Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Heart and Vascular Division, Karolinska University Hospital, Stockholm, Sweden.
Cardiovasc Res. 2019 Sep 1;115(11):1596-1605. doi: 10.1093/cvr/cvz156.
The primary role of red blood cells (RBCs) is to transport oxygen to the tissues and carbon dioxide to the lungs. However, emerging evidence suggests an important role of the RBC beyond being just a passive carrier of the respiratory gases. The RBCs are of importance for redox balance and are actively involved in the regulation of vascular tone, especially during hypoxic and ischaemic conditions by the release of nitric oxide (NO) bioactivity and adenosine triphosphate. The role of the RBC has gained further interest after recent discoveries demonstrating a markedly altered function of the cell in several pathological conditions. Such alterations include increased adhesion capability, increased formation of reactive oxygen species as well as altered protein content and enzymatic activities. Beyond signalling increased oxidative stress, the altered function of RBCs is characterized by reduced export of NO bioactivity regulated by increased arginase activity. Of further importance, the altered function of RBCs has important implications for several cardiovascular disease conditions. RBCs have been shown to induce endothelial dysfunction and to increase cardiac injury during ischaemia-reperfusion in diabetes mellitus. Finally, this new knowledge has led to novel therapeutic possibilities to intervene against cardiovascular disease by targeting signalling in the RBC. These novel data open up an entirely new view on the underlying pathophysiological mechanisms behind the cardiovascular disease processes in diabetes mellitus mediated by the RBC. This review highlights the current knowledge regarding the role of RBCs in cardiovascular regulation with focus on their importance for cardiovascular dysfunction in pathological conditions and therapeutic possibilities for targeting RBCs in cardiovascular disease.
红细胞（RBCs）的主要作用是将氧气输送到组织中，并将二氧化碳输送到肺部。然而，新出现的证据表明，红细胞的作用不仅仅是作为呼吸气体的被动载体。红细胞对于氧化还原平衡很重要，并且积极参与血管张力的调节，特别是在缺氧和缺血条件下，通过释放一氧化氮（NO）生物活性和三磷酸腺苷。最近的发现表明，在几种病理情况下，细胞的功能明显改变，这使得红细胞的作用引起了更多的关注。这种改变包括增加的粘附能力、增加的活性氧形成以及改变的蛋白质含量和酶活性。除了表明氧化应激增加外，红细胞功能的改变还表现为由于精氨酸酶活性增加导致的 NO 生物活性的输出减少。更重要的是，红细胞功能的改变对几种心血管疾病状况有重要影响。已经表明，红细胞在糖尿病的缺血再灌注期间诱导内皮功能障碍并增加心脏损伤。最后，这些新的知识为通过针对 RBC 中的信号转导来干预心血管疾病提供了新的治疗可能性。这些新数据为糖尿病介导的心血管疾病过程背后的潜在病理生理机制提供了全新的视角。这篇综述强调了目前关于 RBC 在心血管调节中的作用的知识，重点介绍了它们在病理情况下心血管功能障碍中的重要性以及针对心血管疾病中 RBC 的治疗可能性。
