Abstract

Background: Furosemide, a loop diuretic inhibiting the renal tubular Na<sup>+</sup>,K<sup>+</sup>,2Cl<sup>-</sup> cotransporter, has been shown to decrease cytosolic Ca<sup>2+</sup> concentration ([Ca<sup>2+</sup>]<sub>i</sub>) in platelets and erythrocytes. [Ca<sup>2+</sup>]<sub>i</sub> in erythrocytes is a function of Ca<sup>2+</sup> permeable cation channels. Activation of those channels e.g. by energy depletion or oxidative stress leads to increase of [Ca<sup>2+</sup>]<sub>i</sub>, which in turn triggers eryptosis, a suicidal erythrocyte death characterized by cell membrane scrambling. The present study was performed to explore whether furosemide influences the cation channels and thus influences eryptosis. Methods: Cation channel activity was determined by whole-cell patch clamp, [Ca<sup>2+</sup>]<sub>i</sub> utilizing Fluo3 fluorescence and annexin V binding to estimate cell membrane scrambling with phosphatidylserine exposure. Results: A 45 min exposure to furosemide (10 and 100 µM) slightly, but significantly decreased cation channel activity and [Ca<sup>2+</sup>]<sub>i</sub> in human erythrocytes drawn from healthy individuals. ATP-depletion (> 3 hours, +37°C, 6 mM ionosine and 6 mM iodoacetic acid) enhanced the non-selective cation channel activity, increased [Ca<sup>2+</sup>]<sub>i</sub> and triggered cell membrane scrambling, effects significantly blunted by furosemide (10 – 100 µM). Oxidative stress by exposure to tert-butylhydroperoxide (0.1 –1 mM) similarly enhanced the non-selective cation channels activity, increased [Ca<sup>2+</sup>]<sub>i</sub> and triggered cell membrane scrambling, effects again significantly blunted by furosemide (10 – 100 µM). Conclusions: The present study shows for the first time that the loop diuretic furosemide applied at micromolar concentrations (10 – 100 µM) inhibits non-selective cation channel activity in and eryptosis of human erythrocytes.

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