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The amino acid residues involved in the areas of contact that stabilise the haemoglobin S polymer fibre seem to be the same ones that stabilise the basic unit of the deoxyhaemoglobin S crystal: the Wishner-Love double strand. The haemoglobin S fibre is probably formed by a unique packing of these double strands.

Much recent interest in the mechanism of dehydration of the dense subpopulation of sickle-cell anaemia (SS) red cells, including the 'irreversibly sickled cells' (ISCs), stems from the view that these relatively rigid cells have a major role in the two main clinical features of the disease, namely haemolytic anaemia and microvascular occlusion. The discovery that SS red cells have an elevated calcium content and accumulate Ca2+ during deoxygenation-induced sickling suggested a working hypothesis of wide appeal for the mechanism of cell dehydration: retained calcium would activate the red cell Ca2+-sensitive K+ channels, causing progressive net loss of KCl and water. However, retained calcium, which seemed as weakly bound to cytoplasmic buffers as in normal red cells, failed to show any measurable activation of K+ channels or Ca2+ pumps in metabolically normal SS cells, despite the apparent functional normality or near-normality of these transport systems. We now offer a possible explanation for this failure. We show that, contrary to the traditional views, SS cells, and to a lesser extent normal human red cells, possess intracellular vesicles with ATP-dependent Ca2+-accumulating capacity, and that nearly all the measurable calcium of fresh SS cells is contained within such vesicles, probably in the form of precipitates with inorganic or organic phosphates.

Sickle cell anaemia red cells (SS) were reported to have a high Ca content and an increased Ca uptake on deoxygenation, but their Ca-pump activity was described as normal. This seemed puzzling because the saturated Ca-extrusion rate of the normal, high Ca-affinity Ca pump is about 10 mmol per 1 cells per h (refs 3, 4) and the highest sickling-induced Ca influx reported in SS cells and observed in ATP-depleted sickle-trait (SA) red cells never exceeded 0.2 mmol per 1 cells per h. Normal pump performance is, therefore, incompatible with Ca accumulation unless SS cells have abnormally high Ca-binding capacity. We provide here evidence which suggests that SS cells have normal Ca-buffering capacity and probably genetically normal Ca pumps, but that the sickling process causes progressive Ca-pump failure and a marked reduction in Ca:Ca exchange.

The physiological actions of Ca2+ as a trigger and second messenger depend on the maintenance of large inward resting Ca2+ gradients across the cell plasma membrane. An ATP-fuelled Ca-pump, originally discovered and still best characterized in human red cells, is now believed to mediate resting Ca2+ extrusion in most animal cells. However, even in red cells, the truly physiological pump-leak turnover rate and cytoplasmic free Ca2+ level are unknown. Previous estimates were only very imprecise upper limits because normal intact red cells have a minute total pool of exchangeable Ca of less than 1 mumol 1 cells; Ca fluxes could not be measured without artificially increasing that pool with ionophores or disrupting the membrane to incorporate Ca buffers. Both procedures leave the membrane considerably leakier than in intact cells. Here, we have increased the exchangeable Ca pool by non-disruptively loading a Ca-chelator into intact cells, using intracellular hydrolysis of a membrane-permeant ester. The trapped chelator made the free cytoplasmic calcium concentration, [Ca2+]i, an easily defined function of directly measurable total cell Ca. We were then able to establish the physiological steady-state [Ca2+]i and pump-leak turnover rate of fresh cells suspended in their own plasma. If [Ca2+]i was lowered below the normal resting level, the Ca pump rate decreased according to the square of [Ca2+]i, and the inward Ca leak increased. The increase in leak did not develop if the cells were depleted of ATP and ADP.