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Review
. 2021 Sep 22:12:722896.
doi: 10.3389/fphys.2021.722896. eCollection 2021.

Deformability of Stored Red Blood Cells

Gregory Barshtein  1 , Ivana Pajic-Lijakovic  2 , Alexander Gural  3
Affiliations
Review

Deformability of Stored Red Blood Cells

Gregory Barshtein et al. Front Physiol. .

Abstract

Red blood cells (RBCs) deformability refers to the cells' ability to adapt their shape to the dynamically changing flow conditions so as to minimize their resistance to flow. The high red cell deformability enables it to pass through small blood vessels and significantly determines erythrocyte survival. Under normal physiological states, the RBCs are attuned to allow for adequate blood flow. However, rigid erythrocytes can disrupt the perfusion of peripheral tissues and directly block microvessels. Therefore, RBC deformability has been recognized as a sensitive indicator of RBC functionality. The loss of deformability, which a change in the cell shape can cause, modification of cell membrane or a shift in cytosol composition, can occur due to various pathological conditions or as a part of normal RBC aging (in vitro or in vivo). However, despite extensive research, we still do not fully understand the processes leading to increased cell rigidity under cold storage conditions in a blood bank (in vitro aging), In the present review, we discuss publications that examined the effect of RBCs' cold storage on their deformability and the biological mechanisms governing this change. We first discuss the change in the deformability of cells during their cold storage. After that, we consider storage-related alterations in RBCs features, which can lead to impaired cell deformation. Finally, we attempt to trace a causal relationship between the observed phenomena and offer recommendations for improving the functionality of stored cells.

Keywords: RBC deformability; RBC storage; RBC storage lesion; red blood cells; transfusion.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
An illustrative micrograph of PRBCs [adhered to glass slide of the flow-chamber (Barshtein et al., 2020b)] under a flow-induced shear stress of 3.0 Pa. Distribution of RBC deformability, expressed by their Elongation Ratio, in RBC population (8’000–10’000 cells), presented by the percentage of RBCs in a discrete elongation ratio value.
FIGURE 2
FIGURE 2
Storage and loss moduli vs. angular velocity for spherocytes and discocytes extracted from microrheological data published by Park (2007) and Amin et al. (2007).
FIGURE 3
FIGURE 3
Viscoelasticity of RBC obtained by the microrheological measurements: Storage and loss moduli (G’ and G”) vs. angular velocity.
See this image and copyright information in PMC

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