MOLECULAR AND RHEOLOGICAL CONSIDERATIONS OF THE RED CELL MEMBRANE IN VIEW OF THE INTERNAL FLUIDITY OF THE RED CELL

An in vitro model of a system of electrical potential compensation in extracorporeal circulation

OBJECTIVES

Extracorporeal circulation (ECC) in patients undergoing cardiac surgery induces systemic immune-inflammatory reaction that results in increased postoperative morbidity. Many factors are responsible for the adverse response after ECC. The present in vitro study aimed to investigate electric charges (ECs) generated during ECC, to set a device compensating the ECs, and checking its effect on red blood cells (RBC).

MATERIALS AND METHODS

The electrical signals of blood in ECC were collected by a custom developed low-noise electronic circuit, processed by a digital oscilloscope (DSO) and a dynamic signal analyzer (DSA). The compensation of ECs was performed using a compensation device, injecting a nulling charge into the blood circuit. The compensation effect of the ECs on RBCs was evaluated by scanning electron microscope (SEM).

RESULTS

The electrical analysis performed using both the DSO and the DSA confirmed the EC formation during ECC. The notable electric signals recorded in standard ECC circuits substantially nulled once the compensation device was used, thus confirming efficient EC compensation. After two hours of ECC, the SEM non-blended test on human RBC samples highlighted morphological changes in acanthocytes of the normal biconcave-shaped RBC.

CONCLUSIONS

The outcomes confirm the development of parasitic ECs during ECC and that a suppressor system may decrease the potential damage of ECs. Nevertheless, further studies are ongoing in order to investigate the complex mechanisms related to lymphocytes and platelet morphological and physiological chances during triboelectric charges in ECC.

Modifications of blood rheology during aging and age-related pathological conditions

In principle there should not be any increase of blood viscosity factors (plasma viscosity, blood viscosity, aggregation of red blood cells, rigidity of red blood cells, dynamic thrombus formation) with aging in a healthy population. Such an increase would be due to pathological caused and not to aging per se. The pathological causes of the increase in the blood viscosity factors often observed in the elderly could be ascribed to the following: use of drugs (e.g. cigarette smoking); lack of exercise; unbalanced diet; psychological states such as anxiety and depression; presence of diseases such as heart disease or cancer or diabetes (although these disorders have the same effect in a younger population). The principal viscosity factors are explained, and their role in tissue perfusion, occlusions, infarctions and other disorders is described. This review will hopefully serve as an introduction to the studies of the haemorheology of aging. A counteraction of the elevation of blood viscosity factors might be helpful in ameliorating many diseases typical of aging, and should allow elderly people to remain active much longer.

Mechanical properties of the red cell membrane skeleton: analysis of axisymmetric deformations

The mechanical properties of erythrocyte membrane composed of a membrane bilayer and membrane skeleton are considered. Two membrane models are described: the model of free boundaries (MFB) and the model of immobilized boundaries (MIB). In MFB, the skeleton is assumed to be attached to the bilayer at a finite number of points, whereas MIB allows the interaction of each spectrin filament with the bilayer along its whole length. For MFB an estimate was made of the mechanical strain generated in the membrane by sucking erythrocytes into a micropipette. The existence of the deformation threshold is demonstrated, below which no mechanical strain, except that of bending, appears in the membrane. Thus only deformations exceeding this threshold result in strain. The relationship between the applied tension and the height of erythrocyte "tongue" sucked into a micropipette was determined. The MIB characteristics correspond to the model of Evans: strains in the membrane are generated at any deformation, however small, i.e. the threshold is equal to zero. A basic feature of this model is quite a different distribution of the skeleton deformations in the membrane. A comparison of the theoretical models and experimental data demonstrated the possibility of either MFB or MIB occurring, depending on the characteristic measurement time.

Viscosity of concentrated solutions and of human erythrocyte cytoplasm determined from NMR measurement of molecular correlation times. The dependence of viscosity on cell volume

Metabolically active human erythrocytes were incubated with [alpha-13C]glycine which led to the specific enrichment of intracellular glutathione. The cells were then studied using 13C-NMR in which the longitudinal relaxation times (T1) and nuclear Overhauser enhancements of the free glycine and glutathione were measured. The T1 values of labelled glycine were also determined in various-concentration solutions of bovine serum albumin and glycerol and also of the natural abundance 13C of glycerol in glycerol solutions. From the T1 estimates the rotational correlation time (tau r) was calculated using a formula based on a model of an isotropic spherical rotor or that of a symmetrical ellipsoidal rotor; for glycine the differences in estimates of tau r obtained using the two models were not significant. From the correlation times and by use of the Stokes-Einstein equations viscosity and translational diffusion coefficients were calculated; thus comment can be made on the likelihood of diffusion control of certain enzyme-catalysed reactions in the erythrocyte. Bulk viscosities of the erythrocyte cytoplasm and the above-mentioned solutions were measured using Ostwald capillary viscometry. Large differences existed between the latter viscosity estimates and those based upon NMR-T1 measurements. We derived an equation from the theory of the viscosity of concentrated solutions which contains two phenomenological interaction parameters, a 'shape' factor and a 'volume' factor; it was fitted to data relating to the concentration dependence of viscosity measured by both methods. We showed, by using the equation and interaction-parameter estimates for a particular probe molecule in a particular solution, that it was possible to correlate NMR viscosity and bulk viscosity; in other words, given an estimate of the bulk viscosity, it was possible to calculate the NMR 'micro' viscosity or vice versa. However, the values of the interaction parameters depend upon the relative sizes of the probe and solute molecules and must be separately determined for each probe-solute-solvent system. Under various conditions of extracellular osmotic pressure, erythrocytes change volume and thus the viscosity of the intracellular milieu is altered. The volume changes resulted in changes in the T1 of [alpha-13C]glycine. Conversely, we showed that alterations in T1, when appropriately calibrated, could be used for monitoring changes in volume of metabolically active cells.

Lateral organization of membranes and cell shapes

The relations among membrane structure, mechanical properties, and cell shape have been investigated. The fluid mosaic membrane models used contains several components that move freely in the membrane plane. These components interact with each other and determine properties of the membrane such as curvature and elasticity. A free energy equation is postulated for such a multicomponent membrane and the condition of free energy minimum is used to obtain differential equations relating the distribution of membrane components and the local membrane curvature. The force that moves membrane components along the membrane in a variable curvature field is calculated. A change in the intramembrane interactions can bring about phase separation or particle clustering. This, in turn, may strongly affect the local curvature. The numerical solution of the set of equations for the two dimensional case allows determination of the cell shape and the component distribution along the membrane. The model has been applied to describe certain erythrocytes shape transformations.

Microrheology and light transmission of blood. IV. The kinetics of artificial red cell aggregation induced by Dextran

Employing both microscopic and photometric methods the rheology of pathological red cell aggregation was studied in model experiments. Suspensions of washed human red blood cells in dextran solutions containing rising concentrations of dextrans (M.W. 40000, 70000, 110000, 250000, 500000) were used. At low concentrations (less than 500 mg-%) of high molecular weight dextrans (greater than 70000) red cell suspensions formed aggregates similar to the ones found in normal human blood. At higher concentrations, the aggregates were similar to those observed in pathological human blood. The aggregates were studied under the condition of stasis, slow flow and at shear rate of their hydrodynamic dispersion. Besides, the flow behavior of the dispersed cells at high shear rates was studied. We found: 1. In all samples the rate of spontaneous aggregate re-formation in stasis (following hydrodynamic desaggregation) rose with rising dextran concentration up to 5.0 g-%. 2. The shear resistance of the aggregates, as measured by the shear stress necessary to keep them dispersed, rose up to concentrations of 2.5g-%, but fell at higher concentrations. 3. Only with dextran of a molecular weight above 110000 coarse agglomerates could be produced at high concentrations. Loose elastic meshes were rapidly produced at high concentrations of Dx 70. 4. When subjected to steady state low shear (m sec-1) only the agglomerates, but not the meshes rapidly grew in size. Most of the aggregation kinetics recorded by photometry and microscopy evaded detection by viscometry.

Influence of deformability of human red cells upon blood viscosity

The viscosity of blood at high rates of shear is unusually low compared to other suspensions of similar concentration. The underlying mechanisms were studied by rotational viscometry, red cell filtration, viscometry of packed cells and direct microscopic observation of red cells under flow in a transparent cone plate viscometer. Deformability of red cells was altered osmotically or abolished by aldehyde fixation. The normal red cells under isosmotic conditions passed easily through filter pores (5 to 14 µ diameter). After osmotic crenation, deformability of cells in pore flow was reduced. Normal cells were deformed into a variety of shapes at high rates of shear, while crenated cells tumbled undeformed. Suspensions of these normal cells showed more pronounced shear thinning (reduction of viscosity with increasing shear rate) than suspensions of crenated cells. Suspensions of rigid cells showed greatly increased viscosity and a shear thickening as a function of shear rate and shear time. The physiological deformability is of critical importance to blood flow at high rates of shear. This is possible through a fluid transition of the erythrocyte caused by a rotation of the membrane with and around the cell contents. This phenomenon is the prime cause of the progressive reduction in viscosity with increasing shear.

Fluid drop-like transition of erythrocytes under shear

Red cells dispersed in a continuous medium of high viscosity possess the flow properties of fluid drops. The cells at rest are biconcave, while under shear they become progressively deformed into prolate ellipsoids, their long axis aligned parallel to the flow direction. The red cell membrane rotates around the hemoglobin like a tread of a tank. At high rates of shear this mechanism greatly reduces viscosity at all hematocrit values.

Metabolic dependence of red cell deformability

The contribution of the metabolic state of human erythrocytes to maintenance of cellular deformability was studied during and after in vitro incubation in serum for periods up to 28 hr. An initial loss of membrane deformability became apparent between 4 and 6 hr when cellular adenosine triphosphate (ATP) levels were approximately 70% of initial values. Membrane deformability then remained stable between 6 and 10 hr. After 10 hr, when cellular ATP had decreased to < 15% of initial values, progressive parallel changes occurred in red cell calcium which increased 400% by 24 hr and in the viscosity of red cell suspensions which had risen 500-750% at 24 hr. A further progressive decrease in membrane deformability also occurred and was reflected by a 1000% increase in negative pressure required to deform the membrane. Red cell filterability decreased to zero as the disc-sphere shape transformation ensued. These changes were accompanied by an increase in ghost residual hemoglobin and nonhemoglobin protein. Regeneration of ATP in depleted cells by incubation with adenosine produced significant reversal of these changes, even in the presence of ouabain. Introduction of calcium into reconstituted ghosts prepared from fresh red cells mimicked the depleted state, and introduction of ATP, ethylenediamine tetraacetate (EDTA), and magnesium into depleted cells mimicked the adenosine effects in intact depleted cells. ATP added externally to 24-hr depleted cells was without effect. Simultaneous introduction of EDTA, ATP, or magnesium along with calcium into reconstituted ghosts prevented the marked decrease in deformability produced by calcium alone. Incorporation of adenosine diphosphate (ADP), nicotinamide adenine dinucleotide (NAD), NAD phosphate (NADP), NADP, reduced form (NADPH), glutatione, reduced form (GSH), inosine triphosphate (ITP), guanosine triphosphate (GTP), and uridine triphosphate (UTP) was without effect. These data suggest that a major role of ATP in maintenance of red cell viability relates to preservation of red cell membrane deformability. It is proposed that the changes seen in the physical properties of ATP-depleted erythrocytes represent ATP-calcium-dependent sol-gel changes occurring at the interface between the membrane and the cell interior, and that the sol-gel balance determines membrane deformability.