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[脾脏对血浆和红细胞脂质代谢的作用。关于遗传性球形红细胞增多症和遗传性高红细胞膜磷脂酰胆碱溶血性贫血]

[Contribution of the spleen to the lipid metabolism in plasma and red cells. On hereditary spherocytosis and hereditary high red cell membrane phosphatidylcholine hemolytic anemia].

作者信息

Sugihara T, Otsuka A, Yawata Y

出版信息

Rinsho Ketsueki. 1989 Aug;30(8):1248-55.

PMID:2601042
Abstract

Clinical and experimental studies on hereditary spherocytosis (HS) and high red cell membrane phosphatidylcholine hemolytic anemia (HPCHA) were performed in relation to lipid metabolism in plasma and in red cells of these patients. In HS, red cell (RBC) membrane lipids (free cholesterol (FC) and phospholipids (PL) such as phosphatidylethanolamine, phosphatidylcholine (PC), sphingomyelin (SM) and lysophosphatidylcholine (LPC] were markedly decreased in unsplenectomized HS. Plasma lipids (total cholesterol, FC, HDL-cholesterol, PL) were also decreased in these patients. After splenectomy, substantial normalization of plasma and RBC lipids were observed. Concerning lipid kinetics, the extents of 14C-PC synthesis in RBC from 14C-LPC in medium and of 14C-PC exchange between RBC and the medium were almost identical to those in normal control in the in vitro incubation conditions. These observations indicate that the decreased RBC lipids may be induced by the shortage of lipid materials in plasma in the presence of the spleen. In unsplenectomized HPCHA, plasma lipids were also decreased same as in HS. In contrast, membrane lipids (FC and PC) were markedly increased. Even after splenectomy, increased PC contents were rather enhanced in their membranes concomitant to developing of hemolytic anemia, although plasma lipids were almost normalized. Thus RBC membrane lipids in HPCHA appeared not to be affected by plasma lipids. In experimental studies on HPCHA, 14C-PC synthesis from 14C-LPC and 14C-PC uptake in these RBC were increased, in spite that large amounts of PC were already accumulated in these RBC.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

针对遗传性球形红细胞增多症(HS)和高红细胞膜磷脂酰胆碱溶血性贫血(HPCHA),开展了与这些患者血浆及红细胞脂质代谢相关的临床和实验研究。在HS患者中,未行脾切除术的HS患者红细胞(RBC)膜脂质(游离胆固醇(FC)和磷脂(PL),如磷脂酰乙醇胺、磷脂酰胆碱(PC)、鞘磷脂(SM)和溶血磷脂酰胆碱(LPC))显著减少。这些患者的血浆脂质(总胆固醇、FC、高密度脂蛋白胆固醇、PL)也减少。脾切除术后,观察到血浆和RBC脂质大幅恢复正常。关于脂质动力学,在体外孵育条件下,RBC中14C-LPC合成14C-PC的程度以及RBC与培养基之间14C-PC的交换程度与正常对照几乎相同。这些观察结果表明,在脾脏存在的情况下,血浆中脂质物质的短缺可能导致RBC脂质减少。在未行脾切除术的HPCHA患者中,血浆脂质也与HS患者一样减少。相比之下,膜脂质(FC和PC)显著增加。即使在脾切除术后,尽管血浆脂质几乎恢复正常,但随着溶血性贫血的发展,其细胞膜中PC含量反而增加。因此,HPCHA患者的RBC膜脂质似乎不受血浆脂质的影响。在HPCHA的实验研究中,尽管这些RBC中已经积累了大量PC,但14C-LPC合成14C-PC以及这些RBC摄取14C-PC的量仍增加。(摘要截取自250字)

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