An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells

Abstract The deformability of red blood cells (RBCs) is essential for peripheral circulation and RBC survival and is reportedly altered in several diseases. However, its detail in iron-deficiency (ID) anemia remains poorly understood. We investigated the association between ID and RBC deformability...

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Main Authors: Kenji Kajitani, Tomohito Ohtani, Rie Higuchi, Misato Chimura, Fusako Sera, Chia-Hung Dylan Tsai, Yasutaka Ueda, Jun-ichi Nishimura, Yasushi Sakata
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-05483-2
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author Kenji Kajitani
Tomohito Ohtani
Rie Higuchi
Misato Chimura
Fusako Sera
Chia-Hung Dylan Tsai
Yasutaka Ueda
Jun-ichi Nishimura
Yasushi Sakata
author_facet Kenji Kajitani
Tomohito Ohtani
Rie Higuchi
Misato Chimura
Fusako Sera
Chia-Hung Dylan Tsai
Yasutaka Ueda
Jun-ichi Nishimura
Yasushi Sakata
author_sort Kenji Kajitani
collection DOAJ
description Abstract The deformability of red blood cells (RBCs) is essential for peripheral circulation and RBC survival and is reportedly altered in several diseases. However, its detail in iron-deficiency (ID) anemia remains poorly understood. We investigated the association between ID and RBC deformability in 120 participants classified into four groups according to their ferritin and hemoglobin levels: non-ID/non-anemia (n = 61), ID/non-anemia (n = 32), ID/anemia (n = 15), and non-ID/anemia (n = 12). In the analysis using the established on-chip deformability checker, the normalized transit velocity of RBCs through the peripheral-vessel constriction models was significantly higher in the ID/anemia group than in the other groups. The RBC deformability index (RDI), derived from the normalized transit velocity and degree of RBC deformation, was highest in the ID/anemia group, followed by the ID/non-anemia group. The RDI was negatively correlated with log10 ferritin levels (r = -0.66, p < 0.01), even after adjusting for hemoglobin levels. Lower log10 ferritin levels correlated with thinner, more oval-shaped RBCs and lower internal viscosity. These RBC characteristics were significantly associated with a higher RDI. These results suggest that, among several known determinants of RBC deformability, RBC morphology and internal viscosity are altered in ID, resulting in higher deformability.
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spelling doaj-art-6cf36cf5412842cbb3bbbc9d113249e22025-08-20T03:38:15ZengNature PortfolioScientific Reports2045-23222025-06-011511910.1038/s41598-025-05483-2An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cellsKenji Kajitani0Tomohito Ohtani1Rie Higuchi2Misato Chimura3Fusako Sera4Chia-Hung Dylan Tsai5Yasutaka Ueda6Jun-ichi Nishimura7Yasushi Sakata8Department of Cardiovascular Medicine, Graduate School of Medicine, The University of OsakaDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of OsakaDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of OsakaDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of OsakaDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of OsakaDepartment of Mechanical Engineering, National Yang Ming Chiao Tung UniversityDepartment of Hematology and Oncology, Graduate School of Medicine, The University of OsakaDepartment of Hematology and Oncology, Graduate School of Medicine, The University of OsakaDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of OsakaAbstract The deformability of red blood cells (RBCs) is essential for peripheral circulation and RBC survival and is reportedly altered in several diseases. However, its detail in iron-deficiency (ID) anemia remains poorly understood. We investigated the association between ID and RBC deformability in 120 participants classified into four groups according to their ferritin and hemoglobin levels: non-ID/non-anemia (n = 61), ID/non-anemia (n = 32), ID/anemia (n = 15), and non-ID/anemia (n = 12). In the analysis using the established on-chip deformability checker, the normalized transit velocity of RBCs through the peripheral-vessel constriction models was significantly higher in the ID/anemia group than in the other groups. The RBC deformability index (RDI), derived from the normalized transit velocity and degree of RBC deformation, was highest in the ID/anemia group, followed by the ID/non-anemia group. The RDI was negatively correlated with log10 ferritin levels (r = -0.66, p < 0.01), even after adjusting for hemoglobin levels. Lower log10 ferritin levels correlated with thinner, more oval-shaped RBCs and lower internal viscosity. These RBC characteristics were significantly associated with a higher RDI. These results suggest that, among several known determinants of RBC deformability, RBC morphology and internal viscosity are altered in ID, resulting in higher deformability.https://doi.org/10.1038/s41598-025-05483-2DeformabilityIron deficiencyRed blood cellMorphologyFerritin
spellingShingle Kenji Kajitani
Tomohito Ohtani
Rie Higuchi
Misato Chimura
Fusako Sera
Chia-Hung Dylan Tsai
Yasutaka Ueda
Jun-ichi Nishimura
Yasushi Sakata
An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells
Scientific Reports
Deformability
Iron deficiency
Red blood cell
Morphology
Ferritin
title An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells
title_full An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells
title_fullStr An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells
title_full_unstemmed An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells
title_short An on-chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells
title_sort on chip deformability checker demonstrates that the severity of iron deficiency is associated with increased deformability of red blood cells
topic Deformability
Iron deficiency
Red blood cell
Morphology
Ferritin
url https://doi.org/10.1038/s41598-025-05483-2
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