Mechanisms of red blood cell trauma in assisted circulation. Rheologic similarities of red blood cell transformations due to natural aging and mechanical stress.
Mechanisms of red blood cell trauma in assisted circulation. Rheologic similarities of red blood cell transformations due to natural aging and mechanical stress.
复制标题
辅助循环中红细胞损伤的机制。
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
R. Kormos
中科院分区：
文献类型：
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作者：
M. Kameneva;J. Antaki;H. Borovetz;B. Griffith;K. Butler;K. Yeleswarapu;M. Watach;R. Kormos
循环支持装置的临床经验通常表明，通过增加血液粘度和降低红细胞变形性，患者血液流变学发生改变。我们的血液流变学研究还显示，与健康供体相比，人工心脏患者血液中的红细胞（RBC）聚集显著增加。这些血液流变学变化可能是由于机械性损伤红细胞所致。作者假设，从流变学的角度来看，机械创伤过程类似于“加速”的RBC老化过程。通过对RBC进行体内和体外实验来检查该假设，根据密度进行年龄分离，特别是为了确定老化和机械创伤RBC之间的流变学相似性。与年轻RBC相比，老年RBC表现出机械脆性增加、变形性降低和聚集能力增加。红细胞暴露于机械应力表现出类似的改变，在相同的流变参数。我们的实验还表明，机械应力降低了RBC的负表面电荷，如已知的在老化RBC中发生的那样。红细胞机械损伤和衰老过程的相似性增强了我们对辅助循环中亚溶血性损伤机制的理解。这可以通过最小化剪切引起的血液创伤来改进未来心脏辅助装置的设计和评估。
Clinical experience with circulatory support devices has typically shown alteration of patient blood rheology exhibited through increasing blood viscosity and decreasing erythrocyte deformability. Our hemorheologic studies have additionally shown a remarkable increase in red blood cell (RBC) aggregation in the blood of artificial heart patients as compared to healthy donors. These hemorheologic changes may be caused by mechanical trauma to RBCs. The authors hypothesize that the mechanical trauma process, from a rheologic point of view, could be analogous to an "accelerated" RBC aging process. The hypothesis was examined through in vivo and in vitro experiments on RBCs, age-separated on the basis of density, specifically to identify the rheologic similarities between aged and mechanically traumatized RBCs. Older RBCs demonstrated an increased mechanical fragility, a decreased deformability, and a increased ability to aggregate as compared to younger RBCs. RBCs exposed to mechanical stress demonstrated similar alterations in the same rheologic parameters. Our experiments have also shown that mechanical stress decreases the negative surface charge of RBCs as is known to occur in aged RBCs. Similarities found between the processes of RBC mechanical trauma and senescence enhance our understanding of mechanisms of subhemolytic trauma incurred in assisted circulation. This may improve the design and evaluation of future heart assist devices through minimizing shear induced blood trauma.