31P nuclear magnetic resonance measurement of free erythrocyte magnesium concentration in man and its relation to blood pressure

Stimulation of Na+/Mg2+ antiport in rat erythrocytes by intracellular Cl-

Mg(2+) efflux from rat erythrocytes was measured in NaCl, NaNO(3), NaSCN and Na gluconate medium. Substitution of extracellular and intracellular Cl(-) with the permeant anions NO(3)(-) and SCN(-) reduced Mg(2+) efflux via Na(+)/Mg(2+) antiport. After substitution of extracellular Cl(-) with the non-permeant anion gluconate, Mg(2+) efflux was not significantly reduced. In Na gluconate medium, an influence of the changed membrane potential and intracellular pH on Mg(2+) efflux could be excluded. The results indicate the existence of Cl(-)-independent Na(+)/Mg(2+) antiport and of Na(+)/Mg(2+) antiport stimulated by intracellular Cl(-). Intracellular Cl(-), as determined by means of (36)Cl(-), was found to stimulate Na(+)/Mg(2+) antiport through a cooperative effect according to a sigmoidal kinetics. The Hill coefficient for intracellular Cl(-) amounted to 1.4-1.8, indicating that two intracellular Cl(-) may be simultaneously active. With respect to specificity, Cl(-) was most effective, followed by Br(-), J(-), and F(-). Stimulation of Na(+)/Mg(2+) antiport by intracellular Cl(-) together with intracellular Mg(2+) may play a role during deoxygenation of erythrocytes and in essential hypertension.

Intralymphocyte free magnesium and calcium and insulin tolerance test in a group of essential hypertensive patients

In order to assess the links which are claimed to exist between peripheral insulin resistance and intracellular magnesium and calcium concentrations, we measured free intralymphocyte magnesium (Mg(i)) and calcium (Ca(i)) concentrations as well as the rate constant of plasma glucose disappearance (K(itt)) after insulin injection (insulin tolerance test: ITT) in a group of 16 normotensive control subjects (NC) and 34 essential hypertensive subjects (EH). Mg(i) and Ca(i) were measured in triplicate by means of a fluorimetric technique based on the dyes furaptra and fura-2 respectively. K(itt) values proved significantly reduced in EH as compared to NC (M +/- SD, EH: 4.49 +/- 1.31 vs 5.28 +/- 1.19, P <0.05; 95% confidence limits: 0.23-1.5). Mg(i) and Ca(i) were not statistically different in EH as compared to NC subjects (Mg(i), NC: 266 +/- 20 micromol/l; EH: 245 +/- 50 micromol/l; Ca(i), NC: 47 +/- 9 nmol/l EH: 46 +/- 13 nmol/l). We found a statistically significant inverse correlation in the whole study group between K(itt) and body mass index (R= -0.363, P<0.01) and a statistically significant positive correlation between K(itt) and Mg(i) (R=0.347, P=0.013) was found. In a step-up multivariate regression analysis including blood pressure, plasma lipids, BMI, plasma magnesium, fasting insulin, fasting glucose, Mg(i) and Ca(i), the dependent variable K(itt) is statistically significantly correlated with body mass index and Mg(i). In a first attempt to study the relationships between insulin resistance, Mg(i) and Ca(i) in nucleated cells, the chosen index of peripheral resistance seems to be linked to intracellular free magnesium.

Apparent Mg2+-adenosine 5-triphosphate dissociation constant measured with Mg2+ macroelectrodes under conditions pertinent to 31P NMR ionized magnesium determinations

Using Mg2+ macroelectrodes based on the sensor ETH 7025 and accurate Mg2+-EDTA buffer solutions, the apparent Mg2+-ATP dissociation constant (Kapp) was measured at 25 and 37 degrees C in background solutions mimicking the cationic intracellular milieu of muscle cells. The mean +/- SD (in microM) at 25 degrees C was 157.0 +/- 13 (n = 4), 127.5 +/- 12.0 (n = 11), 101.0 +/- 9.0 (n = 4) and at 37 degrees C was 106.6 +/- 9.6 (n = 4), 87.4 +/- 4.9 (n = 4), 78.1 +/- 2.0 (n = 4) at pH values of 6.7, 7.2, and 7.7, respectively. The dependence of Kapp at 25 degrees C on the ionic strength was also measured, the mean +/- SD (microM) being 61.9 +/- 2.2 (n = 3), 127.5 +/- 12 (n = 11), and 243.0 +/- 11.8 (n = 3) at ionic strengths of 0. 087, 0.156 (normal background), and 0.3 m, respectively. These values are larger than the Kapp values most commonly used in the literature (87.4 microM compared to 38 microM at pH 7.2 and 37 degrees C) to estimate the [Mg2+]i in 31P NMR experiments, attributed to the difficulties in setting the [Mg2+]i without the use of Mg2+ buffer solutions. If these new values are used, the literature values for [Mg2+]i estimated by 31P NMR increase by a factor of around 1.5, making them similar to values obtained by direct Mg2+ microelectrode measurements.

Free magnesium-ion concentration in erythrocytes by 31P NMR: the effect of metabolite-haemoglobin interactions

The effects that haemoglobin-metabolite interactions have on estimates of free magnesium-ion concentration in human erythrocytes, determined by 31P NMR [Gupta, R. K. et al., J. Biol. Chem. 253, 6172-6176 (1978)], were investigated. If the metabolite-haemoglobin association constants of Berger et al. [Eur. J. Biochem. 38, 553-562 (1973)] are used in the analysis then the estimates of intracellular free magnesium-ion concentration made by Gupta et al. (0.25 and 0.67 mM) become 0.43 and 0.60 mM, for oxygenated and deoxygenated cells, respectively. In oxygenated cells, this difference is primarily due to the lower value of KHbMgATP, given by Berger et al. These newly calculated concentrations are in closer agreement with those of Flatman (0.40 mM for oxygenated cells; 0.62 mM for deoxygenated cells) [Flatman, P. W., J. Physiol. 300, 19-30 (1980)] obtained with the 'zero-point titration' method. In addition, the assumptions that the chemical shift separations between the alpha- and beta-phosphorus resonances of ATP and MgATP are unchanged on association with Hb were shown to be false. Under normal intracellular conditions this may lead to errors of 5-10%. Much larger errors would be possible in cases where significant amounts of ATP or MgATP are bound to Hb. These outcomes place doubt on measurements of intracellular free Mg2+ concentration made using 31P NMR if there is no consideration given to the total concentration of 2,3-bisphosphoglycerate (BPG), ATP and Hb in the sample; the same principle would apply to other cell-types.

Intralymphocyte free magnesium in a group of subjects with essential hypertension

Despite the importance of magnesium in essential hypertension, few data are available on the ionized intracellular concentration of this ion. We therefore studied intralymphocyte free intracellular magnesium (Mgi) in 32 untreated essential hypertensive subjects and 27 normotensive control subjects by means of a fluorimetric technique based on the use of the new magnesium-sensitive dye furaptra. We also measured intralymphocyte ionized calcium (Cai) with fura 2. No statistically significant differences were found in Mgi in hypertensive compared with normotensive subjects (essential hypertensive, 0.291 +/- 0.053 mmol/L; normotensive, 0.293 +/- 0.043 [mean +/- SD]). A statistically significant inverse correlation was established between Mgi and plasma triglycerides in essential hypertensive subjects (r = -.521, P = .002). The hypertensive group was arbitrarily divided into two subgroups according to plasma triglyceride levels (> 2 [n = 10] or < 2 mmol/L [n = 22]), and Mgi proved to be significantly lower in the subgroup with high plasma triglyceride levels compared with either the subgroup with normal triglycerides (P = .009; 95% confidence interval, 0.013-0.088) or the normotensive control group as a whole (P = .03; 95% confidence interval, 0.003-0.069) (high-triglyceride hypertensive subgroup, Mgi = 0.256 +/- 0.045 mmol/L; normal-triglyceride hypertensive subgroup, Mgi = 0.307 +/- 0.049). No statistically significant differences were found in Cai in hypertensive compared with normotensive subjects (hypertensive, 53 +/- 12 nmol/L; normotensive, 54 +/- 14). We did not find statistically significant correlations between Cai and plasma triglycerides, nor did we find any differences in Cai between the subgroup of hypertensive subjects with high plasma triglyceride levels and either the subgroup of hypertensive subjects with normal triglycerides or the normotensive control group as a whole. The discrepancies between our results in lymphocytes and data relating to either erythrocytes or platelets emphasize the need for caution before the results are extrapolated from one tissue to the other. The decreased Mgi levels in the subgroup of high-triglyceride hypertensive subjects may suggest a role for magnesium in plurimetabolic syndrome.

cAMP-induced changes of intracellular free Mg2+ levels in human erythrocytes

To examine the role of cAMP in the regulation of intracellular free magnesium concentration ([Mg2+]i), we measured [Mg2+]i in human erythrocytes by 31P-NMR spectroscopy. (-)-Isoproterenol, forskolin, Bt2cAMP and 8-bromo-cAMP decreased [Mg2+]i in human erythrocytes. Bt2cAMP did not increase the efflux rate of Mg2+ from erythrocytes. HA1004, a potent inhibitor of cAMP-dependent kinases, markedly increased the [Mg2+]i in a Mg(2+)-free buffer solution. Addition of 8-bromo-cGMP or 12-O-tetradecanoylphorbol 13-acetate (TPA) did not affect the [Mg2+]i. These results suggest that beta-adrenergic stimulation and cAMP play an important role in the regulation of [Mg2+]i in human erythrocytes.

Magnesium status and excretion in age-matched subjects with normal and elevated blood pressures

Plasma, erythrocyte, and leucocyte magnesium (Mg) concentration, as well as urinary Mg, calcium (Ca), and phosphorus (P) excretion were determined in male subjects with elevated diastolic blood pressure (DBP) > 90 mmHg. These parameters were compared to those in normotensive age-matched (DBP < 85 mmHg) and drug-treated hypertensive subjects. Mg and Ca were determined by atomic absorption spectroscopy and P was determined by a colorimetric method. Urinary excretion was expressed in terms of creatinine (Cr) excretion. There were no significant differences in plasma, erythrocyte, or leucocyte Mg concentrations. Both urinary Ca and Mg were significantly decreased in the group with elevated blood pressure (BP) and the drug-treated group compared to the normotensive group. Urinary P was elevated in the drug-treated hypertensive group. Of all the variables studied, urinary Mg was the only one that was significantly inversely correlated with both systolic (SBP) and DBP. These data suggest that decreased urinary Mg, which may be indicative of a decreased Mg intake, is associated with hypertension.

New whole blood analyzers and their impact on cardiac and critical care

Miniaturized whole blood biosensors, patient-focused hospitals, and rising expectations of patients and physicians are shifting laboratory diagnostics to the point of care. Expanding transplantation and intensive care are increasing the need for rapid test results. Whole blood analysis improves accuracy, eliminates centrifugation, reduces response time, and conserves blood volume. Several hand-held, and over 20 portable or transportable whole blood instruments are now available. Criteria for instrument evaluation include test menus, point-of-care features, analysis time, on-site performance, and information integration. Whole blood analyzers measure several vital indicators (pO2, pCO2, pH, hematocrit, K+, Ca2+, Na+, Cl-, glucose, and lactate) simultaneously in less than 2 min with less than 200 microliters of whole blood. Other in vitro tests are available (Mg2+, osmolality, CO2 content, urea nitrogen, beta-hydroxybutyrate, hemoglobin, coagulation) or under development (HCO3- phosphorus). Some can be monitored in vivo (O2 saturation, pO2, pCO2, pH, glucose) or ex vivo. The clinical impact is demonstrated by ionized calcium, now established in importance for cardiac and neurologic problems, and ionized magnesium, a promising new measurement. The hybrid laboratory (a composite of conventional clinical laboratory and patient-focused testing), performance maps, and quality paths facilitate implementation of new whole blood analyzers for optimal support of cardiac and critical care, and improved patient outcomes (prospects).

Intracellular free-magnesium levels in vascular smooth muscle and striated muscle cells of the spontaneously hypertensive rat

In humans with essential hypertension and in spontaneously hypertensive rats (SHR), insulin resistance may be present even in lean individuals. As the basis for this abnormality is unknown, we have used a newly developed fluorophore to measure intracellular free-Mg2+ concentrations in cultured aortic vascular smooth muscle cells and striated muscle cells from SHR and normotensive Wistar Kyoto (WKY) rats. Intracellular free-Mg2+ levels were lower in both striated muscle cells (SHR, 0.423 +/- 0.077 mmol.L-1 v WKY, 0.559 +/- 0.068 mmol.L-1; P less than .001) and vascular smooth muscle cells (SHR, 0.406 +/- 0.067 mmol.L-1 v WKY, 0.625 +/- 0.077 mmol.L-1; P less than .001) from hypertensive animals. This widespread, intrinsic defect in the regulation of intracellular Mg2+ may explain the increased vascular resistance and reduced insulin sensitivity present in hypertension.

31P-NMR measurements of ATP, ADP, 2,3-diphosphoglycerate and Mg2+ in human erythrocytes

Absolute 31P-NMR measurements of ATP, ADP and 2,3-diphosphoglycerate (2,3-DPG) in oxygenated and partly deoxygenated human erythrocytes, compared to measurements by standard assays after acid extraction, show that ATP is only 65% NMR visible, ADP measured by NMR is unexpectedly 400% higher than the enzymatic measurement and 2,3-DPG is fully NMR visible, regardless of the degree of oxygenation. These results show that binding to hemoglobin is unlikely to cause the decreased visibility of ATP in human erythrocytes as deoxyhemoglobin binds the phosphorylated metabolites more tightly than oxyhemoglobin. The high ADP visibility is unexplained. The levels of free Mg2+ [( Mg2+]free) in human erythrocytes are 225 mumol/l at an oxygen saturation of 98.6% and instead of the expected increase, the level decreased to 196 mumol/l at an oxygen saturation of 38.1% based on the separation between the alpha- and beta-ATP peaks. [Mg2+]free in the erythrocytes decreased to 104 mumol/l at a high 2,3-DPG concentration of 25.4 mmol/l red blood cells (RBC) and a normal ATP concentration of 2.05 mmol/l RBC. By increasing the ATP concentration to 3.57 mmol/l RBC, and with a high 2,3-DPG concentration of 24.7 mmol/l RBC, the 31P-NMR measured [Mg2+]free decreased to 61 mumol/l. These results indicate, that the 31P-NMR determined [Mg2+]free in human erythrocytes, based solely on the separation of the alpha- and beta-ATP peaks, does not give a true measure of intracellular free Mg2+ changes with different oxygen saturation levels. Furthermore the measurement is influenced by the concentration of the Mg2+ binding metabolites ATP and 2,3-DPG. Failure to take these factors into account when interpreting 31P-NMR data from human erythrocytes may explain some discrepancies in the literature regarding [Mg2+]free.

Increased erythrocyte magnesium content in essential hypertension

The present study aimed at testing the hypothesis of decreased erythrocyte magnesium content and magnesium deficiency in essential hypertension. Atomic absorption was used to measure the erythrocyte content of total magnesium in 50-year-old otherwise healthy white males with essential hypertension (n = 12, blood pressure (mean +/- SE) 155 +/- 4/109 +/- 2 mmHg) that had never been treated and in normotensive control subjects (n = 12, blood pressure 128 +/- 2/88 +/- 1 mmHg) matched for age, sex, race, height, weight and smoking habits. The erythrocyte magnesium content was significantly increased in the hypertensive group (2.266 +/- 0.063 vs 1.903 +/- 0.069 mmol/l erythrocytes, p less than 0.001). No significant difference between the groups was detected for serum concentration or the 24-h urinary excretion of magnesium. In conclusion, the present study indicates increased rather than decreased erythrocyte content of magnesium in 50-year-old white males with 'never-treated', essential hypertension. Magnesium deficiency is, therefore, unlikely in this subset of critically selected and matched hypertensive patients.

Determination of intracellular free magnesium by nuclear magnetic resonance in human magnesium deficiency

Magnesium (Mg) deficiency is a common clinical problem. As Mg is predominantly an intracellular cation and Mg deficiency may exist despite normal serum Mg (sMg) concentrations, we have utilized nuclear magnetic resonance (NMR) techniques in an attempt to measure intracellular free Mg (Mg2+) in red blood cells (RBC). Twenty normal subjects, 22 hypomagnesemic patients, and 17 normomagnesemic alcoholic patients were studied. Mean RBC Mg2+ in normal subjects (178 +/- 6.3 microM) was significantly greater than in hypomagnesemic patients (146 +/- 7.1 microM, p less than 0.002). RBC Mg2+ correlated with sMg concentration (r = 0.54, p less than 0.001). In addition, four normal subjects were given a low Mg diet for 3 weeks. There was a progressive fall in both the sMg concentration and RBC Mg2+ during Mg depletion, with a concomitant rise in retention of a parenterally administered Mg load. These data suggest that the determination of intracellular Mg2+ by NMR may be a useful research tool in assessing the effect of changes in Mg2+ on intracellular processes. Its utility in the clinical evaluation of disorders of Mg deficiency remains to be determined.