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Rouleaux Formation of White Blood Cells and Platelets in Leukemia

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Rouleaux Formation of White Blood Cells and Platelets in Leukemia 410 Original Article ROULEAUX FORMATION OF WHITE BLOOD CELLS AND PLATELETS IN LEUKEMIA FORMAÇÃO DE ROULEAUX DE GLÓBULOS BRANCOS E PLAQUETAS EM LEUCEMIA 1 2 2 2 3 Hafeez ULLAH ; Khalid NAEEM ; Munir AKHTAR ; Fayyaz HUSSAIN ; Mukhtar AHMAD 1. Biohotonics Research laboratory, Department of Physics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; 2. Laser and Optronics Laboratory, Department of Physics, Bahauddin Zakariya University, Unive Bosan Road, Multan, Pakistan; 3. Department of Physics, COMSATS Institute of Information Technology, Lahore, Pakistan. ABSTRACT: The objective of this study was to measure the effects of glucose and salt level on white blood cells, red blood cells and platelets (PLTs) in the blood of a leukemic patient by using a white light microscope. Different concentrations of glucose and salt in the range of 0 mM to 500 mM were admixed in the blood sample to prepare blood smear. We revealed that shape of erythrocytes, leukocytes and platelets changes and form aggregates. Increasing concentrations of glucose cause to increases aggregation process of white blood cells, red blood cells and platelets. And the increasing concentration of sodium chloride causes to increase rouleaux formation and aggregation of platelets but dehydration due to increased sodium chloride concentration causes to break the aggregation of white blood cells. Comparison of CBC reports of these samples with and without analytes shows that total leukocyte count (TLC) decreases gradually towards normal ranges of leukocytes which is favorable in the treatment of leukemia but at the same time decreasing level of hemoglobin HGB, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and increasing level of red blood cell (RBCs) causes to reduce oxygen supply which is in favor of cancer growth and anemia. This work provides us the base for translation this in vitro study towards the in vivo case of blood microvasculature as a non-invasive methodology. KEYWORDS: White light microscopy. Complete blood count (CBC). Total leukocyte count (TLC). Red blood cell (RBC). White blood cell (WBC). Mean corpuscular hemoglobin (MCH). Mean corpuscular hemoglobin concentration (MCHC). INTRODUCTION ARDEKANI, 2007) so when we eat sugar it directly fills the place of vitamin C in white blood Blood is a connective fluid tissue which cell and as a result, the active quantity of vitamin C constitutes about 7% of our total body weight. It is in white blood cell decreases. As sugar is empty composed of 45% of blood cells and 55% plasma. calories so it does not help the white blood cells to In living animals, like the human body, blood destroy pathogens (JANJUA et al., 2016). High transport salts, minerals, oxygen, carbon dioxide consumption of sugar suppresses the immune and ingredients of foods to all parts of the body system causes to decrease the phagocytic capacity (JANJUA et al., 2016). A disease in which cells of neutrophils. Thus, weaken the immune system. violates normal rules of cell division and continue According to the scientist Otto Warburg an uncontrolled growth is called cancer. The (ANNIBALDI; WIDMANN, 2010) increased spreading of cancerous cells to other parts of the levels of sugar cause to increase the production of body is called metastasis and if cancerous cells cancer cells. Tumor cells consume more glucose form a clump it is called tumor (HEJMADI, 2009). than normal cells. Tumor cells convert glucose into Leukemia is a non-solid tumor and causes by the lactic acid even in the normal supply of oxygen. abnormal production of WBCs (LAM, 2003). Tumor cells produce and release many cytokines Cancer of leukocytes arises by the mutation in the that increase the accumulation of leukocytes hematopoietic stem cell. Malignant cells replace (PRANDONI et al., 2005). As we know that and turn off the normal marrow elements, causing glucose is a form of carbohydrates and is a anemia, thrombocytopenia, and a deficiency of compound of carbon, oxygen, and hydrogen. Its normally functioning leukocytes. The leukemic concentration is controlled by two hormone insulin cells infiltrate other organs, destroying normal & glucagon to keep the normal concentration of tissue. glucose in the blood. Any disruption in these Leukemia is caused by abnormal hormones leads to hypoglycemia or hyperglycemia production of white blood cells. Vitamin C and which is known as diabetes. All tumor cells have glucose have the same chemical structure the ability to activate clotting process thus causes (AFKHAMI-ARDEKANI; SHOJAODDINY- the accumulation of different cells like red blood Received: 18/01/17 Biosci. J., Uberlândia, v. 34, n. 2, p. 410-422, Mar./Apr. 2018 Accepted: 05/12/17 411 Rouleaux formation of white blood… ULLAH, H. et al. cells (RBCs), platelets (PLTs) & and white blood Our sample set 1 consists of six different cells (WBCs)(De Cicco, 2004). concentrations i.e. 0 mM, 100 mM, 200 mM, 300 Salt is one of the important gradients of mM, 400 mM and 500 mM of glucose (C 6H12 O6) in diet to maintain homeostasis in the body. The cancerous blood i.e. leukemia. The corresponding normal value of NaCl is 135-145 mM/L. The concentrations of glucose were weighed with concentration of sodium chloride affects the blood Sartorius digital balance (least count 0.0001g). pressure. Hypernatremia causes high blood Each concentration was prepared in 2 ml blood of pressure. Due to the nucleus and sensitive leukemia patient with blood group A+ve and membrane effect of salt is clear in white blood aforementioned concentrations of glucose were cells. Increased level of sodium in the blood causes admixed gently to prepare blood smear of each dehydration (ADROGUÉ; MADIAS, 2000) and concentration. The smear of each concentration was increase the production of immune cells that cause examined under a microscope with the objective of the autoimmune diseases i.e. they destroy healthy 100X and images were saved with the help of CCD cells (WU et al., 2013, KLEINEWIETFELD et al., camera. 2013). Dysfunction of kidneys, drugs, and excess of water intake causes hyponatremia. In cancer, Sample set 2 (Effects of Salt [NaCl] on hyponatremia is more dangerous than cancerous blood) hypernatremia (JANJUA et al., 2016). Tumor cells Our sample set 2 was prepared with the have a higher concentration of sodium inside them same protocol as sample set 1 except the analyte than a healthy one. was replaced with salt (NaCl) having same Accumulation of sodium in blood vessels concentrations. Here, 0 mM means there is no extra results in high blood pressure that causes many salt is added i.e. inherent salt is present. A problems like cardiovascular, renal dysfunction, centrifuge machine for five minutes at 800 rpm was heart strokes, and stiffness of arteries. Platelet used to prepare platelet-rich plasma (PRP). The reactivity increases due to the accumulation of prepared smears were covered with coverslips and sodium, so high intake of sodium chloride results in examined one by one under the microscope at 40X clumping of platelets and causes high blood in dark field to analyze the effect of sodium pressure. chloride on platelets. The blood was drawn after Different techniques and instruments have signing a written consent by the donor for the been used to observe the effects of two analytes purpose of experimentations. (glucose and Table salt) on blood cells including photoacoustic spectroscopy, mid-infrared RESULTS spectroscopy, optical coherence tomography, microscopy, computed tomography, optical diffuse For Glucose analyte reflectance, and light polarimetry etc (JANJUA et 2-D images of each concentration in whole al., 2016). The objective of this work was to measure blood of leukemia of WBCs and PLTs under the effects of glucose and salt level on white blood cells, glucose analyte are shown in Figures 1 and 2 red blood cells and platelets (PLTs) in the blood of a respectively. Table 1 gives CBC reports of glucose leukemic patient by using a white light microscope. containing samples. MATERIAL AND METHODS For Salt analyte 2-D images of each concentration in whole We have used white light digital blood of leukemia of WBCs and PLTs under salt microscopy (Optika, Italy) and dark field analyte are shown in Figures 3 and 4 respectively. microscopy with CCD camera and have recorded Table 2 gives CBC reports of NaCl containing the 2D images in transmission mode. In light samples. microscopy, intense beam of light is used to make sample visible, objective lens magnify the cells up to many times to analyze cells bodies. Sample set 1: (Effect of glucose (C 6H12 O6) on cells in cancerous blood) Biosci. J., Uberlândia, v. 34, n. 2, p. 410-422, Mar./Apr. 2018 412 Rouleaux formation of white blood… ULLAH, H. et al. (a) (b) (c) (d) (e) (f) Figure 1: 2D images of leukocytes and erythrocytes in whole blood of 40 years old leukemic patient obtained with light microscope in transmission mode of glucose concentrations of (a) 0 mM, (b) 100 mM, (c) 200 mM, (d) 300 mM, (e) 400 mM and (f) 500 mM. Biosci. J., Uberlândia, v. 34, n. 2, p. 410-422, Mar./Apr. 2018 413 Rouleaux formation of white blood… ULLAH, H. et al. (a) (b) (c) (d) (e) (f) Figure 2: 2D images of PRP ( platelet-rich plasma) of leukemic patient with 40X magnification in transmission mode for glucose concentrations (a) 0 mM, (b) 100 mM, (c) 200 mM, (d) 300 mM, (e) 400 mM, (f) 500 mM Biosci. J., Uberlândia, v. 34, n. 2, p. 410-422, Mar./Apr. 2018 414 Rouleaux formation of white blood… ULLAH, H. et al. (a) (b) (c) (d) (e) (f) Figure 3: 2D images of leukemia patient with light microscope 100X magnification in transmission mode for NaCl concentrations (a) 0 mM, (b) 100 mM, (c) 200 mM, (d) 300 mM, (e) 400 mM and (f) 500 mM.
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