TY - JOUR
T1 - Novel concepts in red blood cell clearance
AU - Neri, Silvia
AU - Swinkels, Dorine W.
AU - Matlung, Hanke L.
AU - van Bruggen, Robin
N1 - Funding Information: S.N. is supported by a grant from the European Union, ‘EVIDENCE’ an international training network. Publisher Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Purpose of reviewRed blood cell (RBC) clearance has been studied for decades in many different pathologies, which has revealed different routes of RBC degradation, depending on the situation. This review summarizes the latest mechanistic insights on RBC clearance in different contexts; during homeostatic removal, immune-mediated destruction, and systemic inflammation.Recent findingsBesides the recognition of a variety of potential 'eat me' signals on RBCs, recent evidence suggests that normal RBC degradation is driven by the increase of the adhesive properties of RBCs, mediating the retention in the spleen and leading to RBC hemolysis. Furthermore, immune-mediated degradation of RBCs seems to be fine-tuned by the balance between the density of the antigens expressed on RBCs and the presence of 'don't eat me' signals. Moreover, besides RBC clearance by macrophages, neutrophils seem to play a much more prominent role in immune-mediated RBC removal than anticipated. Lastly, RBC clearance during systemic inflammation appears to be driven by a combination of extreme macrophage activity in response to proinflammatory cytokines as well as direct damage of RBC by the inflammation or inflammatory agent.SummaryRecent studies on RBC clearance have expanded our knowledge on their destruction in different contexts.
AB - Purpose of reviewRed blood cell (RBC) clearance has been studied for decades in many different pathologies, which has revealed different routes of RBC degradation, depending on the situation. This review summarizes the latest mechanistic insights on RBC clearance in different contexts; during homeostatic removal, immune-mediated destruction, and systemic inflammation.Recent findingsBesides the recognition of a variety of potential 'eat me' signals on RBCs, recent evidence suggests that normal RBC degradation is driven by the increase of the adhesive properties of RBCs, mediating the retention in the spleen and leading to RBC hemolysis. Furthermore, immune-mediated degradation of RBCs seems to be fine-tuned by the balance between the density of the antigens expressed on RBCs and the presence of 'don't eat me' signals. Moreover, besides RBC clearance by macrophages, neutrophils seem to play a much more prominent role in immune-mediated RBC removal than anticipated. Lastly, RBC clearance during systemic inflammation appears to be driven by a combination of extreme macrophage activity in response to proinflammatory cytokines as well as direct damage of RBC by the inflammation or inflammatory agent.SummaryRecent studies on RBC clearance have expanded our knowledge on their destruction in different contexts.
KW - anemia of inflammation
KW - homeostasis
KW - immune-mediated destruction
KW - red blood cell clearance
UR - http://www.scopus.com/inward/record.url?scp=85117691127&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/MOH.0000000000000679
DO - https://doi.org/10.1097/MOH.0000000000000679
M3 - Review article
C2 - 34494977
SN - 1065-6251
VL - 28
SP - 438
EP - 444
JO - Current opinion in hematology
JF - Current opinion in hematology
IS - 6
ER -