Red blood cell deformability in patients with claudication after pain-free treadmill training.

OBJECTIVES: To assess the effect of pain-free treadmill training on red blood cell deformability and walking distance in patients with claudication. DESIGN: Randomized-controlled trial of exercise training. SETTING: Patients were recruited from the primary care, vascular outpatient clinic. PATIENTS: A total of 60 patients with peripheral arterial occlusive disease (stage II according to Leriche-Fontaine) were randomized into the treadmill program or a control group. Fifty-five patients completed the study (27 in the exercising group and 28 in the control group). INTERVENTIONS: Patients in the exercising group were walking on the treadmill 3 times a week for 3 months. Each session consisted of 1 hour repetitive walking [performed to 85% of the pain-free walking time (PFWT)] was supervised by a qualified physiotherapist. MAIN OUTCOME MEASUREMENTS: Changes in erythrocyte deformability and treadmill walking performance (PFWT, maximal walking time) were assessed in both groups before the study and after 3 months. RESULTS: After 3 months of treadmill training, red blood cell deformability in the exercising group significantly increased (P<0.01). No significant changes were seen in the erythrocyte deformability in the control group. PFWT was prolonged by 102% from 191+/-34 to 386+/-60 seconds (P<0.01), and maximal walking time increased by 49% from 438+/-62 to 656+/-79 seconds (P<0.01) in the exercising group, whereas these changes were insignificant in the control group. CONCLUSIONS: A significant improvement of walking ability over 3 months of pain-free treadmill training is associated with a significant increase in red cell deformability in patients with claudication.

Rheological properties of erythrocytes in patients suffering from erysipelas. Examination with LORCA device.

The rheological properties of erythrocytes: elongation and the aggregation, as well as basic peripheral blood parameters: RBC number, hematocrit, MCV, MCH, MCHC reticulocytes, fibrinogen level, ESR, and glucose level were studied in a group of erysipelas patients. The concentration of malonyl dialdehyde (MDA) in erythrocytes was also measured, as an indicator of oxidative stress exerted. The study involved 18 erysipelas patients and 18 healthy subjects. The rheological properties and the aggregation of erythrocytes were studied with the use of a LORCA instrument (Laser-assisted Optical Rotational Cell Analyser). Differences were found in elongation index (EI) between the blood control (C) and patients (P), with an increase of this value only at 0.58 Pa shear stress and at 1.13 Pa shear stress. Upstroke were used as the indexes of RBC deformability, and the following aggregation parameters: intensity of light scattering in the prior disaggregation (Isc dis) - C - 43.0 au (arbitrary units), P - 44.8 au, time when cells are round and not aggregated (Isc top) - C - 51.6 au, P - 49.3 au, the amplitude of aggregation, the difference between Isc max and Isc min (AMP) - C - 39.9 au, P - 28.7 au, aggregation index (AI) - C - 64.6%, P - 70.0%, time for reach one half of the maximum aggregation (t(1/2)) - C - 2.0 s, P - 1.5 s, threshold shear stress, the lowest force that breaks the aggregation formed (Y(thr)) in P exceed 170% control group were measured. A decrease in the elasticity of erythrocytes in erysipelas patients was associated with the simultaneous increase of MDA - C - 0.08 nM/mgHb, P - 0.11 nM/mgHb content in the membranes of red blood cells. Basic peripheral blood parameters studied in patients with erysipelas did not differ significantly from the control group except for WBC, fibrinogen (C - 3.8 g/l, P - 7.8 g/l), and ESR (C - 6.1 mm/h, P - 45.4 mm/h) which were significantly higher.

Experimental model of pain-free treadmill training in patients with claudication.

OBJECTIVE: Treadmill training in claudication is often based on walking exercise to a pain threshold or longer to the maximum muscle pain of the lower limbs. This kind of exercise may cause an inflammatory response. The purpose of this study was to determine whether pain-free treadmill training using walking exercise to 85% of the distance to onset of claudication pain can significantly improve pain-free walking distance in patients with intermittent claudication and to evaluate whether this kind of program may induce an inflammatory response leading to the progression of atherosclerosis. DESIGN: A total of 98 patients aged 50-70 yrs with stable intermittent claudication were randomized into a supervised treadmill training program or a comparison group. Patients in the treatment group participated in 12 wks of supervised treadmill training. We examined the effects of 12 wks of pain-free treadmill training on pain-free walking distance, total leukocyte count, neutrophil count, and microalbuminuria in patients with claudication. RESULTS: A total of 80 participants completed the program. Exercise rehabilitation increased the time to onset of claudication pain by 119.2%, from 87.4 +/- 38 m to 191.6 +/- 94.8 m (P < 0.001). There was no increase in total leukocyte count, neutrophil count, or microalbuminuria after 12 wks of treadmill exercise (P > 0.05) CONCLUSION: A pain-free training program can be used in the treatment of claudication as a low-risk program, increasing walking ability without potential harmful effects of ischemia-reperfusion injury.

Deformability and enzymes activities of red blood cells in hemodialysed and peritoneal dialysed patients with chronic renal disease.

These studies were focused on the influence of two treatment methods of patients with chronic renal disease on RBC deformability. In peritoneal dialysed-patients (PD) erythrocytes exhibited a decrease in their deformability as compared to control subjects whereas this parameter in RBC deriving from hemodialysed patients (HD) was not altered. The alleviating effect of plasma components on deformability of erythrocytes was confirmed after the isolation of a pure faction of these cells as the parameter became worse. The activity of studied enzymes: acetylcholinesterase (Ache), dehydrogenase glucose-6-phosphate (G-6-PD) and glutathione reductase (GR) maintained their physiological values in both dialysis groups.

Effects of phenylhydrazine or recombinant human erythropoietin on deformability and activity of dehydrogenase glucose-6-phosphate and acetylcholinesterase in Wistar rats blood enriched in reticulocytes.

Deformability and activity of the enzymes: acetylcholinesterase (AChE) and dehydrogenase glucose-6-phosphate (G-6-PD), were assayed for RBC enriched in immature reticulocytes. Reticulocytosis was evoked by administration of two different drugs: recombinant human erythropoietin (rHuEPO) and phenylhydrazine (PHZ) to two groups of Wistar rats. After treatment with the former compound, a group of animals exhibited 17.33% reticulocytes in blood whereas a group of rats treated with the latter drug reached 57.66% of these cells in blood. A marked decrease in RBC deformability was found in both groups of animals. AChE did not significantly change activity neither in PHZ-treated nor in rHuEPO-treated rats, whereas G-6-PD activity was significantly decreased in the PHZ-treated group.

Rheological and biochemical examination of red blood cells after treatment with different pharmacological and toxic substances.

Rheological and enzymatic properties of red blood cells (RBC) were investigated in vitro after the treatment with vasoactive drug - buflomedil (bfl) and toxic substance - 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Studies with bfl included two different concentrations of the drug: 90 microg/ml of blood and 10 microg/ml of blood. The former concentration of the drug corresponds to the amount of bfl which is taken daily by a patient, the latter one is the highest peak of this drug in plasma. The dosage of dioxin was 32 microg/ml of blood and 32 ng/ml of blood. Only the smaller dosage of this compound appears in the environment but the higher one may occur in human organs because of its cumulation. Rheological properties of erythrocytes were examined using a laser diffractometer Rheodyne SSD (Myrenne). The deformability of RBC was expressed as an elongation index IE which was counted from the equation: EI=(L-W)/(L+W) where L is the length of cell and W is the width of cell. As far as the impact of bfl on RBC rheology is concerned studies were conducted in two different ways: (1) RBC were incubated with bfl directly, (2) RBC before incubation with bfl were treated with diamide to cause their rigidity. The action of bfl seems to be not efficient enough as data are not statistically significant in those two cases. Enzymatic properties of RBC were investigated using the methods of Beutler [7]. The activity of three enzymes was measured (acetylcholinesterase - Ache, dehydrogenase glucoso-6-phosphate - G-6-PD and gluthatione reductase - GR) for both bfl and TCDD-treated RBC. For TCDD-treated RBC additionally malonyldialdehyde (MDA) level was assessed.

Iron metabolism in boys involved in intensive physical training.

The purpose of the present study was to compare some haematological and iron-related parameters of prepubertal boys (10-12 years old) involved in intensive physical training program in preparation for the national championship with nontrained age-matched subjects. For this purpose, iron stores, haemoglobin, ferritin and serum transferrin receptor concentrations were taken into account. The athletes' dietary intakes were similar to the respective intakes in the control group. Mean ferritin concentration was similar in investigated groups of boys at the start of the study, but significant changes between those groups occurred during the 8 months of study. Compared with the control group, the trained ones have shown significantly higher serum transferrin receptor concentration during the competition period of the training season, just when they reached maximum performance capacity. Similarly, significant difference in total body iron, estimated as the sum of the individual's red blood cells iron and iron stores, between investigated groups occurred only during the competition period. The main finding of this study is that the endurance training in boys brings about significant decrease in serum ferritin, as well as iron stores in the body. Haematological parameters and iron status of trained children revealed latent anaemia (15%) or even manifest anaemia (9%). These findings indicate high prevalence of nonanaemic iron deficiency in young athletes and bear relationship to swimming training.