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Updated: Sep 9, 2025

Characterization of Sickling During Controlled Automated Deoxygenation with Oxygen Gradient Ektacytometry
Published on: November 5, 2019
Dual Assessment of the RBC Fraction Abnormally Retaining Mitochondria and of the RBC Mitochondrial Load Provides a
Eric Soupene1,2, Hart Horneman1,2, Mikail Alejandro1,2
1University of California San Francisco California USA.
Background:
Mitochondria and other organelles are normally eliminated in a process called mitophagy during the maturation of hematopoietic precursors, leading to the release of enucleated red blood cells (RBCs) in circulation. In sickle cell disease (SCD), a significant fraction of the RBCs of patients abnormally retain mitochondria. This process increases the oxygen consumption rate and formation of reactive oxygen species, augmenting known pathways of hemolysis and playing a significant role in SCD pathophysiology. The retention of mitochondria in RBC is detectable by flow cytometry analysis of whole blood, but this approach does not quantify the number of mitochondria in individual cells.
Methods:
Mitochondrial DNA was isolated from sorted RBC (106 cells) of a cohort of pediatric sickle patients (HbSS, n = 19; HbSC/HbSE, n = 8) and quantified by qPCR with a standard curve.
Results:
The methodology is suitable for the clinical quantification of the severity of mitochondrial retention in RBC of individuals with SCD. The number of mitochondria in RBCs are obtained from quantification of the copy numbers of mtDNA = 21 copies/total RBC) and the mitochondria positive RBCs fraction is determined by flow cytometry ( = 11%), which provides the number of mitochondria present in the population of RBCs retaining mitochondria ( = 400 copies/positive RBC).
Conclusion:
With this approach, future therapies that circumvent mitophagy defects could be assessed for their efficacy in reducing both the size of the RBC fraction retaining mitochondria and the mitochondrial load in each cell.

