Nanoscale insights into hematology: super-resolved imaging on blood cell structure, function, and pathology.

Fluorescence nanoscopy, also known as super-resolution microscopy, has transcended the conventional resolution barriers and enabled visualization of biological samples at nanometric resolutions. A series of super-resolution techniques have been developed and applied to investigate the molecular distribution, organization, and interactions in blood cells, as well as the underlying mechanisms of blood-cell-associated diseases. In this review, we provide an overview of various fluorescence nanoscopy technologies, outlining their current development stage and the challenges they are facing in terms of functionality and practicality. We specifically explore how these innovations have propelled forward the analysis of thrombocytes (platelets), erythrocytes (red blood cells) and leukocytes (white blood cells), shedding light on the nanoscale arrangement of subcellular components and molecular interactions. We spotlight novel biomarkers uncovered by fluorescence nanoscopy for disease diagnosis, such as thrombocytopathies, malignancies, and infectious diseases. Furthermore, we discuss the technological hurdles and chart out prospective avenues for future research directions. This review aims to underscore the significant contributions of fluorescence nanoscopy to the field of blood cell analysis and disease diagnosis, poised to revolutionize our approach to exploring, understanding, and managing disease at the molecular level.

Analysis of mitochondrial respiratory function in tissue biopsies and blood cells.

PURPOSE OF REVIEW: The review provides an overview on latest methodological strategies to assess mitochondrial respiratory function in tissue biopsies or blood cells. In addition, it summarizes the recent literature related to this topic. RECENT FINDINGS: Today, the study of mitochondrial function in key metabolic active tissues has been become more relevant, with increasing focus in clinical applications. In addition, assessment of mitochondrial function in blood cells by respirometry might be a sensitive biomarker of disease progression. High-Resolution Respirometry provides a modern tool to study mitochondrial respiratory physiology which allows direct measurement of cellular metabolic function during health and disease. Moreover, standard operating procedures are required regarding instrumental settings, sample collection and preparation, protocol design and respirometric data analysis of mitochondrial respiratory function in tissue biopsies (such as skeletal muscle, liver and adipose tissue), as well as isolated blood cells. SUMMARY: Mitochondrial function is a key factor in many metabolic diseases. Although various analytical approaches are available, certain well-established protocols for isolated mitochondria are limited for the analysis of mitochondrial function in tissue biopsies or blood cells. Thus, cautious considerations in selecting appropriate protocols and analytical endpoints are crucial for the interpretation of the gained data and to draw robust conclusions.

Ultrastructural, Confocal and Viscoelastic Characteristics of Whole Blood and Plasma After Exposure to Cadmium and Chromium Alone and in Combination: An Ex Vivo Study.

BACKGROUND/AIMS: Heavy metal pollution is increasing in the environment, contaminating water, food and air supplies. This can be linked to many anthropogenic activities. Heavy metals are absorbed through the skin, inhalation and/or orally. Irrespective of the manner of heavy metal entry in the body, the blood circulatory system is potentially the first to be affected following exposure and adverse effects on blood coagulation can lead to associated thrombotic disease. Although the plasma levels and the effects of cadmium (Cd) and chromium (Cr) on erythrocytes and lymphocytes have been described, the environmental exposure to heavy metals are not limited to a single metal and often involves metal mixtures, with each metal having different rates of absorption, different cellular, tissue, and organ targets. Therefore the aim of this study is to investigate the effects of the heavy metals Cd and Cr alone and whether Cr synergistically increases the effect of Cd on physiological important processes such as blood coagulation. METHODS: Human blood was exposed to the heavy metals ex vivo, and thereafter morphological analysis was performed with scanning electron- and confocal laser scanning microscopy (CLSM) in conjunction with thromboelastography®. RESULTS: The erythrocytes, platelets and fibrin networks presented with ultrastructural changes, including varied erythrocytes morphologies, activated platelets and significantly thicker fibrin fibres in the metal-exposed groups. CLSM analysis revealed the presence of phosphatidylserine on the outer surface of the membranes of the spherocytic erythrocytes exposed to Cd and Cr alone and in combination. The viscoelastic analysis revealed only a trend that indicates that clots that will form after heavy metal exposure, will likely be fragile and unstable especially for Cd and Cr in combination. CONCLUSION: This study identified the blood as an important target system of Cd and Cr toxicity.

Microscopy and Microanalysis of Blood in a Snake Head Fish, Channa gachua Exposed to Environmental Pollution.

Conventional and highly sophisticated analytical methods (Cyria et al., 1989; Massar et al., 2012a) were used to analyze micro-structural and micro-analytical aspects of the blood of snake head fish, Channa gachua, exposed to municipal wastes and city garbage. Red (RBC) and white blood cell (WBC) counts and hemhemoglobin content were found to be higher in pollution affected fish as compared with control. Scanning electron microscopy revealed the occurrence of abnormal erythrocytes such as crenated cells, echinocytes, lobopodial projections, membrane internalization, spherocytes, ruptured cells, contracted cells, depression, and uneven elongation of erythrocyte membranes in fish inhabiting the polluted sites. Energy-dispersive X-ray spectroscopy (EDS) revealed the presence of silicon and lead in the RBCs of pollution affected fish. Significance of the study includes the highly sophisticated analytical approach, which revealed the aforementioned micro-structural abnormalities.

Quantitative and qualitative morphologic, cytochemical and ultrastructural characteristics of blood cells in the Crested Serpent eagle and Shikra.

The Crested Serpent eagle (Spilornis cheela) is a bird of prey found in the tropical rain forest in Thailand. The Shikra (Accipiter badius) is a sparrow hawk and common resident in Thailand. Blood samples from 9 Crested Serpent eagles and 12 Shikras were obtained from September 2010 to November 2014. They were clinically healthy and negative for blood parasites detectable by light microscopy and molecular techniques (partial cytochrome b gene for avian malaria and partial 18S rRNA gene for trypanosome). Cytochemical staining (Sudan black B, peroxidase, α-naphthyl acetate esterase, and ß-glucuronidase) and transmission electron microscopy were performed. Hematological results were reported as the mean ± standard deviation and median. Heterophils were the most prevalent leukocytes in the Crested Serpent eagle, but in the Shikra, lymphocytes were the most prevalent leukocytes. In the Shikra, some vacuoles were observed in the cytoplasm of the eosinophils. All blood cells in both types of raptors stained positively for ß-glucuronidase but negatively for peroxidase. The ultrastructure of heterophils showed more clearly differentiate long rod granules in Crested Serpent eagle and spindle-shaped granules in Shikra. The ultrastructure of the eosinophils in the Crested Serpent eagle revealed varied electron-dense, round-shaped granules with round, different electron-dense areas in the centers of some granules, which differed from the structure reported for other raptors. These quantitative results may be useful for clinical evaluations of Crested Serpent eagles and Shikras that are undergoing rehabilitation for release.

Stand up for health--avoiding sedentary behaviour might lengthen your telomeres: secondary outcomes from a physical activity RCT in older people.

BACKGROUND: Telomere length has been associated with a healthy lifestyle and longevity. However, the effect of increased physical activity on telomere length is still unknown. Therefore, the aim was to study the relationship between changes in physical activity level and sedentary behaviour and changes in telomere length. METHODS: Telomere length was measured in blood cells 6 months apart in 49, 68-year-old, sedentary, overweight individuals taking part in a randomised controlled physical activity intervention trial. The intervention group received individualised physical activity on prescription. Physical activity was measured with a 7-day diary, questionnaires and a pedometer. Sitting time was measured with the short version of The International Physical Activity Questionnaire. RESULTS: Time spent exercising as well as steps per day increased significantly in the intervention group. Reported sitting time decreased in both groups. No significant associations between changes in steps per day and changes in telomere length were noted. In the intervention group, there was a negative correlation between changes in time spent exercising and changes in telomere length (rho=-0.39, p=0.07). On the other hand, in the intervention group, telomere lengthening was significantly associated with reduced sitting time (rho=-0.68, p=0.02). CONCLUSIONS: Reduced sitting time was associated with telomere lengthening in blood cells in sedentary, overweight 68-year-old individuals participating in a 6-month physical activity intervention trial.

Comparative study on the effect of energy drinks on haematopoietic system in Wistar albino rats.

Energy drinks have become popularized and the market value for these drinks is continually growing. Therefore, the present study aimed to evaluate the effect of three popular kinds of energy drinks (Power Horse, Red Bull and Code Red) on certain hematological parameters and on the ultrastructure of blood cells in male Wistar albino rats. Animals were treated orally with Power Horse, Red Bull and Code Red respectively for 4 weeks. Blood samples were taken after two and four weeks for determination of haematological indices. Ultrastructure examination of blood cells was carried only after 4 weeks of treatment. The results indicated significant reduction (P < 0.05) in red blood cell count, haemoglobin content, haematocrit value, blood platelets count and neutrophils in animals treated with Red Bull and Power Horse and these changes were time dependant. Insignificant changes were recorded in rats administered with Code Red. On the other hand, ultrastructural alterations, including both nucleus and cytoplasm of peripheral blood cells, were recorded in all treated animals but they were more pronounced in animals received Red Bull and Power Horse. It is concluded that energy drinks have serious detrimental impacts on haematopoietic system of male rats.

Chromosome abnormalities in diffuse large B-cell lymphomas: analysis of 231 Chinese patients.

Genome instability is a hallmark of cancer. Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin lymphoma with high levels of chromosomal aberrations. The purpose of this study was to characterize chromosomal aberrations in Chinese DLBCL patients and to compare chromosomal abnormalities between germinal centre B-cell-like (GCB) and non-GCB subgroups. Fluorescence in situ hybridization, G-band cytogenetics and immunohistochemistry were performed in 231 cases of de novo DLBCL. We demonstrated that the rate of abnormal and complex karyotypes was 89.1% (139/156) and 92.8% (129/139), respectively. We found a total of 490 structural chromosomal aberrations, including 96 frequent and recurring structural alterations. Most importantly, we identified several rare or novel chromosomal alterations: eight gains (5, 13, 14q, 17, 19p, 20, 21p, Y), one loss (21) and three recurrent translocations [t(7;15)(q22;q22), t(3;20)(p24;q13.1), t(2;3)(q21;q25)]. Moreover, the frequent recurrent genomic imbalance between GCB and non-GCB subgroups was different. Finally, we discovered two cases of concurrent IGH-BCL6 and MYC rearrangements. The rate of abnormal karyotypes in DLBCL patients of Chinese descent was similar to that of Western countries, but some common karyotypes were different, as were the abnormal karyotypes of GCB and non-GCB subgroups. Our discovery of rare and novel abnormal karyotypes may represent unique chromosomal alterations in Chinese DLBCL patients.

Evaluation of blood cell attachment on Er: YAG laser applied root surface using scanning electron microscopy.

BACKGROUND: Periodontal regeneration is dependent on the uninterrupted adhesion, maturation and absorption of fibrin clots to a periodontally compromised root surface. The modification of the root surface with different agents has been used for better fibrin clot formation and blood cell attachment. It is known that Er:YAG laser application on dentin removes the smear layer succesfully. AIM: The aim of this study is to observe blood cell attachment and fibrin network formation following ER:YAG laser irradiation on periodontally compromised root surfaces in comparison to chemical root conditioning techniques in vitro. MATERIALS AND METHODS: 40 dentin blocks prepared from freshly extracted periodontally compromised hopeless teeth. Specimens were divided in 5 groups; those applied with PBS, EDTA, Citric acid and Er:YAG. They were further divided into two groups: those which had received these applications, and the control group. The specimens were evaluated with scanning electron microscope and micrographs were taken. Smear layer and blood cell attachment scoring was performed. RESULTS: In the Er:YAG laser applied group, smear layer were totally removed. In the blood applied specimens, better fibrin clot formation and blood cell attachment were observed in the Er:YAG group. In the group that had been applied with citric acid, the smear layer was also removed. The smear layer could not be fully removed in the EDTA group. CONCLUSION: Er:YAG laser application on the root dentin seems to form a suitable surface for fibrin clot formation and blood cell attachment. Further clinical studies to support these results are necessitated.

Morphological and functional characterization of leech circulating blood cells: role in immunity and neural repair.

Unlike most invertebrates, annelids possess a closed vascular system distinct from the coelomic liquid. The morphology and the function of leech blood cells are reported here. We have demonstrated the presence of a unique cell type which participates in various immune processes. In contrast to the mammalian spinal cord, the leech CNS is able to regenerate and restore function after injury. The close contact of the blood with the nerve cord also led us to explore the participation of blood in neural repair. Our data evidenced that, in addition to exerting peripheral immune functions, leech blood optimizes CNS neural repair through the release of neurotrophic substances. Circulating blood cells also appeared able to infiltrate the injured CNS where, in conjunction with microglia, they limit the formation of a scar. In mammals, CNS injury leads to the generation of a glial scar that blocks the mechanism of regeneration by preventing axonal regrowth. The results presented here constitute the first description of neuroimmune functions of invertebrate blood cells. Understanding the basic function of the peripheral circulating cells and their interactions with lesioned CNS in the leech would allow us to acquire insights into the complexity of the neuroimmune response of the injured mammalian brain.

Microcystin-LR induces cytotoxicity and affects carp immune cells by impairment of their phagocytosis and the organization of the cytoskeleton.

Microcystin-LR (MC-LR) is the main isoform of hepatotoxin produced by cyanobacteria, which occur worldwide in the aquatic environment. The present study investigated the in vitro toxic MC-LR effects on immune cells isolated from the blood of carp. Cells were exposed to different MC-LR concentrations ranging from 0.01 to 1 µg ml(-1) for 2, 6 and 24 h. In addition, the effect of the toxin on the phagocytic activity of leukocytes and on actin and tubulin re-organization in phagocytic cells was studied. We observed that MC-LR induces apoptosis in lymphocytes 2 h after incubation, whereas high toxin concentrations induced necrosis in lymphocytes in a time- and concentration-dependent manner. Incubation of the cells for 2 h with 0.1 and 1 µg ml(-1) MC-LR inhibited phagocytosis without affecting apoptosis or glutathione (GSH) levels. Moreover, at this time point and with these concentrations, the toxin also induced a significant re-organization of the actin cytoskeleton in phagocytes, which subsequently collapsed around the nucleus leading to cell shrinkage and the disappearance of filopodia. These results suggest that both phagocytes and lymphocytes are targets for MC-LR and the disturbances of phagocytosis may impair the balance of the immune system.

Kaposiform hemangioendothelioma complicated by Kasabach-Merritt phenomenon: ultrastructural observation and immunohistochemistry staining reveal the trapping of blood components.

Kaposiform hemangioendothelioma (KHE), a borderline tumor of endothelial origin, is associated with Kasabach-Merritt phenomenon, characterized by profound thrombocytopenia and consumptive coagulopathy resulting from the localized intravascular coagulation (LIC) in the tumor. Previous studies have suggested that the trapping of blood components, including platelets, may underlie the LIC in KHE. However, more evidence is needed to support this hypothesis. In this study, one case of a Chinese infant with a KHE in the left arm was complicated by Kasabach-Merritt phenomenon. The tumor was partially resected and the sample was used for ultrastructural observation and immunohistochemistry staining of Glut-1. Ultrastructural observation found the trapping of erythrocytes, platelets, macrophages, and lymphocytes in the slit-like channels of the tumor nodules, and phagocytic vesicles in the cytoplasm of neoplastic cells. Immunohistochemistry staining further showed numerous Glut-1(+) erythrocytes in the channels. In conclusion, our results provided compelling morphological evidence of the trapping of blood components in KHE, which may interpret the LIC in the tumor and subsequent consumptive coagulopathy.

Effect of the association between citric acid and EDTA on root surface etching.

OBJECTIVE: This study aims to compare the clot stabilization on root surfaces conditioned with citric acid and ethylenediamine-tetraacetic acid (EDTA). MATERIALS AND METHODS: Scaled root samples (n = 100) were set in fve groups: group I-control group (saline solution); group II (24% EDTA); group III (25% citric acid); group IV (EDTA + citric acid); group V (citric acid + EDTA). Fifty samples were assessed using the root surface modifcation index (RSMI). The other 50 received a blood drop after conditioning. Clot formation was assessed using blood elements adhesion index (BEAI). A blind examiner evaluated photomicrographs. Statistical analysis considered p < 0.05. RESULTS: Groups-III and G-V attained the best results for RSMI and BEAI in comparison to control. The worst results for clot stabilization were seen in group-II. EDTA employment before citric acid (group-IV) reduced clot formation in comparison to citric acid use alone (group-III). CONCLUSION: Root conditioning with citric acid alone and before EDTA had the best results for smear layer removal and clot stabilization. EDTA inhibited clot stabilization on root surface and must have a residual activity once it has diminished clot adhesion to root even after citric acid conditioning. Thus, EDTA can be used to neutralize citric acid effects on periodontal cells without affecting clot stabilization. Clinical signifcance: To demonstrate that citric acid use on root surfaces previously affected by periodontal disease may favor clot stabilization and may have a benefcial effect on surgical outcomes. Also, EDTA can be used to neutralize citric acid effects on periodontal cells.

Morphological, cytochemical and ultrastructural aspects of blood cells in freshwater stingray species in the middle Rio Negro basin of Amazonian Brazil.

In the present work, we examined the morphology, dimensions, cytochemical staining reactions and ultrastructure of blood cells from three freshwater stingray species, Potamotrygon wallacei, Potamotrygon motoro and Paratrygon aiereba, living in the waters of the middle Rio Negro basin (Barcelos, Amazonas, Brazil). We identified erythrocytes, erythroblasts, thrombocytes and four types of leukocytes (basophils, heterophils, lymphocytes and monocytes) in the blood of these stingray species. In all the freshwater stingray species studied, the shapes and dimensions of these cells were similar to those of marine elasmobranchs. Positive PAS staining occurred in heterophils and thrombocytes, and weak staining occurred in lymphocytes and monocytes, while metachromasia only occurred in basophils. Positive Sudan Black B staining was observed in thrombocytes and lymphocytes, and weak staining occurred in heterophils. Basophils and heterophils were the only cells with positive bromophenol blue staining, while no peroxidase staining was observed in any of the four leukocyte types. This is the first study to establish the dimensions and cytochemical staining profiles of blood cells in Amazonian stingray species. Because these elasmobranch species are exported as ornamental fish to countries worldwide, this study can contribute to establishing standards for blood constituents that may be helpful in assessing the health and welfare of these fish in artificial systems.

Robust Blood Cell Image Segmentation Method Based on Neural Ordinary Differential Equations.

For the analysis of medical images, one of the most basic methods is to diagnose diseases by examining blood smears through a microscope to check the morphology, number, and ratio of red blood cells and white blood cells. Therefore, accurate segmentation of blood cell images is essential for cell counting and identification. The aim of this paper is to perform blood smear image segmentation by combining neural ordinary differential equations (NODEs) with U-Net networks to improve the accuracy of image segmentation. In order to study the effect of ODE-solve on the speed and accuracy of the network, the ODE-block module was added to the nine convolutional layers in the U-Net network. Firstly, blood cell images are preprocessed to enhance the contrast between the regions to be segmented; secondly, the same dataset was used for the training set and testing set to test segmentation results. According to the experimental results, we select the location where the ordinary differential equation block (ODE-block) module is added, select the appropriate error tolerance, and balance the calculation time and the segmentation accuracy, in order to exert the best performance; finally, the error tolerance of the ODE-block is adjusted to increase the network depth, and the training NODEs-UNet network model is used for cell image segmentation. Using our proposed network model to segment blood cell images in the testing set, it can achieve 95.3% pixel accuracy and 90.61% mean intersection over union. By comparing the U-Net and ResNet networks, the pixel accuracy of our network model is increased by 0.88% and 0.46%, respectively, and the mean intersection over union is increased by 2.18% and 1.13%, respectively. Our proposed network model improves the accuracy of blood cell image segmentation and reduces the computational cost of the network.

Evaluation of Mitochondria Content and Function in Live Cells by Multicolor Flow Cytometric Analysis.

To evaluate how a cell responds to the external stimuli, treatment, or alteration of the microenvironment, the quantity and quality of mitochondria are commonly used as readouts. However, it is challenging to apply mitochondrial analysis to the samples that are composed of mixed cell populations originating from tissues or when multiple cell populations are of interest, using methods such as Western blot, electron microscopy, or extracellular flux analysis.Flow cytometry is a technique allowing the detection of individual cell status and its identity simultaneously when used in combination with surface markers. Here we describe how to combine mitochondria-specific dyes or the dyes targeting the superoxide produced by mitochondria with surface marker staining to measure the mitochondrial content and activity in live cells by flow cytometry. This method can be applied to all types of cells in suspension and is particularly useful for analysis of samples composed of heterogeneous cell populations.

How I investigate difficult cells at the optical microscope.

Blood cell morphological identification on the peripheral blood and bone marrow films remains a cornerstone for the diagnosis of hematological neoplasms to be integrated with immunophenotyping, molecular genetics, and histopathology. Although standardization is still far from being achieved, with high interobserver variability, in recent years, several classification approaches, from the 1976 FAB to the 2016 WHO classification, have provided hematologists with detailed morphological descriptions for a large number of diseases. Counting blasts and detecting dysplastic specimens are two cornerstones of morphological diagnosis. This review deals with identifying difficult cells, with particular reference of those with relevant diagnostic implications.

Changes in peripheral blood in SARS CoV-2 patients and its clinico-pathological correlation: A prospective cross-sectional study.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV2 can present from mild flu-like symptoms to acute respiratory distress syndrome. There is multi-organ involvement; particularly, hematopoietic system can be associated with morphological changes in blood cells of COVID-19 patients. METHOD: We conducted a cross-sectional study on a cohort of 50 COVID-19 patients, confirmed on RT-PCR with documented cycle threshold (Ct) value. Peripheral blood sample of these patients was collected and examined for complete blood counts (CBC) on automated haematological analyser as well as Leishman-stained blood smears to look for morphological changes in blood cells. Morphological changes were evaluated with reference to clinical severity and Ct value. Additionally, association between Ct value and clinical severity was also performed. Statistical tests were performed, and P value <.05 was considered significant. RESULTS: Mean age of our study group was 42.16 ± 15.55 years, with male preponderance. Most commonly observed peripheral blood changes were hypolobation (P value = .002) and toxic granules (P value = .005) in neutrophils, atypical granules with nucleolar prominence in lymphocytes, cytoplasmic granulation with clumped nuclear chromatin in monocytes, giant platelets and thrombocytopenia and normocytic normochromic anaemia. CONCLUSION: No association was found between clinical severity and Ct value as well as peripheral blood morphological changes with Ct value. We conclude that examination of peripheral smear coupled with complete blood count (CBC) is only partially supportive of disease pathogenesis and to assess the viral load other parameters should be utilised instead of relying solely on Ct value.

Impedance-based flow cytometry for the measurement of microparticles.

Over the last several years, there has been considerable interest in evaluating the biological relevance of alterations in blood-borne microparticle populations. The most commonly employed technique for the characterization of microparticles is light scatter flow cytometry. However, the enumeration and sizing of submicron particles based on light scattering properties can be problematic. Impedance-based flow cytometry based on the Coulter principle offers a sensitive methodology to characterize microparticles. This review details the rationale for employing impedance-based flow cytometry in the measurement of blood-borne microparticles.