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Poulet FM, Penraat K, Collins N, Evans E, Thackaberry E, Manfra D, Engstrom L, Geissler R, Geraci-Erck M, Frugone C, Abutarif M, Fine JS, Peterson BL, Cummings BS, Johnson RC. Drug-induced Hemolytic Anemia and Thrombocytopenia Associated with Alterations of Cell Membrane Lipids and Acanthocyte Formation. Toxicol Pathol 2010; 38:907-22. [DOI: 10.1177/0192623310378865] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
CXCR3 is a chemokine receptor, upregulated upon activation of T cells and expressed on nearly 100% of T cells in sites of inflammation. SCH 900875 is a selective CXCR3 receptor antagonist. Thrombocytopenia and severe hemolytic anemia with acanthocytosis occurred in rats at doses of 75, 100, and 150 mg/kg/day. Massively enlarged spleens corresponded histologically to extramedullary hematopoiesis, macrophages, and hemosiderin pigment and sinus congestion. Phagocytosed erythrocytes and platelets were within splenic macrophages. IgG and/or IgM were not detected on erythrocyte and platelet membranes. Ex vivo increased osmotic fragility of RBCs was observed. Lipid analysis of the RBC membrane revealed modifications in phosphatidylcholine, overall cholesterol, and/or sphingomyelin. Platelets exhibited slender filiform processes on their plasma membranes, analogous to those of acanthocytes. The presence of similar morphological abnormalities in acanthocytes and platelets suggests that possibly similar alterations in the lipid composition of the plasma membrane have taken place in both cell types. This phenotype correlated with alterations in plasma lipids (hypercholesterolemia and low triglycerides) that occurred after SCH 900875 administration, although other factors cannot be excluded. The increased cell destruction was considered triggered by alterations in the lipid profile of the plasma membranes of erythrocytes and platelets, as reflected morphologically.
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Affiliation(s)
| | - Kelley Penraat
- Alpha-Omega Veterinary Consultant Services, LLC, Lafayette, New Jersey, USA
| | | | - Ellen Evans
- Merck Research Laboratories, Lafayette, New Jersey, USA
| | | | - Denise Manfra
- Merck Research Laboratories, Lafayette, New Jersey, USA
| | | | | | | | | | | | | | - Brianna L. Peterson
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, USA
- Washington State Toxicology Laboratory, Forensic Laboratory Services Bureau, Washington State Patrol, Seattle, Washington, USA
| | - Brian S. Cummings
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, USA
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