Furthermore, the roughness of the cell membrane is a very interesting indicator of cell's health state. It is generally believed that the plasma membrane together with its cytoskeletal support is responsible for the maintenance of the shape and stability of the cell and also for allowing extensive deformations when needed. The plasma membrane is anchored to the spectrin network mainly by proteins ankyrin and the transmembrane protein band 3 and 4.1. The erythrocyte membrane consists of an overlaying asymmetric phospholipid bilayer membrane, supported by an underlying spectrin-actin cytoskeletal complex which is interconnected by junctional complexes resulting in a simple hexagonal geometric matrix.

In order for the cell to be able to survive this, a highly deformable yet robust membrane is required. For the erythrocyte to transport haemoglobin and subsequently oxygen to all cells, it must travel through the circulatory system, including the microcirculation, where it encounters small capillary spaces and high shear stresses.

The erythrocyte is a unique anuclear cell, with a cytoplasm consisting of 95% hemoglobin, the protein responsible for oxygen transfer from the lungs to the rest of the body. Effectiveness of treatment regimes on the integrity, cell shape and roughness of RBCs may be tracked, as this cell’s health status is crucial to the overall wellness of the diabetic patient. We show that the combined AFM and SEM analyses of RBCs give valuable information about the disease status of patients with diabetes. Atomic force microscopy (AFM) was used to study membrane roughness and we correlate this with scanning electron microscopy (SEM) to compare results of both the techniques with the RBCs of healthy individuals.

Consequently, we investigated the membrane roughness and ultrastructural changes in type 2 diabetes. Ultrastructural analysis of RBCs in inflammatory and degenerative diseases can no longer be ignored and should form a fundamental research tool in clinical studies.

These changes may impact erythrocyte function. Previous research showed that in diabetic patients, there is a changed RBC ultrastructure, where these cells are elongated and twist around spontaneously formed fibrin fibers. Red blood cells (RBCs) are highly deformable and possess a robust membrane that can withstand shear force.

Cell membrane structure download