Red Blood Cell Hemoglobin Concentration Research Articles

Hematological Parameters in Hair Goats During and out of Breeding Season Hair Goats Seasonal Hematological Parameters

Background: The hair goat of Anatolia is a breed that has adapted to rugged and mountainous areas and is known to be very resistant to diseases. As the world faces the problem of climate change, we believe that knowing the hematological characteristics of hair goats will provide great benefits for goat breeding. Objectives: This study was performed to determine possible differences in the blood parameters of adult (male and female) hair goats during and out of the breeding season. Methods: For this purpose, blood samples were taken from clinically healthy adult male and female hair goats (n=36, 3-4 years old) in the spring and autumn seasons. Regarding the whole blood, white blood cell (WBC), red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), mean red blood cell volume (MCV), mean red blood cell hemoglobin (MCH), average red blood cell hemoglobin concentration (MCHC) and red blood cell distribution width (RDW) values were determined. Results: In the study, MCV values in males were not significantly (P≥0.05) different between spring and autumn, while all other parameters showed significant differences (P≤0.05). In females, WBC, RBC, Hb, Hct, and RDW blood values were higher in the autumn (estrus period) than in the spring (anestrus period), and the differences were found to be significant (P≤0.05). Comparing males and females between the estrus and anestrus seasons, WBC and MCHC were found to be significantly different (P≤0.05) between males and females in May. In contrast, the difference between other parameters was not significant. In October (estrus season), the MCV value was not significantly different between males and females; however, all other parameters were significantly different (P≤0.05). Conclusion: As a result, there were significant differences in hematological parameters of hair goats based on gender and the breeding season.

Establishment and Validation of a Non-Invasive Diagnostic Nomogram to Identify Spontaneous Bacterial Peritonitis in Patients With Decompensated Cirrhosis.

BackgroundSpontaneous bacterial peritonitis (SBP) is a common and life-threatening infection in patients with decompensated cirrhosis (DC), and it is accompanied with high mortality and morbidity. However, early diagnosis of spontaneous bacterial peritonitis (SBP) is not possible because of the lack of typical symptoms or the low patient compliance and positivity rate of the ascites puncture test. We aimed to establish and validate a non-invasive diagnostic nomogram to identify SBP in patients with DC.MethodData were collected from 4,607 patients with DC from July 2015 to December 2019 in two tertiary hospitals in Chongqing, China (A and B). Patients with DC were divided into the SBP group (995 cases) and the non-SBP group (3,612 cases) depending on whether the patients had SBP during hospitalization. About 70% (2,685 cases) of patients in hospital A were randomly selected as the traindata, and the remaining 30% (1,152 cases) were used as the internal validation set. Patients in hospital B (770 cases) were used as the external validation set. The univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were used to screen variables, and logistic regression was used to determine independent predictors to construct a nomogram to identify patients with SBP. Area under curve (AUC), calibration curve, and dynamic component analysis (DCA) were carried out to determine the effectiveness of the nomogram.ResultThe nomogram was composed of seven variables, namely, mean red blood cell hemoglobin concentration (odds ratio [OR] = 1.010, 95% CI: 1.004–1.016), prothrombin time (OR = 1.038, 95% CI: 1.015–1.063), lymphocyte percentage (OR = 0.955, 95% CI: 0.943–0.967), prealbumin (OR = 0.990, 95% CI: 0.987–0.993), total bilirubin (OR = 1.003 95% CI: 1.002–1.004), abnormal C-reactive protein (CRP) level (OR = 1.395, 95% CI: 1.107–1.755), and abnormal procalcitonin levels (OR = 1.975 95% CI: 1.522–2.556). Good discrimination of the model was observed in the internal and external validation sets (AUC = 0.800 and 0.745, respectively). The calibration curve result indicated that the nomogram was well-calibrated. The DCA curve of the nomogram presented good clinical application ability.ConclusionThis study identified the independent risk factors of SBP in patients with DC and used them to construct a nomogram, which may provide clinical reference information for the diagnosis of SBP in patients with DC.

Retrospective Analysis of Hematological Phenotypes in Patients with Gene Mutation and Deletion α-Thalassemia

To explore the differences between hematological phenotypes of patients with different genotypes in gene mutations and deletion α- thalassemia. By screening the α- thalassemia gene test results in the First Affiliated Hospital, Sun Yat-Sen University from January 2015 to April 2020, the patients with mutation and deletion α- thalassemia were obtained, then the differences between hematological phenotypes of patients with different genotypes were analyzed. There were 96 patients with mutation combined with deletion α- thalassemia from the results of 24 054 α- thalassemia patients screened out, including 79 patients with non-deletion Hb H disease (αTα/--SEA) and 17 patients with mild α- thalassemia (αTα/-α), the incidence was 0.42%. Except the number of red blood cells (RBC) and mean corpuscular volume (MCV), the hemoglobin (Hb) concentration, hematocrit (Ht), average red blood cell hemoglobin concentration (MCHC), average red blood cell hemoglobin amount (MCH), average red blood cell volume (MCV) of the patients with αTα/--SEA genotype were significantly lower than those with αTα/-α genotype. The Hb of the patients with αCSα/--SEA and αQSα/--SEA genotype was (86±20)g/L and (84±9)g/L, respectirely, which was significantly lower than (114±16) g/L of αWSα/--SEA genotype (P<0.05); The MCHC of patients with αCSα/--SEA and αQSα/--SEA genotype was (278.8±8.5) g/L and (282.1±21.1)g/L, respectirely, which was also significantly lower than (315.4±19.5) g/L of αWSα/--SEA genotype (P<0.05); There was no significant difference between the patients with αCSα/--SEA and αQSα/--SEA genotype in hematological phenotypes. Except MCH and MCV, there was no significant differences between the patients with αWSα/--SEA and αTα/-α genotype in RBC, Hb, and Ht. The result of Hb A2 was (2.3±0.9)% for only 27 patients who performed electrophoretic analysis. There was no significant difference between the patients with αTα/--SEA and αTα/-α genotype in Hb A2, aslo among 3 types of the patients with αTα/--SEA genotype. The hematological phenotype changes caused by αWSα/--SEA genotype are similar to those of mild α- thalassemia, and both of them are significantly lighter than those patients with αCSα/--SEA and αQSα/--SEA genotype.

Preliminary Study on the Clinical and Genetic Characteristics of Hereditary Spherocytosis in 15 Chinese Children.

ObjectiveTo investigate the clinical and genetic characteristics of hereditary spherocythemia (HS) in Chinese children, and to analyze the potential genotypic/phenotypic associations.MethodsThe clinical data and gene test results of children with HS were collected. All patients were diagnosed by gene test results, and the laboratory results were obtained before splenectomy. The data of red blood cell (RBC), hemoglobin (HB), mean red blood cell volume (MCV), mean red blood cell hemoglobin (MCH), mean red blood cell hemoglobin concentration (MCHC), and hematocrit (HCT) were statistically analyzed according to different mutation genes. Statistical methods for comparison between groups Mann–Whitney test analysis, two-terminal p < 0.05 was considered significant difference.ResultsA total of 15 children were enrolled in our hospital, and 14 variants were found (nine variants have not been reported before), including 10 ANK1 mutations (seven ANK1 truncated mutations) and five SPTB mutations. Patients with ANK1 mutations had more severe anemia than those with SPTB mutations (significantly lower RBC, HB, MCHC, and HCT).ConclusionThis is one of the few studies on the genetic and clinical characteristics of children with HS in China. This study identified the unique genetic and clinical characteristics of Chinese children with HS and analyzed the pathogenic genotype–phenotypic association. The results confirmed that the anemia degree of HS patients caused by ANK1 was more serious than that of patients with SPTB deficiency. However, further study of the correlation between genotype and phenotype requires a larger sample size.

Evaluation of miR-21 and miR-150 expression in immune thrombocytopenic purpura pathogenesis: a case-control study

Immune thrombocytopenic purpura (ITP) is a common autoimmune disorder diagnosed with thrombocytopenia and bleeding symptoms due to production of autoantibodies (Abs) against platelets. Nowadays, microRNAs are known as novel biomarkers for diagnosis of diseases. The aim of this study was to investigate the expression levels of miR-21 and miR-150 in ITP patients and determine the role of these miRNAs in ITP pathogenesis. Thirty newly diagnosed patients with acute ITP and 30 healthy subjects( age and sex matched) as controls were enrolled in this study. The expression level of miR-21 and miR-150 was investigated using Real-time-PCR. Comparison of demographic characteristics of the cases was done using independent t-test and chi-square test. Comparison of the expression level of miR-21 and miR-150 with the related parameters was done using independent t-test or Mann–Whitney and Kruskal–Wallis test. Spearman rho correlation coefficient was used to investigate the relationship between the expression of miR-21 and miR-150 with demographic characteristics. The expression of miR-21, 150 in the patients was not different compared with the control group in general. A significant relationship between the expression of miR-21 with hemoglobin, hematocrit and red blood cell hemoglobin concentration was observed. Expression of miR-21 and miR-150 is not associated with pathogenesis of acute ITP and can involve the synergistic role of other miRNAs. Investigation of miR-21 and miR-150 expression along with other miRNAs and cytokines can be helpful in diagnosis and pathogenesis of ITP.

Combined assessment of serum folate and hemoglobin as biomarkers of brain amyloid β accumulation.

A relationship between Alzheimer's disease (AD) and folate has been reported. Amyloid positron emission tomography (PET) is currently one of the most reliable biomarkers for AD. We investigated the correlation between serum folate levels and amyloid imaging to clarify whether serum folate could be a biomarker for AD. We also examined the usefulness of a combined assessment of serum folate levels and red blood cell hemoglobin content. Apolipoprotein E (APOE) gene polymorphisms were also assessed. Serum folate levels and hemoglobin content were evaluated by receiver operating characteristic analysis for their diagnostic capability as AD biomarkers relating to brain amyloid β accumulation. The area under the ROC curve (AUC) for serum folate was 0.136 (95% confidence interval [CI]: 0.000–0.312; p = 0.016). The AUC for hemoglobin content was 0.848 (95% CI: 0.661–1.000; p = 0.021). Therefore, the folate deficiency with low folate levels or the non-anaemia with high hemoglobin content levels were found to have a high probability of also testing positive for amyloid. Furthermore, eight patients were found to be folate deficiency and non-anaemia, those who were consist of 7 amyloid positive patients (87.5%), and only one of the amyloid negative patients (12.5%). These results suggest that a deficiency of serum folate and high hemoglobin levels may reflect an increased risk of amyloid β accumulation in the brain. Additionally, we demonstrated that these biomarkers could enhance the effectiveness of APOE as an AD biomarker. This study reveals that the combined assessment of serum folate levels and red blood cell hemoglobin content may be a useful biomarker for amyloid β accumulation in the brain. We also found that the combination of serum folate levels and hemoglobin content is a more specific and sensitive blood biomarker for AD than APOE or folate alone. These findings may be used to support clinical diagnosis of AD using a simple blood test.

Mechanism of faster NO scavenging by older stored red blood cells

The blood storage lesion involves morphological and biochemical changes of red blood cells (RBCs) that occur during storage. These include conversion of the biconcave disc morphology to a spherical one, decreased mean corpuscular hemoglobin concentration, varied mean corpuscular volume, reduced integrity of the erythrocyte membrane with formation of microparticles, and increased cell-free hemoglobin. We studied the extent that older stored red blood cells scavenge nitric oxide (NO) faster than fresher stored red blood cells. Using electron paramagnetic resonance spectroscopy and stopped-flow absorption spectroscopy to measure the rate of NO uptake and reaction with hemoglobin in red cells, we found that older stored red blood cells scavenge NO about 1.8 times faster than fresher ones. Based on these experimental data, we simulated NO scavenging by fresher or older stored red blood cells with a biconcave or spherical geometry, respectively, in order to explore the mechanism of NO scavenging related to changes that occur during blood storage. We found that red blood cells with a spherical geometry scavenges NO about 2 times slower than ones with a biconcave geometry, and a smaller RBC hemoglobin concentration or volume increases NO scavenging by red blood cells. Our simulations demonstrate that even the most extreme possible changes in mean corpuscular hemoglobin concentration and mean corpuscular volume that favor increased NO scavenging are insufficient to account for what is observed experimentally. Therefore, RBC membrane permeability must increase during storage and we find that the permeability is likely to increase between 5 and 70 fold. Simulations using a two-dimensional blood vessel show that even a 5-fold increase in membrane permeability to NO can reduce NO bioavailability at the smooth muscle. BackgroundTransfusion of older stored blood may be harmful. ResultsOlder stored red blood cells scavenge nitric oxide more than fresher cells. ConclusionAs stored red blood cells age, structural and biochemical changes occur that lead to faster scavenging. SignificanceIncreased nitric oxide scavenging by red blood cells as a function of storage age contributes to deleterious effects upon transfusion.

Socio-Economic Status and Hemoglobin Concentration of Type 2 Diabetes Mellitus Patients Attending Diabetic Clinic in Benin City, Nigeria

The aim of this study is to determine the Socio Economic Status and Red Blood Cell Hemoglobin concentration alteration in type 2 Diabetes mellitus patients attending Diabetic Clinic in Benin City, Nigeria. The sample population consists of 142 subjects, 71 of patients were known in Type 2 Diabetes mellitus already on drugs and were confirmed to be Diabetic using Glucose oxidase method while the other 71 subjects were age matched apparently healthy control subject on routine check up, they were confirmed to be non Diabetic using the Glucose oxidase method. Hemoglobin concentrations were done using the Cyanmethemoglobin method. Those under the low income Socio-Economic status had the highest incidence of type 2 Diabetes mellitus (49%) of the Diabetic population, closely followed by the middle income Socio-Economic status (35%) of the Diabetic populations. The Mean ± S.D of Hemoglobin concentration of control subjects against Mean ± S.D of Hemoglobin concentration of the various Socio-Economic status of Males and Females type 2 Diabetes mellitus patient show a statistically significant decrease (P < 0.05). Type 2 Diabetes mellitus is associated with Anemia irrespective of Socio-Economic status. Prevention of the Global Diabetes epidemic must include regular national surveys, introduction of Diabetes health education in schools, emphasis on balance diet, regular exercise and abstention from tobacco smoking.

Effects of iron supplementation on red blood cell hemoglobin content in pregnancy.

Although a mild degree of anemia is common in the third trimester of pregnancy, it remains a challenge to establish whether a decrease in hemoglobin (Hb) concentration is physiological or pathological. The World Health Organization suggested a Hb concentration of 110 g/L to discriminate anemia. Several European investigators recommended Hb cut-off values of between 101–110 g/L. The aim of this study was to establish short-term effects of iron supplementation on the hemoglobin content of reticulocytes (Ret-He) and red blood cells (RBC-He) in case of suspected iron deficient erythropoiesis (IDE) in the third trimester of pregnancy. Twenty-five subjects with suspected IDE during pregnancy (Hb ≤110g/L, Ret-He <29.6 pg, zinc protoporphyrin >75 mol/mol hem) participated in the study. After iron supplementation, reticulocyte counts increased from 0.061±0.015×1012/L to 0.079±0.026×1012/L and Ret-He increased from 23.6±2.8 pg to 28.3±2.6 pg (P=<0.001). RBC-He increased from 26.9±1.9 pg to 27.4±1.8 pg (not significant, NS) and Ret-He/RBC-He ratio increased from 0.97±0.06 towards 1.07±0.05 (P=<0.001). Hb concentrations demonstrated an obvious increase from 105±6 g/L towards 115±5 g/L (P≤0.001) after supplementation. An obvious increase in RBC distribution width was observed from 45.0±3.6 fL towards 52.3±7.0 fL (P≤0.001). We recommend that Ret-He and Ret-He/RBC-He ratio be integrated into the protocols for anemia screening and for monitoring effects of iron supplementation during pregnancy. In particular, the parameters should be considered in subjects with Hb results in the controversial range of 101–108 g/L.

Reply to the letter to the editor submitted by Burkhardt et al.

In response to the letter of Burkhardt et al. (1), we concur with the authors of the letter that multi-angle light scatter can be used to establish the size and hemoglobin concentration of red blood cells (RBCs) that are isovolumetrically sphered in an appropriately formulated isotonic reagent (normal discoidal RBCs are sphered in such reagent). It is also clearly evident that knowledge of the cell size and hemoglobin content of RBCs is valuable in pointing towards RBC abnormalities. The key novelties illustrated by our work is the observations that in a carefully selected three dimensional (3D) space, the scatter signals from the 3 angular intervals of RBCs which were not sphered in the reagent did not fall close to the pre-calibrated grid of the 3D surface conserved to sphered RBCs. The abbreviation which was specifically used to refer to abnormally-shaped RBCs was AbnRBC as defined in the article Abstract on page 43. The term “AbnRBC” was not intended to refer to RBC abnormalities for cell size or hemoglobin concentration, as pointed out again on page 51 under Table 5 (note a) of our article. Thus, it was with specific reference to RBCs which were not sphered in both RBC reagents that we made our observations. In their letter, Burkhardt et al. (1) also suggest that our paper implies a discrete separation of sphered and non-sphered RBCs by the 3D method. This was not our intention and on review of our manuscript, it is difficult to understand why the authors of the letter feel that this is implied. In a situation analogous to cell volume and cell hemoglobin concentration, abnormalities in cellular shape are commonly a continuum of spectrum of magnitude rather than being compartmentalized populations. We have on hand, numerous instances in which samples containing AbnRBCs show cytometric events falling more distant from the calibrated 3D surface than is the case in normal bloods. In Figure 3 of our article, we show an example of a normal sample and a sample containing AbnRBCs. As clearly shown in Fig 3d, it was never suggested that AbnRBCs form a discrete cluster. For the proposed method to be of value, boundaries of abnormality have to be established which give reference ranges for normal RBCs. Six samples in Table 5 of our article contained AbnRBCs as shown and the results analyzed by the closest point finding software of the 3D method was compared to the blood smear results. Fairly good correlation was obtained between the two methods. Concerning schistocytes, at the time of writing the article, we were unaware of any 510(k) cleared reportable parameters pertaining to schistocyte counting derived from any of the Bayer systems. If the situation has been changed since and Bayer hematology instruments now can count and report schistocytes, thank you for informing us. On the last comment in the Letter, the authors refer to the CHr parameter as a “Gold Standard” for iron-deficiency state. To assert that the CHr is the gold standard, implying it being a reference method, is not only not supported in the literature, but is not indicated as such by any publication we can find by a recognized international laboratory standards group, such as ICSH or NCCLS. Therefore, we said that we planned to investigate this area further because the diagnostic threshold for iron deficiency seems to vary with the patient population (2, 3) and may not be reliable in individuals with elevated red cell MCV values (4) (Blood). The finding of alterations in the CHr in healthy individuals following extreme exercise also raises questions as to the specificity of the measurement (5). Perhaps, the claim of red cell parameters serving as a gold standard will require the combination of several measurements, such as both the CHr and the reticulocyte IRF (RNA content) (6). The term, anemia of chronic diseases, was used in our article to describe a broad spectrum of anemias associated with chronic disease state.

In reply:

In reply:

Red Blood Cells: Centerpiece in the Evolution of the Vertebrate Circulatory System

All vertebrates except cold-water ice fish transport oxygen via hemo-globin packaged in red blood cells (RBCs). Vertebrate RBCs vary in size by thirty-fold. Differences in RBC size have been known for over a century, but the func-tional significance of RBC size remains unknown. One hypothesis is that largeRBCs are a primitive character. Agnathans have larger RBCs than do mammals.However, the largest RBCs are found in urodele amphibians which is inconsistentwith the hypothesis that large RBCs are primitive. Another possibility is that smallRBCs increase blood oxygen transport capacity. Blood hemoglobin concentration([Hb]) and mean RBC hemoglobin concentration (MCHC) increase from Agnathato birds and mammals. However, the changes in [Hb] and MCHC do not parallelchanges in RBC size. In addition, RBC size does not affect blood viscosity. Thus,there is no clear link between RBC size and oxygen transport capacity. We hy-pothesize that RBC size attends changes in capillary diameter. This hypothesis isbased on the following observations. First, RBC width averages 25% larger thancapillary diameter which insures cell deformation during capillary flow. Function-ally, RBC deformation minimizes diffusion limitations to gas exchange. Second,smaller capillaries are associated with increased potential for diffusive gas ex-change. However, smaller capillaries result in higher resistances to blood flowwhich requires higher blood pressures. We propose that the large capillary di-ameters and large RBCs in urodeles reflect the evolutionary development of apulmonary vascular supply. The large capillaries reduced systemic vascular resis-tances enabling a single ventricular heart to supply blood to two vascular circuits,systemic and pulmonary, without developing high pressures on the pulmonary side.The large RBCs preserved diffusive gas exchange efficiency in the large capillaries.

Perioperative Epoetin Alfa Increases Red Blood Cell Mass and Reduces Exposure to Transfusions: Results of Randomized Clinical Trials

To avoid the inherent risk of complications associated with perioperative allogeneic transfusion, preoperative autologous blood donation (PAD) is frequently employed by patients undergoing major elective surgical procedures. However, many patients are unable to donate a sufficient quantity of blood prior to surgery. Recent studies have shown that epoetin alfa (Procrit; Ortho-Biotech, Raritan, NJ) effectively increases red blood cell (RBC) mass when administered preoperatively and decreases the requirement for allogeneic transfusion. These studies also demonstrated that patients with baseline hemoglobin levels ranging from 10 to 13 g/dL have the highest risk for requiring allogeneic transfusions and appear to achieve the greatest benefit from epoetin alfa treatment. We evaluated several dosing regimens and schedules for perioperative epoetin alfa administration. In our initial study, the comparative efficacy of three different epoetin alfa regimens was assessed by hemoglobin concentration, hematocrit, and absolute reticulocyte counts. In addition, we analyzed the effect of accelerated erythropoiesis on iron indices and individual RBC hemoglobin content. Our study demonstrated that epoetin alfa is safe and effective in increasing RBC mass; however, iron stores considered sufficient for basal erythropoiesis may not optimally support the accelerated RBC production associated with epoetin alfa therapy. In a subsequent randomized multicenter trial, we compared weekly epoetin alfa dosing to daily dosing in patients undergoing elective major orthopedic surgery. The results of this study indicated that administering epoetin alfa on a weekly schedule for several weeks prior to surgery may be at least as effective and more convenient than perioperative daily epoetin alfa dosing.

Helicobacter pylori infection does not affect red blood cell characteristics in Danish adults

Recent studies have suggested a relationship between iron deficiency anemia and Helicobacter pylori (H. pylori) infection. Furthermore, we have previously reported an association between 11. pylori infection and reduced serum ferritin values; a marker for total body iron. Purpose: to examine whether H. pylori infection affects red blood cell (RBC) characteristics in humans. Methods: In 1994, 2407 Danish adults with no history of peptic ulcer disease, attended a follow-up examination as part of a prospective cohort study initiated in October 1982. A total of 275 blood donors were excluded from the study group. H. pylori infection status was assessed with a validated IgG ELISA. Red blood eel! count (RBCC), red blood cell volume (hematocrit-RBCV), mean RBC haemoglobin concentration (MCHC), mean RBC volume (MCV), and mean RBC haemoglobin (MCli) were assessed. Information on socio-demographic factors and medical history was ascertained from a questionnaire. Results: The table shows median and interquartile values of RBCC, RBCV, MCIIC, MCV, MCH, by sex and H. pylori infection status in 1994.

Enhancement of erythrocyte superoxide dismutase activity: effects on cellular oxidant defense

To delineate further the role of superoxide dismutase (SOD) in red blood cell (RBC) oxidant defense, normal human erythrocytes were osmotically lysed and resealed in the presence of varying concentrations of exogenous SOD. This resulted in a dose-dependent increase in SOD activity in the resealed erythrocytes while maintaining nearly normal RBC hemoglobin concentration (less than 10% decrease from the control value), cell volume, and cellular deformability. Surprisingly, a five- or ninefold increase in SOD activity yielded no additional protection against superoxide-generating drugs (phenazine methosulfate or menadione sodium bisulfite). No significant differences were observed between the control and SOD-loaded RBCs in O2-driven methemoglobin formation or generation of thiobarbituric acid-reactive substances. In contrast, RBCs with elevated SOD activity pretreated with sodium azide (to block catalase activity) or 1-chloro-2,4- dinitrobenzene (to deplete reduced glutathione, GSH) showed significantly enhanced methemoglobin generation in response to superoxide generating drugs. No differential response was noted between the control, control-resealed, and SOD-loaded RBCs to oxidants other than superoxide. Based on our results and other data, we conclude that elevated SOD activity may imbalance cellular oxidant defense, resulting in enhanced oxidation due to the accelerated generation of H2O2, the product of O2- dismutation. This effect is significantly exacerbated under conditions in which H2O2 catabolism is altered.