Biophysical correlates of lysophosphatidylcholine- and ethanol-mediated shape transformation and hemolysis of human erythrocytes. Membrane viscoelasticity and NMR measurement

Albumin, Oral Contraceptives, and Venous Thromboembolism Risk in Astronauts

BACKGROUND

A venous thromboembolism (VTE) event occurred in a female astronaut during long-duration spaceflight. Multiple factors may have contributed to this risk, including the use of combined (progestin + estrogen) oral contraceptives (cOC).

METHODS

Biochemistry data from 65 astronauts were evaluated for associations with cOC use and with sex.

RESULTS

The female astronauts who used cOCs had lower concentrations of serum albumin and higher concentrations of transferrin, a protein involved in the clotting cascade, than the male astronauts and the female astronauts who were not taking cOCs (P<0.001). The women who used cOCs had higher serum concentrations of the acute phase reactant ceruloplasmin during flight and cortisol (P<0.001) than the men and the women who were not taking cOCs; they also had higher calculated whole blood viscosity than women not taking cOCs (P<0.001).

CONCLUSIONS

Lower circulating concentrations of albumin, higher concentrations of transferrin, and elevated markers of inflammation all could contribute to an increased risk of VTE during spaceflight. These changes, in association with a higher blood viscosity can directly affect endothelial glycocalyx integrity and hypercoagulability status, both of which contribute to VTE risk in terrestrial populations.

The Role of Free Radicals in Hemolytic Toxicity Induced by Atmospheric-Pressure Plasma Jet

Atmospheric-pressure plasma (APP) has received attention due to its generation of various kinds of reactive oxygen/nitrogen species (ROS/RNS). The controllability, as well as the complexity, is one of the strong points of APP in various applications. For biological applications of this novel method, the cytotoxicity should be estimated at various levels. Herein, we suggest red blood cell (RBC) as a good cell model that is simpler than nucleated cells but much more complex than other lipid model systems. Air and N₂ gases were compared to verify the main ROS/RNS in cytotoxicity, and microscopic and spectroscopic analyses were performed to estimate the damages induced on RBCs. The results shown here will provide basic information on APP-induced cytotoxicity at cellular and molecular levels.

Effects of ethanol on red blood cell rheological behavior

Consumption of red wine is associated with a decreased risk of several cardiovascular diseases (e.g., coronary artery disease, stroke), but unfortunately literature reports regarding ethanol's effects on hemorheological parameters are not concordant. In the present study, red blood cell (RBC) deformability was tested via laser ektacytometry (LORCA, 0.3-30 Pa) using two approaches: 1) addition of ethanol to whole blood at 0.25%-2% followed by incubation and testing in ethanol-free LORCA medium; 2) addition of ethanol to the LORCA medium at 0.25%-6% then testing untreated native RBC in these media. The effects of ethanol on deformability for oxidatively stressed RBC were investigated as were changes of RBC aggregation (Myrenne Aggregometer) for cells in autologous plasma or 3% 70 kDa dextran. Significant dose-related increases of RBC deformability were observed at 0.25% (p < 0.05) and higher concentrations only if ethanol was in the LORCA medium; no changes occurred for cells previously incubated with ethanol then tested in ethanol-free medium. The impaired deformability of cells pre-exposed to oxidative stress was improved only if ethanol was in the LORCA medium. RBC aggregation decreased with concentration at 0.25% and higher for cells in both autologous plasma and dextran 70. Our results indicate that ethanol reversibly improves erythrocyte deformability and irreversibly decreases erythrocyte aggregation; the relevance of these results to the health benefits of moderate wine consumption require further investigation.

Effect of modest alcohol consumption over 1-2 weeks on the coronary microcirculation of normal subjects

AIMS

It has been reported that imbibing red wine increases coronary blood flow reserve acutely. In the absence of changes in coronary driving pressure, any increases in coronary blood flow reserve should occur through a decrease in capillary resistance, which in turn is determined by capillary dimensions and whole-blood viscosity. Since alcohol intake is unlikely to acutely change capillary dimensions, we hypothesized that it must increase coronary blood flow reserve by reducing whole-blood viscosity.

METHODS AND RESULTS

Forty-five normal subjects were randomly assigned to water (n = 12), vodka (n = 11), white wine (n = 11), and red wine (n = 11). Myocardial blood flow reserve was measured at baseline and after up to 2 weeks of beverage consumption using myocardial contrast echocardiography. In addition, whole-blood viscosity and its principal determinants (haematocrit; erythrocyte deformability, mobility, and charge; plasma fibrinogen; and total serum protein, glucose, and lipids) were also measured. Systolic and diastolic blood pressure and heart rate did not change between the two examinations either at rest or following dipyridamole infusion. Neither did myocardial blood flow reserve nor whole-blood viscosity or any of its determinants. Only high-density lipoprotein-2 increased for all alcohol consumers (12.4 +/- 5.3 vs. 10.9 +/- 4.7, P = 0.007).

CONCLUSION

It is concluded that modest alcohol consumption for up to 2 weeks does not increase myocardial blood flow reserve. It also does not alter whole-blood viscosity or any of its principal determinants. Therefore, the beneficial cardiovascular effects of modest alcohol consumption over 1-2 weeks cannot be attributed either to its effect on the coronary microcirculation or haemorheology.

On the mechanism of drug-induced acceleration of phospholipid translocation in the human erythrocyte membrane

Small amphiphilic compounds (M(r)<200 Da) such as anaesthetics and hexane derivatives with different polar groups produced a concentration-dependent acceleration of the slow passive transbilayer movement of NBD-labelled phosphatidylcholine in the human erythrocyte membrane. Above a threshold concentration characteristic for each compound, the flip rate gradually increased at increasing concentrations in the medium. For compound concentrations required to produce a defined flip acceleration, corresponding membrane concentrations were estimated using reported octanol/water partition coefficients. The effective threshold membrane concentrations (50-150 mmol l(-1)) varied in the order: hexylamine>isoflurane=hexanoic acid>hexanol=chloroform>hexanethiol=1,1,2,2-tetrachloroethane>chlorohexane. Apolar hexane, which mainly distributes in the apolar membrane core, was much less effective and supersaturating concentrations were required to enhance flip. Localization of the drug at the lipid-water interface seems to be required for flip acceleration. Such a localization may increase the lateral pressure in this region and the bilayer curvature stress with concomitant decrease of order and rigidity at the interface. This unspecific bilayer perturbation is proposed to enhance the probability of formation of hydrophobic defects in the bilayer, facilitating penetration of the polar head group of the phospholipid into the apolar membrane core.

Red blood cell fatty acid ethyl esters: a significant component of fatty acid ethyl esters in the blood

Although alcohol abuse is known to cause an array of ethanol-induced red blood cell (RBC) abnormalities, the underlying molecular mechanisms remain poorly understood. Fatty acid ethyl esters (FAEEs) are toxic, nonoxidative ethanol metabolites that have been found in blood, plasma, and tissues. Because FAEEs have been shown to be incorporated into phospholipid bilayers, we conducted a controlled ethanol intake study to test the hypothesis that FAEEs accumulate and persist within RBCs following ethanol ingestion. We demonstrated that RBC FAEEs account for approximately 5% to 20% of total whole-blood FAEEs, and that the fatty acid composition of FAEEs in RBCs and plasma are different and vary differently over time. These data indicate that a significant percentage of FAEEs in the blood is associated with RBCs and that the metabolism of RBC FAEEs and that of plasma FAEEs (bound to albumin or lipoproteins) are largely independent.

Biochemical and structural changes in RBCs stored with different plasticizers: the role of hexanol

BACKGROUND

PVC containers are plasticized with di(2-ethyl)hexylphthalate (DEHP) or a related phthalate. The toxicity of DEHP has been questioned. It has been proposed to use butyryltrihexylcitrate (BTHC) as the plasticizer. The purpose of this study was to determine if hexanol, a component of BTHC, plays a role in the preservation of RBCs stored in BTHC-plasticized PVC bags.

STUDY DESIGN AND METHODS

WBC-reduced RBCs of ABO- and D-matched blood groups were prepared in 1-L polyolefin (PO) bags (PL732). Six 60-g aliquots were transferred to transfer packs made of PL146 (DEHP-plasticized) and PL2209 (BTHC-plasticized) and four PO (PL732) packs. To the PL146 and PL2209 packs, 30 mL of AS-1 was added. To three of the PO packs, 30 mL of AS-1 with sufficient DEHP, BTHC, or hexanol to achieve a final concentration of 3 mM was added, and to the final PO pack, 30 mL of AS-1 only was added (control). The units were stored for 6 weeks at 1 to 6 degrees C. RBC ATP, hemolysis, morphology, membrane lipids, deformability, and fluidity were measured.

RESULTS

ATP levels were not significantly different in any of the systems after 6 weeks. Compared to the PO bags, hemolysis was lowest in the PL146 containers and was also significantly lower (p < 0.006) in the PO bags with added DEHP, BTHC, or hexanol. The accumulation of vesicles was significantly less in the units stored in the PL146 and PL2209 than in the PO plastic with or without added plasticizers or hexanol (p < or = 0.004). There was no significant difference in the formation of vesicles in any of the PO units (p > 0.05). There was no demonstrable change in the membrane fluidity of the RBCs during storage in any of the systems. The decrease in deformability was the same, and the losses of cholesterol and phospholipid during storage were similar in all the studies.

CONCLUSIONS

The hexanol component of the BHTC plasticizer in a concentration of 144.6 microg per mL concentration suppresses hemolysis and vesiculation of RBCs during storage. The hexanol and DEHP that are slowly leached during storage have a greater effect in suppressing hemolysis and vesicle formation than when added extraneously to AS-1 in PO containers.

Hypoalbuminemia causes high blood viscosity by increasing red cell lysophosphatidylcholine

Albumin deficiency is accompanied by a reduction in red cell deformability and blood hyperviscosity. Albumin deficiency increases plasma fibrinogen and triglyceride levels and may alter red cell membrane lipid composition. These options, which could all contribute to reduced red cell deformability (RCD) and hyperviscosity, were studied in the Nagase analbuminemic rat (NAR), a mutant Sprague Dawley rat (CON), characterized by normal total protein levels, with an absolute deficiency of albumin, but elevated levels of non-albumin proteins and hyperlipidemia. Plasma protein-binding of the polar phopholipid lysophosphatidylcholine (LPC) was markedly decreased. LPC comprised only 26 +/- 1% of total plasma phospholipids as compared to 42 +/- 2% in CON. NAR red cells in CON plasma had a viscosity that was similar to CON red cells in CON plasma. Conversely, CON red cells in NAR plasma show an increased viscosity as compared to CON red cells in CON plasma. The maximum deformation index of both NAR and CON red cells was markedly decreased in NAR plasma as compared to either NAR or CON cells in CON plasma (0.04 +/- 0.03 and 0.02 +/- 0.02 vs. 0.22 +/- 0.06 and 0.15 +/- 0.04, respectively; P < 0.05). Thus, plasma composition causes hyperviscosity and reduced RCD in NAR. Fibrinogen is not responsible since red cells in serum and red cells in plasma had a similar viscosity and differences in viscosity and RCD between NAR and CON were maintained. Plasma triglycerides are also not responsible since the viscosity of red cells in serum with a 50% reduction in triglycerides was not reduced. LPC levels in red cells were increased in NAR (8.7 +/- 0.2 vs. 5.5 +/- 0.3% of total phospholipids; P < 0.01). Adding albumin to NAR blood dose-dependently decreased whole blood viscosity, despite marked increases in plasma viscosity, and increased RCD of NAR cells (from 0.04 +/- 0.03 to 0.21 +/- 0.01; P < 0.05). There was also some effect on CON RCD of similar albumin addition to CON blood (from 0.15 +/- 0.04 to 0.29 +/- 0.03; P < 0.05). Adding albumin to NAR blood reduced red cell LPC content and increased plasma LPC content in a dose-dependent fashion, whereas there were only slight effects of adding albumin to CON blood. There was a reciprocal relation between red cell LPC and the other polar phospholipids in the red cell membrane, probably indicating exchange. The maximum deformability index of either NAR or CON cells was not affected much by adding LPC to CON plasma (NAR, from 0.22 +/- 0.06 to 0.18 +/- 0.10; CON, from 0.15 +/- 0.04 to 0.12 +/- 0.05; NS), whereas adding LPC to NAR plasma caused the red cells to become rigid. Adding LPC to CON red cells in NAR plasma caused a much stronger increase in relative LPC content (from 6.6 +/- 0.7 to 10.9 +/- 0.9%; P < 0.05) than adding LPC to CON red cells in CON plasma (from 5.6 +/- 0.4 to 6.4 +/- 0.8%; NS). Thus, in the absence of albumin, LPC in red blood cells is increased. As a consequence of the latter, RCD is decreased and whole blood viscosity increased. Alterations in red cell phospholipids are far more important than increases in plasma fibrinogen or triglycerides in determining hyperviscosity of blood and reduced RCD in NAR.

Ethanol- and acetonitrile-induced inhibition of water diffusional permeability across bovine red blood cell membrane

The effect of 0-3% (v/v) ethanol and acetonitrile on water diffusional permeability of bovine and chicken red blood cells (RBCs) was studied using a pulse 1H-T2 NMR technique. Transmembrane water diffusional exchange times, tau exch, of 9.2 +/- 0.46 ms and 18.3 +/- 1.0 ms were determined for bovine and chicken erythrocytes at 27.5 degrees C, respectively. Arrhenius activation energies Ea of water diffusion were 20.4 and 35.8 kJ mol-1. Ethanol, and acetonitrile being 2-fold more effective, markedly increased both tau exch and Ea in bovine RBC as compared to the well-known mercurial inhibitor of water channels, p-chloromercuribenzene sulfonate. Chicken RBCs that have no protein water channels, were found to be completely insensitive for either agent. It was suggested that ethanol and acetonitrile partitioning into the lipid phase of bovine RBC membrane affects the permeability of CHIP28 water channel but not the lipid confined water diffusion. The results suggest that the inhibition of transmembrane movement of water via CHIP28 channels might be involved in the anti-hemolytic action of anaesthetics such as ethanol.

Metastatic intraperitoneal spread is initiated by phospholipase A2

A new hypothesis is introduced, i.e. that intraperitoneal tumor spread is initiated by activation of phospholipase A2. This view may well have some new therapeutic implications.

Methane-induced haemolysis of human erythrocytes

Human erythrocytes were exposed to high concentrations of methane and nitrogen through the application of elevated partial pressures of these gas molecules. Cell leakage (haemolysis) was measured for cells exposed to these gases under a wide range of experimental conditions. Application of methane produces haemolysis at pressures far below the hydrostatic pressures known to disrupt membrane or protein structure. The effects of changes in buffer, temperature, diffusion rate and detergents were studied. Methane acts co-operatively with detergents to produce haemolysis at much lower detergent concentration than is required in the absence of methane or in the presence of nitrogen. At sufficiently high concentrations of methane, all cells are haemolysed. Increased temperature enhances the effect. Methane produces 50% haemolysis at a concentration of about 0.33 M compared with about 7.5 M methanol required for the same degree of haemolysis.

Cation-sensitive pore formation in rehydrated erythrocytes

Rehydration of red blood cells (RBC) in isotonic media after dehydration in hypertonic electrolyte or nonelectrolyte saline leads to their posthypertonic hemolysis (PH). Ca2+ ions at a concentration of more than 5 mM stimulated hemolysis of RBC treated by hypertonic sucrose but not NaCl if rehydration was carried out in the presence of cations. Zn2+ produced a more complex response of stimulation followed by inhibition as a concentration is increased. Mg2+, Ca2+, Zn2+, EDTA and sucrose exhibited only inhibition when added to isotonic NaCl media immediately after onset of rehydration or later on. At low ionic strength inhibition produced by divalent cations was markedly reduced and sucrose was ineffective. An equimolar concentration of EDTA abolished the inhibition of PH by Zn2+ ions if they were introduced into the isotonic media after the cells, but activated hemolysis when rehydration was carried out in the presence of ions. The same divalent cations prevented shape transformation and hemolysis induced by melittin if they interacted with the plasma membrane prior to the addition of melittin. Subsequent chelation of cations by EDTA triggers the full sequence of events characteristic to the action of melittin alone and resulted in cell spherulation followed by hemolysis. Inhibition of melittin-induced hemolysis produced by all cations was reversible because EDTA abolished the action of divalent cations and even stimulated hemolysis in isotonic sucrose. Similarities in the mode of action of divalent cations and EDTA on posthypertonic hemolysis which is attributed to endogenous stimuli and melittin-induced hemolysis as far as the exogenous agent is concerned imply that in both cases common intrinsic mechanisms are involved in the process of cation-sensitive pore formation in erythrocyte membranes, while differences indicate that more complex pores are formed during posthypertonic injury.

Intra-abdominal adhesion formation is initiated by phospholipase A2

The etiology of intra-abdominal adhesions is explained by hydrolysis of the peritoneal phospholipid layer caused by phospholipase A2 activity. This view could unify the pre-existing hypotheses that intra-abdominal adhesions are due to ischemia or increased plasminogen activator activity. New therapeutic approaches are suggested.

Phospholipase-resistant phosphatidylcholine reduces intra-abdominal adhesions induced by bacterial peritonitis

The majority of intra-abdominal adhesions develop postoperatively or following peritonitis. We have previously shown that L-phosphatidylcholine reduces postoperative peritoneal adhesions in rats. In the present study, we examined whether adhesion formation after bacterial peritonitis is also reduced by L-phosphatidylcholine or by DL-alpha-phosphatidylcholine, which is degraded only 50% by phospholipase A2. Peritonitis was induced in the rat by caecal ligation and double puncture; cecotomy was performed 12, 15, or 18 h later. Adhesions were assessed blindly by a scoring system 7 days after cecotomy. When cecotomy was scheduled for 18 h after caecal ligation and puncture, the 7-day mortality was 90% (n = 20). When cecotomy was performed at 12 h, no mortality was seen; however, the adhesion score was low (2.3 +/- 0.7). When cecotomy was performed 15 h after caecal ligation and puncture, the mortality was 25% and the adhesion score was 4.3 +/- 0.9. This figure was reduced significantly by intraperitoneal instillation of L-phosphatidylcholine or DL-alpha-phosphatidylcholine for 3 subsequent days. However, the mortality increased by L-phosphatidylcholine (P < 0.01), whereas mortality after DL-alpha-phosphatidylcholine remained at 30%. We conclude that administration of both L-phosphatidylcholine and DL-alpha-phosphatidylcholine decrease adhesion formation after bacterial peritonitis.

Alcohols produce reversible and irreversible acceleration of phospholipid flip-flop in the human erythrocyte membrane

The slow, non-mediated transmembrane movement of the lipid probes lysophosphatidylcholine, NBD-phosphatidylcholine and NBD-phosphatidylserine in human erythrocytes becomes highly enhanced in the presence of 1-alkanols (C2-C8) and 1,2-alkane diols (C4-C8). Above a threshold concentration characteristic for each alcohol, flip rates increase exponentially with the alcohol concentration. The equieffective concentrations of the alcohols decrease about 3-fold per methylene added. All 1-alkanols studied are equieffective at comparable calculated membrane concentrations. This is also observed or the 1,2-alkane diols, albeit at a 5-fold lower membrane concentration. At low alcohol concentrations, flip enhancement is reversible to a major extent upon removal of the alcohol. In contrast, a residual irreversible flip acceleration is observed following removal of the alcohol after a treatment at higher concentrations. The threshold concentrations to produce irreversible flip acceleration by 1-alkanols and 1,2-alkane diols are 1.5- and 3-fold higher than those for flip acceleration in the presence of the corresponding alcohols. A causal role in reversible flip-acceleration of a global increase of membrane fluidity or membrane polarity seems to be unlikely. Alcohols may act by increasing the probability of formation of transient structural defects in the hydrophobic barrier that already occur in the native membrane. Membrane defects responsible for irreversible flip-acceleration may result from alterations of membrane skeletal proteins by alcohols.

Influence of phloretin and alcohols on barrier defects in the erythrocyte membrane caused by oxidative injury and electroporation

Oxidative damage by diamide, periodate and oxygen-derived reactive species, but also exposure to electroporation induce in the erythrocyte membrane dynamic, presumably fluctuating, defects having the properties of aqueous holes with definable radii and selectivities. These leaks, which can be quantified by measuring tracer fluxes or rates of colloid-osmotic lysis, are here shown to be inhibited by phloretin and a small number of related phenol compounds (phenolphthalein, hydroxyacetophenones, nitrophenol), while a host of other 'membrane-active' agents is not effective in this respect. I50 values range from about 200 microM for phloretin and phenolphthalein to about 10 mM for 4-nitrophenol. Inhibition by phloretin is reversible, not competitive and not related in its extent to the extent of leakiness. In contrast, the enhancement of transbilayer mobility of amphiphilic lipid probes, which invariably goes along with leak formation of the type described, is not affected by phloretin. Aliphatic alcohols (hexanol, butanol) have an amplifying effect on leaks induced by oxidative damage but do not affect leaks induced by electroporation. The alcohol-amplified leaks maintain the properties of aqueous holes as indicated by a low activation energy of leak fluxes. Since both, inhibition and stimulation of leak fluxes do not go along with appreciable changes of the apparent radii of the aqueous holes, changes in the dynamics (opening and closing) of the defects are proposed to underly the effects of phloretin and alkanols. The membrane lipid domain is likely to be the site of the leaks and of their modulation.

Mechanism of hemolysis of red blood cell mediated by ethanol

The effects of ethanol on hemolysis of human red blood cells (RBCs) were studied at 21 +/- 1 degrees C in the saline buffer (138 mM NaCl, 6.1 mM Na2HPO4, 1.4 mM NaH2PO4, 5 mM glucose and pH 7.4). The hemolysis process for ethanol-treated RBCs was preceded by the leakage of the small cation K+ from the cells indicating the colloid-osmotic nature of lysis. Since the extent of membrane lesion increased with an increasing ethanol concentration, osmotic protection experiments by using solutes varying in size were carried out to estimate the diameter of the pore. Quantitative analysis of the data by considering the effect of molecular seiving of the protectants with different sizes indicated that ethanol induced formation of membrane pores with a diameter of approximately 13 A. There was no detectable release of membrane fragments as assayed by the acetylcholinesterase activity, but the membrane structures were significantly perturbed, presumably at the membrane cytoskeletal protein, as evidenced by the altered rheological properties of RBC in the presence of ethanol. It is suggested that the creation of membrane pores might involve in the deranged cytoskeletal network of ethanol-treated RBC.