Comparison of <scp>Levitt's CO</scp> breath test and the <scp><sup>15</sup>N</scp>‐glycine labeling technique for measuring the lifespan of human red blood cells

Ye, Lei; Ji, Yongqiang; Zhou, Cong; Luo, Junfeng; Zhang, Li; Jing, Liping; Zhao, Xin; Guo, Jie; Gao, Qingyan; Peng, Guangxin; Li, Yang; Li, Yuan; Li, Jianping; Fan, Huihui; Yang, Wenrui; Yang, Yang; Ma, Yongjian; Zhang, Fengkui

doi:10.1002/ajh.26290

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…Levitt’s CO breath test, which has been demonstrated to be not inferior to the [ 15 ] N glycine labelling technique [ 21 ], was applied to detect RBC lifespan. The RBC lifespan was measured as the total capacity of CO from Hb degradation divided by the quantity of CO released per day.…”

Section: Methodsmentioning

confidence: 99%

Genotype-degree of hemolysis correlation in hereditary spherocytosis

Shi

Yang

et al. 2023

BMC Genomics

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Background Hereditary spherocytosis (HS) is a common inherited hemolytic anemia, caused by mutations in five genes that encode erythrocyte membrane skeleton proteins. The red blood cell (RBC) lifespan could directly reflect the degree of hemolysis. In the present cohort of 23 patients with HS, we performed next-generation sequencing (NGS) and Levitt’s carbon monoxide (CO) breath test to investigate the potential genotype-degree of hemolysis correlation. Results In the present cohort, we identified 8 ANK1,9 SPTB,5 SLC4A1 and 1 SPTA1 mutations in 23 patients with HS, and the median RBC lifespan was 14(8–48) days. The median RBC lifespan of patients with ANK1, SPTB and SLC4A1 mutations was 13 (8–23), 13 (8–48) and 14 (12–39) days, respectively, with no statistically significant difference (P = 0.618). The median RBC lifespan of patients with missense, splice and nonsense/insertion/deletion mutations was 16.5 (8–48), 14 (11–40) and 13 (8–20) days, respectively, with no significant difference (P = 0.514). Similarly, we found no significant difference in the RBC lifespan of patients with mutations located in the spectrin-binding domain and the nonspectrin-binding domain [14 (8–18) vs. 12.5 (8–48) days, P = 0.959]. In terms of the composition of mutated genes, 25% of patients with mild hemolysis carried ANK1 or SPTA1 mutations, while 75% of patients with mild hemolysis carried SPTB or SLC4A1 mutations. In contrast, 46.7% of patients with severe hemolysis had ANK1 or SPTA1 mutations and 53.3% of patients with severe hemolysis had SPTB or SLC4A1 mutations. However, there was no statistically significant difference in the distribution of mutated genes between the two groups (P = 0.400). Conclusion The present study is the first to investigate the potential association between genotype and degree of hemolysis in HS. The present findings indicated that there is no significant correlation between genotype and degree of hemolysis in HS.

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Section: Methodsmentioning

confidence: 99%

Genotype-degree of hemolysis correlation in hereditary spherocytosis

Shi

Yang

et al. 2023

BMC Genomics

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“…RBC lifespan was measured using Levitt's carbon monoxide (CO) breath test by an electrophoretic light scattering (ELS) instrument (Seekya Biotec, Shenzhen, China) as described previously [ 10 ]. RBC lifespan values determined from the CO breath test using this instrument and the 15N-glycine labelling technique have been proved to be comparable, which suggested that the CO breath test is a reliable method for quickly determining human RBC lifespans in clinical applications [ 23 ]. Alveolar air samples were collected pre-dialysis in the morning of the dialysis day without a fasting requirement.…”

Section: Methodsmentioning

confidence: 99%

Effect of roxadustat on red blood cell lifespan in patients with long-term haemodialysis: a single-centre, prospective, single-arm study

Zhao

Yang

et al. 2023

Clinical Kidney Journal

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Background Reduced survival of red blood cells (RBCs) in patients with chronic kidney disease (CKD) is thought to contribute to renal anemia. Although renal anemia improved greatly because of the wide use of erythropoiesis-stimulating agents (ESAs) and the advancement of dialysis technique, RBC longevity seems not to be obviously ameliorated. Methods In this single-center, single-arm trial, patients who had been undergoing hemodialysis and ESAs therapy with epoetin alfa for at least 12 weeks changed their anti-anemia drugs from epoetin alfa to oral roxadustat three times per week for 24 weeks. The primary end point was the change in RBC lifespan level from baseline at week 24. The change in circulating percentage of eryptotic RBCs, RBC deformability, and RBC oxygen-transport ability were also assessed. Results A total of 27 patients were enrolled, with 26 completing the full course of intervention. At baseline, average RBC lifespan was 60.1 days (SD: 14.4 days; n = 27). At the end of study period, 26 patients had RBC lifespan measurement (83.9 days on average; SD: 21.9 days). RBC lifespan increased by 22.8 days on average (95% CI: 15.5–30.0 days) (P < 0.001). This equated to an average RBC lifespan increase of 39.2% (95% CI: 27.8 to 50.6%). The percentage of circulating eryptotic RBCs, erythrocyte filtration index and P50 levels decreased significantly from baseline to week 24 (1.39% ± 0.44% vs. 0.89% ± 0.25%, P < 0.0001; 0.29 ± 0.12 vs. 0.16 ± 0.08, P < 0.0001; 32.54 ± 4.83 vs. 28.40 ± 2.29, P < 0.001; respectively). Conclusion Roxadustat prolonged RBC lifespan in patients with long-term hemodialysis.

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“…The values of Vb and Vt are approximately the same. Thus, erythrocyte lifespan = (Hb × K)/endPCO [K: 1,380, unit: mL/(dg)] [124][125][126][127]. Hemoglobin concentration can be determined through a routine blood test, while the endogenous CO concentration during expiration can be measured using specific instruments.…”

Section: Co Expiratory Methodsmentioning

confidence: 99%

New Clues to Cardiovascular Disease: Erythrocyte Lifespan

Zhang

2023

Aging and disease

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Comparison of Levitt's CO breath test and the ¹⁵N‐glycine labeling technique for measuring the lifespan of human red blood cells

Cited by 12 publications

References 21 publications

Genotype-degree of hemolysis correlation in hereditary spherocytosis

Genotype-degree of hemolysis correlation in hereditary spherocytosis

Effect of roxadustat on red blood cell lifespan in patients with long-term haemodialysis: a single-centre, prospective, single-arm study

New Clues to Cardiovascular Disease: Erythrocyte Lifespan

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Comparison of Levitt's CO breath test and the 15N‐glycine labeling technique for measuring the lifespan of human red blood cells

Cited by 12 publications

References 21 publications

Genotype-degree of hemolysis correlation in hereditary spherocytosis

Genotype-degree of hemolysis correlation in hereditary spherocytosis

Effect of roxadustat on red blood cell lifespan in patients with long-term haemodialysis: a single-centre, prospective, single-arm study

New Clues to Cardiovascular Disease: Erythrocyte Lifespan

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Comparison of Levitt's CO breath test and the ¹⁵N‐glycine labeling technique for measuring the lifespan of human red blood cells