Red blood cell aggregation and sedimentation: the role of the cell shape

Reinhart, Walter H.; Singh, Ajit Pal; Straub, P W

doi:10.1111/j.1365-2141.1989.tb00296.x

Cited by 52 publications

(42 citation statements)

References 19 publications

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“…This is opposite to what might be expected from the fact that echinocytes undergo much less aggregation, 48, 49 but echinocytes have been shown to increase low shear viscosity irrespective of RBC aggregation. 18, 50 Washing stored RBCs had no beneficial effect at high shear rates and slightly decreased the viscosities at low shear rates.…”

Section: Discussioncontrasting

confidence: 63%

Washing stored red blood cells in an albumin solution improves their morphologic and hemorheologic properties

et al. 2015

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BACKGROUND Prolonged storage of red blood cells leads to storage lesions, which may impair clinical outcomes after transfusion. A hallmark of storage lesions is progressive echinocytic shape transformation, which can be partially reversed by washing in albumin solutions. Here we have investigated the impact of this shape recovery on biorheological parameters. METHODS Red blood cells stored hypothermically for 6–7 weeks were washed in a 1% human serum albumin solution. Red cell deformability was measured with osmotic gradient ektacytometry. The viscosity of red cell suspensions were measured with a Couette-type viscometer. The flow behaviour of red cells suspended at 40% hematocrit was tested with an artificial microvascular network. RESULTS Washing in 1% albumin reduced higher degrees of echinocytes and increased the frequency of discocytes, thereby shifting the morphological index towards discocytosis. Washing also reduced red cell swelling. This shape recovery was not seen after washing in saline, buffer or plasma. Red cell shape normalisation did not improve cell deformability measured by ektacytometry, but it tended to decrease suspension viscosities at low shear rates and improved the perfusion of an artificial microvascular network. CONCLUSIONS Washing of stored red blood cells in a 1% human serum albumin solution specifically reduces echinocytosis, and this shape recovery has a beneficial effect on microvascular perfusion in vitro. Washing in 1% albumin may represent a new approach to improving the quality of stored red cells, and thus potentially reducing the likelihood of adverse clinical outcomes associated with transfusion of blood stored for longer periods of time.

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Section: Discussioncontrasting

confidence: 63%

Washing stored red blood cells in an albumin solution improves their morphologic and hemorheologic properties

et al. 2015

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“…CRP is produced in the liver in response to IL-6 [38], whereas ESR is a laboratory phenomenon affected by fibrinogen, immunoglobulin levels and red blood cell count and shape, among other factors [39,40]. Several studies have found that pioglitazone decreased CRP concentrations [19-21], but ESR has not been measured routinely in most clinical trials of pioglitazone or other thiazolidinediones.…”

Section: Discussionmentioning

confidence: 99%

Peroxisome proliferator-activated receptor γ agonist effect on rheumatoid arthritis: a randomized controlled trial

et al. 2013

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IntroductionRheumatoid arthritis (RA), a chronic inflammatory disease, is associated with insulin resistance. Experimental evidence indicates that the relationship between insulin resistance and inflammation is bidirectional: Inflammation promotes insulin resistance, and insulin resistance promotes inflammation. Therefore, we examined the hypothesis that pioglitazone, a thiazolidinedione peroxisome proliferator-activated receptor γ agonist, would decrease inflammation and disease activity and improve insulin resistance in patients with RA.MethodsIn a single-center, randomized, double-blind, placebo-controlled crossover study patients with RA (N = 34) receiving stable therapy were randomized to also receive either pioglitazone 45 mg daily (n = 17) or matching placebo (n = 17) for eight weeks. This was followed by a four-week washout period and alternative treatment for eight weeks. Outcomes included change in Disease Activity Score in 28 joints (DAS28) score, individual components of the DAS28 score and homeostatic model assessment for insulin resistance (HOMA). Intention-to-treat analysis and linear mixed-effects models were used.ResultsPatients had a mean (±SD) age of 51 (±14.2) years, 82.4% were female and baseline DAS28 high-sensitivity C-reactive protein (DAS28-CRP) was 4.58 (±1.1) units. Addition of pioglitazone was associated with a 9.3% reduction (95% confidence interval (CI) = 0.17% to 17.6%) in DAS28-CRP (P = 0.046), but no significant change in DAS28 erythrocyte sedimentation rate (DAS28-ESR) (P = 0.92). There was a 10.7mm (95% CI = 0.4 to 20.9 mm) improvement in patient-reported global health (P = 0.042), a 48.6% decrease (95% CI = 27.6% to 63.5%) in CRP (P < 0.001) and a 26.4% decrease (95% CI = 3.7% to 43.8%) in insulin resistance as measured by HOMA (P = 0.025), but no significant reduction in swollen or tender joint count or in ESR (all P > 0.05). Lower-extremity edema was more common during pioglitazone treatment (16%) than placebo (0%).ConclusionAddition of pioglitazone to RA therapy improves insulin resistance and modestly reduces RA disease activity measured by DAS28-CRP and two of its components, including patient-reported global health and CRP, but not DAS28-ESR or ESR.Trial registrationNCT00763139

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“…Reinhart et al [9,10] demonstrated that echinocytosis, induced by sodium salicylate and cytostatic mesna, led to …”

Section: Y a Sheremet'ev Et Al 214mentioning

confidence: 99%

“…Also, in the alteration of RBC aggregation for blood containing the anticoagulant CPDA1 stored at 4˚C, the effect of the plasma factor was slightly stronger than that of the cellular factor [8]. It was shown that the shape plays a crucial role in the aggregation and sedimentation of red cells [9,10].…”

Section: Introductionmentioning

confidence: 99%

Effects of Storage Duration and Temperature of Human Plasma and Serum on Red Blood Cell Aggregation and Shape

Sheremet’ev¹,

Поповичева²,

Levin³

2013

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Platelet-free plasma of human blood (sodium citrate and EDTA as an anticoagulant) and serum were stored at 4˚C, room temperature (25˚C) and at 37˚C for 24 hours. RBC aggregation decreased after incubation of plasma and serum at 37˚C for 4 hours. The RBC shape was changed at the same time: discocytes transformed to echinocytes. Storage of plasma and serum at 4˚C and room temperature did not lead to significant alterations of RBC aggregation. The RBC shape did not change in influence of such plasma and serum. The most considerable decrease of RBC aggregation and change of their shapes were observed in the plasma and serum incubated at 37˚C for 24 hours. Dilution of incubated plasma by fresh plasma led to consistent restoration of erythrocyte shape and their aggregation.

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Red blood cell aggregation and sedimentation: the role of the cell shape

Cited by 52 publications

References 19 publications

Washing stored red blood cells in an albumin solution improves their morphologic and hemorheologic properties

Washing stored red blood cells in an albumin solution improves their morphologic and hemorheologic properties

Peroxisome proliferator-activated receptor γ agonist effect on rheumatoid arthritis: a randomized controlled trial

Effects of Storage Duration and Temperature of Human Plasma and Serum on Red Blood Cell Aggregation and Shape

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