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Updated: Mar 15, 2026

Induction of Eryptosis in Red Blood Cells Using a Calcium Ionophore
Published on: January 21, 2020
Ca2+ Entry, Oxidative Stress, Ceramide and Suicidal Erythrocyte Death Following Diosgenin Treatment
Morena Mischitelli1, Mohamed Jemaà, Mustafa Almasry
1Departments of Cardiology, Vascular Medicine and Physiology, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany.
Background/Aims:
The bioactive steroid sapogenin diosgenin is considered for a wide variety of applications including treatment of malignancy. The substance counteracts tumor growth in part by stimulating apoptosis of tumor cells. Similar to apoptosis of nucleated cells, erythrocytes may enter suicidal death or eryptosis, which is characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine translocation to the erythrocyte surface. Signaling involved in the stimulation of eryptosis includes increase of cytosolic Ca2+ activity ([Ca2+]i), oxidative stress and ceramide. The present study explored, whether diosgenin induces eryptosis and, if so, to decipher cellular mechanisms involved.
Methods:
Flow cytometry was employed to estimate phosphatidylserine exposure at the cell surface from annexin-V-binding, cell volume from forward scatter, [Ca2+]i from Fluo3-fluorescence, ROS formation from DCF dependent fluorescence, and ceramide abundance utilizing specific antibodies. Hemolysis was quantified by determination of haemoglobin concentration in the supernatant.
Results:
A 48 hours exposure of human erythrocytes to diosgenin significantly increased the percentage of annexin-V-binding cells (≥ 5 µM), significantly decreased forward scatter (15 µM), significantly increased Fluo3-fluorescence (≥ 10 µM), significantly increased DCF fluorescence (15 µM), significantly increased ceramide abundance (15 µM) and significantly increased hemolysis (15 µM). The effect of diosgenin (15 µM) on annexin-V-binding was significantly blunted but not abolished by removal of extracellular Ca2+.
Conclusions:
Diosgenin stimulates eryptosis with erythrocyte shrinkage and phospholipid scrambling of the erythrocyte cell membrane, an effect paralleled by and at least in part due to Ca2+ entry, oxidative stress and ceramide.
Insights
Diosgenin, a steroid sapogenin, induces eryptosis, a form of programmed cell death in erythrocytes. This process involves cell shrinkage, membrane scrambling, calcium influx, oxidative stress, and ceramide accumulation.
Area of Science:
- Biochemistry
- Cell Biology
- Pharmacology
Background:
- Diosgenin, a bioactive steroid sapogenin, is investigated for its anti-cancer properties, including the induction of tumor cell apoptosis.
- Eryptosis, or programmed suicidal death of erythrocytes, shares signaling pathways with apoptosis and is characterized by cell shrinkage and phosphatidylserine exposure.
- Key signaling molecules in eryptosis include increased cytosolic calcium (Ca2+), oxidative stress, and ceramide.
Purpose of the Study:
- To investigate whether diosgenin induces eryptosis in human erythrocytes.
- To elucidate the cellular mechanisms underlying diosgenin-induced eryptosis.
Main Methods:
- Flow cytometry was used to analyze phosphatidylserine exposure (annexin-V binding), cell volume (forward scatter), cytosolic Ca2+ levels (Fluo3 fluorescence), and reactive oxygen species (ROS) formation (DCF fluorescence).
- Ceramide abundance was assessed using specific antibodies.
- Hemolysis was quantified by measuring hemoglobin concentration in the supernatant.
Main Results:
- Diosgenin exposure (≥ 5 µM for 48 hours) significantly increased phosphatidylserine exposure and hemolysis.
- Higher concentrations (≥ 10 µM) led to decreased cell volume and increased cytosolic Ca2+ and ROS formation.
- Diosgenin (15 µM) significantly increased ceramide abundance, and its effect on phosphatidylserine exposure was partially reduced by removing extracellular Ca2+.
Conclusions:
- Diosgenin stimulates eryptosis in human erythrocytes.
- This effect is characterized by cell shrinkage and phospholipid scrambling.
- The mechanism involves Ca2+ influx, oxidative stress, and ceramide accumulation.
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