Red blood cell alterations in systemic sclerosis: a pilot study.
OBJECTIVE
The aim of this work was to investigate whether systemic oxidative imbalance that occurs in patients with systemic sclerosis affects red blood cell integrity.


METHODS
Reactive oxygen species, intracellular content of total thiols and molecules involved in red blood cell aging (e.g., glycophorin A, band 3, CD47 and phosphatidylserine externalization), have been analyzed in erythrocytes from 39 patients with systemic sclerosis and 30 healthy donors by using flow and static cytometry. Analyses were carried out taking into account the two clinical subsets of scleroderma: diffuse cutaneous sclerosis and limited cutaneous sclerosis.


RESULTS
A significant reduction (p<0.05) of intracellular total thiols and a significant loss (p<0.01) of glycophorin A, band 3 and CD47 was found in red blood cells from patients with limited cutaneous sclerosis. Conversely, a significant increase (p<0.01) of reactive oxygen species levels and CD47 expression was found in red blood cells from patients with diffuse cutaneous sclerosis. Phosphatidylserine externalization was significantly increased both in patients with limited and diffuse disease. Importantly, this increase was related with disease severity and nailfold capillaroscopy.


CONCLUSIONS
Altogether these results suggest a reappraisal of the red blood cells as useful markers in the clinical management of the disease.
Department of Clinical Medicine, Clinical Immunology Unit-Scleroderma Center, Sapienza University of Rome, Rome, Italy.
Antonello
A
Giovannetti
Lucrezia
L
Gambardella
Donatella
D
Pietraforte
Edoardo
E
Rosato
Anna Maria
AM
Giammarioli
Felice
F
Salsano
Walter
W
Malorni
Elisabetta
E
Straface
D000328:Adult; D000368:Aged; D001457:Anion Exchange Protein 1, Erythrocyte / Q000378:metabolism; D051928:CD47 Antigen / Q000378:metabolism; D016922:Cellular Senescence / Q000187:drug effects; D004912:Erythrocytes / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry; D006021:Glycophorins / Q000378:metabolism; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D010718:Phosphatidylserines / Q000494:pharmacology; D010865:Pilot Projects; D017382:Reactive Oxygen Species / Q000378:metabolism; D012595:Scleroderma, Systemic / Q000378:metabolism / Q000503:physiopathology*; D013438:Sulfhydryl Compounds / Q000378:metabolism
D001457:Anion Exchange Protein 1, Erythrocyte; D051928:CD47 Antigen; D006021:Glycophorins; D010718:Phosphatidylserines; D017382:Reactive Oxygen Species; D013438:Sulfhydryl Compounds