Isolation of Nucleated Red Blood Cell from Peripheral Blood of β-Thalassemia Major Patients using CD71 Magnetic Beads and Future Application
Keywords:
β-thalassemia major, CD71, MACS, NRBCs.Abstract
Introduction: Isolation of specific cell types is important in providing a better understanding of hematological disorders. The knowledge of molecular biology aspect in β-thalassemia is still limited. This is because hemoglobin disorder involves various erythropoietic processes in which the genetic information is lack due to enucleation of red blood cells occurs in bone marrow. It is invasive to collect samples from bone marrow and cord blood although nucleated red blood cells (NRBCs) are abundant in these sites. NRBCs are precursors of red blood cells and typically found in peripheral blood (PB) of β-thalassemia major patients and abundant post-splenectomy. The utilization of PB NRBCs will provide a further understanding of the molecular aspects of ineffective erythropoiesis in β-thalassemia major patients. Objective: The objective of this study was to isolate the NRBCs using CD71 magnetic beads from PB of β-thalassemia major; non-splenectomy and post-splenectomy patients. Methods: NRBCs were isolated from 6 mL PB of β-thalassemia major patients based on density gradient and magnetic activated cell sorting (MACS) for NRBCs enrichment using a CD71 marker. Cell count was determined by using hemocytometer (Weber Scientific, NJ, USA) and BD FACSCantoTM II flow cytometry (Becton-Dickson, NJ, USA) was performed for method validation. Results: NRBCs were successfully isolated from the PB of both non-splenectomy and post-splenectomy β-thalassemia major patients with >90% specificity by flow cytometric analysis. The median number of enriched NRBCs (x104) was 58.5 (283) and 340 (338) respectively using hemocytometer. Conclusion: The MACS method was found to be convenient and efficient in the isolation of the targeted cells for downstream applications.
References
Franceschi LD, Bertoldi M, Matte A, Franco SS, Pantaleo A, Ferru E, et al. Oxidative stress and β-thalassemic erythroid cells behind the molecular defect. Oxidative Medicine and Cellular Longevity. 2013:1-10.
Liu S, McConnell SC, Ryan TM. Erythropoiesis in the absence of adult hemoglobin. Molecular and Cellular Biology. 2013;33(11):2241-2251.
Constantino BT, Cogionis B. Nucleated RBCs - Significance in the peripheral blood film. Laboratory Medicine. 2000;31(4):223-229.
Byeon Y, Ki CS, Han KH. Isolation of nucleated red blood cells in maternal blood for non-invasive prenatal diagnosis. Biomedical Microdevices. 2015;17(6):118.
Zhao XX, Ozaki Y, Suzumori N, Sato T, Suzumori K. Enrichment of fetal cells from maternal blood by magnetic activated cell sorting (MACS) with fetal cell specific antibodies: Oneâ€step versus twoâ€step MACS. Congenital Anomalies. 2002;42(2):120-124.
Fucharoen S, Weatherall DJ. The hemoglobin E thalassemias. Cold Spring Harbor Perspectives in Medicine. 2012;2(8):1-15.
Fornas O, Domingo JC, Marin P, Petriz J. Flow cytometricâ€based isolation of nucleated erythroid cells during maturation: An approach to cell surface antigen studies. Cytometry. 2002;50(6):305-312.
Kwon K, Jeon Y, Hwang H, Lee K, Kim Y, Chung H, et al. A high yield of fetal nucleated red blood cells isolated using optimal osmolality and a double-density gradient system. Prenatal Diagnosis. 2007;27(13):1245-1250.
Tomlinson, M.J., et al., Cell separation: Terminology and practical considerations. Journal of tissue engineering, 2013.(4):1-14.
Wang JY, Zhen DK, Falco VM, Farina A, Zheng YL, Delliâ€Bovi L, et al. Fetal nucleated erythrocyte recovery: Fluorescence activated cell sortingâ€based positive selection using antiâ€gamma globin versus magnetic activated cell sorting using antiâ€CD45 depletion and antiâ€gamma globin positive selection. Cytometry Part A. 2000;39(3):224-230.
Fukushima A, Utsugisawa Y, Wada Y, Mizusawa N, Horiuchi S, Kagabu T. The application of magnetic cell sorter (MACS) to detect fetal cells in maternal peripheral blood. Journal of Obstetrics and Gynaecology Research. 2001;27(3):155-162.
Yassim HM, Ali H, Hassan R, Abdullah WZ, Johan MF. Isolation of Peripheral Blood Nucleated Red Blood Cells from β-Thalassaemia Patients Using CD71 Magnetic Activated Cell Sorting. Journal of Biomedical and Clinical Sciences (JBCS). 2018;2(2):14-16.
Houseman EA, Kim S, Kelsey KT, Wiencke JK. DNA methylation in whole blood: uses and challenges. Environmental Epigenetics. 2015;2(2):145-154.
Schrier SL. Approach to the adult patient with anemia. UpToDate. 2012;12(7133):1-23.
Karakukcu M, Karakukcu C, Unal E, Ozturk A, Ciraci Z, Patiroglu T, et al. The importance of nucleated red blood cells in patients with beta-thalassemia major and comparison of two automated systems with manual microscopy and flow cytometry. Clin Lab. 2015;61:1289-1295.
Haddad A, Tyan P, Radwan A, Mallat N, Taher A. β-thalassemia intermedia: a bird’s-eye view. Turkish Journal of Hematology. 2014;31(1):5.
Zhao XX, Ozaki Y, Suzumori N, Sato T, Suzumori K. An examination of different fetal-specific antibodies and magnetic activated cell sorting for the enrichment of fetal erythroblasts from maternal blood. Congenital Anomalies. 2002;42(3):175-180.
Malleret B, Li A, Zhang R, Tan KS, Suwanarusk R, Claser C, et al. Plasmodium vivax: restricted tropism and rapid remodeling of CD71-positive reticulocytes. Blood. 2015;125(8):1314-1324.
Meissner A, Mikkelsen TS, Gu H, Wernig M, Hanna J, Sivachenko A, et al. Genome-scale DNA methylation maps of pluripotent and differentiated cells. Nature. 2008;454(7205):766-770.
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