[Effect of smoking on blood rheology]. / Influence du tabagisme sur la rhéologie sanguine.

The aim of this study was to compare the effects of cigarette smoking on biologic and rheologic tests, chiefly on the red blood cells (RBC) in measuring the deformability by the Cell Transit Analyser (CTA) and their aggregation by using an ultrasonic interferometry method based on A-mode echography allowed for the measurement of the accumulation rate of particles in a solid plate which is related to their sedimentation rate (Echo-Cell). Nine male smoker subjects with a high nicotine addiction measured by Fagerström questionnaire (> 8) and level of carbon monoxide (CM) in the breathed out air (> 20 ppm), have been compared with ten healthy no-smoker volunteers (CM < 3 ppm). One smoker has been eliminated of statistic evaluations because his glucose level showed a diabetes (10.5 mmol/l). A nailfold capillaroscopy performed in all subjects has eliminated the patterns of latent vasculitis or scleroderma. RBC and platelets counts, hemoglobin, ionogram, gamma GT, ASAT, ALAT, uric acid, total cholesterol and glucose levels were not significantly different between the two groups. On the other hand, in the smoker group, white blood cells count, serum triglycerides and especially fibrinogen values were higher than in the non-smoker's group. RBC sedimentation rate was normal in the two groups but was higher in smoker's group too. Without consumption of alcohol, the mean RBC volume was more important in smokers (91.9 +/- 1.2 versus 87.5 +/- 0.4, p = 0.003). Rheologic tests were more pathologic in smokers. The transit time or RBC by CTA was longer than in control group (1.6 ms +/- 0.02 versus 1.2 +/- 0.05, p = 0.0003). Echo-Cell technic showed a number and size of RBC aggregates more important with a rate of speed of accumulation higher than in the control group. These results demonstrated the toxic effects of smoking alone on blood toward a propensity for thrombotic status.

The involvement of the Ca-dependent K channel and of the KCl co-transport in sickle cell dehydration during cyclic deoxygenation.

We have investigated the mechanisms involved in sickle cell dehydration upon continuous or cyclic deoxygenation: the Ca(2+)-activated K+ channel and the KCl co-transport system. Short-term continuous deoxygenation (1 h) of sickle cells in a Ca(2+)-containing medium promoted a stimulation of the efflux of K+ and cell dehydration. This latter was reduced by the replacement of Ca2+ in the medium by EGTA, but not by addition of [(dihydro-indenyl) oxy] alkanoic acid (DIOA), an inhibitor of the KCl co-transport. During cycles of deoxygenation-reoxygenation, cell dehydration was partly prevented by EGTA and significantly reduced by DIOA only in the presence of Ca2+. The present data support the view that sickle cell dehydration during deoxygenation arises from the stimulation of the Ca(2+)-dependent K+ permeability leading to water loss, whereas during reoxygenation periods, subsequent activation of the KCl co-transport also contributes to cell dehydration.

Ca2+ permeability in deoxygenated sickle cells.

Deoxygenation of sickle cells is known to increase cation permeabilities (Na+, K+, and Ca2+). The possible mechanisms involved in the increased uptake of Ca2+ were investigated: activation of Ca2+ channels, involvement of the anion channel, and the formation of endocytic vacuoles. The Ca2+ channel blocker nifedipine reduced the deoxy-stimulated Ca2+ uptake by about 30% to 40%. The anion channel inhibitor DIDS (4,4' diisothiocyanate stilbene 2,2' disulfonate) inhibited the deoxy-stimulated Ca2+ uptake by approximately 50%. Maximal possible endocytic uptake, measured by using an impermeant marker ([3H] inuline), accounted for 6% to 9% of the total Ca2+ uptake. These data indicate that the deoxygenation-induced increase in Ca2+ permeability could result from both the activation of a Ca2+ channel and of a transport system for cations involving interactions between polymerized hemoglobin S, band 3 and other membrane components. Endocytosis appears to play only a minor role in the Ca2+ uptake of deoxygenated sickle cells.

Alteration in protein kinase C activity and subcellular distribution in sickle erythrocytes.

In agreement with previous data, membrane protein phosphorylation was found to be altered in intact sickle cells (SS) relative to intact normal erythrocytes (AA). Similar changes were observed in their isolated membranes. The involvement of protein kinase C (PKC) in this process was investigated. The membrane PKC content in SS cells, measured by [3H]phorbol ester binding, was about 6-times higher than in AA cells. In addition, the activity of the enzyme, measured by histone phosphorylation was also found to be increased in SS cell membranes but decreased in their cytosol compared to the activity in AA cell membranes and cytosol. The increase in membrane PKC activity was observed mostly in the light fraction of SS cells, fractionated by density gradient, whereas the decrease in cytosolic activity was only observed in the dense fraction. PKC activity, measured in cells from the blood of reticulocyte-rich patients, exhibited an increase in both membranes and cytosol, thus explaining some of the effects observed in the SS cell light fraction, which is enriched in reticulocytes. The increase in PKC activity in the membranes of SS cells is partly explained by their young age but the loss of PKC activity in their cytosol, particularly in that of the dense fraction, seems to be specific to SS erythrocytes. The relative decrease in membrane PKC activity between the dense and the light fractions of SS cells might be related to oxidative inactivation of the enzyme.

Calcium permeability in deoxygenated sickle erythrocytes - abstract

Sickle cell have an abnormally high level of calcium and, by an unknown mechanism, exhibit an increase in Caý+ permeability when they are sickled upon deoxygenation. This reversible increase in Caý+ permeability might contribute to cell dehydration by activation of K+ and water loss through the Caý+ permeability might contribute to cell dehydration by activation of K+ and water loss through the Caý+ dependent K+ channel (Gardos pathway). In the present study, the mechanism involved in Ca+ influx stimulation in sickle cells induced by deoxygenation was investigated by three different experiments: Ca2+uptake (1) in the presence of an extracellular impermeant marker to test endocytosis, (2) in the presence of the Caý+uptake (1) in the presence of an extracellular impermeant marker to test endocytosis, (2) in the presence of the Caý= -channel inhibitor Nifedipine, and (3) in the presence of an anion-exchanger inhibitor 4,4' - diisothiocyanatostilbene-2,2' - disulfonic acid (DIDS). These experiments revealed that endocytosis accounted for 6 percent to 19 percent of the Ca2+ uptake in deoxygenated sickle cells a nd that the increased Ca2+ influx was in part blocked by Nifedipine and by DIDS. The present findings, describing different pathways involved in the Caý+ increased permeability of deoxygenated sickle cells are of potential therapeutic interest (AU)