TY - JOUR
T1 - Potassium leakage primes stored erythrocytes for phosphatidylserine exposure and shedding of pro-coagulant vesicles
AU - Burger, Patrick
AU - Kostova, Elena
AU - Bloem, Esther
AU - Hilarius-Stokman, Petra
AU - Meijer, Alexander B
AU - van den Berg, Timo K
AU - Verhoeven, Arthur J
AU - de Korte, Dirk
AU - van Bruggen, Robin
N1 - © 2012 Blackwell Publishing Ltd.
PY - 2013/2
Y1 - 2013/2
N2 - During storage, erythrocytes undergo changes that alter their clearance and function after transfusion and there is increasing evidence that these changes contribute to the complications observed in transfused patients. Stored erythrocytes were incubated overnight at 37°C to mimic the temperature after transfusion. After incubation, several markers for erythrocyte damage were analysed. After overnight incubation, stored erythrocytes showed increased potassium leakage, haemolysis, PS exposure and vesicle formation, and all these effects increased with increasing storage time. Furthermore, we demonstrated that long-term stored erythrocytes develop decreased flippase activity and increased scrambling activity after overnight incubation, leading to PS exposure and the release of vesicles. Reduced intracellular potassium was identified as the cause of the decreased flippase activity. Lastly, we provide evidence that erythrocytes can return to a PS-negative state by shedding parts of their membrane as PS-containing vesicles and that these vesicles can serve as a platform for the coagulation cascade. These findings reveal that potassium leakage, a well-known phenomenon of prolonged erythrocyte storage, primes erythrocytes for PS exposure. PS exposure will lead to vesicle formation and might have an important impact on the post-transfusion function and side effects of stored erythrocytes.
AB - During storage, erythrocytes undergo changes that alter their clearance and function after transfusion and there is increasing evidence that these changes contribute to the complications observed in transfused patients. Stored erythrocytes were incubated overnight at 37°C to mimic the temperature after transfusion. After incubation, several markers for erythrocyte damage were analysed. After overnight incubation, stored erythrocytes showed increased potassium leakage, haemolysis, PS exposure and vesicle formation, and all these effects increased with increasing storage time. Furthermore, we demonstrated that long-term stored erythrocytes develop decreased flippase activity and increased scrambling activity after overnight incubation, leading to PS exposure and the release of vesicles. Reduced intracellular potassium was identified as the cause of the decreased flippase activity. Lastly, we provide evidence that erythrocytes can return to a PS-negative state by shedding parts of their membrane as PS-containing vesicles and that these vesicles can serve as a platform for the coagulation cascade. These findings reveal that potassium leakage, a well-known phenomenon of prolonged erythrocyte storage, primes erythrocytes for PS exposure. PS exposure will lead to vesicle formation and might have an important impact on the post-transfusion function and side effects of stored erythrocytes.
KW - Blood Coagulation Factors/metabolism
KW - Blood Coagulation/drug effects
KW - Blood Preservation
KW - Erythrocytes/chemistry
KW - Hemolysis
KW - Humans
KW - Phosphatidylserines/analysis
KW - Potassium/metabolism
KW - Transport Vesicles/metabolism
U2 - https://doi.org/10.1111/bjh.12133
DO - https://doi.org/10.1111/bjh.12133
M3 - Article
C2 - 23190498
SN - 0007-1048
VL - 160
SP - 377
EP - 386
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 3
ER -