Oncotarget

Research Papers:

Enhanced eryptosis contributes to anemia in lung cancer patients

Rosi Bissinger _, Carla Schumacher, Syed M. Qadri, Sabina Honisch, Abaid Malik, Friedrich Götz, Hans-Georg Kopp and Florian Lang

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Oncotarget. 2016; 7:14002-14014. https://doi.org/10.18632/oncotarget.7286

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Abstract

Rosi Bissinger1,*, Carla Schumacher2,*, Syed M. Qadri3, Sabina Honisch1, Abaid Malik1, Friedrich Götz4, Hans-Georg Kopp2,#, Florian Lang1,#

1Department of Physiology, University of Tübingen, Tübingen, Germany

2Department of Internal Medicine, University of Tübingen, Tübingen, Germany

3Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada

4Department of Microbial Genetics, University of Tübingen, Tübingen, Germany

*These authors have contributed equally and thus share first authorship

#These authors have contributed equally and thus share last authorship

Correspondence to:

Florian Lang, e-mail: [email protected]

Keywords: anemia, eryptosis, ceramide, cell shrinkage, carcinoma

Received: November 16, 2015     Accepted: January 29, 2016     Published: February 9, 2016

ABSTRACT

Objectives: Anemia is a common complication of malignancy, which could result from either compromised erythropoiesis or decreased lifespan of circulating erythrocytes. Premature suicidal erythrocyte death, characterized by cell shrinkage and phosphatidylserine (PS) externalization, decreases erythrocyte lifespan and could thus cause anemia. Here, we explored whether accelerated eryptosis participates in the pathophysiology of anemia associated with lung cancer (LC) and its treatment.

Methods: Erythrocytes were drawn from healthy volunteers and LC patients with and without cytostatic treatment. PS exposure (annexin V-binding), cell volume (forward scatter), cytosolic Ca2+ (Fluo3 fluorescence), reactive oxygen species (ROS) production (DCFDA fluorescence) and ceramide formation (anti-ceramide antibody) were determined by flow cytometry.

Results: Hemoglobin concentration and hematocrit were significantly lower in LC patients as compared to healthy controls, even though reticulocyte number was higher in LC (3.0±0.6%) than in controls (1.4±0.2%). The percentage of PS-exposing erythrocytes was significantly higher in LC patients with (1.4±0.1%) and without (1.2±0.3%) cytostatic treatment as compared to healthy controls (0.6±0.1%). Erythrocyte ROS production and ceramide abundance, but not Fluo3 fluorescence, were significantly higher in freshly drawn erythrocytes from LC patients than in freshly drawn erythrocytes from healthy controls. PS exposure of erythrocytes drawn from healthy volunteers was significantly more pronounced following incubation in plasma from LC patients than following incubation in plasma from healthy controls.

Conclusion: Anemia in LC patients with and without cytostatic treatment is paralleled by increased eryptosis, which is triggered, at least in part, by increased oxidative stress and ceramide formation.


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