title: Is the blood donated by habitual nut quid chewers suitable for use in transfusion?
abstract: OBJECTIVE
  Betel quid (BQ) chewing is a popular oral masticatory activity, and there are approximately 600 million BQ chewers worldwide. Although chewing BQ has been linked to the patho-genesis of oral cancer, leukoplakia, and oral submucous fibrosis. The question whether the mixed constituents present in areca nut, which may exert cytotoxic effects on red blood cells (RBCs), has never been addressed.
  
  
  METHODS
  Heparinized blood specimens were obtained with informed consent from healthy laboratory personnel. RBCs were separated with the standard procedure and adjusted to 10% hematocrit with PBS. Various concentrations of areca nut extract (ANE; 100-800 microg/mL) were added to these RBC preparations and incubated at 37 degrees C for 4 hours. Two portions (0.4 mL each) of the incubated RBCs were then used for measuring osmotic deformability index and for observing RBC morphology with scanning electron microscopy. The remaining RBCs were used for determining membrane sulfhydryl groups and protein profiles by sodium dodecyl sulfate polyacrylamide gel electrophoresis.
  
  
  RESULTS
  Blood incubated with various concentrations of ANE showed concentration-dependent decreases in osmotic deformability index and membrane sulfhydryl groups. Membrane protein profiles revealed a significant loss of the band 3 fraction, with the concomitant appearance of several new protein bands in the electropheretogram. Finally, drastic morphological changes of ANE-treated RBCs were observed.
  
  
  CONCLUSIONS
  We suggest that to assure the quality of transfusion, the blood donated by a habitual BQ chewer should be used with caution because of its possible contamination with areca nut ingredients that may be cytotoxic to RBCs.
authors.affiliation: Department of Family Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
authors.forename: Kuang-Ping
authors.initials: KP
authors.lastname: Peng
authors.forename: Jeng-Fong
authors.initials: JF
authors.lastname: Chiou
authors.forename: Yen-Tsun
authors.initials: YT
authors.lastname: Chen
authors.forename: Tsan-Zon
authors.initials: TZ
authors.lastname: Liu
mesh_terms: D001114:Areca / Q000378:metabolism / Q000633:toxicity*; D001782:Blood Donors; D001803:Blood Transfusion; D004591:Electrophoresis, Polyacrylamide Gel; D004907:Erythrocyte Deformability / Q000187:drug effects*; D004912:Erythrocytes / Q000187:drug effects*; D006801:Humans; D008409:Mastication; D008565:Membrane Proteins / Q000378:metabolism; D008855:Microscopy, Electron, Scanning; D009754:Nuts / Q000009:adverse effects / Q000737:chemistry* / Q000378:metabolism; D010936:Plant Extracts / Q000009:adverse effects / Q000737:chemistry*; D012967:Sodium Dodecyl Sulfate
chemical_list: D008565:Membrane Proteins; D010936:Plant Extracts; D012967:Sodium Dodecyl Sulfate