Impaired Hemorheology in Exacerbations of COPD

Investigation of hemorheology in patients with hyperthyroidism via blood viscosity, erythrocyte deformability and aggregation

OBJECTIVE

Hyperthyroidism's impact on cardiovascular, hematopoietic systems and metabolism might lead to hemorheological changes. This study aimed to investigate the changes in hemorheological properties via erythrocyte deformability and aggregation, whole blood viscosity (WBV) and plasma viscosity (PV) in hyperthyroid patients. The effect of anti-thyroid treatment on hemorheology was also studied. MATERIAL METHODS: Thirty-six patients with overt hyperthyroidism, 19 patients with subclinical hyperthyroidism and 66 controls were included in the study. Hematocrit, erythrocyte deformability and aggregation, plasma and whole blood viscosity values were measured before treatment. Hemorheological parameters of the patients were compared with the control. Before and after treatment results of overt hyperthyroidism were analyzed. Methimazole was given as anti-thyroid treatment. Deformability and aggregation measurements were conducted using a laser ektacytometer (LORRCA) while viscosity measurements were performed with a cone-plate viscometer (Brookfield DV-III).

RESULTS

The maximum elongation index (EImax) decreased significantly from 0.664 (0.01) pre-treatment to 0.657 (0.01) post-treatment (p = 0.04). The aggregation index was significantly higher in both the subclinical hyperthyroidism group [68.05 (7.66), p = 0.001] and the overt hyperthyroidism group [66.78 (8.815), p = 0.001] compared to the control group. Additionally, the aggregation half-time was significantly shorter in the subclinical hyperthyroidism group [1.9 (1.21-2.27), p = 0.001] and the overt hyperthyroidism group [1.91 (1.43-2.46), p = 0.001] relative to the control group.

CONCLUSION

The hemorheological status of patients was influenced by excessive thyroid hormones in both subclinical and overt hyperthyroidism groups. Additionally, anti-thyroid therapy with methimazole may play a role in the observed decrease in the maximum elongation index following treatment.

Red blood cell changes due to cancer and cancer treatments: a narrative review

PURPOSE OF REVIEW

To date, there is relatively limited research investigating changes in red blood cells (RBCs), particularly qualitative changes, in cancer patients and cancer patients receiving treatment. These changes may be important in better understanding cancer-associated anemia, which is the most prevalent hematological disorder in cancer patients with wide-ranging implications on patient care and quality of life. This review aims to summarize available evidence regarding qualitative and quantitative changes in RBCs in individuals with cancer prior to treatment and in patients undergoing treatment.

RECENT FINDINGS

The most commonly reported changes in RBCs in cancer patients were increased mean corpuscular volume (MCV) and decreased hemoglobin, RBC count, and hematocrit. There were increased lipid peroxidation products and decreased antioxidants. There were increased polyunsaturated fatty acids (PUFAs) and decreased monounsaturated fatty acids (MUFAs) and saturated fatty acids (FAs). Additionally, RBC shape alterations with various atypical morphologies, membrane structure abnormalities, and impaired fluidity were also reported. These and various other reported findings are discussed in depth.

SUMMARY

There are several reported quantitative and qualitative RBC changes in individuals with cancer, with some studies exhibiting conflicting results. Further research is needed to solidify the data and to better understand hematological-associated comorbidities in those patients.

Chronic Obstructive Pulmonary Disease and Its Effect on Red Blood Cell Indices

Chronic obstructive pulmonary disease (COPD) constitutes a set of heterogeneous symptoms affecting millions of people worldwide. The associated comorbidities developing in COPD involve dysregulation in physiological pathways resulting from systemic inflammation in respiratory airways. In addition to mentioning the pathophysiology, stages, and consequences of COPD, this paper also defines red blood cell (RBC) indices such as hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cell distribution width, and RBC count. It explains the role of RBC indices and RBC structural abnormalities with disease severity and exacerbations in COPD patients. Although many factors have been studied as a marker of morbidity and mortality for COPD patients, RBC indices have emerged as revolutionary evidence. Therefore, the effectiveness of evaluating RBC indices in COPD patients and their importance as a negative predictor of survival, mortality, and clinical outcomes have been debated through rigorous literature reviews. Furthermore, the prevalence, mechanisms of development, and prognosis of underlying anemia and polycythemia in COPD have also been evaluated, with anemia most significantly associated with COPD. Therefore, more studies should be conducted to address underlying anemia in COPD patients to lessen the severity and disease burden. Correcting the RBC indices in COPD patients remarkably impacts the quality of life and reduces in-patient admissions, healthcare resource utilization, and costs. Hence, it is noteworthy to understand the significance of considering RBC indices while dealing with COPD patients.

Erythrocyte Deformability and Na,K-ATPase Activity in Various Pathophysiological Situations and Their Protection by Selected Nutritional Antioxidants in Humans

The physicochemical and functional properties of erythrocytes are worsened in a variety of diseases. Erythrocyte deformability refers to their ability to adjust their shape according to external forces exerted against them in the circulation. It is influenced by the functionality of the Na,K-ATPase enzyme, which is localized in their membranes. The proposed review is focused on knowledge regarding changes in erythrocyte Na,K-ATPase activity, and their impact on erythrocyte deformability in various pathophysiological situations observed exclusively in human studies, as well as on the potential erytroprotective effects of selected natural nutritional antioxidants. A clear link between the erythrocyte properties and the parameters of oxidative stress was observed. The undesirable consequences of oxidative stress on erythrocyte quality and hemorheology could be at least partially prevented by intake of diverse antioxidants occurring naturally in foodstuffs. Despite intensive research concerning the effect of antioxidants, only a small number of investigations on erythrocyte properties in humans is available in databases. It is worth shifting attention from animal and in vitro experiments and focusing more on antioxidant administration in human studies in order to establish what type of antioxidant, in what concentration, and in which individuals it may provide a beneficial effect on the human organism, by protecting erythrocyte properties.

Fibrinogen is a promising biomarker for chronic obstructive pulmonary disease: evidence from a meta-analysis

Backgrounds: Some studies have reported association of circulating fibrinogen with the risk of chronic obstructive pulmonary disease (COPD), and the results are conflicting. To yield more information, we aimed to test the hypothesis that circulating fibrinogen is a promising biomarker for COPD by a meta-analysis.

Methods: Data extraction and quality assessment were independently completed by two authors. Effect-size estimates are expressed as weighted mean difference (WMD) with 95% confidence interval (95% CI).

Results: Forty-five articles involving 5586/18604 COPD patients/controls were incorporated. Overall analyses revealed significantly higher concentrations of circulating fibrinogen in COPD patients than in controls (WMD: 84.67 mg/dl; 95% CI: 64.24–105.10). Subgroup analyses by COPD course showed that the degree of increased circulating fibrinogen in patients with acute exacerbations of COPD (AECOPD) relative to controls (WMD: 182.59 mg/dl; 95% CI: 115.93–249.25) tripled when compared in patients with stable COPD (WMD: 56.12 mg/dl; 95% CI: 34.56–77.67). By COPD severity, there was a graded increase in fibrinogen with the increased severity of COPD relative to controls (Global Initiative for Obstructive Lung Disease (GOLD) I, II, III, and IV: WMD: 13.91, 29.19, 56.81, and 197.42 mg/dl; 95% CI: 7.70–20.11, 17.43–40.94, 39.20–74.41, and −7.88 to 402.73, respectively). There was a low probability of publication bias.

Conclusion: Our findings indicate a graded, concentration-dependent, significant relation between higher circulating fibrinogen and more severity of COPD.

Impacts of Mycoplasma loads and lung lesions on immune and hematological statuses of pigs in an eight-breed cross heterogeneous population

Developments of pulmonary diseases, often accompanied by infections of bacteria, severely affect the meat production and welfare of pigs. This study investigated 307 pigs at age of 240 d from an eight-breed cross reared under standardized housing conditions for associations among the extent of lung lesions, bacteria load inferred from 16S rRNA sequencing of bronchoalveolar lavage fluid, as well as 57 immune cells and 25 hematological traits. We showed that the pigs under study suffered substantial and varied lung lesions, and the Mycoplasma is the most associated bacteria genera. At a false discovery rate of 0.05 (FDR < 0.05), the severity of lung lesions were significantly associated with greater CD8+ to CD3+ cell ratio, neutrophil-to-lymphocyte ratio (NLR), and standard deviation of red blood cell volume distribution width (RDW-SD), and lower CD4-CD8-/CD3+, CD3+CD4-CD8-/PBMCs (peripheral blood mononuclear cells) and CD14-CD16-/PBMCs cell ratios, mean corpuscular hemoglobin concentration, lymphocyte count, and lymphocyte count percentage, reflecting an status of inflammation, immune suppression, and hypoxia of the pigs accompanying the progression of the lung lesions. The Mycoplasma abundance showed positive correlations with neutrophil count, neutrophil count percentage, NLR, monocyte count, coefficient of variation in red blood cell volume distribution width , and RDW-SD, and negative correlations with mean corpuscular hemoglobin concentration, lymphocyte count, and lymphocyte count percentage; these correlations are largely consistent with those of lung lesions, supporting the comorbidity of lung lesions and Mycoplasma infection. We also observed nonlinear associations that sharp increases in neutrophil count and neutrophil count percentage occurred only when Mycoplasma abundance raised above the population-average level. The results provide helpful insights into the changes of host immune status in response to Mycoplasma relevant lung diseases in pigs.