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In vitro effects of zinc gluconate and acetate on red cell aggregability.

Erythrocyte aggregation is a reversible physiological process which plays an important role in blood rheological properties at low shear conditions [1,2]. Although emphasis is now given on red cell intrinsic factors [2], it is clear that the suspending medium has a key role in promoting interactions among adjacent cells [3], due to specific plasma proteins (fibrinogen and globulins) which have been reported to bind to the cell surface [4], although characteristics of this binding are poorly known [2]. While the bridging theory was generally believed to explain most of this aggregation process, there is an alternative hypothesis assuming that aggregation may rather result from electrostatic interactions explained by macromolecular depletion near the cell surface [5,6]. Red cells thus bind to form rouleaux, which may explain part of the Fahraeus–Lindqvist effect and thus improve blood flow in terminal arterioles [2] while it is clear that they increase whole blood viscosity in veins and venules. Dissociation of rouleaux occurs when a shear stress is applied to the red cell suspension [7,8]. Studies have demonstrated that some bivalent cations can influence blood rheology by inducing alterations in red cell properties. In this respect, Ca2+ (at high concentrations) decreases red cell deformability [9], and increases red cell aggregation [10]; on the opposite, Zn2+ improves red cell deformability [11–18] but its effect on aggregation remains unknown. However, there are preliminary results suggesting that zinc may modify red cell aggregability, since in vivo zinc supplementation has been shown to significantly decrease erythrocyte aggregation in healthy adult volunteers [19]. In order to determine whether red cell aggregation is directly influenced by zinc, we in vitro investigated the effect of increasing concentrations of two zinc salts versus a control buffer.