We show that in solutions of human hemoglobin (Hb)-oxy-and deoxy-Hb A or S-of near-physiological pH, ionic strength, and Hb concentration, liquid-liquid phase separation occurs reversibly and reproducibly at temperatures between 35 and 40°C. In solutions of deoxy-HbS, we demonstrate that the dense liquid droplets facilitate the nucleation of HbS polymers, whose formation is the primary pathogenic event for sickle cell anemia. In view of recent results that shifts of the liquid-liquid separation phase boundary can be achieved by nontoxic additives at molar concentrations up to 30 times lower than the protein concentrations, these findings open new avenues for the inhibition of the HbS polymerization.T he primary pathogenic event in sickle cell anemia (1) is the polymerization of the mutated hemoglobin (Hb) S into linear fibers (2), mostly in the postcapillary venules (3-5), forming spherulitic domains, sheaves of parallel polymers (6-8), and other secondary structures, which stretch the erythrocytes and increase the intracellular viscosity leading to vasoclussion (9). In the absence of a curative treatment (2, 10), the main impetus for research has been on slowing and preventing the polymerization of deoxy-HbS (11). Recent experiments (12), simulations (13), and theory (14) suggest that the kinetics of formation of protein solid phases can be controlled by shifting the phase boundary for liquid-liquid (L-L) separation, occurring with some proteins (15)(16)(17). In this article, we discuss the tests of the first prerequisite for the action of this control mechanism-the existence of a dense liquid phase in the solutions of normal and sickle cell Hb at near-physiological conditions.
Methods
Procedures for Direct Monitoring of L-L Separation and Nucleation ofPolymers. Samples of Hb solutions (A or S) with concentration in the range 9.6-35 g͞dl, in oxygenated or deoxygenated state, in 0.15 M potassium phosphate buffer at pH 7.35, with 0.1-1% (wt͞vol) polyethylene glycol (PEG) of molecular mass 8,000 g͞mol (PEG 8000) were held between two microscope slides. The solution layer thickness, determined by focusing on imperfections on the bottom and top inside glass surfaces, was 10-40 m and the sample volume was a few microliters. The slides were sealed with Maunt-Quick (Daido Sangyo, Japan) sealant, and mounted on a custom-made temperature control stage. The latter consists of an aluminum block attached to thermoelectric (Peltier, Sterling, MA) coolers and has an opening that allows the approach of the microscope condenser from the slide bottom for differential interference contrast (DIC) imaging. The controller ensures temperature stability and control within Ϯ0.05°C between Ϫ5 and 70°C. For the detection of the HbS polymers, polymer bundle domains, and gels, we used a DIC-equipped microscope (Leitz Orthoplan, magnification ϫ1,000) as in refs. 6, 7, and 18. To avoid heat loss through the microscope lens or the condenser, they were both inserted in brass coolers through which we flowed water coming from a temperature-contr...