by viscosity measurements of erythrocyte suspensions with a hematocrit of 80%. Erythrocytes of the patients passed through the filter pores more slowly than the cells from controls. The diminished deformability of the erythrocytes of the patients was solely due to an unfavorable ratio of cell surface area to microcytic cell volume. The viscosity of the ghost suspensions of the patients showed a normal flexibility. The hemoglobin content of the isolated ghosts was diminished, indicating an in-increased hemoglobin fluidity in the interior of the intact cells. The viscosity of erythrocytes of the patients was slightly increased at low shear rates but was normal at intermediate and high shear rates. We suggest that the decreased erythrocyte flexibility of microcytosis at low shear rates is no longer present at higher shear rates because of an increased fluidity of the intracellular hemoglobin. We discuss whether or not this mechanism also operates in vivo. The in vitro diminished deformability of erythrocytes explains the shortened survival of the patients' erythrocytes in vivo.
References
Card RT, Weintraub LR (1971) Metabolic abnormalities of erythrocytes in severe iron deficiency. Blood 37: 725
Cartwright GE (1968) Diagnostic laboratory hematology, 4th ed. Grune & Stratton, New York, London
Dacie JV, Lewis SM (1970) Estimation of plasma haemoglobin. Practical haematology, 4th edn. Churchill, London, p 481
Diez-Ewald M, Layrisse M (1968) Mechanisms of hemolysis in iron deficiency anemia. Further studies. Blood 32: 894
Dodge JT, Mitchell C, Hanahan DJ (1963) The preparation and chemical characteristics of hemoglobin-free ghosts of human erythrocytes. Arch Biochem 100: 119
Fung YC (1966) Theoretical considerations of the elasticity of red cells and small blood vessels. Fed Proc 25: 1761
Gross GP, Hathaway WE (1972) Fetal erythrocyte deformability. Pediatr Res 6: 593
McKee LC, Wasson M, Heyssel RM (1968) Experimental iron deficiency in the rat. The use of51Cr, DF32 and59Fe to detect hemolysis of iron-deficient cells. Br J Haematol 14: 87
Layrisse M, Linares J, Roche M (1965) Excess hemolysis in subjects with severe iron deficienca anemia associated and nonassociated with hookworm infection. Blood 25: 73
Linderkamp O, Mayr S, Sengespeik C, Klose H, Betke K (1976) Eisenmangel bei Vorliegen von cyanotischen Herzvitien: Eine Ursache für cerebrale Komplikationen. Monatsschr Kinderheilkd 124: 301
Macdougall LG, Judisch JM, Mistry SB (1970) Red cell metabolism in iron deficiency anemia. II. The relationship between red cell survival and alterations in red cell metabolism. J Pediatr 76: 660
Rasch CA, Cotton EK, Griggs RC, Harris JW (1976) Shortened survival of autotransfused51Cr-labeled erythrocytes in infants with severe iron-deficiency anemia. Semin Hematol 13: 181
Schmid-Schönbein H, Wells RE (1969) Fluid drop-like transition of erythrocytes under shear. Science 165: 288
Schmid-Schönbein H, Wells RE (1971) Rheological properties of human erythrocytes and their influence upon the “anomalous” vsiscosity of blood. Ergeb Physiol 63: 146
Schmid-Schönbein H, Heinrich L (1973) A simple device allowing blood viscometry at low rates of shear with the Wells-Brookfield-Viscometer. Res Exp Med 161: 49
Schmid-Schönbein H, Weiss I, Ludwig H (1973) A simple method for measuring red cell deformability in models of the microcirculation. Blut 26: 369
Tillmann W, Cordua A, Schröter W (1975) Organization of enzymes of glycolysis and of gluthatione metabolism in human red cell membranes. Biochim Biophys Acta 382: 157
Tillmann W, Labitzke N, Schröter W (1976) Rheological properties of red cells in haemoglobin Köln disease. Br J Haematol 33: 279
Tillmann W, Schröter W (1979) Rheological properties of erythrocytes in heterozygousΒ-Thalassaemia. Br J Haematol 43: 401
Usami S, Chien S (1973) Shear deformation of red cell ghosts. Biorheology 10: 425
Weed RI, La Celle PL, Merrill EW (1969) Metabolic dependence of red cell deformability. J Clin Invest 48: 795
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This work was supported by the Deutsche Forschungsgemeinschaft
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Tillmann, W., Schröter, W. Deformability of erythrocytes in iron deficiency anemia. Blut 40, 179–186 (1980). https://doi.org/10.1007/BF01008575
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DOI: https://doi.org/10.1007/BF01008575