Preprint Article Version 1 This version is not peer-reviewed

Accompanying Hemoglobin Polymerization in Red Blood Cells in Patients with Sickle Cell Disease Using Fluorescence Lifetime Imaging

Version 1 : Received: 2 October 2024 / Approved: 3 October 2024 / Online: 3 October 2024 (12:09:46 CEST)

How to cite: Borges da Silva, F. A.; Florindo, J. B.; Mattos, A. C. D.; Costa, F. F.; Lorand-Metze, I.; Metze, K. Accompanying Hemoglobin Polymerization in Red Blood Cells in Patients with Sickle Cell Disease Using Fluorescence Lifetime Imaging. Preprints 2024, 2024100252. https://doi.org/10.20944/preprints202410.0252.v1 Borges da Silva, F. A.; Florindo, J. B.; Mattos, A. C. D.; Costa, F. F.; Lorand-Metze, I.; Metze, K. Accompanying Hemoglobin Polymerization in Red Blood Cells in Patients with Sickle Cell Disease Using Fluorescence Lifetime Imaging. Preprints 2024, 2024100252. https://doi.org/10.20944/preprints202410.0252.v1

Abstract

In recent studies it has been shown that fluorescence lifetime imaging (FLIM) may reveal intracellular structural details in unstained cytological preparations which are not revealed by standard staining procedures. The aim of this investigation was to show whether FLIM images could reveal areas suggestive of polymerization in red blood cells (RBCs) of sickle cell disease (SCD) patients. We examined air-dried unstained blood films using auto-fluorescence FLIM images of 45 SCD patients and compared the results with those of 27 control persons without hematological disease. All control RBCs revealed homogeneous cytoplasm without any foci. Rounded non-sickled RBCs in SCD showed between zero and three small intensively fluorescent dots with higher lifetime values. In sickled RBCs we found additionally larger irregularly shaped intensively fluorescent areas with increased FLIM values. These areas were interpreted as equivalent to polymerized hemoglobin. The rounded non-sickled RBCs of SCD patients with homogeneous cytoplasm were not different from those of erythrocytes of control patients in light microscopy. Yet, variables from the local binary pattern transformed matrix of the FLIM values per pixel, showed significant differences between non-sickled RBCs and those of control cells. In a linear discriminant analysis, using local binary pattern transformed texture features (mean and entropy) of the erythrocyte cytoplasm of normal appearing cells, the final model could distinguish between SCD patients and control persons with an accuracy of 84.7% of the patients.

Keywords

fluorescence lifetime imaging; auto-fluorescence; hemoglobin; polymerization; machine learning

Subject

Medicine and Pharmacology, Hematology

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