Red Cell Rheology

417 Pages·1978·10.666 MB·English

by  P.-I. Brånemark, U. Bagge (auth.), Marcel Bessis, Stephen B. Shohet, N. Mohandas (eds.)

Red Cell
Rheology
Editors:
M. Bessis, S. B. Shohet and N. Mohandas
With 200 Figures and 36 Tables
Springer-Verlag Berlin Heidelberg New York 1978
Acknowledgements
This Symposium, held at the Institut de Pathologie Cellulaire, Hopital de Bicetre, France,
July 16-18, 1976, was made possible by the generosity of HOECHST Laboratories.
The proofs have been corrected by each author. The discussions were edited by Stephen
B. Shohet and N aria Mohandas; they have been somewhat shortened because of difficulties
of intelligibility in the recordings. Authors so inclined are always welcome to submit
letters or other commentaries for the next issue of BLOOD CELLS.
MARCEL BESS]S
Institut de Pathologie Cellulaire
H6pital de Bicetre
F -94270 Bicetre, France
STEPHEN B. SHOHET
The University of California
School of Medicine
Cancer Research Center
San Francisco, CA 94143, USA
N. MOHANDAS
University of California
School of Medicine
Cancer Research Institute
San Francisco, CA 94143, USA
This monograph comprises Vol. 3, 1-2 of the international journal Blood Cells
(Editor: Marcel Bessis, Associate Editor: Stephen B. Shohet and N. Mohandas)
ISBN-13: 978-3-540-09001-4 e-ISBN -13: 978-3-642-67059-6
DOl: 10.1007/978-3-642-67059-6
This work is subject to copyright. All rights are reserved, whether the whole or part of the material
is concerned, specifically those of translation, reprinting, re-use of illustrations. broadcastings, repro
duction by photocopying machine or similar means, and storage in data banks. Under § 54 of the
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publisher, the amount of the fee to be determined by agreement with the publisher.
© by Springer-Verlag Berlin Heidelberg 1978.
The use of general descriptive names, trade names, trade marks etc. in this publication, even if
the former are not especially identified, is not be taken as a sign that such names, as understood
by the trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone.
2121/3140-543210
Table of Contents
Part I
SECTION I: METHODS FOR EVALUATION OF RED CELL
DEFORMABILITY
P.-I. BRANEMARK, U. BAGGE: Intravascular Rheology of Erythrocytes in
Man II
Discussion . . . 21
J.D. BRAILSFORD, R.A. KORPMAN, B.S. BULL: The Aspiration of Red Cell
Membrane into Small Holes: New Data . . . . . . . . . . . .. 25
B.S. BULL, J.D. BRAILSFORD, R.A. KORPMAN: Red Cell Membrane De
formability: an Examination of Two Apparently Disparate Methods of
Measurement . . . . . . . . . . . . . . . . . . 39
Discussion of Papers by Brailsford et al. and Bull et al. . . . . . . . . . 50
P. TEITEL: Basic Principles of the' Filterability Test' (FT) and Analysis of
Erythrocyte Flow Behavior. . . . . . . . . . . . . . . . . . . . . 55
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
S. CHIEN: Principles and Techniques for Assessing Erythrocyte Deformability 71
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . 95
W.M. PHILLIPS: Viscometric Techniques and the Rheology of Blood 101
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . 111
SECTION II: BIOCHEMICAL BASIS FOR RED CELL SHAPE
AND DEFORMABILITY
S.B. SHOHET, A.C. GREENQUIST: Possible Roles for Membrane Protein
Phosphorylation in the Control of Erythrocyte Shape 115
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
E. BEUTLER, E. GUINTO, C. JOHNSON: Human Red Cell Protein Kinase in
Normal Subjects and Patients with Hereditary Spherocytosis, Sickle Cell
Disease, and Autoimmune Hemolytic Anemia 135
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
C. FEO, N. MOHANDAS: Role of A TP Depletion on Red Cell Shape and
Deformability 153
Discussion . . . . . . . . . . . . 158
4 Table of Contents
K. TADANO, J.D. HELLUMS, E.C. LYNCH, E.J. PECK, c.P. ALFREY: The Effects
of A TP Depletion on the Response of Erythrocytes to Shear Stress 163
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
R.S. HEUSINKVELD, D.A. GOLDSTEIN, R.I. WEED, P.L. LACELLE: Effect of
Protein Modification on Erythrocyte Membrane Mechanical Properties 175
A.C. GREENQUIST, S.S. SHOHET: Commentary . . . . . . . . . . .. 183
SECTION III: CLINICAL APPLICATIONS
N. MOHANDAS, A.DEBOISFLEURY: Antibody-Induced Spherocytic Anemia.
I. Changes in Red Cell Deformability . . . . . . . . . . . . . . .. 187
A. DE BOISFLEURY, N. MOHANDAs: Antibody-Induced Spherocytic Anemia.
II. Splenic Passage and Sequestration of Red Cells. . . . . . . . . . . 197
Discussion of Papers by Mohandas, Boisfleury and Boisfleury, Mohandas 206
C. ALLARD, N. MOHANDAS, M. BESSIS: Red Cell Deformability Changes in
Hemolytic Anemias Estimated by Diffractometric Methods (Ektacytometry).
Preliminary Results 209
Discussion . . . . 220
Part II
SECTION I: SICKLE CELL RHEOLOGY
M. BESSIS, N. MOHANDAS: Laser Diffraction Patterns of Sickle Cells in
Fluid Shear Fields. 225
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
L.S. LESSIN, J. KURANTSIN-MILLS, H.B. WEEMS: Deformability of Normal
and Sickle Erythrocytes in a Pressure-flow Filtration System . . . . . . 237
P.P. KLUG, L.S. LESSIN: Microvascular Blood Flow of Sickled Erythrocytes:
A Dynamic Morphologic Study. . . . . . . . . . . . 259
Discussion of Papers by Lessin et al. and Klug and Lessin . . . . . . . 264
P.L. LACELLE: Oxygen Delivery to Muscle Cells during Capillary Occlusion
by Sickled Erythrocytes . . . . . . . . . . . . . . . . 269
Discussion . . . . . . . . . . . . . . . . . . . . . . 276
S. CHIEN: Rheology of Sickle Cells and Erythrocyte Content 279
Discussion . . . . . . . . . . . . . . . . . . . . . . 294
Table of Contents 5
H.S. ZARKOWSKY, R.M. HOCHMUTH: Experimentally-Induced Alterations
in the Kinetics of Erythrocyte Sickling 301
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306
SECTION II: GENERAL THEORIES OF RED CELL SHAPE,
STRUCTURE, AND RHEOLOGY
R.A. KORPMAN, D.C. DORROUGH, J.D. BRAILSFORD, B.S. BULL: The Red
Cell Shape as an Indicator of Membrane Structure: Ponder's Rule Re
examined. 311
Discussion . . 330
P.L. LACELLE, E.A. EVANS, R.M. HOCHMUTH: Erythrocyte Membrane
Elasticity, Fragmentation and Lysis 331
Discussion . . . . . . . . . . . . . . . . . 343
T. FISCHER, H. SCHMID-SCHONBEIN: Tank Tread Motion of Red Cell
Membranes in Viscometric Flow: Behavior of Intracellular and Extracellular
Markers (with Film). . . . . . . . . . . . . . . . . . . . . . . . 347
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359
L. DINTENFASS: Theoretical Aspects and Clinical Applications of the Blood
Viscosity Equation Containing a Term for the Internal Viscosity of the
Red Cell ......... . 363
J.D. BRAILSFORD: Commentary 371
P.L. BLACKSHEAR, JR., R.J. ANDERSON: Hemolysis Thresholds in Micro
porous Structures 373
Discussion . . 386
P. ASPELIN, H. SCHMID-SCHONBEIN: Effect of Radio Contrast Media on
the Red Blood Cell: An in vitro Study on Human Erythrocytes. . . . . 393
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402
J.A. SIRS: Effects of Storage on the Respiratory Function and Flexibility
of Red Blood Cells 405
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . .. 414
SECTION III: SUMMING UP
S. CHIEN: Rheological Methods 423
B. BULL: The Implications of Rheology for Red Cell Membrane Structure 427
G. BRECHER: Clinical Applications. . . 433
Red Cell Rheology; Glossary of Terms . . . . . . . . . . . . . . . 435
This issue is dedicated to the memory of
Robert I. WEED (1929-1976)
Bob was Associate Editor of the journal Blood Cells to which he gave his
enthusiasm and his knowledge.
His industry, his creativity, his thoroughness and efficiency made him one of the
leaders of International Hematology. He never hesitated to commit himself and
to explore new fields. He fought for his ideas which were numerous and some
times shocking for the classical hematologist, a certain sign of originality.
Those who knew him and loved him are aware that the projects that death
kept him from accomplishing may be more important than those his short life
allowed him to conclude. His legacy of ideas remains for the hematologists of
the world a source of stimulation and inspiration.
Part I
SECTION I
METHODS FOR EVALUATION
OF RED CELL DEFORMABILITY
Intravascular Rheology of Erythrocytes in Man
P.-I. BRANEMARK and U. BAGGE
ABSTRACT. The deformation and behaviour of red blood cells (RBC) were
studied in vivo in man with the aid of a skin-tube chamber technique enabling
light microscopic observation of the microcirculation at high resolution.
Evidence is presented indicating that RBC deformations in the living microcircu
lation may be regarded as distortions of the basic biconcave disc shape.
Rouleaux and diapedesis phenomena are discussed and the integrity of the
RBC in relation to other blood cells and to the endothelium is emphasized.
KEY WORDS: Human microcirculation - Erythrocyte deformability.
INTRODUCTION
Despite the apparent structural simplicity of the red blood cells (RBC) as com
pared to other cells of the body, the exact intravascular behaviour of the RBC
is not yet fully elucidated. This is particularly true for the microvascular system
where the capacities of the RBCs as carrier components of blood are utilized
in capillary tubes of 3--8 ~m in width. It is obviously of crucial importance
to dissect in detail the functional anatomy of the RBCs in the nutritive capillaries
of man in order to create a solid basis for qualitative and quantitative, physical
and mathematical analyses of the transfer of energy between blood and tissue.
Because of the inherent technical difficulties in exploring human blood in this
location various indirect experimental procedures have been used in vivo and
in vitro to provide material for numerical calculations.
We have tried over a period of years to study the intravascular behaviour
of blood by using direct microscopic observation of the microvessels in man.
The information is related to similar in vivo studies in various animal tissues
and in vitro analyses of the individual blood corpuscles.
The aim of this paper is to illustrate, by some pictorial examples, the intricate
intravascular dynamics of RBC in man.
METHOD
The technique used for in vivo studies of human microcirculation has been described in detail
elsewhere [I]. Basically the procedure consists of two steps. First, a dipedicJed skin-tube is produced
Laboratory of Experimental Biology, Department of Anatomy, University of Goteborg, S-40033
Goteborg 33, Sweden
Reprint requests to: P.-I. Branemark
12 P.-I. Branemark and U. Bagge
on the inside of the left upper arm. So far we have mostly performed our studies in healthy
volunteers of 20-25 years of age but in a small series also diabetics were studied [3].
After the skin-tube has healed and matured for 8-\2 months, a titanium chamber is installed
in the skin-tube and becomes incorporated within the skin and the subcutaneous tissue (Fig. I).
The chamber consists of a titanium framework which supports an optical system. The chamber
has been designed to provide a living tissue which is adapted to the basic construction principles
of the light microscope, requiring a thin preparation enclosed between parallel glass surfaces.
Accordingly, there is a thin slit of about 50 j.lm in height between a cover slip and the upper
surface of a light-conducting quartz rod. Vessels and tissue grow into this slit which after a few
weeks contains a normal subcutaneous tissue with its characteristic microvessels. The observations
usually start about I month after the chamber has been installed and they can be continued for
several months with the same vessels. So far the longest period of studies in a chamber is 7 months.
The time limit is set not by the chamber procedure itself but by the relative immobilization of
the left arm that is required in order to maintain the tissue in the chamber undamaged.
The observations are performed in a special microscope which has been designed to provide
high resolution of low contrast living objects and it is equipped with different recording units
including a closed-circuit TV system and cine camera operating with synchronized flash [2].
Fig. 1. a Schematic cross section of titanium chamber installed in the skin-tube. b The chamber
in situ. c Overall view of microscope setup. Arrow denotes skin tube positioned for observation
Fig. 2. a-c Sequence of photomicrographs showing the shape of RBC at slow flow in a sprouting
capillary. J, 2 and 3 illustrate the disc shape in various projections. Rx A small rouleaux; P A Loose
platelet aggregate; P Platelet; E Endothelium; D RBC in diapedesis with a spherical part projecting
into vessel lumen. ArrolVs indicate flow direction