Abstract:
We have noted in previous work, in a variety of inflammatory diseases, where iron dysregulation occurs, a strong
tendency for erythrocytes to lose their normal discoid shape and to adopt a skewed morphology (as judged by
their axial ratios in the light microscope and by their ultrastructure in the SEM). Similarly, the polymerization of
fibrinogen, as induced in vitro by added thrombin, leads not to the common ‘spaghetti-like’ structures but to dense
matted deposits. Type 2 diabetes is a known inflammatory disease. In the present work, we found that the axial
ratio of the erythrocytes of poorly controlled (as suggested by increased HbA1c levels) type 2 diabetics was
significantly increased, and that their fibrin morphologies were again highly aberrant. As judged by scanning
electron microscopy and in the atomic force microscope, these could be reversed, to some degree, by the addition
of the iron chelators deferoxamine (DFO) or deferasirox (DFX). As well as their demonstrated diagnostic significance,
these morphological indicators may have prognostic value.
