Mechanics of diseased red blood cells in human spleen and consequences for hereditary blood disorders.
Mechanics of diseased red blood cells in human spleen and consequences for hereditary blood disorders.
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DOI:
10.1073/pnas.1806501115
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发表时间:
2018-09-18
影响因子:
11.1
通讯作者:
Suresh S
中科院分区:
文献类型:
--
作者:
Li H;Lu L;Li X;Buffet PA;Dao M;Karniadakis GE;Suresh S
The interendothelial slit (IES) is the narrowest circulatory pathway in the human spleen where aged and diseased red blood cells (RBCs) are filtered. We use a two-component RBC model to probe the dynamics of healthy and diseased RBCs traversing IES. Our simulations reveal that the spleen not only senses and clears RBCs with abnormal shapes and deformability but also alters the geometries of RBCs that contain protein defects arising from hereditary blood disorders. The framework presented here is sufficiently general to be extended to elucidate the pathophysiological roles of the spleen in other blood diseases. In red blood cell (RBC) diseases, the spleen contributes to anemia by clearing the damaged RBCs, but its unique ability to mechanically challenge RBCs also poses the risk of inducing other pathogenic effects. We have analyzed RBCs in hereditary spherocytosis (HS) and hereditary elliptocytosis (HE), two typical examples of blood disorders that result in membrane protein defects in RBCs. We use a two-component protein-scale RBC model to simulate the traversal of the interendothelial slit (IES) in the human spleen, a stringent biomechanical challenge on healthy and diseased RBCs that cannot be directly observed in vivo. In HS, our results confirm that the RBC loses surface due to weakened cohesion between the lipid bilayer and the cytoskeleton and reveal that surface loss may result from vesiculation of the RBC as it crosses IES. In HE, traversing IES induces sustained elongation of the RBC with impaired elasticity and fragmentation in severe disease. Our simulations thus suggest that in inherited RBC disorders, the spleen not only filters out pathological RBCs but also directly contributes to RBC alterations. These results provide a mechanistic rationale for different clinical outcomes documented following splenectomy in HS patients with spectrin-deficient and ankyrin-deficient RBCs and offer insights into the pathogenic role of human spleen in RBC diseases.
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DOI:
10.1073/pnas.1606751113
发表时间:
2016-07-12
影响因子:
11.1
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通讯作者:
Suresh, Subra