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To explore basic properties of the sickling-induced cation permeability pathway, the Ca2+ component (Psickle-Ca) was studied in density-fractionated sickle cell anemia (SS) discocytes through its effects on the activity of the cells' Ca2+sensitive K+-channels (KCa). The instant state of KCa channel activation was monitored during continuous or cyclic deoxygenation of the cells using a novel thiocyanate-densecell formation method. Each deoxy pulse caused a reversible, sustained Psickle-Ca, which activated KCa channels in only 10-45% of cells at physiological [Ca2+]o ("activated cells"). After removal of cells activated by each previous deoxy pulse, subsequent pulses generated similar activated cell fractions, indicating a random determination rather than the response of a specific vulnerable subpopulation. The fraction of activated cells rose monotonically with [Ca2+]o along a curve reflecting the cells' distribution of Psickle-Ca, with values high enough in a small cell fraction to trigger near-maximal KCa channels. Consistent with the stochastic nature of Psickle-Ca, repeated deoxygenated-oxygenated pulsing led to progressive dense cell formation, whereas single long pulses caused one early density shift. Thus deoxygenation-induced Ca2+-permeabilization in SS cells is a probabilistic event with large cumulative dehydrating potential. The possible molecular nature of Psickle-Ca is discussed.

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We developed a mathematical model of the reticulocyte, seeking to explain how a cell with similar volume but much higher ionic traffic than the mature red cell (RBC) regulates its volume, pH, and ion content in physiological and abnormal conditions. Analysis of the fluxbalance required by reticulocytes to conserve volume and composition predicted the existence of previously unsuspected Na(+)-dependent Cl- entry mechanisms. Unlike mature RBCs, reticulocytes did not tend to return to their original state after brief perturbations. The model predicted hysteresis and drift in cell pH, volume, and ion contents after transient alterations in membrane permeability or medium composition; irreversible cell dehydration could thus occur by brief K+ permeabilization, transient medium acidification, or the replacement of external Na+ with an impermeant cation. Both the hysteresis and drift after perturbations were shown to depend on the pHi dependence of the K:Cl cotransport, a major reticulocyte transporter. This behavior suggested a novel mechanism for the generation of irreversibly sickled cells directly from reticulocytes, rather than in a stepwise, progressive manner from discocytes. Experimental tests of the model's predictions and the hypothesis are described in the following paper.

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To explore our hypothesis of a direct reticulocyte origin of irreversibly sickled cells (ISCs), we fractionated light, reticulocyte-rich, and discocyte-rich sickle anemia red cells on Stractan gradients, and examined the effects of deoxygenation-induced sickling, external Ca2+, acidification, and replacing external Na+ by impermeant N-methyl-D-glucamine (NMG+). Sickling permeabilized light reticulocyte-rich cells to cations (Na+, K+, and Ca2+) more than discocytes; without external Ca2+, Na+ influx matched K+ efflux, with stable cell volume; with Ca2+, many light, low hemoglobin (Hb) F reticulocytes dehydrated rapidly (preventable by quinine, a Ca2(+)-dependent K+ channel inhibitor). Acidification of oxygenated discocytes (high mean Hb F) and reticulocyte-rich fractions yielded denser, reticulocyte-enriched cells with lower Hb F (as in light reticulocyte or dense ISC-rich fractions). Light cells shrank when NMG+ replaced Na+, supporting predictions of a Na(+)-dependent volume control system. Demonstration of sickling-induced, Ca2(+)-dependent dehydration of Hb F-free reticulocytes, and conservation of acid-stimulated K:Cl cotransport among low Hb F, reticulocyte-enriched cells in discocyte fractions support the hypothesis. Ancillary new findings included heparin stimulation of sickling-induced Na+ and K+ permeabilizations, and Ca2+ inhibition of the Na+ leak.

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1. Our findings of a low total magnesium content in the dense fraction (over 1.118 g ml-1) of sickle cell anaemia (SS) red cells seemed inconsistent with the low Mg2+ permeability and outward Mg2+ gradient seen in normal red cells, and prompted studies of the Mg2+ permeability and equilibria in the SS cells. 2. Deoxygenation and sickling induced Mg2+ permeabilization in SS cells, supporting non-specificity of the sickling-induced cation permeabilization, previously described for Na+, K+ and Ca2+. The extent of Mg2+ permeabilization was comparable in SS cells with normal or high density. 3. Compared with normal-density SS cells and normal red cells, the dense SS cells showed a much larger increase in the fraction of ionized magnesium ([Mg2+]i) on deoxygenation, resulting in [Mg2+]i levels sufficient to reverse the normal inward direction of the transmembrane Mg2+ gradient. 4. The molar ratio of 2,3-diphosphoglycerate (2,3-DPG) to haemoglobin was markedly reduced in the dense SS cells. Since 2,3-DPG and ATP are the main cytoplasmic Mg2+ buffers, their further reduction upon binding to deoxyhaemoglobin accounts for the high [Mg2+]i in the deoxygenated dense SS cells; the resulting outward electrochemical Mg2+ gradient, together with sickling-induced Mg2+ permeabilization, could explain the decreased total magnesium content of these cells. 5. The above findings suggested that the documented low sodium pump fluxes in dense SS cells may result from an increased Mg2+:ATP ratio, which is known to inhibit Na(+)-K+ exchange fluxes through the sodium pump. If so, deoxygenation, by increasing the Mg2+:ATP ratio, should inhibit the pump further, whereas increasing ATP should relieve the inhibition. Experiments designed to test this possibility showed that in these dense SS cells, the ouabain-sensitive K(86Rb) influx was low in oxygenated cells, was reduced further by deoxygenation, but was substantially increased after treatment with inosine, pyruvate and phosphate to increase their organic phosphate pool. These results were thus consistent with such a mechanism for Na+ pump inhibition in the dense SS cells.

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We have recently modified the dialysis tubing osmotic lysis and resealing method to examine the role of intracellular red blood cell (RBC) antioxidants. However, the potential effect of resealing on the RBC was not fully investigated. This study examined a number of cellular characteristics to determine the effects of physical lysis and resealing on the RBC. Following resealing, RBC exhibited normal morphology and at most only slight alterations in mean cell volume and mean cell hemoglobin concentration. RBC density distribution was significantly affected by resealing with increased populations of both light and dense cells, though the mean cell density was similar to that of control cells. Endogenous enzyme activities and adenosine triphosphate (ATP) concentration were unaffected by the resealing procedure. While reduced glutathione (GSH) concentration was decreased by 15%, RBC oxidant sensitivity was found to be unaltered. Cellular deformability of the resealed RBC was 80% to 90% that of the control cells. Membrane phospholipid and fatty acyl composition of the resealed RBC were unaffected when compared with matched control samples. Membrane transport, permeability, and Ca2(+)-mediated cellular vesiculation were minimally altered by resealing. Finally, entrapment of fluorescent compounds demonstrated that greater than 95% of the resealed RBC had incorporated exogenous agents. In summary, the osmotic lysis and resealing method described resulted in only minor changes in cellular characteristics while allowing for the efficient loading of compounds to which the RBC membrane is normally impermeable. Consequently, this method provides great potential for the selective modification of erythrocyte constituents in order to further define their roles within the RBC.

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The power of mathematical cell models to predict novel behaviour concerned with the volume, pH and ion content regulation of red cells and reticulocytes is illustrated with three examples. Experimental results support the theoretical predictions.

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Giant axons from the marine annelid, Myxicola infundibulum, were internally dialyzed with ATP-free media and with media with lower than normal ATP levels in an attempt to determine quantitatively the ATP requirement of the Na pump in these cells. This was accomplished by using 22Na ions to measure Na efflux. When [ATP]i in dialysis fluid fell to values within the range of 20-40 microM, a marked stimulation of Na efflux was observed even though an essentially normal ouabain sensitivity of Na efflux persisted; when axons were dialyzed with ATP-free solutions with ouabain present in the external medium throughout the dialysis period, the stimulation of Na efflux still occurred. The stimulation of Na efflux produced by low [ATP]i levels could be reversed by reintroducing normal ATP levels into the dialysis medium. Reversibility was complete provided axons were not depleted of ATP for periods longer than about 1 hr. Longer periods of ATP depletion led to larger and ultimately irreversible increases in Na efflux. The increases in Na efflux occasioned by ATP depletion either prevented or obscured the decrease in Na efflux expected to occur from unfueling the Na pump. Since [ATP]i levels required to significantly unfuel the Na pump lie below the levels at which the Na efflux stimulation occurred, it is problematic to quantitatively assess the influence of [ATP]i levels on Na pump rate by measurements of Na efflux in this preparation. Substitutes for ATP failed to prevent increases in Na efflux. The large increases in Na efflux observed at low [ATP]i occurred with no important changes in the resting membrane potential, and also occurred in Na-free and Ca-free external media. At least part of the increased Na efflux under these conditions may be due to a Na/Na exchange component, as a significant dependence of Na efflux on [Na]o appropriate for this kind of exchange was observed in the ATP-depleted axons. Whether the highly reproducible anomalous effect on Na efflux in Myxicola axons has some fundamental significance in its own right is a matter for future investigation. A few possible explanations of the anomalous effect of reduced ATP levels are discussed.

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Reported findings of elevated total calcium (Ca) contents in erythrocytes (RBCs) from patients with beta-thalassemia intermedia (beta-TI) prompted the question of whether the state and transport of Ca in these RBCs are similar to those in sickle cell anemia (SS) RBCs where the increased Ca is compartmentalized in endocytic inside-out vesicles and extracted by exposure of the cells to the Ca ionophore A23187 and a Ca chelator (ethylene glycol tetraacetic acid) and the levels of cytoplasmic free ionized Ca [( Ca2+]i) are normal. We confirmed a high total Ca content of 51 +/- 13 mumol/L RBCs in splenectomized (SPX) beta-TI and 24 +/- 1 mumol/L RBCs in non-SPX beta-TI. Unlike SS RBCs, however, most of the increased Ca was in the lighter, presumably younger beta-TI RBCs, and about half the Ca was not ionophore mobilizable but apparently firmly bound, possibly to remnants of organelles in nucleated and other young RBCs. In the denser RBCs from non-SPX beta-TI, total and extractable Ca amounts were normal. beta-TI RBCs loaded with the Ca chelator Benz 2 showed an initial influx of 45Ca in the normal range, which indicated normal Ca permeability, and near-steady-state levels of [Ca2+]i that were normal (22 +/- 7 nmol/L RBCs in non-SPX beta-TI) or minimally increased (40 +/- 19 nmol/L RBCs in SPX beta-TI). Serial-section electron microscopy of beta-TI ghosts from the denser cell fractions showed more fully enclosed vesicles in non-SPX ghosts than were seen in normal ghosts and many large vesicles and structured, electron-dense material in SPX ghosts. A delayed extrusion of ionophore-preloaded 45Ca only by the SPX beta-TI RBCs together with normal [Ca2+]i suggested compartmentalization of the loaded Ca in these RBCs, perhaps in endocytic inside-out vesicles, and normal Ca pumps. Since beta-TI RBCs show essentially normal levels of [Ca2+]i and normal Ca influx, their high total Ca content should not be associated with any of the deleterious effects observed in vitro with increased levels of [Ca2+]i.

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Experiments were performed to test specific predictions of an integrated red cell model developed by Lew and Bookchin [Lew, V.L., Bookchin, R.M. J. Membrane Biol. 92:57-74 (1986)], that K-permeabilized human red cells suspended in low-K media would dehydrate and lose an alkaline, hypertonic fluid with excess K over accompanying anions, and that cell dehydration would precede medium alkalinization. Red cells were suspended at about 30% hematocrit in an initially K-free Na-saline and permeabilized to K by the addition of valinomycin. The results showed that by the time a quasi-steady state had been reached the cells had lost the equivalent of a hypertonic fluid containing about 180 mM KCl (SCN) and 10 mM KOH, and that cell dehydration did precede alkalinization of the medium, in good agreement with the theoretical predictions. Since these experiments critically test the interaction between transport, pH and volume regulatory functions in the human red cell, the observed agreement validates the basic assumptions and structure of the integrated model. The functional implications of these results are discussed.

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We investigate here the hypothesis that the high Ca content of sickle cell anemia (SS) red cells may produce a sustained activation of the Ca2+-dependent K+ permeability (Gardos effect) and that the particularly high Ca levels in the dense SS cell fraction rich in irreversibly sickled cells (ISCs) might account for the Na pump inhibition observed in these cells. We measured active and passive 86Rb+ influx (as a marker for K+) in density-fractionated SS cells before and after extraction of their excess Ca by exposure to the Ca ionophore (A23187) and ethylene glycol tetra-acetic acid and with or without adenosine triphosphate depletion or addition of quinine. None of these maneuvers revealed any evidence of a Ca2+-dependent K leak in SS discocytes or dense cells. Na pump inhibition in the dense SS cells was associated with normal activation by external K+ and a low Vmax that persisted after Ca extraction from the cells. These results are consistent with our recent findings that the excess Ca in these cells is compartmentalized in intracellular inside-out vesicles and unavailable as free Ca2+ to the inner membrane surface. Although the steady-state free cytoplasmic Ca2+ in oxygenated SS cells must be below the levels needed to activate the K+ channel, possible brief activation of the channels of some SS cells resulting from transient elevations of cell Ca2+ during deoxygenation-induced sickling cannot be excluded. The dense, ISC-rich SS cell fraction showed a Ca2+-independent increase in the ouabain-resistant, nonsaturable component of 86Rb+ influx that, if uncompensated by Na+ gain, could contribute to the dehydration of these cells.

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Much recent interest in the mechanism of dehydration of the dense subpopulation of sickle-cell anaemia (SS) red cells, including the 'irreversibly sickled cells' (ISCs), stems from the view that these relatively rigid cells have a major role in the two main clinical features of the disease, namely haemolytic anaemia and microvascular occlusion. The discovery that SS red cells have an elevated calcium content and accumulate Ca2+ during deoxygenation-induced sickling suggested a working hypothesis of wide appeal for the mechanism of cell dehydration: retained calcium would activate the red cell Ca2+-sensitive K+ channels, causing progressive net loss of KCl and water. However, retained calcium, which seemed as weakly bound to cytoplasmic buffers as in normal red cells, failed to show any measurable activation of K+ channels or Ca2+ pumps in metabolically normal SS cells, despite the apparent functional normality or near-normality of these transport systems. We now offer a possible explanation for this failure. We show that, contrary to the traditional views, SS cells, and to a lesser extent normal human red cells, possess intracellular vesicles with ATP-dependent Ca2+-accumulating capacity, and that nearly all the measurable calcium of fresh SS cells is contained within such vesicles, probably in the form of precipitates with inorganic or organic phosphates.

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Axoplasm from freshly isolated Myxicola giant axons was mixed with small volumes of 'artificial axoplasm' containing 45Ca and either CaEGTA/EGTA or CaDTPA/DTPA buffers giving various nominal values of [Ca2+]. The axoplasm samples were centrifuged at 100 000 X g for 30 min to form a pellet and the percentage of 45Ca bound to the pellet was determined. The fraction of bound calcium rose with increasing values of [Ca2+] along an S-shaped curve. Carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP) was used to reveal the presence of mitochondrial Ca uptake. At physiological values of [Ca2+], around 100 nM, Ca uptake was insensitive to FCCP. As [Ca2+] was elevated, increasing sensitivity to FCCP was noted above [Ca2+] = 0.5 microM. At low values of [Ca2+], including the physiological range, Ca binding was significantly reduced by vanadate and quercetin, agents known to inhibit Ca uptake mediated by Ca2+-activated ATPase reactions. Inhibition of Ca binding by these agents was approximately 50% at physiological values of [Ca2+]. ATP depletion decreased the percentage of Ca binding by the pellet at physiological [Ca2+]. The results suggest that about 50% of the Ca buffering by particulate matter in axoplasm is via organelles requiring intact Ca2+-ATPase reaction at physiological values of [Ca2+].

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Inside-out vesicles from the membranes of dog erythrocytes were obtained by the method of Lew & Seymour (1982) for study of Ca movements. In the absence of ATP, 45Ca accumulation by the vesicles was inhibited by external Na and stimulated by internal Na. The presence of either MgCl2, quinidine sulphate, or LaCl3 in the incubation medium inhibited 45Ca accumulation in the absence of ATP. The release of 45Ca from 45Ca-loaded vesicles was specifically promoted by Na+ in the absence as well as in the presence of ATP. The accumulation of 45Ca by vesicles was stimulated by ATP and the effect of ATP was entirely dependent on the presence of Mg. The Mg- and ATP-dependent 45Ca accumulation was stimulated by the presence of either K or Na in the medium, was hyperbolically activated by increasing the Ca2+ concentration in the medium, was stimulated by calmodulin and inhibited by orthovanadate (10(-4) M) or LaCl3 (10(-3) M). The data demonstrate the presence of two mechanisms for controlling Ca movements in inside-out vesicles from dog erythrocyte membranes, a Na-dependent one similar to the Na-Ca exchange described for squid axons and cardiac muscle and a Ca pump utilizing ATP with characteristics similar to those described for human erythrocytes and squid axons.

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A comparative study of the effects of vitamin D3 and of a partially purified extract of Solanum malacoxylon has been carried out in rachitic chicks. Vitamin D3 and Solanum malacoxylon increased intestinal calcium absorption and serum calcium levels. They normalized the bone water and ash content. Vitamin D3 produced an increase of serum phosphate while Solanum malacoxylon further decreased the already low phosphate values. Vitamin D3 significantly increased the body weight increment of rachitic chicks, but Solanum malacoxylon did not. It appears that Solanum malacoxylon duplicates certain actions of vitamin D but lacks its phosphate-regulating and growth-promoting actions.

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