Electric field pulses >2-3 kV cm(-1), long known to induce membrane po
ration and fusion of erythrocytes as well as to enhance the transbilay
er mobility of phospholipids and to perturb aminophospholipid asymmetr
y, are shown to induce, at 0 degrees C, transformation of the discocyt
ic cells into echinocytes and spheroechinocytes. The extent of transfo
rmation increases with strength, duration and number of pulses. Its ti
me course is biphasic, a major rapid phase (t/2 similar to 5 s) being
followed by a minor one, lasting for 2-3 h. Shape transformation goes
along with the exofacial exposure of phosphatidylserine (PS), detected
by FITC-annexin V binding and quantified by a calibration curve estab
lished via externally inserted dilauroylphosphatidylserine. Incubation
of these echinocytes at 37 degrees C leads to a rapid recovery of the
discocytic shape followed by slower formation of stomatocytes. Shape
recovery is temperature dependent (E-a similar to 100 kJ/mol), and can
be impaired by depletion of ATP or Mg++ and by addition of vanadate o
r fluoride, Shape recovery and stomatocyte formation go along with a r
apid loss of annexin binding in about 45% of the cells while the rest
maintains its binding capacity, In the presence of vanadate, annexin b
inding increases in all cells. The results are discussed in the light
of the bilayer couple concept of erythrocyte shape and the enhanced tr
ansverse mobility of phospholipids. Echinocyte formation is most likel
y caused by the reorientation of endofacial aminophospholipids to the
outer leaflet of the bilayer, Shape recovery and stomatocyte formation
probably result from a continuous reinternalization of PS via the ATP
dependent aminophospholipid translocase, but may also be supported by
downhill movement of PC to the inner leaflet and by other yet unident
ified processes.