Smokers as blood donors: what do their red blood cell membranes tell us?

Abstract

1RBC membrane lipids are rich in polyunsaturated fatty acids; therefore, the exposure to toxins and peroxidants causes hemolysis, as well as loss of membrane stability. 1 In this research, we studied the ultrastructure of RBC membranes of 10 smokers using scanning electron microscopy (SEM) at 1 kV, to determine if this altered membrane fluidity can be visualized. Hundreds of RBCs from the 10 smokers were compared to our RBC database of thousands of micrographs from healthy nonsmoker individuals. Figure A shows a typical healthy nonsmoker’s RBC (scale, 1 mm), while Fig. B shows an RBC from a smoker (scale, 1 mm), and Fig. C is a high machine magnification (100,000 ¥) of the smoker’s RBC membrane (scale, 200 nm). Figure B is a representative RBC of the 10 smokers. RBCs of smokers are smaller and slightly elongated when compared to those of healthy nonsmokers, and membranes form small globular areas, as well as blister-like areas (Fig. C). (No micrograph features were changed and color was added with Adobe Photoshop CS6.) These changes may influence the RBC rheology and confirm the fluidity changes previously noted. These membrane changes are not visible using a traditional light microscope. The membranes of healthy RBCs typically show smooth membrane surfaces. Some researchers believe that there is no fundamental evidence that smokers’ blood does not comply with physiologic quality requirements for transfusion. The altered RBC membrane ultrastructure and fluidity might impact the health of the cell, ultimately impacting the therapeutic benefit to the individual receiving the blood. Therefore, we suggest that there is cause for concern when using blood from smokers for transfusion. Perhaps we must again rethink the use of smokers’ blood in blood donation. ETHICAL APPROVAL DISCLOSURE