Agents Causing Red Blood Cell Lysis Worsens Endometriosis

Dapsone hydroxylamine is used in the treatment of skin and infectious diseases, but research shows that the agent adversely affects red blood cell survival and advances disease progression in individuals with endometriosis.

Key Points

Highlights:

• This study explores the effects of pharmacological treatments, specifically dapsone hydroxylamine (DDS-NHOH), on red blood cell (RBC) lysis.
• The degradation of red blood cell membrane causes oxidative stress and is important in the pathogenesis of endometriosis which is a characteristic of the disease.

Importance:

• Dapsone hydroxylamine is used in the treatment of skin and infectious diseases. However, it adversely affects red blood cell survival and advances disease progression in individuals with endometriosis.
• The authors of this study want to ensure that patients with endometriosis are not given any prescription that can potentially worsen their condition or alter the results.

What’s done here?

• The participants were split into two groups: a control group and an endometriosis group.
• Each member provided a blood sample and samples were analyzed for band 3-tyrosine phosphorylation (TYR-3), high molecular weight aggregate (HMWA), glutathione (GSH), and carbonic anhydrase (CA) levels. The former two can be found in the RBC membrane, and the latter is located in the cytosol.
• The RBCs were then incubated with DDS-NHOH and the researchers once again determined the different levels of each factor.

Key results:

• The RBCs of the endometriosis patients not treated with DDS-NHOH show an increase in the factors indicative of oxidative stress when compared to the control group.
• The RBCs of the endometriosis patients treated with DDS-NHOH contained the largest number of factors relating to oxidative stress. These participants also had increased CA activity. An upregulation of CA is worrisome because it is linked to other diseases, such as glaucoma.
• The results show that endometriosis uses systemic inflammation to bar the RBCs from protecting themselves against oxidative stress. Treatment such as DDS-NHOH can further aggravate this relationship and can make the patient susceptible to other illnesses.

Limitations of the study:

• This study only explores the interactions between the disease and one pharmacological agent but proceeds to warn readers about the potential effects other treatments could have.
• The researchers did not administer DDS-NHOH on the participants in vivo. As a substitute, they removed the participant's RBCs and treated the cells with DDS-NHOH.

Lay Summary

Endometriosis is a painful disease characterized by inflammation and the presence of pro-oxidation factors. These pro-oxidation factors are also released when red blood cells (RBCs) lyse. A paper titled “Dapsone hydroxylamine-mediated alterations in human red blood cells from endometriotic patients” was recently published in medical journal Gynecological Endocrinology. It is hypothesized that Dapsone hydroxylamine (DDS-NHOH), a Dapsone metabolite used to treat skin and infectious diseases, might contribute to RBC denaturation in endometriosis patients. In this paper, Andrisani et al. also looked at carbonic anhydrase (CA) levels to see how DDS-NHOH affects this metalloenzyme.

The study placed participants in one of two groups: a control group and endometriosis group. A blood sample was taken from each participant. From this blood sample, the researchers could determine an individual’s level of band 3 tyrosine phosphorylation (TYR-P) and high molecular weight aggregate (HMWA) within the RBC membranes. The researchers also looked at the cytosol to determine glutathione (GSH) and CA levels.

The results show that endometriosis patients have an upregulation of the markers in the cytosol and membrane of the RBC that are indicative of oxidative stress. Additionally, an endometriosis patient taking DDS-NHOH has comparatively higher levels of the markers.

The authors of the study conclude that the nature of the disease and side effects such as peripheric inflammation can adversely affect the RBC’s ability to fight harmful oxidative stress. It is recommended that health care providers pay careful attention to the effects of any prescribed treatments as it could potentially worsen the patient’s condition, and can also make them susceptible to other ailments.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/28557604