Major Disease States Cause Slowdown in Red Blood Cell Production and Destruction

MedicalResearch.com Interview with:
John M. Higgins, MD
MGH Center for Systems Biology
Boston, MA

Medical Research: What is the background for this study? What are the main findings?

Dr. Higgins: Hundreds of studies over the past 8 years have shown that increased variation in the size of red blood cells (RBCs) is associated with increased risk for a very wide range of common diseases, like heart disease, many types of cancer, infection, many autoimmune diseases, and lots of other conditions.  The size of red blood cells (RBCs) in the circulation of a healthy person usually varies by about 12-14%, meaning that if you took a sample of the cells, most of the bigger cells would be about 14% larger than the smaller cells.  People whose red blood cells show more variation in size have a greater risk of developing a wide range of diseases.  Also, among patients already diagnosed with many common diseases like heart disease or cancer, those with higher RBC size variation have worse outcomes.  It is unknown how all of these different diseases could be connected to variation in the size of red blood cells.  The study explains a major cause for this connection.  We find that the human body seems to slow down the production and destruction of RBCs in just about every major disease very slightly.  Since red blood cells gradually become smaller as they age, a delay in destruction will increase the fraction of small cells, and the overall variation in size increases.  The study also describes a method to estimate a patient’s RBC clearance rate.

Medical Research: What should clinicians and patients take away from your report?

Dr. Higgins: Not much is known about how RBCs are removed from the bloodstream after their roughly 100-day lifespan.  This study demonstrates that the removal process is extremely tightly regulated in healthy people and that it is often adjusted to be a bit slower in the earliest stages of a wide range of diseases.  Clinicians should now suspect that patients with greater variation in RBC size likely have a slightly reduced rate of both RBC production and destruction.  If we can accurately measure the production or destruction rate, we can screen patients for many common and important diseases in their early stages when they are most treatable.  This paper shows how the destruction rate can be estimated using existing blood test measurements and a mathematical model.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Higgins: Future research will need to determine for which diseases healthy patients can be most effectively screened by estimating their RBC clearance rates.  Future research will also help decide which chronic conditions can be best monitored by estimating patients’ RBC clearance rates.

Citation:

Patel, H. H., Patel, H. R. and Higgins, J. M. (2015), Modulation of red blood cell population dynamics is a fundamental homeostatic response to disease. Am. J. Hematol., 90: 422–428. doi: 10.1002/ajh.23982

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MedicalResearch.com Interview with: John M. Higgins, MD (2015). Major Disease States Cause Slowdown in Red Blood Cell Production and Destruction 

Last Updated on April 28, 2015 by Marie Benz MD FAAD