Synergistic effects of oxidation and deformation on erythrocyte monovalent cation leak

The normal red blood cell (RBC) membrane is remarkable for its durability (eg, preservation of permeability barrier function) despite its need to remain deformable for the benefit of microvascular blood flow. Yet, it may be hypothesized that the membrane's tolerance of deformation might be compromised under certain pathologic conditions. We studied this by subjecting normal RBC in viscous suspending medium (20% dextran) to elliptical deformation induced by application of shear stress under physiologic conditions (290 mOsm/L, 37 degrees C, pH 7.40) in the presence of ouabain and furosemide. Measurement of resulting net passive K efflux ("K leak") demonstrated that shear-induced RBC deformation causes K leak in a dose-dependent fashion at shear stresses far below the hemolytic threshold, an effect shown to be due to deformation per se. To model the specific hypothesis that oxidatively perturbed RBC membranes would be abnormally susceptible to this potentially adverse effect of deformation, we treated normal RBC with the lipid peroxidant t-butylhydroperoxide. Under conditions inducing only minimal K leak due to either oxidation alone or deformation alone, deformation of peroxidant-pretreated RBC showed a markedly enhanced K leak (P less than .001). This highly synergistic oxidation-plus-deformation leak pathway is less active at low pH, is neither chloride-dependent nor calcium-dependent, and allows K efflux to be balanced by Na influx so there is no change in total monovalent cation content or cell density. Moreover, it is fully reversible since deformation-induced K leak terminates on cessation of shear stress (even for oxidant-treated RBC). Control experiments showed that our results are not explained simply by hemolysis, RBC vesiculation, or development of prelytic pores. We conclude that oxidation and deformation individually promote passive leak of monovalent cation through RBC membranes and that a markedly synergistic effect is exerted when the two stresses are combined. We hypothesize that these findings may help explain the abnormal monovalent cation leak stimulated by deoxygenation of sickle RBC.     

The monovalent cation leak in overhydrated stomatocytic red blood cells results from amino acid substitutions in the Rh-associated glycoprotein

Overhydrated hereditary stomatocytosis (OHSt) is a rare dominantly inherited hemolytic anemia characterized by a profuse membrane leak to monovalent cations. Here, we show that OHSt red cell membranes contain slightly reduced amounts of Rh-associated glycoprotein (RhAG), a putative gas channel protein. DNA analysis revealed that the OHSt patients have 1 of 2 heterozygous mutations (t182g, t194c) in RHAG that lead to substitutions of 2 highly conserved amino acids (Ile61Arg, Phe65Ser). Unexpectedly, expression of wild-type RhAG in Xenopus laevis oocytes induced a monovalent cation leak; expression of the mutant RhAG proteins induced a leak about 6 times greater than that in wild type. RhAG belongs to the ammonium transporter family of proteins that form pore-like structures. We have modeled RhAG on the homologous Nitrosomonas europaea Rh50 protein and shown that these mutations are likely to lead to an opening of the pore. Although the function of RhAG remains controversial, this first report of functional RhAG mutations supports a role for RhAG as a cation pore.     

Redesigning the monovalent cation specificity of an enzyme

Monovalent-cation-activated enzymes are abundantly represented in plants and in the animal world. Most of these enzymes are specifically activated by K+, whereas a few of them show preferential activation by Na+. The monovalent cation specificity of these enzymes remains elusive in molecular terms and has not been reengineered by site-directed mutagenesis. Here we demonstrate that thrombin, a Na+-activated allosteric enzyme involved in vertebrate blood clotting, can be converted into a K+-specific enzyme by redesigning a loop that shapes the entrance to the cation-binding site. The conversion, however, does not result into a K+-activated enzyme.     

Exaggerated cation leak from oxygenated sickle red blood cells during deformation: evidence for a unique leak pathway.

An abnormal susceptibility of the sickle red blood cell (RBC) membrane to deformation could compromise its permeability barrier function and contribute to the exuberant cation leakiness occurring during the sickling phenomenon. We examined this hypothesis by subjecting RBCs at ambient oxygen tension to elliptical deformation, applying shear stress in a viscous medium under physiologic conditions. Compared with normal and high-reticulocyte control RBCs, sickle RBCs manifest an exaggerated K leak response to deformation. This leak is fully reversible, is both Cl and Ca independent, and at pHe 7.4 is fully balanced so that Kefflux equals Nainflux. This abnormal susceptibility is also evident in that the K leak in response to deformation occurs at an applied shear stress of only 141 dyne/cm2 for sickle RBCs, as compared to 204 dyne/cm2 for normal RBCs. Fresh sickle RBC membranes contain elevated amounts of lipid hydroperoxide, the presence of which is believed to provide the biochemical basis for enhanced deformation susceptibility. When examined at pHe 6.8, oxygenated sickle RBCs acquire an additional, unbalanced (Kefflux > Nainflux) component to the K leak increment specifically ascribable to deformation. Studies with inhibitors suggest that this additional component is not caused by a known leak pathway (eg, either K:Cl cotransport or the Gardos channel). This abnormal susceptibility of the sickle membrane to development of cation leakiness during deformation probably contributes to the exuberant cation leak taking place during RBC sickling.     

Location of monovalent cation binding sites in the gramicidin channel.

Six syntheses of gramicidin A have been carried out, each with 90% 13 C enrichment of a single carbonyl carbon these being the formyl, Val-1, Trp-9, Trp-11, Trp-13, and Trp-15 carbonyl carbons. Each gramicidin A was incorporated as the channel state into phospholipid structures, and the chemical shift of the carbonyl carbon resonance was monitored by 13C NMR as a function of ion concentration. Plots of Na+- and Tl+-induced chemical shifts as a function of carbonyl location in the channel indicate two symmetrically related binding sites centered at the tryptophan carbonyls and separated by 23 A. The absence of ion-induced chemical shifts for the formyl and Val-1 carbonyl carbon resonances indicates that there is no binding site midway through the channel but rather a central free-energy barrier for ion transit through the channel. Ion induced chemical shifts of the tryptophan carbonyl carbon resonances at 100 mM Na+ verify that the tight binding constant (Kbt congruent to 70 M-1), observed with 23Na NMR, results from binding within the channel. This observation and the lateral, triangular distribution of the coordinating Trp-9, -11, and -13 carbonyls combine to provide an experimental demonstration that the carbonyls of the walls of the channel directly coordinate the ion, successfully competing with the polar solvent. With the binding sites verified and localized, it is possible to conclude that the transport mechanism for Na+ is well represented by the case of the two-site model [D. W. Urry, Venkatachalam, C. M., Spisni, A., Läuger, P. & Khaled, M. A. (1980) Proc. Natl. Acad. Sci. USA 77, 2028--2032].     

Sodium and calcium cation transport of erythrocytes in essential hypertension

The sodium and calcium transport of erythrocyte and the influencing factors were studied in essential hypertensive (EH) subjects. The result showed that plasma endogenous digitalis-like compound (EDLC) increased and sodium pump depressed in some EH patients, but there were no parallel correlation between EDLC and sodium pump. The patients with normal sodium pump mainly showed their maximal Ca2+ pump activity and decreased calmodulin (CaM) content of erythrocyte. Thus there may be different types of ion transport defect in EH, and the abnormalities of these cation transports have an important role in the pathogenesis of EH.     

Abnormal parachloromercuriphenylsulfonate-sensitive cation channel in the erythrocytes of hereditary spherocytosis.

The erythrocytes of hereditary spherocytosis (HS) demonstrate an increased inward movement of sodium ions, an alteration which has been proposed as the primary defect leading to cell destruction. Parachloromercuriphenylsulfonate (PCMBS), an agent reacting with sulfhydryl groups of the membrane, increases the cation permeability of normal red cells, but does so to a much lesser extent in the HS red cells. On the other hand, pronase that is specific for amino groups of the membrane increases cation permeability and decreases anion permeability equally in normal and HS red cells. It may be postulated that a decreased number of sulfhydryl sites or a mutation of proteins in the PCMBS-sensitive cation channels of the HS cell membrane result in this hyposensitivity to PCMBS.     

Lipid peroxidation in the erythrocytes under condition of their increased aggregation

The aim of the present study was investigation of the lipid peroxidation changes within the erythrocytes under conditions of increased RBC aggregation. This latter was produced both in the in vitro and in vivo conditions by the addition of Dextran T-500. For the in vitro studies blood samples were taken from the cubital veins of 15 healthy subjects. During the in vivo studies 10 ml of the 10 percent Dextran T-500 solution was administered intravenously in six chinchilla rabbits. Another six animals were treated with rheopolyglucyne. The RBC aggregation in blood was investigated with the "Georgian technique". The malondialdehyde (the end product of lipid peroxidation) was determined in all cases by its reaction with thiobarbituric acid. We found that in the in vitro conditions, as well as in the in vivo studies, the lipid peroxidation was significantly increased in the erythrocytes during the enhanced RBC aggregation induced by addition of Dextran T-500. Therefore we suppose that the elevated RBC aggregation cause an increase of cell's lipid peroxidation and it is possible to think that appropriate prooxidant: antioxidant balance is shifted toward the pro-oxidants in the erythrocytes.     

pH regulation of divalent/monovalent Ca/K cation transport selectivity by a macrocyclic carrier molecule.

The lipophilic dicarboxylic acid-dicarboxamide macrocycle 1 is an efficient carrier for calcium and potassium transport through a liquid membrane. The process involves competitive Ca2+/K+ symport coupled to proton antiport in a pH gradient. It presents a very pronounced phenomenon of pH regulation of transport selectivity from preferential K+ transport to preferential Ca2+ transport as the pH increases from 2 to 9 in the starting aqueous phase containing the metal ions. The results demonstrate how carrier design allows control of the rate and selectivity of divalent/monovalent M2+/M+ cation transport.     

Energy metabolism in human erythrocytes: the role of phosphoglycerate kinase in cation transport.

Three models of disturbed erythrocyte metabolism, triose-depleted normal, phosphoglycerate kinase (PGK)-deficient, and pyruvate kinase (PK)-deficient cells, have been studied to examine further the role of PGK in erythrocyte cation transport. Sodium (Na-+) and potassium (K-+) transport were reduced only in cells fully depleted of triose. In such cells the PGK step presumably was inoperative due to total lack of substrate; 2,3-diphosphoglycerate (2,3-DPG) then became the sole substrate source for remaining steps in glycolysis. At increased intracellular Na-+ concentrations which normally stimulate transport and glycolysis, triose-depleted cells had marked impairment of cation transport and ouabain-inhibitable lactate and pyruvate production from 2,3-DPG. PGK-deficient cells and normal cells with high intracellular Na-+ concentrations had similar increases in transport and ouabain-inhibitable lactate production. PK-deficient cells with high intracellular Na-+ concentrations showed an appropriate increase in transport but less stimulation of lactate production. Transport was not related to total cellular adenosine triphosphate (ATP) concentration. These data suggested that normal coupled cation transport occurred despite diminished metabolite flow through PGK, as in PGK- or PK-deficient cells. Transport was diminished only in triose-depleted cells where metabolite flow through PGK was presumably absent. These data, therefore, support the concept that transport and glycolysis interact at the PGK step, although impairment of PGK must be profound before its effect on transport is evident.     

Deformation of swollen erythrocytes provides a model of sickling- induced leak pathways, including a novel bromide-sensitive component

Deoxygenation-induced red blood cell (RBC) sickling probably activates multiple cation leak pathways. In an attempt to model this, we examined the net passive K efflux ("K leak") from normal and sickle RBCs undergoing elliptical deformation in hypotonic media (200 mOsmol/L). This hypotonic deformation activates two deformation-dependent K leak pathways that are not detectable during the balanced leak (Kefflux = Nainflux) resulting from deformation of RBCs in isotonic medium. These are (1) a calcium-dependent leak component and (2) a novel leak pathway that is inhibited by substitution of bromide (but not sulfamate) for chloride, which converts the unbalanced K leak (Kefflux > Nainflux) of hypotonic deformation to a residual balanced leak. This dramatic effect of hypotonic deformation is reversible, is detected in both normal and sickle RBCs, and is inhibited significantly by 4,4'-diisothiocyano-2,2'- stilbene disulfonate. Remarkably, bromide also inhibits by 55% the K leak resulting from authentic deoxygenation-induced RBC sickling and, thereby, blunts the imbalance of accompanying monovalent cation leaks. The unique effect of bromide is not readily explainable on the basis of known behaviors of known ion leak/transport pathways. The mechanical threshold for triggering K leak during hypotonic deformation is at applied shear stress of 164 dyne/cm2, a value similar to the abnormal susceptibility we previously found for oxygenated sickle RBCs during isotonic deformation. These data suggest that membrane stretch accompanying hypotonic deformation activates the same multiple leak pathways that contribute to net K leak during authentic RBC sickling, including a previously unknown bromide-sensitive leak.     

Effect of quinidine on differing sensitivities of Purkinje fibers and myocardium to inhibition of monovalent cation transport by digitalis in dogs

Studies have implicated quinidine in increasing serum digoxin levels, resulting in serious arrhythmias. Arrhythmias caused by digitalis intoxication are thought to originate in Purkinje fibers. Thus, the extent of inhibition of monovalent cation-active transport in Purkinje fibers and myocardium may explain the enhanced toxicity of the combined administration of digoxin and quinidine. Monovalent cation transport was assessed by measuring the uptake of the potassium analog rubidium in samples of myocardium and Purkinje fibers after in vitro exposure to ouabain and after long-term administration of digoxin and quinidine or digoxin alone. A group of dogs received chronic digoxin administration and achieved a steady-stage digoxin level of 2.1 ± 0.3 ng/ml. Quinidine administered intravenously caused a 134% increase in the serum digoxin level. The transport in myocardium was unchanged, while it was reduced to 40% of control levels in Purkinje fibers. The difference in sensitivity between Purkinje fibers and myocardium may explain the finding that digitalis-toxic arrhythmias arise in Purkinje fibers and that quinidine, when combined with digitalis, increases the incidence of such arrhythmias.     

Decreased deformability of erythrocytes from smokers

The deformability of erythrocytes from smoking and non-smoking human subjects was examined by filtration through 3-mu pores and capillary viscometry of cell suspensions. In both cases, small but significant differences were found between the two groups that are consistent with a reduction in the surface area-to-volume ratio and/or a diminished membrane flexibility in erythrocyte from smokers. Additional evidence suggests that these findings represent a chronic rather than an acute effect of smoking on erythrocyte deformability.     

Membrane cation and anion transport activities in erythrocytes of hereditary spherocytosis: Effects of different membrane protein defects

Hereditary spherocytosis (HS) is due to different membrane protein defects (i.e., deficiency of spectrin and ankyrin, band 3, or band 4.2). In order to gain new insight into the relationships between band 3 function and proteins associated with the cytoskeleton, we studied erythrocyte anion transport activity in HS characterized by different membrane protein defects. Anion transport activity was increased in HS due to partial band 4.2 deficiency or to band 4.2 absence, while in HS associated with deficiency of spectrin + ankyrin or band 3, the anion transport results were normal or decreased, respectively. Moreover, since HS erythrocytes are characterized by an increased Na and a decreased K, we studied the principal membrane cation transport pathways. Activity of the Na/K pump was increased in all HS studied, while no changes in Na/K/2Cl cotransport and Na/Li exchange were evident between control and HS as well as between forms of HS associated with different membrane protein defects. K/Cl cotransport activity was decreased in all HS studied compared to normal red cells. In all HS, passive membrane permeability to Na and K was increased compared to normal erythrocytes. The increased Na and the low K content can be attributed to the abnormal membrane permeability to cations, which is not related to a specific membrane protein defect. Am. J. Hematol. 55:121–128, 1997. © 1997 Wiley-Liss, Inc.     

Rheological properties of erythrocytes from male hypercholesterolemia

Diet and general health status has close relation to the flow behavior of blood, which influences the circulation of the blood in the body. In this study, we have compared the rheological properties of erythrocyte, plasma and whole blood from high-cholesterol male subjects with healthy male subjects. Intravenous blood was taken from healthy males (n=10) and males with high cholesterol (n=14). Basic health profile, BMI, hematological count and lipid profile (total cholesterol, LDL, HDL and triglyceride) of the blood were determined. Viscosity and shear rate dependent flow behavior of the subjects blood were measured by cone and plate rheometer, and permeability of erythrocytes by pulsed field gradient NMR. Using the microchannel flow analyzer (MC-FAN), the microcirculation of erythrocyte and plasma were investigated. Our data showed a difference in viscosity and consistency index of the whole blood, and permeability (P<0.05) of erythrocytes between the two groups. Also, the time taken for the flow of erythrocyte and plasma through the MC-FAN was slower for the high-cholesterol group. Correlation study showed that consistency index of the blood is closely related to the level of LDL (P<0.05), and total cholesterol, HDL and LDL (P<0.01) highly correlated with the microcirculation of erythrocyte and plasma. A negative correlation (P<0.05) was found between total cholesterol, HDL and LDL, and permeability of erythrocytes. It is concluded that high level of cholesterol, LDL and HDL in vivo alter the morphology and flow behavior of blood cells that can subsequently increase the risk of impairing physical function and microcirculation.