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9 - The Erythrocyte Membrane

from SECTION TWO - PATHOPHYSIOLOGY OF HEMOGLOBIN AND ITS DISORDERS

Published online by Cambridge University Press:  03 May 2010

Martin H. Steinberg ,
Bernard G. Forget ,
Douglas R. Higgs  and
David J. Weatherall
By
Patrick G. Gallagher  and
Clinton H. Joiner
Martin H. Steinberg
Affiliation:
Boston University
Bernard G. Forget
Affiliation:
Yale University, Connecticut
Douglas R. Higgs
Affiliation:
MRC Institute of Molecular Medicine, University of Oxford
David J. Weatherall
Affiliation:
Albert Einstein College of Medicine, New York
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Summary

INTRODUCTION

Hemoglobinopathies, including the thalassemia syndromes and sickle cell disease, are complex disorders with protean manifestations. Their pathophysiology is influenced by environmental and genetic factors in addition to the pleiotropic effects of the globin gene mutations themselves. The erythrocyte membrane plays a critical role in these disorders because of the effects of its structural and functional perturbations and alterations in ion and water homeostasis regulated by membrane proteins. The first portion of this chapter reviews the structural and functional characteristics of the erythrocyte membrane; this is followed by a review of the alterations in ion and water homeostasis observed in the erythrocytes of sickle cell disease and thalassemia.

MEMBRANE STRUCTURE AND FUNCTION

The erythrocyte membrane is a complex, multifunctional structure. Although providing a protective layer between hemoglobin and other intracellular components and the external environment, it provides the erythrocyte with the deformability and stability required to withstand its travels through the circulation. The erythrocyte is subjected to high sheer stress in the arterial system, dramatic changes in size in the microcirculation, and wide variations in tonicity, pH, and pO2 as it travels throughout the body. It facilitates the transport of cations, anions, urea, water and other small molecules in and out of the cell, but denies entry to larger molecules, particularly if charged. A unique anucleate cell, the erythrocyte has a limited capacity for self-repair.

Membrane Structure

The erythrocyte membrane is composed of a lipid bilayer linked to an underlying cortical membrane skeleton.

Type
Chapter
Information
Disorders of Hemoglobin
Genetics, Pathophysiology, and Clinical Management
 , pp. 158 - 184
Publisher: Cambridge University Press
Print publication year: 2009

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