27
System biolog
y
The criteria of life and aging from a molecular viewpoint…
channel) and leads to potassium loss. In order to differentiate
this process from apoptosis in nucleated cells, it is referred to as
eryptosis. Evidence shows that prostaglandins are also involved
in the regulation of erythrocyte death [22]. Phosphatidylserine in
the external layer of the cell membrane (being also the feature of
nucleated cells undergoing apoptosis) is recognised by macro-
phages [23]. It is a result of limiting the quantity of ATP available
to ATP-dependent lippase, the protein which is responsible for
transport of this phospholipid to the internal cell membrane. Ad
-
ditionally, abrupt increase in the concentration of calcium ions
during eryptosis leads to activation of scramblase, an enzymatic
protein necessary for phosphatidylserine externalization [24]. All
these changes enable phagocytes to recognize aging erythro-
cytes. The above described processes lead to removal of red
blood cells from the vascular lumen.
Programmed erythrocyte death allows for control. The
breakdown of red blood cells is extravascular and occurs in the
monocyte-macrophage system of the spleen, the liver and the
bone marrow. Intravascular hemolysis is unfavorable and it may
occur in the course of hemolytic diseases, for instance transfusion
of incompatible blood in the AB0 or Rh system or in the course
of a rare disease paroxysmal nocturnal hemoglobinuria [11].
Therefore, the programmed alteration in cell surface structure
is the body’s strategy enabling the phagocytes to recognize
such blood cells.
Erythrocyte life span is also dependent on osmotic and oxi-
dative stress. Death of erythrocytes is a complex programmed
metabolic process. Only 0.06-0.4% of red blood cells, irrespective
of their age, are destroyed accidentally, in a non-programmed
manner [11]. Interestingly, erythropoietin has been found to
increase erythrocyte life span. The protective effects of erythro
-
poietin are observed in dialysis patients when the number of cells
exposing phosphatedylserine (which is a signal for cell removal)
decreases several hours after hormone injection. It appears then
that in exceptional cases the programmed erythrocyte life span
can be modiied by a signal command [12, 25].
According to the approved criteria erythrocytes, unlike vi-
ruses, are living things. They are automatons with a naturally
determined life span.
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