Pathological mechanism of hidden blood loss after TKA: oxidative stress induced by free fatty acids

Abstract Objective: To study the correlation between high-level free fat acids（FFA）and red blood cell (RBC) injury and to explore the pathological mechanism of hidden blood loss (HBL) after total knee arthroplasty (TKA).Methods: Perioperative blood indexes were tested in 120 patients underwent unilateral total knee replacement for end-stage knee osteoarthritis. Venous blood samples were collected before operation and 24h, 48h, 72h and 120 h after operations. The changes of FFA, hemoglobin (Hb) and red blood cell number in the blood samples were detected by automatic hematology analyzer. The activity of glutathion peroxidase (GSH-Px), total superoxide dismutase (T-SOD) and hydrogen peroxide (H2O2) levels in the blood were measured. Measurement of reactive oxygen species（ROS）was performed by flow cytometry. Meanwhile, the morphological changes of RBC were analyzed under microscope. Results: Significant hidden blood loss was observed for all patients. The Hb content, RBC and hematocrit（Hct）decreased significantly 24 h after surgery (P <0.05)，while FFA concentration was significantly increased and heteromorphic red blood cells appeared under the microscope. The hemoglobin content decreased to the lowest level at 48 h after the operation (P < 0.01). The change of HBL was the most significant according to the Gross equation with the levels of FFA and ROS in the blood increased significantly and reached the peak at 48 h after operation (P <0.01). Meanwhile, GSH-PX activity, T-SOD activity and H2O2 levels significantly decreased compared with preoperative tested samples (P <0.01). Microscopically, erythrocyte atypia increased significantly with cellular rupture and necrosis identified. After 72 h of operation, ROS concentration began to decline along with FFA concentration. However, the Hb and RBC began to rise. Also, GSH-Px activity, T-SOD activity and H2O2 levels increased as well. All tested parameters tended to return to normal levels five days after surgery.Conclusion: High levels of FFA in blood can induce oxidative stress and damage RBCs, which in turns causes HBL after surgery.

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Arachidonic acid causes hidden blood loss–like red blood cell damage through oxidative stress reactions

Journal of Surgical Research ◽

10.1016/j.jss.2016.11.060 ◽

2017 ◽

Vol 211 ◽

pp. 14-20 ◽

Cited By ~ 6

Author(s):

Tao Yuan ◽

Yu Cong ◽

Jia Meng ◽

Hong Qian ◽

Wei Ye ◽

...

Keyword(s):

Oxidative Stress ◽

Arachidonic Acid ◽

Blood Loss ◽

Blood Cell ◽

Red Blood Cell ◽

Cell Damage ◽

Stress Reactions ◽

Hidden Blood Loss

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Indicator Characterizing Carbonyl-Dependent Modification of Erythrocytic Superoxydismutase as a Biochemical Marker of Oxidative Stress in Coronary Heart Disease

Kardiologiia ◽

10.18087/cardio.2020.5.n1019 ◽

2020 ◽

Vol 60 (5) ◽

pp. 57-61

Author(s):

A. K. Tikhaze ◽

V. Ya. Kosach ◽

V. Z. Lankin ◽

A. A. Panferova ◽

M. D. Smirnova

Keyword(s):

Oxidative Stress ◽

Heart Disease ◽

Stress Intensity ◽

Blood Cell ◽

Red Blood Cell ◽

Oxidative Modification ◽

Oxidative Stress Marker ◽

Control Group ◽

Sod Activity ◽

Stress Marker

Aim To study the oxidative modification of red blood cell Cu,Zn superoxide dismutase (SOD) in patients with ischemic heart disease (IHD) in vivo and in vitro to substantiate the use of a new oxidative stress marker.Material and methods Red blood cell Cu,Zn SOD was measured by depression of nitrotetrazolium blue reduction by the superoxide anion generated in xanthine oxidase xanthine oxidation. Red blood cell Cu,Zn SOD was measured immunochemically. The biochemical study was performed in the control group (patients with low extremity fracture without known history of cardiovascular diseases and hyperlipidemia) and in groups of patients with acute myocardial infarction, stable angina, and decompensated heart failure. For evaluation of oxidative stress intensity in IHD patients, an empirical SOD oxidative modification coefficient (OMCSOD) was proposed, which is a Cu,Zn SOD activity / Cu,Zn SOD content ratio.Results The red blood cell Cu,Zn SOD activity was significantly decreased in all IHD groups compared to the control group. Furthermore, OMCSOD was also considerably decreased in IHD patients, which warrants the use of this biochemical index as an oxidative stress marker.Conclusion It was shown that the Cu,Zn SOD modification was induced by interaction of the enzyme molecules with a natural dicarbonyl, malonic dialdehyde, and OMCSOD can be used for evaluation of oxidative stress intensity in IHD patients.

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Abnormal red blood cell morphological changes in thalassaemia associated with iron overload and oxidative stress

Journal of Clinical Pathology ◽

10.1136/jclinpath-2019-205775 ◽

2019 ◽

Vol 72 (8) ◽

pp. 520-524 ◽

Cited By ~ 3

Author(s):

Pornthip Chaichompoo ◽

Ariz Qillah ◽

Pornpan Sirankapracha ◽

Jirada Kaewchuchuen ◽

Poramate Rimthong ◽

...

Keyword(s):

Oxidative Stress ◽

Blood Cell ◽

Iron Overload ◽

Serum Ferritin ◽

Red Blood Cell ◽

Morphological Changes ◽

Normal Subjects ◽

Target Cells ◽

Red Cell ◽

And Oxidative Stress

AimsIron overload is a major factor contributing to the overall pathology of thalassaemia, which is primarily mediated by ineffective erythropoiesis and shorter mature red blood cell (RBC) survival. Iron accumulation in RBCs generates reactive oxygen species (ROS) that cause cellular damage such as lipid peroxidation and RBC membrane deformation. Abnormal RBCs in patients with thalassaemia are commonly known as microcytic hypochromic anaemia with poikilocytosis. However, iron and ROS accumulation in RBCs as related to RBC morphological changes in patients with thalassaemia has not been reported.MethodsTwenty-one patients with thalassaemia, including HbH, HbH with Hb Constant Spring and β-thalassaemia/HbE (splenectomy and non-splenectomy) genotypes, and five normal subjects were recruited. RBC morphology was analysed by light and scanning electron microscopy. Systemic and RBC iron status and oxidative stress were examined.ResultsDecreased normocytes were observed in the samples of patients with thalassaemia, with RBC morphological abnormality being related to the type of disease (α-thalassaemia or β-thalassaemia) and splenic status. Target cells and crenated cells were mainly found in splenectomised patients with β-thalassaemia/HbE, while target cells and teardrop cells were found in non-splenectomised patients. Patients with thalassaemia had high levels of serum ferritin, red cell ferritin and ROS in RBCs compared with normal subjects (p<0.05). Negative correlations between the amount of normocytes and serum ferritin (rs=−0.518, p=0.011), red cell ferritin (rs=−0.467, p=0.025) or ROS in RBCs (rs=−0.672, p<0.001) were observed.ConclusionsIron overload and its consequent intracellular oxidative stress in RBCs were associated with reduce normocytes in patients with thalassaemia.

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In vivo Antioxidant Related Effect of Orally Administered Aqueous Extract of Saliva triloba in Human Volunteers

Pharmaceutics and Pharmacology Research ◽

10.31579/2693-7247/040 ◽

2022 ◽

Vol 5 (2) ◽

pp. 01-04

Author(s):

Nessrin G. Alabdallat

Keyword(s):

Oxidative Stress ◽

Blood Cell ◽

Red Blood Cell ◽

Heart Function ◽

Water Extract ◽

In Vivo Studies ◽

Biochemical Tests ◽

Bottom Line ◽

Sod Activity

Saliva triloba, belongs to the Lamiaceae family, is one in all the vital medicinal plant species. This work aims to study the antioxidant-related effects of trilobite saliva in the human body through in vivo studies and the effects on liver, kidney, and heart function tests. For five days, nine healthy participants consumed 250 mL of trilobite saliva extract orally. On the fifth day, blood samples were taken one hour before and after the first dosage of water extract (samples I and II, respectively), and again one day after the last dose (ie, day 6, sample III). Before the first dosage, the first blood sample was taken (ie sample I) was used as a control for the subsequent II and III samples. Subsequent determinations were performed: serum total antioxidant status (TAS), red blood cell reduced glutathione (GSH), red blood cell superoxide dismutation (SOD) A activity, malondialdehyde (MDA), and serum-selected biochemical tests. After 5 days of oral administration of trilobite saliva extract in healthy volunteers, serum TAS, erythrocyte GSH and erythrocyte SOD activity were significantly increased, and had no influence on serum biochemical examinations of kidney, liver, heart, pancreas, etc., contrasted with zero-time management. In Conclusion, salivary clover extract has effective anti-oxidation related effects in vivo. Because these findings were obtained in healthy people without oxidative stress, it means that clover saliva will enhance the bottom line of the defense system against probable oxidative stress while having no adverse effects, decreasing or avoiding pathological diseases associated with oxidative stress

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Safety of Antitheilerial Drug Buparvaquone in Rams

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.82066 ◽

2018 ◽

Vol 46 (1) ◽

Author(s):

Nermin Isik ◽

Ozlem Derinbay Ekici ◽

Ceylan Ilhan ◽

Devran Coskun

Keyword(s):

Oxidative Stress ◽

Hydrogen Peroxide ◽

Lipid Peroxidation ◽

Alkaline Phosphatase ◽

Blood Cell ◽

Blood Urea Nitrogen ◽

Troponin I ◽

Oxidative Status ◽

Blood Samples ◽

Heart Damage

Background: Theileriosis is a tick-borne disease caused by Theileria strains of the protozoan species. Buparvaquone is the mostly preferred drug in the treatment theileriosis, while it is safety in sheep, has not been detailed investigated. It has been hypothesized that buparvaquone may show side effects and these effects may be defined some parameters measured from blood in sheep when it is used at the recommended dose and duration. The aim of this research was to determine the effect of buparvaquone on the blood oxidative status, cardiac, hepatic and renal damage and bone marrow function markers.Materials, Methods & Results: In this study, ten adult (> 2 years) Akkaraman rams were used. Healthy rams were placed in paddocks, provided water ad libitum, and fed with appropriate rations during the experiment. Buparvaquone was administered at the dose of 2.5 mg/kg (IM) intramuscularly twice at 3-day intervals. Blood samples were obtained before (0. h, Control) and after drug administration at 0.25, 0.5, 1, 2, 3, 4 and 5 days. The blood samples were transferred to gel tubes, and the sera were removed (2000 g, 15 min). During the study, the heart rate, respiratory rate, and body temperature were measured at each sampling time. In addition, the animals were clinically observed. Plasma oxidative status markers (Malondialdehyde, total antioxidant status, catalase, glutathione peroxidase, superoxide dismutase), serum cardiac (Troponin I, creatine kinase-MBmass, lactate dehydrogenase), hepatic (Alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, total protein, albumin, globulin) and renal (Creatinine, blood urea nitrogen) damage markers and hemogram values (white blood cell, red blood cell, platelet, hemogram, hematocrit) were measured. Buparvaquone caused statistically significantly (P < 0.05) increases in the troponin I and blood urea nitrogen levels and fluctuations in alkaline phosphatase activity, but there was no any statistically significance difference determined in the other parameters.Discussion: In this study, buparvaquone was administered two times at a dose of 2.5 mg/kg (IM) at 3-day intervals. Although the result was not statistically significant (P > 0.05), it was determined that buparvaquone gradually increased the levels of the main oxidative stress marker, MDA, by approximately 2.8 fold. CAT and GPX levels were also found to have decreased by 2.2 fold. Buparvaquone may cause lipid peroxidation by producing free radicals. Some other antiprotozoal drugs may affect the oxidative status and may increase MDA level and decrease SOD level. In this study, MDA, which is an indicator of lipid peroxidation in vivo, was used to partially detect developing lipid peroxidation. Changes in the levels of reduced GPX and CAT enzymes could be attributed to their use in mediating the hydrogen peroxide detoxification mechanisms. The absence of significant changes in the TAS levels in this study suggests that buparvaquone may partially induce oxidative stress by producing hydrogen peroxide, but no significant changes occurred in the oxidative stress level because of the high antioxidant capacity of sheep. In this study, buparvaquone caused a statistically significant increase (P < 0.05) in the level of Tn-I, which is a marker of specific cardiac damage (P < 0.05), whereas there was no statistically (P > 0.05) significant increase in CK-MBmass. Tn-I and CK-MB levels, which are used to define heart damage in humans, have been successfully used to determine heart damage in sheep. In this research study, the statistically significant increases in Tn-I but not CK-MBmass levels could be considered indicative of mild cardiac damage.Keywords: ram, buparvaquone, safety.

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Real-time Red Blood Cell Counting and Osmolarity Analysis using a Photoacoustic-based Microfluidic System

Lab on a Chip ◽

10.1039/d1lc00263e ◽

2021 ◽

Author(s):

Wenxiu Zhao ◽

Haibo Yu ◽

Yangdong Wen ◽

Hao Luo ◽

Boliang Jia ◽

...

Keyword(s):

Blood Cell ◽

Physical Properties ◽

Red Blood Cell ◽

Blood Cells ◽

Diagnostic Procedure ◽

Microfluidic System ◽

Cell Counting ◽

Blood Samples ◽

System P ◽

Blood Cell Counting

Counting the number of red blood cells (RBCs) in blood samples is a common clinical diagnostic procedure, but conventional methods are unable to provide the size and other physical properties...

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In vitro effects of temperature on red blood cell deformability and membrane stability in human and various vertebrate species

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211118 ◽

2021 ◽

pp. 1-10

Author(s):

Adam Attila Matrai ◽

Gabor Varga ◽

Bence Tanczos ◽

Barbara Barath ◽

Adam Varga ◽

...

Keyword(s):

Blood Cell ◽

Red Blood Cell ◽

Whole Blood ◽

Mechanical Stability ◽

Cell Deformability ◽

Blood Samples ◽

Effects Of Temperature ◽

The Way ◽

Rbc Deformability

BACKGROUND: The effects of temperature on micro-rheological variables have not been completely revealed yet. OBJECTIVE: To investigate micro-rheological effects of heat treatment in human, rat, dog, and porcine blood samples. METHODS: Red blood cell (RBC) - buffer suspensions were prepared and immersed in a 37, 40, and 43°C heat-controlled water bath for 10 minutes. Deformability, as well as mechanical stability of RBCs were measured in ektacytometer. These tests were also examined in whole blood samples at various temperatures, gradually between 37 and 45°C in the ektacytometer. RESULTS: RBC deformability significantly worsened in the samples treated at 40 and 43°C degrees, more expressed in human, porcine, rat, and in smaller degree in canine samples. The way of heating (incubation vs. ektacytometer temperation) and the composition of the sample (RBC-PBS suspension or whole blood) resulted in the different magnitude of RBC deformability deterioration. Heating affected RBC membrane (mechanical) stability, showing controversial alterations. CONCLUSION: Significant changes occur in RBC deformability by increasing temperature, showing inter-species differences. The magnitude of alterations is depending on the way of heating and the composition of the sample. The results may contribute to better understanding the micro-rheological deterioration in hyperthermia or fever.

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