Abstract
That red blood cells (RBCs) become progressively denser with age has become a universally acknowledged truth. However, as with all universally acknowledged truths, troublesome singularities often arise. We focus here on one particular departure from the rule, the terminal density reversal (TDR) phenomenon, discovered by Bookchin (Bookchin et al., 2000), and documented so far in RBCs from healthy subjects (Bookchin et al., 2000; Lew et al., 2007), from sickle cell anemia patients (SS RBCs) (Bookchin et al., 2000; Franco et al., 2000; Lew et al., 2002; Holtzclaw et al., 2002), from patients with β-thalassemia intermedia (Bookchin et al., 2000), and from diabetic subjects with sustained high levels of glycated hemoglobin, Hb A1c (Bookchin et al., 2009).
Highlights
That red blood cells (RBCs) become progressively denser with age has become a universally acknowledged truth
We focus here on one particular departure from the rule, the terminal density reversal (TDR) phenomenon, discovered by Bookchin (Bookchin et al, 2000), and documented so far in RBCs from healthy subjects (Bookchin et al, 2000; Lew et al, 2007), from sickle cell anemia patients (SS RBCs) (Bookchin et al, 2000; Franco et al, 2000; Lew et al, 2002; Holtzclaw et al, 2002), from patients with β-thalassemia intermedia (Bookchin et al, 2000), and from diabetic subjects with sustained high levels of glycated hemoglobin, Hb A1c (Bookchin et al, 2009)
There are a number of reasons that justify focusing on TDR: it is of substantial physiological and pathophysiological relevance as it defines the late and terminal homeostatic condition of RBCs in the circulation both in health and disease; it remains controversial and in need of further independent confirmation; its mechanism is still poorly understood, and on the evidence so far it is not yet clear whether it is the common final path of all RBCs or of only a selected RBC subpopulation
Summary
That red blood cells (RBCs) become progressively denser with age has become a universally acknowledged truth. This was resolved in a series of experiments aimed at preventing any possible sodium gains in vitro by repeatedly washing RBCs from freshly extracted blood with large volumes of sodiumfree isotonic media before testing for dehydration resistance.
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