Red Blood Cell Indices Research Articles

Common Single Nucleotide Polymorphism of TMPRSS6, an Iron Regulation Gene, Associated with Variable Red Blood Cell Indices in Deletional α-Globin Genotypes.

Red blood cell (RBC) indices, including mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH), have been widely used for primary screening for thalassaemia (thal) syndromes. Recently, a single nucleotide polymorphism (SNP) rs855791 of TMPRSS6, an iron regulation gene involved in the substitution of a nucleotide between thymine (T) and cytosine (C) in exon 17 resulted in an amino acid change, p.Val736Ala (V736A), has been described to associate with RBC indices. The objective was to study the effects of common SNP V736A on RBC indices in deletional α-thal variations. SNP rs855791 genotypes were identified from 433 Thai volunteers, including 32.6% males and 67.4% females with an average age of 23.0 ± 8.7 years. These populations included individuals (82.4%) who had normal globin genotype (αα/αα, ββ) and α-thal carriers, which were divided into two subgroups, including α+-thal (-α/αα) (14.1%) and αo-thal (--/αα) (3.5%). Among three SNP genotypes, the C allele gradually expressed higher MCV and MCH than those of the T allele in both α+- and αo-thal traits. Importantly, SNP rs855791 of TMPRSS6 responded to α-globin deletions for sustaining RBC sizes and haemoglobinisation in α-thal carriers.

Complete blood count in the elderly vs. selected biochemical parameters associated with inflammation. Results of PolSenior2 study

Introduction: Complete blood counts provide a lot of valuable information about the health condition. As the value of individual morphological parameters depends on many factors, the interpretation of the test result should be carried out taking into account clinical data and the results of other laboratory tests. Inflammation activates mechanisms that affect the amount of blood cells produced. Deviations in blood level of inflammatory markers (such as C-reactive protein (CRP), transferrin) and iron, may account hematological abnormalities. Aim: The assessment of the relationship between the examinated biochemical parameters and changes in selected hematological parameters. Material and methods: This analysis was based on laboratory data from 5623 participants of the nationwide PolSenior2 study, assessing the health of Poles over 60 years of age. Results: It was shown that in the study population with age, the concentrations of CRP, iron and transferrin change. Concentration of iron correlates positively with the concentration of transferrin, and negatively with CRP. It has been found that the incidence of anemia increases with age. Higher CRP levels and lower iron and transferrin levels were more frequently observed in the anemic group. Changes in the analyzed biochemical parameters correlated with a change (decrease or increase) in the red blood cell indices, the majority of leukocyte subpopulations and platelets. Conclusions: The analysis shows that inflammation, as expressed by changes in the concentrations of related biochemical parameters, can affect blood morphology. Therefore, when assessing abnormalities in blood morphology, the results of other laboratory assays, including biochemical markers associated with inflammation, should be taken into account.

Associations between red blood cell indices and iron status and neurocognitive function in young adults: Evidence from memory and executive function tests and event-related potentials.

Cognitive impairment has been associated with anemia and iron deficiency; however, brain electrophysiological studies correlating red blood cell (RBC) indices and iron status to cognition in adulthood are scarce. We aimed to assess neurocognitive function in young adults of the general population and its correlation with RBC indices and iron status. Neurocognitive function was investigated using scalp-recorded event-related potentials (ERPs) within the context of a task-switching paradigm. ERPs and test performance were also compared across groups of "high"/"low" RBC and iron indices. Working memory was examined using the digit span test, in which mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), and ferritin were found to be significant predictors of test performance, with higher MCH/MCV/ferritin being associated with better test scores. In the switching task, MCH, MCV, and ferritin were found to be significant predictors of task performance, with higher MCH/MCV/ferritin levels associated with a lower percentage of errors. Electrophysiological results showed that MCH and MCV were significant predictors of ERPs amplitude, with lower MCH/MCV levels associated with greater amplitude, which may reflect compensatory processes. P1, N1, P2, and P3 were greater for the low MCH/MCV groups. This is the first evidence of association between levels of MCH/MCV and brain function while engaged in an executive function task; possibly reflecting brain iron availability.

EFFECT OF IRON DEFICIENCY ANEMIA ON HbA1c IN DIABETIC, PRE-DIABETIC AND NONDIABETIC PATIENTS- IS THERE A DIFFERENCE??

Background and objectives: HbA1c is routinely used to follow up blood sugar levels and is a useful index of chronic hyperglycaemia. Besides blood sugar, several factors like hemoglobinopathies, nutritional deficiencies etc. affect HbA1c levels.Present study was conducted to study the effect of IDA on HbA1c levels in Indian diabetic,pre-diabetic and non-diabetic adults. Materials & Methods: This is a retrospective cross section study consisting of 1657 patients over a period of 3 months.The diabetic group,prediabetic and normal control groups comprised of 251 ,373 and 1023 patients respectively . Results: The mean HbA1c levels were significantly lower in IDA diabetic group as compared to non-IDA diabetic group.In the prediabetic group the HbA1c levels were higher in IDA group as compared to non-IDA group but the difference was not statistically significant. In the normal control group the mean HbA1c levels were significantly higher in IDA group as compared to non-IDA group.HbA1c did not show significant correlation with RBC indices or iron profile parameters. Interpretation & Conclusion: HbA1c levels are higher in IDA patients in pre diabetic and normal controls. On contrary HbA1c levels are lower when IDA coexists with diabetes.It is highly advisable to correct the IDA deficiency in all patients before diagnosing diabetes as well as correction of IDA once the diagnosis so that the HbA1c levels are actual depiction of glycaemic control.

RS12574989 and haplotype associated with α/β-chain imbalance and population HbA2 reduction

Determining the associated relationship of genotype and phenomenon would benefit the understanding of disease and renew disease intervention means. 14,518 patients who underwent haemoglobin electrophoresis from June 2020 to December 2020 were enrolled in our study, and additional data including sex, age and routine blood examination results were collected. We focused on individuals with normal red blood cell indices and no common thalassemia pathogenic mutation and selected three groups for the following study: the control group (2.5% ≤ HbA2 ≤ 3.5%), the HbA2 under 2.5 group (HbA2 < 2.5%) and the HbA2 under 2.4 group (HbA2 < 2.4%). Four regions of β-globin regulation were sequenced. Statistical analysis was conducted to compare the collected information of the three groups and the genotype distributions in the control group and sequenced group. The HbA2 under 2.5 group was characterized by a majority of females and lower red blood cell counts and haemoglobin compared with the control group. There were genotypes associated with the grouping as the T of rs12574989 and TTTAGC of the haplotype were significantly increased in the HbA2 under 2.4 group and CTTAGC was significantly decreased in the HbA2 under 2.4 group. This study demonstrated that the genotypes of the population associated with HbA2 were reduced in southern China.

Prognostic Potential of RDW in Discriminating Hemoglobinopathies among Patients reporting to Aga Khan Hospital, Kisumu

BackgroundRed cell distribution width (RDW) measures the extent of variation in red blood cell (RBC) volume in terms of coefficient of variation. It reflects the degree of variation in RBC’s sizes and shapes, characteristic of iron deficiency and anemias involving RBC destruction, especially hemoglobinopathies. Its values are often available as one of the RBC indices generated as complete blood cell count (CBC) using automated hematology analyzers. Hemoglobinopathies are highly prevalent in malaria-endemic geographical settings like the Sub-Saharan African which has over 200,000 currently documented annual major hemoglobinopathies with an alarming mortality rate of 50–90% by the age of 5 years usually undiagnosed. With a vast growing majority of hemoglobinopathy carriers, this public health problem is projected to escalate by the year 2050 due to unaffordable laboratory tests for screening of newborns and populations as recommended by World Health Organization in resource-limited settings. Therefore, innovative of a cost-effective diagnostic method would improve the survival of these children. The current study aimed to evaluate the overall ability of RDW in discriminating hemoglobinopathy and hemoglobinopathy-free cases within the Lake Victoria Economic Block region of Western Kenya served partly by the Aga Khan Hospital, Kisumu.ObjectiveTo determine the significance of RDW as a tool to differentiate between individuals with hemoglobinopathies and those without.MethodThis was a cross-sectional retrospective comparative hospital-based study that analyzed data from the hematology laboratory database for patients examined using high-performance liquid chromatography during the years 2015–2020. The study consisted of 488 participants (49.4%, n = 241 control; 50.6% n = 247 case, p = 0.786) aged between 1 month and 66 years selected conveniently through census. The relationship between RDW of the controls and cases was analyzed using Mann–Whitney U, Kruskal–Wallis tests among population groups and Dunn’s post hoc test within groups since the data were non-normally distributed.ResultsThe RDW cutoff value was computed at 95% confidence interval (CI), and values greater than this indicated a diagnosis of hemoglobinopathy.ConclusionRDW at 95% CI was 19.9 [14.5 + (2.7 × 2 = 19.9)] cutoff point which proved to be an excellent screening tool for sickle cell disease phenotypes in Western Kenya but would generate many false positive and false negatives for pure Hb AS. RDW is a poor screening tool for, Hb AS + HbF, Hb AS + β thal and β-thalassemia since it could not differentiate diseased from non-diseases populations. Even though RDW proved to be a poor screening tool for beta thalassemia, other complete blood count (CBC) parameters such as MCV and red cell count can be used to identify thalassemia syndromes as well as iron deficiency anemia. Though out of the scope of this work, highlighting the significance of these parameters in addition to the RDW would improve its feasibility as a screening tool for all hemoglobinopathies. Normal reference range for children ≤ 5 years needs to be developed using prospective data for precise marking of disorders associated with red cell anisocytosis, and individuals ≥ 6 years can share RDW normal reference range regardless of their gender.

Calcium carbide–induced derangement of hematopoiesis and organ toxicity ameliorated by cyanocobalamin in a mouse model

BackgroundCalcium carbide (CaC2) is a chemical primarily used in the production of acetylene gas. The misuse of CaC2 to induce fruit ripening is a global challenge with a potential adverse effects to human health. Additionally, CaC2 is known to contain some reasonable amount of arsenic and phosphorous compounds that are toxic and pose a danger to human health when ingested. The current study sought to characterize CaC2 toxicity and elucidate any protective effects by cyanocobalamin (vitamin B12), a well-established antioxidant and anti-inflammatory bio-molecule. Female Swiss white mice were randomly assigned into three groups; the first group was the control, while the second group was administered with CaC2. The third group received CaC2 followed by administration of vitamin B12. The mice were sacrificed at 60 days post treatment, hematological, biochemical, glutathione assay, cytokine ELISA and standard histopathology was performed.ResultsCaC2 administration did not significantly alter the mice body weight. CaC2 administration resulted in a significant decrease in packed cell volume (PCV), hemoglobin (Hb), red blood cells (RBCs) and RBC indices; indicative of CaC2-driven normochromic microcytic anaemia. Further analysis showed CaC2-driven leukopenia. Evidently, vitamin B12 blocked CaC2-driven suppression of PCV, Hb, RBCs and WBCs. Monocytes and neutrophils were significantly up-regulated by CaC2. CaC2-induced elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin signaled significant liver damage. Notably, vitamin B12 stabilized AST, ALT and bilirubin in the presence of CaC2, an indication of a protective effect. Histopathological analysis depicted that vitamin B12 ameliorated CaC2-driven liver and kidney injury. CaC2 resulted in the depletion of glutathione (GSH) levels in the liver; while in the brain, kidney and lungs, the GSH levels were elevated. CaC2 administration resulted in elevation of pro-inflammatory cytokines TNF-α and IFN-γ. Vitamin B12 assuaged the CaC2-induced elevation of these pro-inflammatory cytokines.ConclusionsThese findings demonstrate for the first time that oral supplementation with vitamin B12 can protect mice against CaC2-mediated toxicity, inflammation and oxidative stress. The findings provide vital tools for forensic and diagnostic indicators for harmful CaC2 exposure; while providing useful insights into how vitamin B12 can be explored further as an adjunct therapy for CaC2 toxicity.

Low-Level Environmental Mercury Exposure and Thyroid Cancer Risk Among Residents Living Near National Industrial Complexes in South Korea: A Population-Based Cohort Study.

Background: Previous studies suggested that mercury may be linked to thyroid cancer due to its bioaccumulation in the thyroid gland, but no studies have evaluated the association between mercury exposure and thyroid cancer risk. We examined the relationship between mercury exposure and thyroid cancer risk, with the potential modification of hematological parameters. Methods: We performed a secondary analysis of a prospective cohort study among residents living near industrial complexes in South Korea (recruited from 2003 to 2011). Incident thyroid cancer cases (C73, ICD-10 code) were identified from the National Cancer Registry and Statistics Korea. Urinary mercury concentrations were measured using thermal decomposition amalgamation atomic absorption spectrometry (TDA-AAS). Cox proportional hazards regression models (adjusted for age, sex, educational level, smoking status, and employment) were used to estimate the hazard ratio (HR) and confidence interval [CI] between mercury exposure and the incidence of thyroid cancer. Results: We documented 69 cases of thyroid cancer in a total of 5213 participants during follow-up (median 8.7 years). The geometric mean of urinary mercury concentration was 1.8 μg/L for thyroid cancer cases and 1.2 μg/L for noncases (p for difference = 0.001). After adjusting for potential confounders, those in the highest tertile of urinary mercury levels had a twofold higher risk of thyroid cancer (HR = 1.97 [CI 1.03 - 3.80] in the highest tertile vs. the lowest tertile, p for trend = 0.043). This association was stronger for those with lower mean corpuscular volume and mean corpuscular hemoglobin status. Conclusions: Urinary mercury concentration was positively associated with the risk of thyroid cancer among residents living near national industrial complexes, and this association was influenced by red blood cell indices status. These results provide some evidence suggesting the adverse effects of environmental metal pollution in the development of thyroid cancer.

Significance of the mathematically calculated red cell indices in patients with qualitative and quantitative hemoglobinopathies

BackgroundHemoglobinopathies represent a set of inherited red blood cell (RBCs) disorders, characterized by abnormal hemoglobin molecule. They include qualitative and quantitative hemoglobinopathies, with a structurally abnormal globin chain in the first and defective production in the later. This study assessed, for the first time, the significance of the mathematically calculated RBC indices to identify patients with hemoglobinopathies from normal subjects or iron deficiency anemia (IDA) and to differentiate various types of hemoglobinopathies from each other.Subjects and methodsThe study was a comparative hospital based and included 167 participants with hemoglobinopathies (group 1) and 49 participants with IDA (group 2) as an active comparator. Another 50 healthy volunteers (group 3) were also included. All participants were subjected to medical history, clinical examination, CBC, and HPLC. Next, 10 RBC indices were mathematically calculated from the CBC for each participant.ResultsGender analysis shows that females represent 36.8% in thalassemia group, 42% in sickle cell disease (SCD) group, and 71.4% in IDA group. The receiver operating characteristic (ROC) curve shows that Ehsani index (EI) is the most reliable screening tool for thalassemics because of showing the highest Youden index and specificity of 41.88% and 88.89%, respectively, followed by Shine and Lal index (SL), with Youden index (YI) value, specificity, and sensitivity equal to 39.78%, 69.70%, and 70.09%, respectively. Similar results were found for IDA. For SCD, SL index is the most suitable screening tool. In conclusion, the mathematically calculated RBC indices are available, cheap, reliable, and sensitive tools for screening patients with hemoglobinopathies.

Preclinical Characterization of Vadadustat (AKB-6548), an Oral Small Molecule Hypoxia-Inducible Factor Prolyl-4-Hydroxylase Inhibitor, for the Potential Treatment of Renal Anemia.

Pharmacological inhibition of prolyl-4-hydroxylase domain (PHD) enzymes stabilizes hypoxia-inducible factors (HIFs), transcription factors that activate target genes that, among others, increase erythropoietin (EPO) synthesis, resulting in the production of new red blood cells (RBCs). Herein, we summarize the preclinical characteristics of the small molecule HIF prolyl-4-hydroxylase inhibitor vadadustat (AKB-6548), which is in development for the treatment of anemia in patients with chronic kidney disease (CKD). Vadadustat inhibits the enzyme activity of all three human PHD isozymes, PHD1, PHD2, and PHD3, with similar low nanomolar inhibitory constant values. PHD enzyme inhibition by vadadustat is competitive with endogenous cofactor 2-oxoglutarate and is insensitive to free iron concentration. In the human hepatocellular carcinoma cell line (Hep 3B) and human umbilical vein endothelial cells, PHD inhibition by vadadustat leads to the time- and concentration-dependent stabilization of HIF-1α and HIF-2α In Hep 3B cells, this in turn results in the synthesis and secretion of EPO; vascular endothelial growth factor is not measured at detectable levels. A single oral dose of vadadustat in rats potently increases circulating levels of EPO, and daily oral dosing for 14 days increases RBC indices in healthy rats and in the 5/6 nephrectomy model of CKD. In mice and dogs, once-daily repeat oral dosing increases hemoglobin and hematocrit. Vadadustat has a relatively short half-life in all nonclinical species evaluated and does not accumulate when administered as a single bolus dose (oral or intravenous) or upon repeat oral dosing. The pharmacological profile of vadadustat supports continued development for treatment of renal anemia. SIGNIFICANCE STATEMENT: Vadadustat (AKB-6548) is an orally bioavailable small molecule prolyl-4-hydroxylase inhibitor in development for anemia of chronic kidney disease. It is an equipotent inhibitor of the three human prolyl-4-hydroxylase domain isoforms, which activates erythropoiesis through stabilization of hypoxia-inducible factor (HIF)-1α and HIF-2α, increasing production of erythropoietin, without detectable stimulation of vascular endothelial growth factor.

Detection of erythroid progenitors and erythrocytopathies in patients with severe COVID-19 disease.

To assess the effect of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection on erythropoiesis and red blood cells (RBC) surface markers by evaluating erythroid progenitor cells (CD [cluster of differentiation]71+/CD235a+) and RBC surface markers (CD235a and CD36), together with various hematological parameters. This case-control study includes 47 participants recruited in the study: 30 patients with coronavirus disease 2019 (COVID-19) and 17 healthy individuals. The COVID-19 patients were recruited from the intensive care unit (ICU) of various hospitals in Makkah, Saudi Arabia. Blood samples were collected during July and September 2021. Red blood cells indices were measured using a CBC analyzer. The expression of CD235a, CD71, and CD36 was obtained using flow cytometry technique. The unpaired t-test was conducted to evaluate the differences in these markers in COVID-19 patients and healthy individuals. The data showed that more than half of the COVID-19 patients were anemic (64%). Expansion of erythroid progenitors (CD71+/CD235a+) was detected in the COVID-19 patients. Analysis of the expression of RBC surface markers, such as CD235a and CD36, showed that SARS-CoV-2 was associated with significantly higher expression of these markers in COVID-19 patients. Severe acute respiratory syndrome coronavirus-2 promoted the expansion of erythroid progenitors in the peripheral blood of COVID-19 patients. In addition, the expression of RBC surface markers was higher in COVID-19 patients. The expansion of erythroid progenitors and alteration of RBC surface markers can contribute to erythrocytopathies observed in severe COVID-19 patients and can therefore be used as prognostic factors.

Molecular characterization of beta globin gene in beta thalassemia patients at Hue Central Hospital

Background: Thalassemia is the most common monogenic disease worldwide. The severity of thalassemia depends on the degree of imbalance between the α-globin and β-globin chains. The aims of the current study were (1) to describe clinical and hematological characteristics of β-thalassemia patients; and (2) to investigate mutations of β-globin gene using Sanger sequencing, as well as the association between β-globin genotype and severity of β-thalassemia. Materials and method: 57 β-thalassemia patients treated at Hue Central Hospital were examined by sequencing the whole β-globin gene. Results: 80.7% with β-thalassemia intermedia, 19.3% with β-thalassemia major. Patients had 100% anemia, 75.4% splenomegaly, 50.9% hepatomegaly, 38.6% thalassemia facies, 28.1% jaundice and 15.8% iron overload; The red blood cell indices were decreased: Hb 7.5 ± 1.3 g/dL, MCV 70.9 ± 8.4 fL, MCH 20.5 ± 2.1 pg. Hemoglobin composition included HbA 35.2 ± 33.9%, HbA2 6.1 ± 2.7%, HbF 24.8 ± 18.0%, and HbE 38.6 ± 15.2%. Nine β-globin gene mutations were observed. The most common genotype was βE/β0, which occupied 80.7%. The βE/βA, β0/βA and βE/β+ genotypes were only found in β-thalassemia intermedia individuals, while the β0/β0 genotype was limited to β-thalassemia major patients. The βE/β0 genotype was seen in both types. Conclusion: There was differences in age of blood transfusion initiation between the genotypes. Among them, the β0/β0 genotype was the most severe. Key words: β-thalassemia intermedia, β-thalassemia major, genotype.

The spectrum of thalassemia syndromes and abnormal haemoglobins in adult patients based on HPLC in a tertiary care centre of Punjab, India

In the present study adult patients with anemia were analysed for thalassemia syndromes and other haemoglobino pathies by using high performance liquid chromatography. A total of 102 Patients’ blood samples were evaluated for complete blood count, RBC indices, reticulocyte count and peripheral blood film for morphology. For the confirmation and characterization of hemoglobinopathy, ‘BIORAD VARIANT II’ of HPLC instrument with CDM software was utilized. 60.8% of the patients were females while the remaining 39.2% were males. The results of this study showed that 79.4% of patients were having a normal hemoglobin while 17% patients showed the prevalence of thalassemia trait. Two cases of hereditary persistence of fetal hemoglobin (HPFH) were seen and one case each of sickle cell-beta thalassemia (HbSThal) and hemoglobin D-Iran (HD-Iran) were seen. It was observed that 65.4% of the patients without thalassemia trait had normocytic normochromic type of anemia. In contrast, all the patients with thalassemia trait and HbSThal had microcytic hypochromic anemia. This association was statistically significant with hemoglobinopathies mostly having microcytic hypochromic. The present findings show high performance liquid chromatography forms a rapid, accurate, and reproducible tool for the early detection and management of hemoglobinopathies and variants.

Effect of temperature change on refractive index of an egg white and yolk: a preliminary study

In this article, the refractive index of an egg white and yolk depending on temperature in range 30 - 47 °C over 1550 nm was determined. The measurement head was constructed as fiber optic Fabry-Perot interferometer with interference between polished fiber end-face and aluminum weighing dish. The measurement setup has been made of an optical spectrum analyzer, a superluminescent diode with a central wevelength of 1550 nm, 2:1 fiber coupler and heat plate. Full Text: PDF ReferencesP. Magdelaine, "Egg and egg product production and consumption in Europe and the rest of the world, Improving the Safety and Quality of Eggs and Egg Products", Egg Chemistry, Production and Consumption, 3 (2011). CrossRef H. Kuang, F. Yang, Y. Zhang, T. Wang, and G. Chen, "The Impact of Egg Nutrient Composition and Its Consumption on Cholesterol Homeostasis", Cholesterol (2018). CrossRef J. Gienger, K. Smuda, R. Müller, M. Bär, and J. Neukammer, "Refractive index of human red blood cells between 290 nm and 1100 nm determined by optical extinction measurements", Sci. Rep. 9, 1 (2019). CrossRef P. Listewnik, M. Hirsch, P. Struk, M. Weber, M. Bechelany, and M. Jędrzejewska-Szczerska, "Preparation and Characterization of Microsphere ZnO ALD Coating Dedicated for the Fiber-Optic Refractive Index Sensor", Nanomaterials 9, 2 (2019) CrossRef Y. Wu, Y. Zhang, J. Wu, and P. Yuan, "Fiber-Optic Hybrid Structured Fabry-Perot Interferometer Based On Large Lateral Offset Splicing for Simultaneous Measurement of Strain and Temperature", J. Lightwave Technol., 35, 19 (2017). CrossRef M. Islam, M. Mahmood, M Lai, K. Lim, and H. Ahmad, "Chronology of Fabry-Perot Interferometer Fiber-Optic Sensors and Their Applications: A Review", Sensors 14, 4 (2014). CrossRef K. Karpienko, M. Wróbel, and M. Jędrzejewska-Szczerska, "Determination of refractive index dispersion using fiber-optic low coherence Fabry-Perot interferometer: implementation and validation", Opt. Eng. 53, 7 (2014). CrossRef M. Kosowska, D. Majchrowicz, K. Sankaran, M. Ficek, K. Haenen, and M. Szczerska, "Doped Nanocrystalline Diamond Films as Reflective Layers for Fiber-Optic Sensors of Refractive Index of Liquids", Materials 12, 13 (2019). CrossRef G. Xiao, A. Adnet, Z. Zhang, F. Sun, and C. Grover, "Monitoring changes in the refractive index of gases by means of a fiber optic Fabry-Perot interferometer sensor", Sensors and Actuators 118, 2 (2005). CrossRef

Back to the "Gold Standard": How Precise is Hematocrit Detection Today?

IntroductionThe commonly used method for hematocrit detection, by visual examination of microcapillary tube, known as “micro-HCT”, is subjective but remains one of the key sources for fast hematocrit evaluation. Analytical automation techniques have increased the standardization of RBC index detection; however, indirect hematocrit measurements by blood analyzer, the automated HCT, do not correlate well with “micro-HCT” results in patients with hematological pathologies. We aimed to overcome those disadvantages in “micro-HCT” analysis using “ImageJ” processing software.Methods223 blood samples from the “general population” and 19 from sickle cell disease patients were examined in parallel for hematocrit values using the automated HCT, standard “micro-HCT,” and “ImageJ” micro-HCT methods.ResultsFor the “general population” samples, the “ImageJ” values were significantly higher than the corresponding values evaluated by standard “micro-HCT” and automated HCT, except for the 0 to 2 month old newborns, in which the automated HCT results were similar to the “ImageJ” evaluated HCT. Similar to the “general population” cohort, we found significantly higher values measured by “ImageJ” compared to either “micro-HCT” or the automated HCT in SCD patients. Correspondent differences for the MCV and MCHC were also found.DiscussionThis study introduces the “micro-HCT” assessment technique using the image-analysis module of “ImageJ” software. This procedure allows overcoming most of the data errors associated with the standard “micro-HCT” evaluation and can replace the use of complicated and expensive automated equipment. The presented results may also be used to develop new standards for calculating hematocrit and associated parameters for routine clinical practice.

The oral ferroportin inhibitor vamifeport improves hemodynamics in a mouse model of sickle cell disease

AbstractSickle cell disease (SCD) is an inherited hemolytic anemia caused by a single point mutation in the β-globin gene of hemoglobin that leads to synthesis of sickle hemoglobin (HbS) in red blood cells (RBCs). HbS polymerizes in hypoxic conditions, leading to intravascular hemolysis, release of free hemoglobin and heme, and increased adhesion of blood cells to the endothelial vasculature, which causes painful vaso-occlusion and organ damage. HbS polymerization kinetics are strongly dependent on the intracellular HbS concentration; a relatively small reduction in cellular HbS concentration may prevent HbS polymerization and its sequelae. We hypothesized that iron restriction via blocking ferroportin, the unique iron transporter in mammals, might reduce HbS concentration in RBCs, thereby decreasing hemolysis, improving blood flow, and preventing vaso-occlusive events. Indeed, vamifeport (also known as VIT-2763), a clinical-stage oral ferroportin inhibitor, reduced hemolysis markers in the Townes model of SCD. The RBC indices of vamifeport-treated male and female Townes mice exhibited changes attributable to iron-restricted erythropoiesis: decreased corpuscular hemoglobin concentration mean and mean corpuscular volume, as well as increased hypochromic and microcytic RBC fractions. Furthermore, vamifeport reduced plasma soluble VCAM-1 concentrations, which suggests lowered vascular inflammation. Accordingly, intravital video microscopy of fluorescently labeled blood cells in the microvasculature of Townes mice treated with vamifeport revealed diminished adhesion to the endothelium and improved hemodynamics. These preclinical data provide a strong proof-of-concept for vamifeport in the Townes model of SCD and support further development of this compound as a potential novel therapy in SCD.

The red blood cells cytometric characteristics of young fresh-water fish of various families

The morphometric indices of red blood cells of young fish of various species inhabiting coastal zones of the water bodies were studied. The subjects of the research were the fish of four families: Carp (Alburnus alburnus, Carassius gibelio, Rhodeus amarus, Abramis brama, Rutilus rutilus), Needles (Syngnathus abaster nigro lineatus), Centrarchidae (Lepomis gibbosus), Loaches (Cobitis taenia taenia), Gobies (Neogobius fluviatilis). The hydroecological conditions were characterized by an intense oxygen regime, high content of phosphates, and heavy metals (zinc). The fish peripheral blood was taken from the tail vein; smears were made according to the classical Romanowsky-Giemsa method. Our research showed that the red blood cells of young fish belonging to the ecological group of inactive and unpretentious species (Neogobius fluviatilis, Carassius gibelio) had the largest cross-sectional area and a high index of nuclear-cytoplasmic ratio. The indicators of erythrocyte eccentricity were the highest in the active fish with high energy costs (Alburnus alburnus, Lepomis gibbosus). The largest number of erythrocytes with pathological events (cytolysis, karyolysis, pyknosis, poikilocytosis) was observed in the young Alburnus alburnus (14%), and the smallest one in Rhodeus amarus and Lepomis gibbosus (2–4%). In the individuals of Syngnathus abaster nigro lineatus affected by parasitic nematodes of the genus Ascaris, the number of erythrocytes with pathologies increased to 81%. Under the toxic load, destabilization of the fish circulatory system begins with the appearance of the young forms of erythrocytes as compensation for depleted mature erythrocytes and ends with the mass destruction of mature erythrocytes. Given these patterns, as well as the relatively low number of young ballast forms of erythrocytes and mature erythrocytes with pathological features, we can assume that the state of the red blood cells in the studied young fishes meets the conditional norm, with the exception of the blood of Syngnathus abaster nigro lineatus infected with parasites. In our opinion, the main characteristics of the fish red blood that reflect the fishes’ adaptive capacities are as follows: eccentricity ratio of erythrocytes, the nuclear-cytoplasmic ratio, ratio of the young ballast forms of erythrocytes, and the relative number of erythrocytes with pathology.

Screening of Thalassemia Carrier Traits in Students Using the One Tube Osmotic Fragility Method

Thalassemia is an inherited disorder resulting from a mutation or deletion of a gene that causes one of the globin chains to experience a decrease or cessation in the rate of synthesis. This leads to a decrease in the rate of haemoglobin synthesis. The highest prevalence of thalassemia in the world is found in tropical countries. The incidence of thalassemia carriers in Indonesia ranges from 6-10%. Thalassemia screening can be carried out by several examinations, including one tube osmotic fragility (OTOF) examination, red blood cell index, peripheral blood morphology and electrochemistry of haemoglobin. This study aimed to examine the screening of thalassemia carriers in undergraduate students using osmotic fragment examination of the OTOF method. This study used descriptive methods with 100 TLM D3 female students not yet known to have thalassemia. Univariate analyses were carried out. The results of the capillary blood samples indicated that 12% of the students were positive (indicating a suspected carrier of thalassemia) and 88% were negative according to the OTOF method using a hypotonic solution of 0.36% NaCl. From the positive OTOF results, the percentage of haemolysis was measured with varying results (17% - 65%). Those who had positive OTOF results in general were without significant symptoms. The findings accentuate that early detection of thalassemia is important.&#x0D; Keywords: thalassemia, OTOF, microcytic, hypochromic

1224-P: Multidimensional Characterization of Prediabetes in the Project Baseline Health Study

Prediabetes is a recognized entity but has been incompletely characterized in a contemporary context. We sought to characterize participants with prediabetes with extensive multi-dimensional clinical and laboratory data and to identify predictors of progression to diabetes. The Project Baseline Health Study (PBHS) is a multi-site prospective U.S. cohort study of 2502 adults with deep clinical phenotyping at enrollment. At enrollment and follow-up, participants were classified by diabetes status (diabetes [DM], prediabetes [preDM], or no diabetes [noDM]) based on glucose, A1c, medications, and self-reported medical history. Principal component analysis (PCA) was performed on 1clinical, survey, and lab variables to create orthogonal factors composed of correlated variables, which were compared between groups using linear models. Logistic regression was used to identify factors associated with progression from preDM to DM. At enrollment, 16participants had noDM; 544 had preDM; and 352 had DM. Over up to 4 years of follow-up, 52 participants with preDM developed DM. PCA identified 33 factors composed of clusters of clinical variables; 24 factors differed significantly by diabetes status: 6 factors significantly differed between noDM and both preDM and DM after adjustment for multiple comparisons, including factors with variables of glucose measures, anthropometry and physical function (q= 1.3 × 10−21) , red blood cell indices (q= 8.3 × 10−10) , lung function (q= 2.0 × 10−6) , cardiac function (q= 0.001) , and risk of chronic disease. Five factors were significantly associated with progression to DM, including factors of anthropometry and physical function [OR (95% CI) 0.6 (0.5,0.9) ], hematologic measures, and cardiac function. Conclusions: PBHS participants with preDM demonstrated pathophysiologic changes in cardiac, pulmonary, and hematology measures and declines in physical function that precede DM and could be markers of higher risk of progression to DM and complications. Disclosure R.Chatterjee montgomery: Research Support; Bristol-Myers Squibb Company, Epigenomics AG. L.C.Kwee: None. N.Pagidipati: Advisory Panel; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, ESPERION Therapeutics, Inc., Consultant; Boehringer Ingelheim International GmbH, Novo Nordisk, Research Support; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Eggland's Best, Eli Lilly and Company, Novartis AG, Novo Nordisk, Sanofi, Verily Life Sciences. A.F.Hernandez: Consultant; Merck &amp; Co., Inc., Novo Nordisk, Research Support; AstraZeneca, Boehringer Ingelheim International GmbH. F.Rodriguez: Advisory Panel; Amgen Inc., Consultant; HealthPals, Novartis Pharmaceuticals Corporation, Novo Nordisk, Stock/Shareholder; Carta Healthcare, Inc. K.W.Mahaffey: Consultant; Novo Nordisk. L.Palaniappan: Consultant; Amgen Inc. S.H.Shah: Research Support; Verily Life Sciences. Funding The Baseline Health Study and this analysis were funded by Verily Life Sciences, San Francisco, California.

Determination of the Association Between Serum Ferritin and C-Reactive Protein in Children Presented with Iron Deficiency Anemia in Combined Military Hospital Pathology Department Multan

Objective: To determine association between Serum ferritin and C-reactive protein (CRP) in children having iron scarcity anemia.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Pathology Department, Combined Military Hospital Multan Pakistan, from Jun to Dec 2018&#x0D; Methodology: One hundred and thirty-eight (138) children were consecutively selected as per inclusion and exclusion criteria. Each sample of blood was collected from children for serum ferritin, Blood complete picture (Blood CP) which include hemoglobin level and red blood cell indices and serum sample for C-reactive protein (CRP). Sandwich chemilumine-scence immunoassay technique was used to analyze serum ferritin, Blood CP was analyzed on sysmex and C-reactive protein was analyzed immuneturbidi-metric method.&#x0D; Result: A total of 138 children were included in our study. Mean age group of our population is 4.5 ± 0.65 years. Out of these 138, 67 (49%) were male children and 71 (51%) were female children. CRP was found negative in 50 (36%) and positive in 88 (64%) children. ANOVA and chi-square test showed association between CRP and anemia was statically significant.&#x0D; Conclusion: Increased ferritin level, secondary to inflammation may mask an underlying iron inadequacy in children. CRP in children with normal or high ferritin can be helpful in diagnosing iron deficiency. Serum ferritin was found to be positively correlated with CRP in children.