fredag den 23. november 2018

Red blood cell deformability, metabolism and extracellular vesicles in ME/CFS

Red blood cell deformability

Red blood cells (RBCs; erythrocytes) are typically biconcave in shape, transport hemoglobin-bound oxygen and are reversibly deformable facilitating trafficking through capillaries. Decreased deformability of RBCs adversely affects tissue oxygenation (1).

RBC deformability is reduced in some ME/CFS patients (2).

Metabolism and red blood cell membrane

The cell membranes in red blood cells are made up of proteins, fats, and carbohydrates. This means that abnormalities in the cell membrane can be a good way to spot disordered metabolism of these nutrients. Issues with producing too much of a certain metabolite, or not being able to break down a nutrient can cause abnormalities in the cell membrane, which lead to irregular shapes of RBCs (2).

Erythrocyte omega-3 index (5.75%) and n-3 PUFA levels are low in individuals with CFS/ME (3).

Extracellular vesicles in sepsis decrease RBC deformability

A growing body of evidence suggests that extracellular vesicles (EVs) play a role in cell-to-cell communication, and are involved in both physiological and pathological processes (4).

A study on mice showed a significant decrease in RBC deformability following sepsis. Extracellular vesicles isolated from the plasma of mice with sepsis significantly decreased deformability of RBCs ex vivo (1).

Extracellular vesicles in blood from ME patients have been analyzed: The amount of EV-enriched fraction was significantly higher in CFS/ME subjects than in healthy controls (HCs) (p = 0.007) and that EVs were significantly smaller in CFS/ME patients (p = 0.014). Circulating EVs could be an emerging tool for biomedical research in CFS/ME. These findings provide preliminary evidence that blood-derived EVs may distinguish CFS/ME patients from HCs (4).

I suggest a pilot study:

ME/CFS vesicles put together with red blood cells from healthy controls. Can microvesicles from ME/CFS patients decrease deformability of RBCs from healthy controls in vitro?


1) Subramini et al. Effect of plasma-derived extracellular vesicles on erythrocyte deformability in polymicrobial sepsis. Int Immunopharmacol. 2018 Oct 16;65:244-247. doi: 10.1016/j.intimp.2018.10.011.

2) Erythrocyte Deformability As a Potential Biomarker for Chronic Fatigue Syndrome. Amit K Saha, Brendan R Schmidt, Julie Wilhelmy, Vy Nguyen, Justin Do, Vineeth C Suja, Mohsen Nemat-Gorgani, Anand K Ramasubramanian and Ronald W Davis

Blood 2018 132:4874; doi:

OMF-funded research: red blood cell deformability in ME/CFS

RBC shape, RBC deformability

3) Castro-Marrero et al: Low omega-3 index and polyunsaturated fatty acid status in patients with chronic fatigue syndrome/myalgic encephalomyelitis.
Prostaglandins, Leukotrienes and Essential Fatty Acids
Volume 139, December 2018, Pages 20-24

4) Castro-Marrero et al:
Circulating extracellular vesicles as potential biomarkers in chronic fatigue syndrome/myalgic encephalomyelitis: an exploratory pilot study. J Extracell Vesicles. 2018 Mar 22;7(1):1453730. doi: 10.1080/20013078.2018.1453730. eCollection 2018.

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