When the red cells from patients with sickle cell anemia (S-S) were kept in the disk shape by incubation in O2, they maintained cell sodium in the steady state for at least 10 hours. The sodium flux in such cells at 37°C. was 6.0 ± 1.5 m.eq./ (liters RBC) x (hours).

When S-S cells were sickled by incubation in N2, sodium outflux increased two- to threefold, while influx increased four- to fivefold and the cells gained net sodium. A small but undetermined fraction of the sodium in disk and sickle shaped S-S cells exchanges at one or more rates which are substantially slower than those calculated here from the initial rate of transfer of tracer from cells to the medium.

The penetration of tracer Cs into normal and both disk and sickled S-S cells was markedly inhibited by increasing the K concentration in the medium, indicating that Cs and K compete for an entrance pathway in all three cell types. The ratio of the inward rate constant for tracer Cs to that for K42 in normal and disk-shaped S-S cells increased only slightly when the K concentration in the medium was increased, indicating that almost all the Cs entered such cells in competition with K. Sickling accelerated the entrance of tracer cesium into S-S cells. Furthermore, the rate constant ratio increased with increasing external K concentration in sickled cells, suggesting the simultaneous presence of a non-competitive route for cesium influx in this cell type.

The results are interpreted to support the view that sickling (a) accelerates inward transport of K and Cs and outward transport of Na by a non-diffusion, assumed carrier, process and (b) opens pathways for the diffusion of all three ions.

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