Previous reports have suggested that non-ionic poloxamer surfactants of app
ropriate molecular mass and composition can reduce red blood cell (RBC) agg
regation in whole blood and in RBC-plasma suspensions. We have thus evaluat
ed this phenomenon for RBC aggregated by several water-soluble polymers, us
ing poloxamer 188 (P188), a non-ionic, tri-block molecule (total molecular
mass of 8.40 kDa, 80% polyoxyethylene). Human RBC were washed, then re-susp
ended in isotonic solutions of dextran 70 (70.3 kDa), dextran 500 (476 kDa)
, PVP (360 kDa) or P-L-GLU (61.2 kDa); density-separated RBC were also stud
ied. RBC aggregation was quantitated via a computerized Myrenne Aggregomete
r (extent, strength) and by the Microscopic Aggregation Index (MAI) method.
Over the range of 0.5 to 5 mg/ml, poloxamer 188 inhibited both the extent
and strength of aggregation in a dose-dependent manner, with the magnitude
of the decrease related to polymer type (e.g., at 5 mg/ml, 62% decrease for
dextran 70 vs. 14% decrease for P-L-GLU); MAI results with dextran 70 also
showed a dose-dependent decrease. Poloxamer 188 at 5 mg/ml was more effect
ive with younger, less-dense cells. Based upon the depletion model for poly
mer-induced aggregation, these findings suggest that poloxamer 188 acts by
penetrating the depletion layer near the glycocalyx, thereby reducing the o
smotic gradient between the intercellular gap and the suspending medium. Re
gardless of the specific mechanism(s) of action, poloxamers appear to offer
interesting approaches for future basic science and clinical studies, and
thus the possibility for greater insight into RBC aggregation.