“…1,2 However, the process by which ATP depletion leads to the disc-sphere transformation still remains unknown in spite of continuous investigations over the years in which the disc-sphere transformation was generally induced by glucose depletion in buffered saline. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Indeed, it appears unrelated to any of the following: (i) active transport of Na + and K + by ouabain-sensitive membrane Na + , K + -ATPase, opposed by Na + and K + leakage; 4,5 (ii) Ca 2+ uptake, opposed by membrane Ca 2+ -ATPase; 8,13 (iii) formation of lysophosphatidylcholine by a fatty acid deacylation of phosphatidylcholine, opposed by a ATP-dependent fatty acid acylation; 7,23 (iv) phosphorylation state of long and flexible filamentous spectrin, 11,14,18 constituting 60% of the total proteins of the two-dimensional reticulated membrane skeleton; (v) phosphorylation state of the major transmembrane protein Band 3 (AE1), exchanging anion chloride (Cl -), and bicarbonate (HCO 3 -) and binding to filamentous spectrin near its center by intermediary of ankyrin R; 14 (vi) metabolism of phosphatidylinositides, constituting 1-2% of the total membrane phospholipids; 18,21 (vii) contraction of the erythrocyte by myosin present at a relatively low cell number copies (~6000), presumably interacting with actin protofilament cross-linking spectrin at its ends with Band 4.1R binding to glycophorin C. [15][16][17] Moreover, there are several observations suggesting that ATP is not the only determinant of the erythrocyte shape.…”