Rheological Properties Of Erythrocytes Research Articles

Hypoxic exercise training causes erythrocyte senescence and rheological dysfunction by depressed Gardos channel activity

Despite enhancing cardiopulmonary and muscular fitness, the effect of hypoxic exercise training (HE) on hemorheological regulation remains unclear. This study investigates how HE modulates erythrocyte rheological properties and further explores the underlying mechanisms in the hemorheological alterations. Twenty-four sedentary males were randomly divided into hypoxic (HE; n = 12) and normoxic (NE; n = 12) exercise training groups. The subjects were trained on 60% of maximum work rate under 15% (HE) or 21% (NE) O(2) condition for 30 min daily, 5 days weekly for 5 wk. The results demonstrated that HE 1) downregulated CD47 and CD147 expressions on erythrocytes, 2) decreased actin and spectrin contents in erythrocytes, 3) reduced erythrocyte deformability under shear flow, and 4) diminished erythrocyte volume changed by hypotonic stress. Treatment of erythrocytes with H(2)O(2) that mimicked in vivo prooxidative status resulted in the cell shrinkage, rigidity, and phosphatidylserine exposure, whereas HE enhanced the eryptotic responses to H(2)O(2). However, HE decreased the degrees of clotrimazole to blunt ionomycin-induced shrinkage, rigidity, and cytoskeleton breakdown of erythrocytes, referred to as Gardos effects. Reduced erythrocyte deformability by H(2)O(2) was inversely related to the erythrocyte Gardos effect on the rheological function. Conversely, NE intervention did not significantly change resting and exercise erythrocyte rheological properties. Therefore, we conclude that HE rather than NE reduces erythrocyte deformability and volume regulation, accompanied by an increase in the eryptotic response to oxidative stress. Simultaneously, this intervention depresses Gardos channel-modulated erythrocyte rheological functions. Results of this study provide further insight into erythrocyte senescence induced by HE.

Activation of N-methyl D-aspartate (NMDA) receptors has no influence on rheological properties of erythrocytes

Red blood cells (RBCs) express N-methyl D-aspartate (NMDA) receptors on their surface. We tested if NMDA receptor activation or inhibition had an influence on RBC deformability and aggregability. Heparinized blood was drawn from healthy volunteers and centrifuged. RBCs were washed twice and resuspended with a hematocrit of 30% in a same buffer solution containing 3% dextran 70. Aliquots were prepared: a) control; b) containing 100 μM homocysteic acid (NMDA receptor agonist); c) 100 μM memantine (NMDA receptor inhibitor) and 100 μM homocysteic acid. RBC suspension viscometry (Contraves LS-30) was done at 37 °C with shear rates of 37.6 s(-1) and 0.1 s(-1). RBC aggregability was assessed with a Myrenne aggrometer and sedimentation rate. Neither NMDA receptor activation nor inhibition had an influence on biophysical properties of RBCs. RBC suspension viscosity at a shear rate of 37.6 s(-1) was 3.62 ± 0.16, 3.61 ± 0.13, and 3.62 ± 0.16 mPa.s for control, homocysteic acid, and memantine + homocysteic acid, respectively, indicating an unchanged RBC deformability. The RBC aggregability parameters (low shear viscosity, Myrenne aggregometry at stasis (M) and 3 s(-1) (M1), and the sedimentation rate) showed no influence of either memantine and/or homocysteic acid. A large interindividual variability in RBC aggregability was observed. A good correlation was found between M, M1 and sedimentation values, but not with low shear viscosity values. An activation or inhibition of NMDA receptors on RBCs has no influence on their deformability and aggregability. RBC aggregability varies largely among individuals, which was consistently detected by the sedimentation rate and the Myrenne aggregometer, but not by low shear viscosity, which should not be used for this purpose.

Effects of swimming on erythrocyte rheological properties

Exercise and lactate usually change blood rheology but, effect of swimming on blood rheology is not clear. Blood lactate concentration increases after 400-meter freestyle swimming. In the hemorheological studies, determination of the erythrocyte deformability and aggregation facilitates the evaluation of rheological behaviours of the erythrocytes. The present study was performed to investigate the effects of acute swimming exercise on erythrocyte deformability and aggregation. Seventeen male university swimmers participated in the study. For 400-meter freestyle swimming, participants were asked to swim as fast as they could. Blood lactate concentration, erythrocyte lipid peroxidation and plasma protein oxidation levels, erythrocyte deformability and aggregation, and several haematological parameters were investigated after swimming and they were compared with pre-exercise values. Erythrocyte lipid peroxidation and plasma protein oxidation were unchanged with swimming. Blood lactate concentration increased after 400-meter swimming (p<0.001). Erythrocyte aggregation increased after acute swimming (p<0.01) while erythrocyte deformability was not change. There were no correlations between blood lactate and erythrocyte hemorheological properties before and after swimming. In conclusion, we found that erythrocyte aggregation increased after acute swimming. Further studies are needed to reveal the late effects of acute swimming and to elucidate the effect of swimming different distances on erythrocyte rheological properties.

Blood rheological profiles in patients with chronic urticaria

Psychological factors, such as stress, anxiety, depression, as well as immuno-inflammatory processes may influence blood rheology. On the other hand, these factors may be involved in triggering, aggravating or maintenance of urticaria symptoms. The present study was designed to compare blood rheological properties of patients with chronic urticaria with positive response to autologous serum skin test (ASST) and negative response to ASST. The study comprised 15 female patients with chronic urticaria showing positive response to ASST, 14 female patients with chronic urticaria showing negative response to ASST and 15 healthy subjects. Rheological properties of erythrocytes, such as deformability and aggregation, were measured. Overall blood viscosity measurements were performed with the use of cone-plate Brookfield's viscometer, and plasma viscosity measurement employed capillary Ubbelohd's viscometer. The hemorheological parameters did not differ significantly between the groups. It seems that blood rheological properties do not alter in patients with chronic urticaria, irrespective of their response to ASST.

In vitro and ex vivo effect of hyaluronic acid on erythrocyte flow properties

BackgroundHyaluronic acid (HA) is present in many tissues; its presence in serum may be related to certain inflammatory conditions, tissue damage, sepsis, liver malfunction and some malignancies. In the present work, our goal was to investigate the significance of hyaluronic acid effect on erythrocyte flow properties. Therefore we performed in vitro experiments incubating red blood cells (RBCs) with several HA concentrations. Afterwards, in order to corroborate the pathophysiological significance of the results obtained, we replicated the in vitro experiment with ex vivo RBCs from diagnosed rheumatoid arthritis (RA) patients, a serum HA-increasing pathology.MethodsErythrocyte deformability (by filtration through nucleopore membranes) and erythrocyte aggregability (EA) were tested on blood from healthy donors additioned with purified HA. EA was measured by transmitted light and analyzed with a mathematical model yielding two parameters, the aggregation rate and the size of the aggregates. Conformational changes of cytoskeleton proteins were estimated by electron paramagnetic resonance spectroscopy (EPR).ResultsIn vitro, erythrocytes treated with HA showed increased rigidity index (RI) and reduced aggregability, situation strongly related to the rigidization of the membrane cytoskeleton triggered by HA, as shown by EPR results. Also, a significant correlation (r: 0.77, p < 0.00001) was found between RI and serum HA in RA patients.ConclusionsOur results lead us to postulate the hypothesis that HA interacts with the erythrocyte surface leading to modifications in erythrocyte rheological and flow properties, both ex vivo and in vitro.

Evolution of rheological properties of erythrocytes and left ventricular geometry in cardiovascular disease risk patients

The evolution of rheological properties of erythrocytes and geometrical parameters of left ventricle during therapies aimed at reducing cardiovascular disease (CVD) risk has been investigated. The study group consisted of 29 individuals who were diagnosed with the presence of at least one CVD risk factor at the time of entry to the study. Appropriate therapies were applied and the patients were followed for two years. Two groups of patients could be distinguished. The first group consisted of 12 individuals who were rigorously applying the therapy and for whom blood pressure, total cholesterol, LDL and glucose returned to normal levels. The second group included 17 patients for whom the above mentioned parameters remained pathological in spite of the applied therapy. In the first group, erythrocyte deformability as well as LVMI improved: deformability increased on average by 17% (p < 0.025), whereas LVMI decreased by 8% but not in a statistically significant manner (p < 0.27). In the second group, the results indicate worsening of both hemorheological properties and left ventricular geometry: RBC deformability became lower by 15% (p < 0.00001) and LVMI increased by 18% although this change was not statistically significant (p < 0.19). The results indicate that blood rheology improves when the CVD risk is reduced by administered therapy and worsens when the risk increases. Similar behavior shows LVMI. It is very likely that left ventricular geometry is influenced by blood rheology.

Changes of gas exchange parameters and of functional-biochemical properties of erythrocytes in dynamics of experimental anemia in rats

In experiments on Wistar male rats, on a specially constructed computer installation, O2 consumption by the animals in comparison with changes of hematological, biochemical, and rheological blood properties is studied after anemization--acute bloodletting (12-15% of the total blood mass). An increase of the O2 consumption by the organism and tissues by 18-28% has been revealed for the first 7 days after the bloodletting, in spite of a pronounced decrease of hematocrit, and of the amount of erythrocytes and hemoglobin in peripheral blood by 20-25% of the initial level. There was a 5-10-fold increase of the content of immature erythrocyte forms--reticulocytes and a progressive rise of cell acidic resistance, which is characteristic of young erythrocyte forms. An increase of O2 consumption at a decrease of the blood oxygen capacity (a low hemoglobin level) seems to be due to the more efficient transport and yield of O2 to tissues. At the 3rd 7th day after the bloodletting, activity of Na,K-ATPase has been shown to increase by 60% and 20%, respectively. Analysis of the erythrocyte rheological properties has shown that the maximal firmness of aggregates (Uq) and the aggregation rate (1/T) decrease progressively beginning from 3 days after the bloodletting; index of deformability (I(max)) turned out to be elevated by 7-11%, probably due to an increase of the cell membrane elasticity. The conclusion is made that changes of erythrocyte rheological properties are interconnected with changes of the Na,K-ATPase activity and are directed to optimization of blood circulation in large vessels and the capillary network.

Left ventricular geometry and rheological properties of erythrocytes in patients at cardiovascular disease risk

The relationship between erythrocyte deformability and aggregability with left ventricular mass index has been examined in patients diagnosed with at least one cardiovascular risk factor but without ongoing coronary heart disease. The group consisted of 66 individuals, 30 men and 36 women, of the average age 57.7 years. For each patient, deformability and aggregability of red blood cells (RBCs) as well as end-diastolic left ventricle diameter (LVD), interventricular septum thickness (IVST) and posterior wall thickness (PWT) were measured. On the basis of the echocardiographical parameters and anthropometric data, left ventricular mass index (LVMI) was calculated. The analysis revealed statistically significant correlation between the LVMI and erythrocyte deformability and aggregability: the LVMI increases with decreasing deformability and is higher in patients with higher aggregability. This finding indicates that the worsening of RBC rheological properties is one of the main factors contributing to alterations of cardiac geometry through the increase of peripheral resistance which, in turn, significantly augments the heart afterload. Given that left ventricular hypertrophy (LVH) is a predictor of cardiovascular morbidity and mortality, the association between hemorheological parameters and left ventricular geometry may be important in clinical practice.

Determination of RBC membrane and serum lipid composition in Trinidadian type II diabetics with and without nephropathy.

The rheological properties of erythrocytes are impaired in diabetes mellitus, especially because of changes in their membrane lipid composition.The aim of this study was to determine and examine the relationship between red blood cell (RBC) membrane and serum lipid composition in type II diabetes subjects with and without nephropathy. Trinidadian subjects aged 18-65 years were recruited for the study regardless of gender and ethnicity. Fasting blood samples were collected from 60 subjects of whom 20 were healthy individuals, 20 had type II diabetes without complications, and 20 were type II diabetics with nephropathy. Weight, height, waist/hip ratio, and blood pressure were recorded. All the blood samples were analysed to determine the serum lipid concentration, membrane lipid composition and plasma glucose concentration. The body mass index and the systolic blood pressure of the diabetics (28.17 +/- 4.98 kg/m2, 153.21 +/- 22.10 mmHg) and those with nephropathy (25.87 +/- 4.68, 158.60 +/- 22.49 mmHg) were higher when compared with controls (24.67 +/- 5.18, 119.15 +/- 13.03 mmHg). The diabetic (175.89 +/- 102.73 microg/mgprotein) and diabetic nephropathy (358.80 +/- 262.66) subjects showed significantly higher levels of RBC membrane cholesterol compared with controls (132.27 +/- 66.47). The membrane phospholipids, protein and Na+/K+ATPase concentrations were altered in diabetics and diabetic nephropathy patients when compared with controls. The trends of increased serum cholesterol and decreased high-density lipoprotein in diabetics and diabetic nephropathy patients were noted as compared with controls but they are not significant as expected. The low-density lipoprotein cholesterol was significantly higher in diabetics when compared with diabetic nephropathy and control subjects. Our data suggest that there is a relationship between RBC membrane and serum lipid composition in subjects with type II diabetes with and without nephropathy. This relationship shows that diet and lifestyle plays a significant role in the alterations of the lipids both in serum and RBC membrane. The membrane and serum lipid composition may be used as possible indicators for type II diabetic patients with and without nephropathy to control their diet in the beginning stages to prevent them from further complications.

Rheological properties of erythrocytes in patients with high risk of cardiovascular disease

Rheological properties of erythrocytes from patients with high risk of cardiovascular disease (CVD) were analyzed in relation to individual patient risk factors as well as to the medication. Additionally, comparative statistical analysis was performed considering plasma concentration of the selected mediators of vascular endothelium: 6-keto-prostaglandin F(1alpha) (PGF(1alpha)), sVCAM-1 and E-selectin adhesion molecules and interleukin-6 (IL-6). It was found that antihypertensive therapy with angiotensin-converting enzyme inhibitor (ACEI) is accompanied by improvement of RBC rheology: the increase of deformability and the decrease of aggregability. This improvement is probably mediated by endothelial prostacyclin and nitric oxide which are generated by ACEI. A correlation was observed between RBC deformability/aggregability and the patient's hematocrit level, what implicates that the hematocrit level should be explicitly taken into consideration when investigating rheological properties of erythrocytes. A strong relationship was also found between the plasma concentration of sVCAM-1 and patient's age.

Protective effect of ginsenosides Rg2 and Rh1 on oxidation-induced impairment of erythrocyte membrane properties

The extract from Panax ginseng has been reported to improve the microcirculation in various organs. However, the mechanisms underlying this phenomenon are still poorly understood. In the present study, using the rheological properties of erythrocytes as an index, we have screened the components of Panax ginseng extract and identified Rg(2) and Rh(1) as the active ingredients. These two ginsenosides prevented the oxidative stress-induced elevation of erythrocyte suspension viscosity and the impairment of erythrocyte elongation in response to shear stress. Rg(2) and Rh(1) ginsenosides did not have antioxidant activity in an aqueous phase and did not inhibit the peroxidation of membrane lipids, either. However, they inhibited the oxidation-induced decrease of SH-groups in band 3 (anion exchanger-1), one of the important structural proteins of the erythrocyte membrane, but not in other structural proteins: bands 1 and 2 (spectrins), band 4.2 or band 5 (actin). These results suggest that ginsenosides Rg(2) and Rh(1) protect the rheological functions of erythrocytes against oxidative stress by preventing the oxidation of SH-groups in band 3 protein.

Modulation of hemorheological parameters by the erythrocyte redox thiol status

There is growing knowledge about the association between hemorheological blood disorders and compromised microcirculation in erythrocyte abnormalities. Effects of the non-neuronal cholinergic elements, especially acetylcholinesterase, on the erythrocyte hemorheological parameters were characterized in the past. However, alterations of these parameters have not been studied under the influence of the cellular redox thiol status. Aliquots of venous blood from ten healthy male subjects were incubated in vitro with increasing concentrations of a thiol reducer agent (dithiothreitol 1, 10, 50 microM final concentrations) in the presence and absence of acetylcholinesterase substrate (acetylcholine) or inhibitor (velnacrine maleate). The following parameters were determined in all blood samples aliquots: erythrocyte aggregation, erythrocyte deformability and lipid membrane fluidity. Blood smears were performed. Dithiothreitol induces no significant changes on the hemorheological behaviour of human red cells. Upon intracellular thiol stimulation, the presence of AChE effectors (either acetylcholine or velnacrine) decreases erythrocyte aggregation and elongation indexes. The addition of DTT to blood samples aliquots, contributing to the redox thiol status, is not directly involved in the modulation of erythrocyte rheological properties. However, upon acetylcholinesterase modulation by its substrate or inhibitor, changes on the hemorheological parameters are triggered by DTT. Associated pharmacological interest is considerable to address the hemorheology-hemostasis-microcirculation triad disorders.

Changes of physiological and biochemical characteristics of rat erythrocytes after blood loss

In experiments of Wistar male rats, changes are studied of erythrocyte hematological, biochemical (activitities of transport ATPases), and rheological properties (capability for aggregation and deformability) 7 days after bloodletting of 12-15 % of the total blood mass. It has been shown that alongside with an elevation of erythrocyte volume and of the number of immature cells - reticulocytes, there was a statistically significant increase of Na,K-ATPase and Ca-ATPase activities in the whole erythrocytes and their membrane preparations - ghosts, the increment of activity in the case of Na,K-ATPase being essentially higher in the whole cells. This indicates the appearance of an enzyme activator inside the erythrocytes. There are also revealed a decrease of firmness of erythrocyte aggregates, a deceleration of spontaneous aggregation, and an increase of index of erythrocyte deformability. The conclusion is made that changes of erythrocyte rheological properties are interconnected with changes of the Na,K-ATPase activity and are directed to optimization of blood circulation in large vessels and capillary network.

Effects of Triphasic Exercise on Blood Rheology and Pathophysiology

The aim of this work is to study the relevance of physiology and pathophysiology in blood rheology as effects of triphasic exercise. Regular exercise which has been established as life prolonging has led to decrease in both peripheral vascular and coronary morbidity that has been associated with certain improvements in cardiovascular disease (VCD) risk factors. Haemorheology is affected by exercise, which has a possible connection between beneficial haemodynamics and metabolism. This is affected by exercise of any type. A possible link between the beneficial metabolic and haemodynamic effects of exercise could be blood rheology, which is markedly affected by exercise. It was proposed here a description of the haemorheological effects of exercise as a triphasic phenomenon. Short-term effects of exercise are an increase in blood viscosity resulting from both fluid shifts and alterations of erythrocyte rheological properties (rigidity and aggregability). Increased blood lactate, stress and acute phase play a role in this process. Middle-term effects of regular exercise are a reversal of these acute effects with an increase in blood fluidity, explained by plasma volume expansion (autohaemodilution) that lowers both plasma viscosity and haematocrit. Long term effects further improve blood fluidity in parallel with the classical training-induced hormonal and metabolic alterations. While body composition, blood lipid pattern, and fibrinogen improve (thus decreasing plasma viscosity), erythrocyte metabolic and rheologic properties are modified, with a reduction in aggregability and rigidity. On the whole, these improvements reflect on reversal of the so-called “insulin-resistance syndrome” induced by a sedentary life-style. Since impaired blood rheology has been demonstrated to be a risk for vascular diseases, the haemorheologic effects of exercise can be hypothesized to be a mechanism (or at least a marker) of risk reversal. The latter point requires further investigation. The physiological meaning of the triphasic pattern of exercise-fluidity may improve several steps of oxygen transfer to the muscle, as clearly demonstrated in hypoxic conditions. Increasing evidence emerges from the literature, that blood fluidity is a physiological determinant of fitness. Keywords: Triphasic exercise, blood rheology, aggregation, physiology. Journal of Medical Laboratory Sciences Vol. 14 (2) 2005: pp. 13-22

The rheologic properties of erythrocytes: a study using an automated rheoscope

Red blood cells (RBCs) suspended in a high-viscosity medium were filmed while flowing through a microchannel using an automated rheoscope. Under these conditions, erythrocytes take different orientations and undergo varying deformation according to their location in the velocity profile. Measurements of the mean deformation at several distances from the center of the microchannel at a constant flow rate were acquired for normal and thalassemia erythrocytes. The measurements demonstrate how diagnosis can be made based on a single flow rate in contrast to conventional methods where shear is mechanically controlled. The spatial distribution and velocity of RBCs and rigid microspheres (1 μm) were measured. The maximum slip velocity was found to be linearly correlated to the flow rate for both cells and microspheres. RBCs showed enhanced inward lateral migration compared to the rigid spheres, which is attributed to RBC deformation. The results demonstrate the coupling between RBC mechanical properties and their motion in microvessels.

Red Blood Cell Aggregation and Deformability among Patients Qualified for Bariatric Surgery

The study presents red blood cell (RBC) aggregability and deformability among obese patients qualified for bariatric surgery and its correlation with plasma lipid concentration. We studied 40 morbidly obese patients who were qualified for bariatric surgery: mean age was 43.5 +/- 11.3 years, and mean body mass index (BMI) was 48.9 +/- 7.7 kg/m2. The RBC deformability and aggregation parameters: aggregation index (AI), syllectogram amplitude (AMP) and aggregation half-time (t1/2) were measured by Laser-assisted Optical Rotational Cell Analyser - LORCA. Elongation index of RBC was significantly lower in obese patients than in the control group (P<0.001) in 3.16-60.03 Pa shear stresses. Correlations between elongation index and triglyceride levels ranged between 0.42 to 0.44 (P<0.05). AI was significantly higher in the obese patients (P<0.001), t1/2 and the AMP were decreased (P<0.001) compared to the control group. The RBC aggregation index correlated positively with total cholesterol level (r = 0.61, P<0.05), non-HDL cholesterol level (r = 0.54, P<0.05) and BMI (r = 0.48, P<0.05). Negative correlation presented t1/2 with total cholesterol (r = -0.64, P<0.05), non-HDL cholesterol (r = - 0.51, P<0.05) and BMI (r= -0.59, P<0.05). Obesity is associated with RBC rheological disturbances expressed by a decrease in RBC deformability, increased total aggregation extent and the alteration of kinetics of RBC aggregation. These results may suggest the necessity of introducing treatment forms to correct erythrocyte rheological properties, which may improve the blood-flow condition in the microcirculation and prevent postoperative complications after bariatric surgery.

Effect of Adsorbed Proteins on the Rheological Properties of Erythrocytes

Impedance spectroscopy in the radio-frequency band was used to probe the adsorptive properties of red blood cells. Fluidity assays of concentrated erythrocyte suspensions revealed a close relationship between the protein adsorption on erythrocyte membranes and the extent of cell interaction in the flow. Patients with impaired peripheral circulation displayed an increase in adsorption of high-molecular-weight proteins and a dramatic decrease in fluidity of erythrocyte suspensions. Hence, adsorption was assumed to contribute to rheological disorders.

Micro-simulation of Blood Flow

We have developed a microscopic blood model, that can express the deformation of an erythrocyte in micro-circulation, based on the Smoothed Particle Hydrodynamics (SPH) method. In the method, plasma fluid is discretized by SPH particles and an erythrocyte is modeled by internal SPH particles wrapped in elastic membrane particles. For verifying the model, in two dimensions, we numerically analyzed a popular phenomenon of erythrocyte; the tank tread motion of an erythrocyte under a constant shear field. The numerical results agreed well with the experimental data and the tank tread motion of erythrocyte was well realized by the model. From these results, it is confirmed that our blood model based on the SPH method can well express microscopic and rheological properties of erythrocytes.

Effects of C-peptide on microvascular blood flow and blood hemorheology.

Beside functional and structural changes in vascular biology, alterations in the rheologic properties of blood cells mainly determines to an impaired microvascular blood flow in patients suffering from diabetes mellitus. Recent investigations provide increasing evidence that impaired C-peptide secretion in type 1 diabetic patients might contribute to the development of microvascular complications. C-peptide has been shown to stimulate endothelial NO secretion by activation of the Ca2+ calmodolin regulated enzyme eNOS. NO himself has the potency to increase cGMP levels in smooth muscle cells and to activate Na+ K+ ATPase activity and therefore evolves numerous effects in microvascular regulation. In type 1 diabetic patients, supplementation of C-peptide was shown to improve endothelium dependent vasodilatation in an NO-dependent pathway in different vascular compartments. In addition, it could be shown that C-peptide administration in type 1 diabetic patients, results in a redistribution of skin blood flow by increasing nutritive capillary blood flow in favour to subpapillary blood flow. Impaired Na+ K+ ATPase in another feature of diabetes mellitus in many cell types and is believed to be a pivotal regulator of various cell functions. C-peptide supplementation has been shown to restore Na+ K+ATPase activity in different cell types during in vitro and in vivo investigations. In type 1 diabetic patients, C-peptide supplementation was shown to increase erythrocyte Na+ K+ATPase activity by about 100%. There was found a linear relationship between plasma C-peptide levels and erythrocyte Na+ K+ATPase activity. In small capillaries, microvascular blood flow is increasingly determined by the rheologic properties of erythrocytes. Using laser-diffractoscopie a huge improvement in erythrocyte deformability could be observed after C-peptide administration in erythrocytes of type 1 diabetic patients. Inhibition of the Na+ K+ATPase by Obain completely abolished the effect of C-peptide on erythrocyte deformability. In conclusion, C-peptide improves microvascular function and blood flow in type 1 diabetic patients by interfering with vascular and rheological components of microvascular blood flow.

Erratum to Influence of adsorbed plasma proteins on erythrocyte rheological properties: in vitro and ex vivo studies

Erratum to Influence of adsorbed plasma proteins on erythrocyte rheological properties: in vitro and ex vivo studies