Many studies during the last decade have been concerned with the biochemical properties underlying various states of the human red blood cell, including its maturation, aging, and some abnormal conditions.A considerable amount of work has been devoted particularly to the study of erythrocyte metabolism in the fava bean-and drug-induced hemolytic anemias. Observations were first made by Beutler and his co-workers (1, 2) concerning the instability and decreased content of reduced glutathione (GSH) in red cells in drug-induced anemia. Carson (3) and Gross (4) and their colleagues, and Sansone and Segni (5, 6) demonstrated glucose-6-phosphate dehydrogenase (G6PD) deficiency in these cells. Further work has since been done in an attempt to find a link between the genetically determined metabolic defect and the hemolytic phenomenon.Such studies have been concerned mainly with the activity and properties of various enzymes, and some work in this field has been done also in our laboratory (7-10). In the present paper a somewhat different approach is described. Glucose metabolism in fava bean-sensitive versus normal erythrocyte suspensions has been followed by quantitatively estimating the different metabolites that arise from its consumption in vitro. On these transformations, as well as on triose phosphate oxidation by hemolyzed red cells, the action of methylene blue (Mb) has also been studied.
METHODSSubjects. Blood was obtained from seven men and two women from Sardinia, five of whom belong to the same *This work was supported by Grant H 4586 of the United States Public Health Service. Preliminary communications concerning some of the results reported in the present paper have appeared in Boll. Soc. ital. Biol. sper. 1961, 37, 1046, 1048 family. Two of them had experienced acute hemolytic anemia (24 and 16 months ago, respectively) after fava bean ingestion. In all of them red cell G6PD was lacking, reduced glutathione was decreased, the Beutler test (2) was positive, and the reticulocyte count was normal. Normal subjects of both sexes and of approximately corresponding ages were used as controls.Preparation of red blood cell suspensions. The blood was collected by venipuncture, and heparin added. After centrifugation the plasma and buffy coat were removed by suction, the red blood cells (RBC) were washed thrice with buffered isotonic KCl, pH 7.4, and then made up to volume. The packed cell volume was determined on this suspension by centrifuging in a hematocrit tube for 60 minutes at 1,200 X G. RBC suspensions were never completely free from leukocytes. The contamination, however, was always less than 0.05 per cent.Hemolyzed preparations. These were prepared by treating the washed RBC with 2 vol of ice-cold water. The ghosts were removed by centrifuging for 30 minutes at 30,000 X G. The supernatant fluid was then diluted as required. All manipulations were performed at + 20 C.Incubation and extraction. In the experiments concerning glucose metabolism in intact RBC, each reaction vessel contained, per milliliter: 1...