Abstract
Iron deficiency is the most common and widespread nutritional disorder worldwide. The automated haematology analyser XN-30 (Sysmex, Kobe, Japan) was developed to detect malaria-infected red blood cells (RBCs) in human blood samples using flow cytometry. The optical system of the analyser detects autofluorescence (AF)-emitting RBCs containing iron-deficient haem groups and would aid in the diagnosis of anaemia resulting from iron deficiency. Here, an RBC-optical (RBO) channel was devised and implemented on the analyser. In vitro analyses showed that the analyser detected AF-emitting RBCs treated with 5-aminolevulinic acid. Furthermore, the analyser detected AF-emitting RBCs in mice fed a low iron diet and infected with a rodent malaria parasite; it could also be effectively used in humans. This study demonstrates that the analyser can quantitatively and reproducibly detect AF-emitting RBCs and measure other haematological parameters, suggesting its usefulness for the initial evaluation of latent iron deficiency anaemia in conjunction with the diagnosis of malaria.
Highlights
Iron deficiency anaemia (IDA) is the most common and widespread nutritional disorder and is estimated to affect approximately two billion people w orldwide[1]
In the M chamber, the samples were treated with both Lysercell M and Fluorocell M14; in the RBO chamber, the samples were treated with CELLPACK DFL, which enables the precise determination of red blood cells (RBCs) size
Fluorescence microscopy showed that AF was not necessarily emitted from smaller RBCs (Fig. 4e). These results indicate that RBCs treated with CELLPACK DFL, which enables the precise determination of RBC size, are displayed on the scattergram according to their size
Summary
Iron deficiency anaemia (IDA) is the most common and widespread nutritional disorder and is estimated to affect approximately two billion people w orldwide[1]. Iron administered to women and children without prophylaxis or access to adequate health care is often accompanied by an increase in malaria incidence, suggesting that IDA protects against Plasmodium falciparum malaria infection[6,7,8,9,10,11]. The automated haematology analyser XN-30 (Sysmex, Kobe, Japan) was developed to quickly detect malariacausing parasites and to calculate parasitaemia in human blood samples through flow cytometric a nalysis[14]. In this system, the nucleic acids of malaria-infected RBCs (iRBCs) are stained with a Fluorocell M solution and excited by a semiconductor 405 nm laser beam. We assessed the ability of the analyser to detect AF-emitting RBCs in healthy human blood samples
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