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Blood, 15 November 2000, Vol. 96, No. 10, pp. 3610-3617
RED CELLS
The survival characteristics of dense sickle cells
Robert S. Franco,
Zahida Yasin,
Joni M. Lohmann,
Mary B. Palascak,
Therese A. Nemeth,
Murray Weiner,
Clinton H. Joiner, and
Donald L. Rucknagel
From the University of Cincinnati College of Medicine,
Children's Hospital Research Foundation, and Cincinnati Comprehensive
Sickle Cell Center, Cincinnati, OH.
Sickle red blood cells (RBCs) become depleted of potassium,
leading to dehydration and abnormally elevated cellular density. The
increased sickling that results is important for both hemolysis and
vasocclusion. In this study, sickle cells were subjected to high-speed centrifugation, and the bottom 15% were isolated. This procedure removed light cells and to a variable degree enriched cells
that were denser than normal to produce a high-density-enriched (HDE)
population of sickle cells. Autologous HDE cells from 3 subjects were
labeled with biotin and re-infused. The following determinations were
performed: (1) the survival and density changes of HDE cells; (2) the
amount of fetal hemoglobin (HbF) in labeled cells after magnetic
isolation; (3) the percentage of labeled F cells; (4) the percentage of
labeled cells displaying external phosphatidylserine (PS). For patients
with 3.5%, 4.5%, and 24% HbF in the HDE RBCs, the circulation
half-time was 40, 80, and 180 hours, respectively. The percentage of
HbF (measured in all 3 subjects) and of F cells (measured in 2 subjects) in labeled RBCs increased with time after re-infusion,
indicating that HDE F cells have longer in vivo survival than HDE non-F
cells. The percentage of PS+, biotin-labeled HDE cells
showed no consistent increase or decrease with time after re-infusion.
These data provide evidence that HDE sickle cells, especially those
that do not contain HbF, have a very short in vivo survival, and that
the percentage of PS+ cells in a re-infused HDE population
does not change in a consistent manner as these cells age in the circulation.
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