PubMed: 19276082

Title
Erythrocyte hemolysis and hemoglobin oxidation promote ferric chloride-induced vascular injury.
Journal
The Journal of biological chemistry
Volume
284
Issue
None
Pages
13110-8
Date
2009-05-08
Authors
Chin-Dusting JP | Jackson SP | Salem HH | Sturgeon S | Woollard KJ

Evidence fd5413edb4

By-products of heme and iron metabolism, such as heme oxygenase-dependent generation of carbon monoxide (CO), have antioxidant and anti-inflammatory protective functions against iron-induced vascular damage (33); therefore we examined the impact of CO donors on collagen exposure and thrombus formation in the ex vivo vascular injury model.

Evidence e9d8490e69

Pretreating anticoagulated whole blood with tricarbonyldichlororuthenium(II) dimer, a CO donor, significantly reduced collagen exposure (Fig. 5A) and thrombus formation (Fig. 5B) induced by FeCl3.

Evidence 782be71210

High concentrations of FeCl3 induce profound injury to the vasculature, leading to endothelial denudation, and collagen and tissue factor exposure, leading to the rapid formation of vaso-occlusive thrombi.

Evidence 34dbe7a8e9

As demonstrated in Fig. 1, topically exposing aorta in vivo (Fig. 1A) or ex vivo (Fig. 1B) to 6% FeCl3 resulted in major vascular injury as evidenced by endothelial denudation, collagen exposure, and the subsequent formation of arterial thrombi (Fig. 1D and supplemental Video 1).

Evidence 3531271182

Analysis of the time course of hemolysis in whole blood revealed a rapid linear increase in Hb levels, peaking 10 min after FeCl3 addition (Fig. 2B), a time course consistent with the rapid hemolysis and vascular injury observed in the ex vivo aortic thrombosis model.

Evidence a3a4527f75

To investigate the direct effects of FeCl3 on aortic endothelium, FeCl3 was perfused through isolated aorta independently of flowing blood. Strikingly no endothelial denudation or collagen exposure was evident following prolonged exposure to FeCl3 (6%) (Fig. 1C).

Evidence 547d80ab7f

Subsequent perfusion of anticoagulated whole blood through FeCl3-pretreated vessels was associated with an increase in leukocyte and platelet adhesion to the vessel wall (Fig. 1E and supplemental Video 2); however, relative to untreated aorta (Fig. 1F and supplemental Video 3) and treatment in the presence of flowing blood (Fig. 1D and supplemental Video 1), thrombus formation was not observed.

Evidence 63fd009fc5

In contrast, selectively removing RBCs prevented endothelial denudation and collagen exposure, resulting in a relatively mild perturbation of endothelial function similar to that observed with FeCl3 alone (data not shown).

Evidence ee70dc49e2

Analysis of Hb release from ex vivo vessel chamber experiments revealed a significant (p  0.05; n  4) increase in Hb levels following FeCl3 treatment of isolated aorta in the presence of flowing blood (157  45 g/ml), whereas FeCl3 pretreatment of vessels prior to blood perfusion caused no hemolysis (Fig. 2A).

Evidence 1ae5c4f2ce

FeCl3 treatment resulted in a dose- (Fig. 3) and timedependent (data not shown) increase inRBClipid peroxidation, which correlated closely with hemolysis (Fig. 2B).

Evidence 1f95f3eaed

Interestingly elevated levels of body iron stores are associated with an increased risk of myocardial infarction, and carriers of the hemochromatosis gene have an increased risk of myocardial infarction and cardiovascular death (20, 21).

Evidence 6645229ee7

Free heme is lipophilic and intercalates into the membrane of endothelial cells increasing vascular permeability and ICAM-1, VCAM-1, and E-selectin expression (19).

Evidence b512e90f2b

As a consequence, infused heme (hemin) has been demonstrated to enhance leukocyte adhesion to the vessel wall (17, 18), a finding confirmed in the current study.

Evidence 924d833a4c

Platelet thrombus formation in the ex vivo model occurred in the presence of hirudin (Fig. 1B); however, it was critically dependent on collagen activation of platelets as thrombus formation failed to develop using platelets deficient in the major collagen receptor GPVI/FcR -chain (FcR / mice) (data not shown).

Evidence 3d0c9ec6ad

Moreover they have demonstrated that released Hb plays an important role in exacerbating RBC hemolysis, establishing a damaging hemolysis/ oxidative cycle that drives further red cell damage, vascular injury, and thrombosis.

Evidence c48079f23a

Topical treatment with 6% FeCl3 with hemin (1mM) perfusions caused no greater endothelial injury than FeCl3 or hemin (1 mM) alone (data not shown), whereas FeCl3 in the presence of low concentrations of metHb (0.38 mg/ml) induced extensive vascular injury similar to that observed with FeCl3 in the presence of whole blood (Figs. 4 and 1D, respectively).

Evidence 9504c2eed0

Third, reintroduction of washed RBCs or purified metHb in the presence of FeCl3 led to a similar level of vascular injury as observed with whole blood, whereas isolated RBC membranes and heme, even in the presence of FeCl3, produced relatively mild injury.

Evidence 4c1b862db1

Clinical studies have confirmed endothelial dysfunction and vasculopathy in a patient with HO-1 deficiency, and similarly, mice lacking HO-1 have increased vascular injury and thrombotic complications (43, 44).

Evidence b0049e73f0

Furthermore superoxide can react with Hb to produce hydrogen peroxide (H2O2), a well defined prooxidative molecule that causes vascular injury (1).

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