Mechanical sensitivity of red blood cells improves in individuals with hemochromatosis following venesection therapy

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Richardson, KJ
McNamee, AP
Simmonds, MJ
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2020
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Abstract

Background: Individuals with hereditary hemochromatosis (HH) receive frequent blood withdrawals (ie, venesections) as part of their primary treatment to assist in normalizing blood iron levels. It remains unclear whether this source of blood is suitable for use in blood product development, as current data indicate that red blood cell (RBC) deformability, both before and after shear stress exposure, is impaired in individuals with HH, relative to healthy controls. Given that venesection therapy is known to significantly reduce circulating iron levels in individuals with HH, the current study examined whether venesection therapy is effective at improving RBC mechanical properties, both before and after shear stress exposure, in individuals with HH. Study Design and Methods: Blood samples were initially collected from untreated HH patients (age, 61 ± 9 years; 14% female) undergoing their first venesection, and then again during their second (approx. 9 weeks later) and third (approx. 16 weeks later) venesections. RBC deformability was measured at each time point with a commercial ektacytometer. Moreover, to determine cell responses to mechanical stimuli, the mechanical sensitivity of blood samples was determined at each time point. Results: The salient findings indicate that venesection therapy used for managing plasma ferritin concentration significantly improves the cellular deformability of RBC in individuals with HH. Further, the sensitivity of RBC to supraphysiological mechanical stress is decreased (ie, improved) in a dose-response fashion with routine venesection. Conclusion: While cellular mechanics of RBC from individuals with HH are impaired when untreated, venesection therapy significantly improves cellular properties of RBC, supporting the use of venesections in blood product development from individuals with well-managed HH.

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Transfusion

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This publication has been entered in Griffith Research Online as an advanced online version.

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Cardiovascular medicine and haematology

Clinical sciences

Immunology

RBC deformability

hemorheology

iron overload

mechanical damage

sublethal trauma

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Richardson, KJ; McNamee, AP; Simmonds, MJ, Mechanical sensitivity of red blood cells improves in individuals with hemochromatosis following venesection therapy, Transfusion, 2020

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