Ca2+ induces transbilayer redistribution of all major phospholipids in human erythrocytes

Elevating cytoplasmic Ca2+ levels in erythrocytes activates a pathway for transbilayer diffusion of plasma membrane phospholipids. The use of spin-labeled and fluorescent phospholipid analogues revealed that the pathway permits diffusion of all the major classes of phospholipids and does not distinguish between the two types of probes. Diffusion was bidirectional, began immediately upon elevation of cytoplasmic [Ca2+] above 50-100 microM, persisted as long as the [Ca2+] remained elevated, and disappeared promptly when Ca2+ levels fell. Diffusion was unaffected by conditions which suppress shedding of vesicles, discounting this event as a requisite for phospholipid reorientation induced by Ca2+.