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2015 ; 126
(15
): 1831-4
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Autophagic vesicles on mature human reticulocytes explain
phosphatidylserine-positive red cells in sickle cell disease
#MMPMID26276668
Mankelow TJ
; Griffiths RE
; Trompeter S
; Flatt JF
; Cogan NM
; Massey EJ
; Anstee DJ
Blood
2015[Oct]; 126
(15
): 1831-4
PMID26276668
show ga
During maturation to an erythrocyte, a reticulocyte must eliminate any residual
organelles and reduce its surface area and volume. Here we show this involves a
novel process whereby large, intact, inside-out phosphatidylserine (PS)-exposed
autophagic vesicles are extruded. Cell surface PS is a well-characterized
apoptotic signal initiating phagocytosis. In peripheral blood from patients after
splenectomy or in patients with sickle cell disease (SCD), the number of
circulating red cells exposing PS on their surface is elevated. We show that in
these patients PS is present on the cell surface of red cells in large (?1.4 µm)
discrete areas corresponding to autophagic vesicles. The autophagic vesicles
found on reticulocytes are identical to those observed on red cells from
splenectomized individuals and patients with SCD. Our data suggest the increased
thrombotic risk associated with splenectomy, and patients with hemoglobinopathies
is a possible consequence of increased levels of circulating mature reticulocytes
expressing inside-out PS-exposed autophagic vesicles because of asplenia.