Dynamic deformability of Plasmodium falciparum-infected erythrocytes exposed to artesunate in vitro

Artesunate (ART) is widely used for the treatment of malaria, but the mechanisms of its effects on parasitized red blood cells (RBCs) are not fully understood. We investigated ART's influence on the dynamic deformability of ring-stage Plasmodium falciparum infected red blood cells (iRBCs) in order to elucidate its role in cellular mechanobiology. The dynamic deformability of RBCs was measured by passing them through a microfluidic device with repeated bottleneck structures. The quasi-static deformability measurement was performed using micropipette aspiration. After ART treatment, microfluidic experiments showed 50% decrease in iRBC transit velocity whereas only small (~10%) velocity reduction was observed among uninfected RBCs (uRBCs). Micropipette aspiration also revealed ART-induced stiffening in RBC membranes. These results demonstrate, for the first time, that ART reduces the dynamic and quasi-static RBC deformability, which may subsequently influence blood circulation through the microvasculature and spleen cordal meshwork, thus adding a new aspect to artesunate's mechanism of action.Singapore-MIT Alliance for Research and Technology CenterNational Institutes of Health (U.S.) (Grant R01 HL094270-01A1

Analysis of red blood cell mechanical properties

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2010.Cataloged PDF version of thesis.Includes bibliographical references (p. 118-126).Decreased deformability of human red blood cells (RBCs) is both a cause of disease and biomarker for disease (1). To traverse blood capillaries, the biconcave disk-shaped RBC must deform dramatically, since the diameter of the unconstrained RBC is larger than that of the capillaries. If the RBC becomes immobilized in a capillary, hypoxia and tissue injury may result, potentially leading to death. Changes in RBC deformability may be attributable to genetics (e.g. sickle cell anemia (2) and spherocytosis (3)), drug exposure (e.g. pentoxifylline (4)), and disease (e.g. diabetes (5) and malaria (6)). Within the past 15 years, microfabrication techniques have enabled the creation of pores comparable in size and shape to the smallest human capillaries (7) and slits in the spleen (8). We use this microfabrication ability to create devices that analyze and separate RBCs of different deformability. The first device we create is an automated 'deformability cytometer' that measures dynamic mechanical responses of 103~104 individual cells in a cell population. Fluorescence measurements of each cell are simultaneously acquired, resulting in a population-based correlation between biochemical properties (e.g. cell surface markers) and dynamic mechanical deformability. This device is especially applicable to heterogeneous cell populations, and we demonstrate its ability to mechanically characterize a small number of ring-stage malaria-infected RBCs in a large population of healthy RBCs. Next we present a device whose design is based on the architecture of the human spleen. This device is able to continuously separate more deformable from less deformable RBCs. We demonstrate the ability of this device to separate schizont-stage malaria-infected RBCs from healthy RBCs. Together, these devices enable the analysis and separation of single-RBCs based on deformability.by Hansen Chang Bow.Ph.D

Characterization of nanofilter arrays for small molecule separation

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2006.Includes bibliographical references (p. 59-60).Experimental studies were performed to evaluate methods of improving separation resolution and speed in microfabricated nanofilter arrays. Experiment parameters investigated include electric field strength, nanofilter geometry, and buffer concentration. DNA polymers of size 25-1000 base pairs were the subject of our study. We concluded that increasing electric field strength resulted in inferior separation for larger DNA polymers (400-1000 bp). Additionally, we quantified the improvement in resolution of smaller nanofilter pores and lower buffer concentration. A theoretical model based on Macrotransport Theory was developed to estimate average species velocity and peak dispersion.by Hansen Chang Bow.S.M

A microfabricated deformability-based flow cytometer with application to malaria

Malaria resulting from Plasmodium falciparum infection is a major cause of human suffering and mortality. Red blood cell (RBC) deformability plays a major role in the pathogenesis of malaria. Here we introduce an automated microfabricated “deformability cytometer” that measures dynamic mechanical responses of 10[superscript 3] to 10[superscript 4] individual RBCs in a cell population. Fluorescence measurements of each RBC are simultaneously acquired, resulting in a population-based correlation between biochemical properties, such as cell surface markers, and dynamic mechanical deformability. This device is especially applicable to heterogeneous cell populations. We demonstrate its ability to mechanically characterize a small number of P. falciparum-infected (ring stage) RBCs in a large population of uninfected RBCs. Furthermore, we are able to infer quantitative mechanical properties of individual RBCs from the observed dynamic behavior through a dissipative particle dynamics (DPD) model. These methods collectively provide a systematic approach to characterize the biomechanical properties of cells in a high-throughput manner.National Institutes of Health (U.S.) (Grant R01 HL094270-01A1)National Institutes of Health (U.S.) (Grant 1-R01-GM076689-01)Singapore-MIT Alliance for Research and Technology Cente

Utility of the Modified 5-Items Frailty Index to Predict Complications and Mortality After Elective Cervical, Thoracic and Lumbar Posterior Spine Fusion Surgery: Multicentric Analysis From ACS-NSQIP Database.

STUDY DESIGN: Retrospective review of multicentric data. OBJECTIVES: The modified 5-item frailty index is a relatively new tool to assess the post-operative complication risks. It has been recently shown a good predictive value after posterior lumbar fusion. We aimed to compare the predictive value of the modified 5-item frailty index in cervical, thoracic and lumbar surgery. METHODS: The American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) Database 2015-2020 was used to identify patients who underwent elective posterior cervical, thoracic, or lumbar fusion surgeries for degenerative conditions. The mFI-5 score was calculated based on the presence of 5 co-morbidities: congestive heart failure within 30 days prior to surgery, insulin-dependent or noninsulin-dependent diabetes mellitus, chronic obstructive pulmonary disease or pneumonia, partially dependent or totally dependent functional health status at time of surgery, and hypertension requiring medication. Multivariate analysis was used to assess the independent impact of increasing mFI-5 score on the postoperative morbidity while controlling for baseline clinical characteristics. RESULTS: 53 252 patients were included with the mean age of 64.2 ± 7.2. 7946 suffered medical complications (14.9%), 1565 had surgical complications (2.9%), and 3385 were readmitted (6.3%), 363 died (.68%) within 30 days postoperative (6.3%). The mFI-5 items score was significantly associated with higher rates of complications, readmission, and mortality in cervical, thoracic, and lumbar posterior fusion surgery. CONCLUSION: The modified 5-item frailty score is a reliable tool to predict complications, readmission, and mortality in patients planned for elective posterior spinal fusion surgery