title: Adaptation of uraemic patients to anaemia: A31 P nuclear magnetic resonance study.
abstract: It is well established that ESRD patients can tolerate a greater degree of anaemia than anaemic subjects of other aetiologies. It is widely accepted that this is partly due to a decrease in the oxygen affinity of haemoglobin (Hb) associated with a greater concentration of 2,3-diphosphoglycerate (2,3-DPG) observed in uraemic patients. In order to verify whether this is a concentration effect or whether the binding of 2,3-DPG in erythrocytes is structurally affected, we have studied 2,3-DPG haemoglobin binding by measuring spin-spin relaxation times (T2) of 31P in living erythrocytes (RBC) by NMR. In uraemic RBC, 2,3-DPG relaxation is faster. This difference is not due to the reduced intracellular pH of uraemic RBC: we have verified that increased presence of paramagnetic substances can also be discarded since intra-RBC proton T2 is longer. Our results are compatible with stronger binding of 2,3-DPG to haemoglobin in uraemic erythrocytes, stabilising the deoxyhaemoglobin form and therefore facilitating oxygen release.
authors.affiliation: Laboratoire de Biophysique, Faculté de Pharmacie, Marseille, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Monti
authors.forename: M
authors.initials: M
authors.lastname: Baz
authors.forename: H
authors.initials: H
authors.lastname: Klinkmann
authors.forename: R
authors.initials: R
authors.lastname: Elsen
authors.forename: Y
authors.initials: Y
authors.lastname: Berland
authors.forename: A
authors.initials: A
authors.lastname: Crevat
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000378:metabolism*; D000222:Adaptation, Physiological; D000740:Anemia / Q000209:etiology / Q000503:physiopathology*; D016022:Case-Control Studies; D004912:Erythrocytes / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D009682:Magnetic Resonance Spectroscopy; D010759:Phosphorus Isotopes / Q000008:administration & dosage; D014511:Uremia / Q000503:physiopathology
chemical_list: D006454:Hemoglobins; D010759:Phosphorus Isotopes; D019794:2,3-Diphosphoglycerate