title: Aristolochic acid induced suicidal erythrocyte death.
abstract: OBJECTIVE
  Aristolochic Acid, a component of Aristolochia plants, has been shown to cause acute kidney injury, renal aristolochic acid nephropathy, Balkan endemic nephropathy, and urothelial carcinoma. Aristolochic acid nephropathy may be associated with severe anemia. The anemia could theoretically be due to stimulation of eryptosis, the suicidal death of erythrocytes characterized by cell shrinkage and cell membrane scrambling with translocation of phosphatidylserine to the erythrocyte cell membrane surface. Signalling involved in the stimulation of eryptosis include increase of cytosolic Ca(2+)-activity ([Ca(2+)]i) and formation of ceramide.
  
  
  METHODS
  Cell volume was estimated from forward scatter, phosphatidylserine-exposure from annexin V binding, [Ca(2+)]i from Fluo3 fluorescence, and ceramide abundance from binding of fluorescent antibodies in flow cytometry.
  
  
  RESULTS
  A 48 hours exposure to Aristolochic Acid (≥ 75 µg/ml) was followed by a significant decrease of forward scatter and increase of annexin-V-binding. The effects were paralleled by a significant increase of [Ca(2+)]i and significantly blunted, but not abrogated by removal of extracellular Ca(2+). Aristolochic Acid further significantly increased ceramide abundance.
  
  
  CONCLUSIONS
  Aristolochic Acid triggers eryptosis, an effect at least in part due to entry of extracellular Ca(2+) and ceramide formation.
authors.affiliation: Department of Physiology, University of Tuebingen, Germany.
authors.forename: Abaid
authors.initials: A
authors.lastname: Malik
authors.forename: Rosi
authors.initials: R
authors.lastname: Bissinger
authors.forename: Salvatrice
authors.initials: S
authors.lastname: Calabrò
authors.forename: Caterina
authors.initials: C
authors.lastname: Faggio
authors.forename: Kashif
authors.initials: K
authors.lastname: Jilani
authors.forename: Florian
authors.initials: F
authors.lastname: Lang
mesh_terms: D034341:Aristolochic Acids / Q000633:toxicity*; D016923:Cell Death / Q000187:drug effects / Q000502:physiology; D048429:Cell Size / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004912:Erythrocytes / Q000187:drug effects* / Q000502:physiology*; D006801:Humans
chemical_list: D034341:Aristolochic Acids; C000228:aristolochic acid I