Abstract
Among the sequelae of phosphate depletion is anaemia, due in part to a decreased life span of mature erythrocytes. Recent studies have disclosed that cellular stress leads to an increase of cytosolic Ca2+ activity in erythrocytes thereby triggering cell shrinkage and breakdown of phosphatidylserine asymmetry of the cell membrane, both typical features of apoptosis. In the present experiments, phosphatidylserine exposure and cell size were measured by fluorescence-activated cell sorting (FACS) analysis of annexin binding and forward scatter, respectively. Erythrocytes from intact mice were compared with erythrocytes from mice exposed to a low-phosphate diet for 4 days. Annexin binding of freshly drawn erythrocytes was slightly but significantly enhanced by the low-phosphate diet. Furthermore, intracellular phosphate and ATP concentrations were significantly decreased in those erythrocytes whereas intracellular Ca2+ activity was unaltered. Osmotic shock (exposure to 700 mOsm by addition of sucrose for 12 h), removal of Cl− (replaced by gluconate for 15 h) or removal of glucose (12 h) decreased cell volume and increased the number of annexin-binding erythrocytes. Interestingly, these effects were significantly larger in erythrocytes from phosphate-depleted animals. The experiments reveal a novel mechanism triggered by phosphate depletion that presumably contributes to the enhanced vulnerability and accelerated sequestration of erythrocytes and, thus, to anaemia.
Similar content being viewed by others
References
Altuntas Y, Innice M, Basturk T, Seber S, Serin G, Ozturk B (2002) Rhabdomyolysis and severe haemolytic anaemia, hepatic dysfunction and intestinal osteopathy due to hypophosphataemia in a patient after Billroth II gastrectomy. Eur J Gastroenterol Hepatol 14:555–557
Andree HA, Reutelingsperger CP, Hauptmann R, Hemker HC, Hermens WT, Willems GM (1990) Binding of vascular anticoagulant alpha (VAC alpha) to planar phospholipid bilayers. J Biol Chem 265:4923–4928
Andrews DA, Yang L, Low PS (2002) Phorbol ester stimulates a protein kinase C-mediated agatoxin-TK-sensitive calcium permeability pathway in human red blood cells. Blood 100:3392–3399
Berg CP, Engels IH, Rothbart A, Lauber K, Renz A, Schlosser SF, Schulze-Osthoff K, Wesselborg S (2001) Human mature red blood cells express caspase-3 and caspase-8, but are devoid of mitochondrial regulators of apoptosis. Cell Death Differ 8:1197–1206
Boas FE, Forman L, Beutler E (1998) Phosphatidylserine exposure and red cell viability in red cell aging and in hemolytic anemia. Proc Natl Acad Sci USA 95:3077–3081
Bookchin RM, Ortiz OE, Lew VL (1987) Activation of calcium-dependent potassium channels in deoxygenated sickled red cells. Prog Clin Biol Res 240:193–200
Bortner CD, Cidlowski JA (1999) Caspase independent/dependent regulation of K+, cell shrinkage, and mitochondrial membrane potential during lymphocyte apoptosis. J Biol Chem 274:21953–21962
Bortner CD, Hughes FM Jr, Cidlowski JA (1997) A primary role for K+ and Na+ efflux in the activation of apoptosis. J Biol Chem 272:32436–32442
Brand VB, Sandu CD, Duranton C, Tanneur V, Lang KS, Huber SM, Lang F (2003) Dependence of Plasmodium falciparum in vitro growth on the cation permeability of the human host erythrocyte. Cell Physiol Biochem 13:347–356
Bratosin D, Estaquier J, Petit F, Arnoult D, Quatannens B, Tissier JP, Slomianny C, Sartiaux C, Alonso C, Huart JJ, Montreuil J, Ameisen JC (2001) Programmed cell death in mature erythrocytes: a model for investigating death effector pathways operating in the absence of mitochondria. Cell Death Differ 8:1143–1156
Brautbar N, Carpenter C, Baczynski R, Kohan R, Massry SG (1983a) Impaired energy metabolism in skeletal muscle during phosphate depletion. Kidney Int 24:53–57
Brautbar N, Leibovici H, Massry SG (1983b) On the mechanism of hypophosphatemia during acute hyperventilation: evidence for increased muscle glycolysis. Miner Electrolyte Metab 9:45–50
Brugnara C, Franceschi L de, Alper SL (1993) Inhibition of Ca2+-dependent K+ transport and cell dehydration in sickle erythrocytes by clotrimazole and other imidazole derivatives. J Clin Invest 92:520–526
Daugas E, Cande C, Kroemer G (2001) Erythrocytes: death of a mummy. Cell Death Differ 8:1131–1133
Dekkers DW, Comfurius P, Bevers EM, Zwaal RF (2002) Comparison between Ca2+-induced scrambling of various fluorescently labelled lipid analogues in red blood cells. Biochem J 362:741–747
Duranton C, Huber SM, Lang F (2002) Oxidation induces a Cl−-dependent cation conductance in human red blood cells. J Physiol (Lond) 539:847–855
Duranton C, Huber S, Tanneur V, Lang K, Brand V, Sandu C, Lang F (2003) Electrophysiological properties of the Plasmodium falciparum-induced cation conductance of human erythrocytes. Cell Physiol Biochem 13:189–198
Eda S, Sherman IW (2002) Cytoadherence of malaria-infected red blood cells involves exposure of phosphatidylserine. Cell Physiol Biochem 12:373–384
Fadda GZ, Hajjar SM, Zhou XJ, Massry SG (1992) Verapamil corrects abnormal metabolism of pancreatic islets and insulin secretion in phosphate depletion. Endocrinology 130:193–202
Fadok VA, Bratton DL, Rose DM, Pearson A, Ezekewitz RA, Henson PM (2000) A receptor for phosphatidylserine-specific clearance of apoptotic cells. Nature 405:85–90
Franco RS, Palascak M, Thompson H, Rucknagel DL, Joiner CH (1996) Dehydration of transferrin receptor-positive sickle reticulocytes during continuous or cyclic deoxygenation: role of KCl cotransport and extracellular calcium. Blood 88:4359–4365
Gomez-Angelats M, Bortner CD, Cidlowski JA (2000) Protein kinase C (PKC) inhibits fas receptor-induced apoptosis through modulation of the loss of K+ and cell shrinkage. A role for PKC upstream of caspases. J Biol Chem 275:19609–19619
Henson PM, Bratton DL, Fadok VA (2001) The phosphatidylserine receptor: a crucial molecular switch? Nat Rev Mol Cell Biol 2:627–633
Huber SM, Gamper N, Lang F (2001) Chloride conductance and volume-regulatory nonselective cation conductance in human red blood cell ghosts. Pflugers Arch 441:551–558
Hughes FM Jr, Cidlowski JA (1999) Potassium is a critical regulator of apoptotic enzymes in vitro and in vivo. Adv Enzyme Regul 39:157–171
Hughes FM Jr, Bortner CD, Purdy GD, Cidlowski JA (1997) Intracellular K+ suppresses the activation of apoptosis in lymphocytes. J Biol Chem 272:30567–30576
Jacob HS, Amsden T (1971) Acute hemolytic anemia with rigid red cells in hypophosphatemia. N Engl J Med 285:1446–1450
Joiner CH (1993) Cation transport and volume regulation in sickle red blood cells. Am J Physiol 264:C251–C270
Kaiser U, Barth N (2001) Haemolytic anaemia in a patient with anorexia nervosa. Acta Haematol 106:133–135
Kiersztejn M, Chervu I, Smogorzewski M, Fadda GZ, Alexiewicz JM, Massry SG (1992) On the mechanisms of impaired phagocytosis in phosphate depletion. J Am Soc Nephrol 2:1484–1489
Knochel JP (1977) The pathophysiology and clinical characteristics of severe hypophosphatemia. Arch Intern Med 137:203–220
Knochel JP (1992) The clinical and physiological implications of phosphorus deficiency. In: Seldin DW, Giebisch G (eds) The kidney: physiology and pathophysiology. Raven Press, New York, pp 2533–2562
Kreusser W, Ritz E, Boland R (1980) [Phosphate-depletion (author’s transl)]. Klin Wochenschr 58:1–15
Lang KS, Roll B, Myssina S, Schittenhelm M, Scheel-Walter HG, Kanz L, Fritz J, Lang F, Huber SM, Wieder T (2002) Enhanced erythrocyte apoptosis in sickle cell anemia, thalassemia and glucose-6-phosphate dehydrogenase deficiency. Cell Physiol Biochem 12:365–372
Lang KS, Duranton C, Poehlmann H, Myssina S, Bauer C, Lang F, Wieder T, Huber SM (2003a) Cation channels trigger apoptotic death of erythrocytes. Cell Death Differ 10:249–256
Lang PA, Kaiser S, Myssina S, Wieder T, Lang F, Huber SM (2003b) Role of Ca2+-activated K+ channels in human erythrocyte apoptosis. Am J Physiol 285:C1553–C1560
Lang PA, Warskulat U, Heller-Stilb B, Huang DY, Grenz A, Myssina S, Duszenko M, Lang F, Haussinger D, Vallon V, Wieder T (2003c) Blunted apoptosis of erythrocytes from taurine transporter deficient mice. Cell Physiol Biochem 13:337–346
Lew VL, Bookchin RM (1991) Osmotic effects of protein polymerization: analysis of volume changes in sickle cell anemia red cells following deoxy-hemoglobin S polymerization. J Membr Biol 122:55–67
Lim SK, Kim H, Lim SK, bin AA, Lim YK, Wang Y, Chong SM, Costantini F, Baumman H (1998) Increased susceptibility in Hp knockout mice during acute hemolysis. Blood 92:1870–1877
Lim YK, Jenner A, Ali AB, Wang Y, Hsu SI, Chong SM, Baumman H, Halliwell B, Lim SK (2000) Haptoglobin reduces renal oxidative DNA and tissue damage during phenylhydrazine-induced hemolysis. Kidney Int 58:1033–1044
Massry SG, Smogorzewski M (2001) Dysphosphatemias. In: Massry SG, Glassock RJ (eds) Textbook of nephrology. Lippincott Williams & Wilkins, Philadelphia
Matz R (1972) Hemolytic anemia and hypophosphatemia. N Engl J Med 286:380
Melvin JD, Watts RG (2002) Severe hypophosphatemia: a rare cause of intravascular hemolysis. Am J Hematol 69:223–224
Messmer UK, Pfeilschifter J (2000) New insights into the mechanism for clearance of apoptotic cells. Bioessays 22:878–881
Montague JW, Bortner CD, Hughes FM Jr, Cidlowski JA (1999) A necessary role for reduced intracellular potassium during the DNA degradation phase of apoptosis. Steroids 64:563–569
Perez GI, Maravei DV, Trbovich AM, Cidlowski JA, Tilly JL, Hughes FM Jr (2000) Identification of potassium-dependent and -independent components of the apoptotic machinery in mouse ovarian germ cells and granulosa cells. Biol Reprod 63:1358–1369
Sheldon GF, Grzyb S (1975) Phosphate depletion and repletion: relation to parenteral nutrition and oxygen transport. Ann Surg 182:683–689
Shilo S, Werner D, Hershko C (1985) Acute hemolytic anemia caused by severe hypophosphatemia in diabetic ketoacidosis. Acta Haematol 73:55–57
Van Dissel JT, Gerritsen HJ, Meinders AE (1992) Severe hypophosphatemia in a patient with anorexia nervosa during oral feeding. Miner Electrolyte Metab 18:365–369
Woon LA, Holland JW, Kable EP, Roufogalis BD (1999) Ca2+ sensitivity of phospholipid scrambling in human red cell ghosts. Cell Calcium 25:313–320
Worley G, Claerhout SJ, Combs SP (1998) Hypophosphatemia in malnourished children during refeeding. Clin Pediatr (Phila) 37:347–352
Yoshida Y, Take H, Kurabayashi H, Tamura K, Kubota K (2002) Rhabdomyolysis, hepatitis and multiple hematological disorders associated with alcohol abuse: a case report. J Med 33:3–8
Acknowledgements
The authors acknowledge the technical assistance of E. Faber and the meticulous preparation of the manuscript by Lejla Subasic and Tanja Loch. This study was supported by the Deutsche Forschungsgemeinschaft, Nr. La 315/4-3 and La 315/6-1, the Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Centre for Interdisciplinary Clinical Research) 01 KS 9602 and the Biomed program of the EU (BMH4-CT96-0602).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Birka, C., Lang, P.A., Kempe, D.S. et al. Enhanced susceptibility to erythrocyte “apoptosis” following phosphate depletion. Pflugers Arch - Eur J Physiol 448, 471–477 (2004). https://doi.org/10.1007/s00424-004-1289-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00424-004-1289-y