METHODS AND PROCEDURES FOR PREPARING RED BLOOD FRACTIONS

Abstract: Methods and apparatus for separating red blood cells by density are described. Older red blood cells are more dense than younger ones. Certain changes in the physiology are recorded in changes in hemoglobin or the red blood cells. By assaying different aged red blood cells, one can determine the historical physiological changes over a period of many weeks. Improved separation of red blood cells is accomplished by using rigid capillary tubes having an inner surface which augments the density equilibrium of red blood cells and/or incrementally increasing the centrifugation forces.

Description: METHODS AND PROCEDURES FOR PREPARING RED BLOOD FRACTIONS The experiments performed in this applications were supported in part by the National Institute of Diabetes, Digestive and Kidney Disorders grant number RYDK41597. The United States Government has certain rights to this patent application. The entire specification and drawings of USSN 07/970,840, filed November 3, 1992, are hereby incorporated by reference. FIELD OF THE INVENTION The invention relates to methods and apparatus for determining the physical condition of a patient over time which is recognizable in red blood cells of different ages taken from a single sample. BACKGROUND TO THE INVENTION Blood tests provide useful information but generally only indicate the current status of a patient. Many clinicians have wished for a way to determine the physical condition of a patient over a period of time. In a number of diseases such as diabetes, it would be useful to determine the recent changes in health status in a patient. However, currently, there are few easily assayed records of physiological changes. Previous infections have been detectable by the presence of antibodies. However, measuring antibodies is indicative of only a few conditions and generally does not indicate how long it has been since exposure to the antigen unless it is recent enough for IgM antibodies to be present. Metabolic changes in the past are generally not detectable using currently commercially available assays. During the 120 days of average red blood cell (RBC) life, the RBC are exposed to the entire body and may undergo many changes in response to the body condition. The most prominent red blood cell component is hemoglobin. Hemoglobin is a molecule which contains a protein portion (globin) and an organometallic portion (he e) . This molecule is responsible for delivering oxygen throughout the body. A number of compounds modify hemoglobin, some of which affect its activity. For example, carbon monoxide binds to hemoglobin, making it unable to carry oxygen and thus poisons the molecule. Certain drugs react with hemoglobin to form sulfhemoglobin. Hemoglobin also may be glycosylated. The resulting molecule, glycohemoglobin, retains its original ability to carry oxygen. There are at least five different forms of glycosylated hemoglobin. The rate at which hemoglobin is glycosylated to form glycohemoglobin is dependent on the sugar concentration (especially glucose) in the circulating plasma around the red blood cells at the time of exposure, or on the concentration of sugar accumulating within the red blood cell. It has been proposed to use such measurements as a diagnostic test for diabetes, to determine whether a patient is complying with a particular diet or therapy, and to evaluate the effectiveness of a particular therapy. Several U.S. Patents involve measuring the proportion of glycohemoglobin to hemoglobin such as 4,399,227, 4,647,654, 4,448,888, 4,438,204, 4,372,747, 4,465,774, 4,268,270 and 4.835.097. The '097 patent teaches the use of this ratio as a clock for determining the age of individual red blood cells and correlating this age with the level of a drug in the cell. In recent years glycohemoglobin measurements have attracted attention as a possible indicator of diet in diabetics. Nakashima et al, Clinical Chemistry. 35(6): 958-62 (1989). Other chemicals may be measured in red blood cells. Alcohol causes a sugar molecule to become trapped on the hemoglobin molecule due to the indirect action of alcohol on the normal breakdown of sugar in the red blood cell. The altered hemoglobin contains 5-deoxy-D-xylulose-1-phosphate (DXP) and is called "DXP-hemoglobin. " Hoberman, U.S. Patent 4.463.098, has proposed a method for determining the historic record of alcohol consumption or abnormal alcohol in the blood by measuring DXP- hemoglobin. However he does not seek to measure hemoglobin with altered glycosylation from non-alcohol related sources. Over time erythrocytes, RBC, slowly change density, and may be separated according to age based on their relative densities, Leif et al, Biochemistry. 51: 520-28 (1964) . As erythrocytes age, they lose water and therefore become more dense, Leif et al, Proceedings of the National Academy of Sciences. 51: 520-8 (1964) . A number of other biochemical changes also occur in erythrocytes over time which has led to various proposals to assay for the age of erythrocytes. See U.S. Patent 4,835,097. While some successes at separating red blood cells have been published, this technique has suffered from a number of problems which have prevented its general clinical use. Previous methods for ordering red blood cells by density, i.e., by age, have been cumbersome. These methods generally involve carefully preparing densicy gradients and placing the desired sample on top. A centrifugation step follows and harvesting of cells at each layer completes the process. The present invention has overcome the deficiencies of prior blood cell ordering techniques by variable speed centrifugation of RBCs in plastic-coated glass capillary tubes. Varying speed centrifuge techniques such as Wissler, U.S. Patent 4,343,793, have been used to obtain thrombocytes and leukocytes from blood. The blood is centrifuged at low speed whereby all the leukocytes are sedimented together while the plasma constituents and the thrombocytes remain in the supernatant. The supernatant rich in thrombocytes and plasma constituent is separ-: •.ed from the plasma constituents by brief centrifugation at a higher speed. Wissler did not seek to order red blood cells by age. McEwen et al., U.S. Patent 4,828,716, disclose a centrifuge assembly for blood separation into serum or plasma and "cellular component" in which the velocity of the linear actuation of the motor is accomplished by a control computer in accordance with sensors which relate the color and degree of turbidity of the separated fluid. The computer uses the signals produced by the optical sensors to determine when optimal separation of the sample has occurred, and stops the motor when the separation process is complete. Glass capillary tubing has been coated previously using a polymer. Springston, U.S. Patent 4,966,785, discloses a method of coating the interior surfaces of glass capillary columns with a stationary polymer phase to minimize progressive phase loss and diminished efficiency of the polymer coating. These columns are used for gas chromatography. These plastic-coated capillary tubes have not been used in cell separation, and the criterion for the interior coating is stability of the coating to solvents used for washing. The present invention also contemplates removal of layers of the ordered blood cells by suction. A number of techniques, including simple decanting have been tried to separate the red blood cells from the remaining components of the blood after centrifugation. Farr, U.S. Patent 3,355,098, discloses an open plunger tube within which is a plastic flexible small bore tube whose lower end extends through an opening in the piston head. After centrifuging, the plunger tube is inserted into the centrifuge tube. As the head of the plunger is pressed into the centrifuge tube, the air above the serum is released to the atmosphere, and serum can be extracted through the capillary tube without disturbing the solids. Taylor, U.S. Patent 3,705,018, discloses a plug for sealing a test tube which permits access to the tube for removal of some or all of the contents thereof. A U-shaped flow tube extends removably through a pair of spaced-apart apertures in the plug. Withdrawal of one tube end from one of the apertures and application of a negative or positive pressure forces fluid materials into or out of the test tube. Ayres, U.S. Patent 3,850,174, discloses an assembly for separation of blood into a light liquid phase of serum or plasma and a heavy phase including means for pushing a piston member downwardly in a container. The piston also acts as a closure, and a pointed tubular member can be used to pierce the piston to provide a passage for conducting the separated light liquid phase from one side of the stopper-piston to the ot^-er side thereof. Rogers, U.S. Patent 4,416,778, discloses a method for preparing neocyte-enriched blood wherein a sample of whole blood is centrifuged at high speed to distribute the blood components in the chamber along a density continuum. The container system used contains two chambers. Near the end of the centrifuge cycle, when the container has slowed to a relatively low speed, a valve is opened to permit communication between the two chambers so that the older, dense blood cells distal to the spin axis flow through the conduit into the other chamber. None of the above-cited patents describes a process for separating red blood cells into refined fractions of red blood cells which can be sequentially harvested by age. SUMMARY OF THE INVENTION It is an object of the present invention to make a system which will be acceptable as a general analytical system, complete with good cell separation based on age and sorting of red blood cell fractions for analysis of other changes which would be indicative of past metabolism. The use of this system for monitoring and diagnosing diabetes or hypoglycemia is particularly preferred. The present invention accomplishes this goal by a number of improvements over the conventional systems. The modifications fall into three areas: the use of plastic coated glass capillary tubes, the use of multiple centrifugation speeds to provide more refined fractions of red blood cells, and use of a particular technique for sequentially harvesting red blood cell age cohorts. The apparatus particularly useful for the sequential separation step is a suction device for harvesting layers of red blood cells by slowly moving the device through the red blood cell pack. Apparatus useful for harvesting red blood cells includes means for solidifying or immobilizing the red blood cells, e.g., by freezing, and extracting the solid fractions with a plunger. These three improvements act together to make a well ordered array of centrifuged red blood cells which have been separated and packed according to their density and presumably by age. The pack of separated red blood cells may then be advantageously harvested according to the invention without mixing different density cohorts of red blood cells. The combination of these three techniques permits an accurate measurement of glycosylated hemoglobin as it pertains to the age of red blood cells. Likewise, the history of other chemical ch nges may be determined by the method of the present invention if the change leaves a permanent, detectable mark on red blood cells. BRIEF DESCRIPTION OF THE DRAWING The Figure shows a suction probe for sequentially harvesting by age cohorts of red blood cells from a blood sample. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The separation of red blood cells by age is dependent upon the deformability of the red blood cells. Deformability of red blood cells is an adaptation for these cells to pass through capillaries in the body when the capillaries are smaller than the red blood cells. This adaptation is a squeezing c the red blood cells and a stretching of the capillary. The present invention takes advantage of the fact that red blood cells may deform as they pass each other under the force of gravity. A number of tubes have previously been used to separate blood upon centrifugation. These include glass, polypropylene, polyethylene and heparin coated capillary glass. However, polyethylene centrifuge tubes, with customary dimensions, do not have the desired strength and it is common to place them within metal supports to help them withstand centrifugation. This may be true of polypropylene tubes, too. For purposes of the present invention, the term "capillary tube" denotes a tube having a length to width ratio that makes fractionation possible. A wide tube requires too much sample for separation to be practical. The conventional glass capillary tubes do not function well to permit adequate separation of red blood cell age cohorts because rigidity of the glass boundary does not augment the deformability of the individual red cells seeking equilibrium density under the hydrodynamic forces of centrifugation. Most plastic capillary tubes lack the structural strength of glass capillary tubes and may bend, collapse or rupture upon centrifugation during high gravitational forces, and are difficult to seal. According to the present invention, these problems have been overcome by the use of rigid capillary tubes such as metal or glass, with an inner coating of a material that augments the density equilibrium of red blood cells. Any material may be used for the inner coating that augments the density equilibrium of red blood cells, for purposes of the present invention. "Plastic" is defined herein as a material which is capable of deformation and return to the previous state, which properties are useful for augmenting the density equilibrium of red blood cells. The most preferred inner coating is a plastic that closely mimics the flexibility of the body's capillaries. To the extent that plastic tubing can be fabricated so as to withstand centrifugation, without further support, it may be too rigid to deform sufficiently to augment density separation. The manner in which the internal surface of the capillary tube is coated will vary depending on the inner coating material used. Generally any suitable coating technique may be used. One such example is dissolving a plastic in a solvent and passing the solution or suspension through the glass capillary tube. Other techniques include extrusion, vapor deposition, blowing an inner coating, in situ polymerization on the glass surface and glass coating of a plastic capillary tube. Alternatively, a plastic/glass composite tube may be manufactured directly. One skilled in the art of coating rigid surfaces will readily appreciate that there are a variety of coating techniques that can be used to provide a tube which will withstand the rigors of centrifugation while having an interior which augments the density equilibrium of red blood cells. Materials other than conventional polymeric plastics .can be used as well to augment the density equilibrium of the red blood cells. One such material is a coating of bovine serum albumin. However, the coating need not be albumin or other proteins. Water soluble organic polymers such as poly(vinylpyrrolidone) can also be used to improve density separation of red blood cells. The choice of plastics and glasses may be broad and can easily be determined by simple experimentation. For example, the glass capillary tube may be made of borosilicate glass, soda lime glass, lime glass, flint glass, crown glass, optical glass, lead glass and alumina glass. The types of plastic which may be used include polyethylene, polypropylene, polystyrene, polytetrafluoroethylene, polyvinyl alcohol, polyvinyl chloride, polyethylene glycols and their fatty acid esters, polycarbonates, polyesters, polyisoprene, polyisobutylene, urea formaldehyde, nylons, polyacetal, acrylic resins, ionomer resins, phenolic resins, epoxy resins and poly aryl sulfones. The plastics may be a homopolymer, copolymer, block copolymer, graft copolymer or a mixture. Of the above plastics, polystyrene is most preferred. Other techniques for imparting a plastic-like surface onto glass may be used provided that the resulting inner surface augments sufficient red blood cell deformity to allow adequate separation of red blood cells based on age. One such method for doing this is by plasma discharge, a technique known per se and used to treat the surface of medical implants, cell culture apparatus and other surfaces contacting biological materials. Other materials may be added between the plastic coating and the glass base to facilitate adequate bonding between the two materials. The exposed surface of the plastic layer may be coated with heparin, a chemical reacting with calcium or other suitable means to prevent blood coagulation. Where the blood has already been pretreated to prevent coagulation, this coating is unnecessary. Other compounds may be used to coat the plastic to deliver compounds into the sample or to reduce or enhance certain characteristics of the plastic coating. These compounds, of course, are readily determined by one skilled in the art. A suitable capillary tube is typically a very long, very thin tube which is capable of holding blood and which is capable of maintaining layers of red blood ce--ls and plasma in distinct layers until analysis can be carried out on the various fractions. A tube meeting these requirements is usually up to 75 mm long and up to 2 mm wide. Wider tubes can be used, but they are not generally practical because the size of the sample required increases too rapidly with increases in the diameter of the tube. Tubes with diameters up to 2.4 mm have been found useful. Tubes of a diameter less than about 1.2 mm are also less effective than slightly wider tubes. The size of the tube is not particularly importart, and convenient sizes are commercially available between 100 μl to 10 ml. Larger and smaller sizes may be used depending on the quantity of sample available and the amount needed for a particular assay. Whole blood is withdrawn from the patient and preferably treated to prevent coagulation by any standard means such as heparin or other agent to coat the surfaces, citrate ions, EDTA or other calcium chelating agent, or other agent which blocks platelet aggregation and formation of fibrin. EDTA is the preferred anticoagulant. The blood is then placed in a capillary tube. A funnel shaped or wider head space at the top of the capillary tube may be used to facilitate filling and holding plasma after centrifugation. When whole blood is not treated with anticoagulant, the interior of the capillary tube should be so treated to prevent formation of clots. The capillary tube is then sealed at the bottom if it had not been sealed before filling. It may be sealed with any suitable material, but the standard clay used for hematocrit capillary tubes is an example of such sealant. The top of the capillary tube may also be sealed but the requirements for sealing are generally less stringent since centrifugal forces do not apply pressure from the blood. At least one end of the capillary tube should be readily openable to permit access to the pack of red blood cells. The capillary tubes from one or more samples are then loaded into a centrifuge. Another key feature of the present invention is in the centrifugation of blood filled capillary tubes. Unlike conventional centrifugation at a single high speed, the present invention uses a graduated approach. This approach is believed to allow time for the finer density separation between red blood cells in the sample. This process may be performed by a gradual increase in centrifugal force to achieve optimal age separation of red blood cells. Also important is the centrifugation of whole blood without using an artificial medium. In the present invention, three centrifugation steps may be used, with the first step being centrifugation at about 20 to about 200 G for about 5 minutes followed by about 2,000 to about 6,000 G for about twenty minutes followed by greater than about 8,000 G for about five minutes. The lowest forces used enable capillary filling and generally separate RBC from plasma. At this point, a gross separation by density begins. At intermediate centrifugal forces, the cells migrate against a gradient of other cells. An equilibrium is probably reached at intermediate G levels. The highest forces cause tight packing and are used for easier subsequent manipulation. These higher forces may have a lesser contribution to differential cell migration. Lesser or greater centrifugal force, with corresponding changes in duration, may also be used. After centrifugation, the capillary tube is removed from the centrifuge. For the purposes of this application, the upper portion of the capillary tube is the portion which contains the least dense contents. The capillary tube should contain a pack of red blood cells on the bottom with, buffy coat (of white blood cells and platelets) and plasm above them. The orientation of the tube is not important as long as good separation and clear fractions are obtained. The plasma may be removed by cutting the capillary tube at the level of the buffy coat. Alternatively, one could insert a tight- fitting plunger into the bottom end of the capillary tube and extrude the plasma out from the top of the capillary tube. Freezing the tube minimizes adherence of the cells to the wall of the capillary tube. Another method for removing plasma is to pump it off with a suction tube. The same structure may be used for removing portions of the red blood cell pack. Once the plasma is removed, portions of the red blood cell pack are removed sequentially based on their density. It does not matter whether the cells are removed starting with the most dense, the "oldest", or the least dense, the "youngest". The cells may be harvested by pushing out sequential portions of the red blood cell pack, for example, with a plunger, and washing or cutting off a layer. Examples of this are found in Nakashima, Clinical Chemistry. 35(6): 958-962 (1989) and Saunders, Clinical Chemistry. 37(9): 1531-3 (1991) . The suspension is then removed for analysis and the process is repeated as many times as necessary to produce a number of fractions each corresponding to a different aged of RBC cohorts. One preferred method for removing red blood cells from the pack is to pump them off with a suction device, as shown in Figure 1. The suction device 1 used is lowered into a centrifuged capillary tube 2 until just above the surface of the contents of the capillary tube 2. The outer diameter of the suction device 1 is slightly less than the internal diameter of the capillary tube 2. The space between them should be sufficient to permit a liquid to travel between them. Alternatively , one or preferably several grooves may be located around the suction device 1 part of the way down, but not as far down as the tip of the device, to permit fluid to pass between the suction device 1 and the capillary tube 2. Air or other gas inert to red blood cells may be added to the sucked flow of red blood cells and liquid through a side port 3 to form a gas bubble in the flowing stream in order to provide further separation of red blood cell age cohorts. The gas flow may also be modified to adjust the suction effect of the suction device 1. A supply of liquid, of a pH and salt concentration acceptable to red blood cells, is provided to the space between the capillary tube 2 and the suction device 1 by suitable means 4. One good liquid is phosphate buffered saline (PBS) . This liquid suspends the red blood cells as it washes away a thin layer of the red blood cell pack and permits the fraction to be withdrawn by the suction device 1 without significant damage. As the suction device 1 is lowered, successive layers of packed red blood cells are removed. The suction tube may be connected to a peristaltic pump to effect constant pressure and may also be coupled with pumping a liquid such as PBS into any suitable means for delivering liquid. As an alternative to lowering the suction device, the entire capillary tube, or the contents thereof, may be raised. One convenient mechanism is through an advancing screw 5 which can be slowly rotated to advance the tube upwards. A swivel 6 or 2ubricant may be placed between the advancing screw and the capillary tube lower plug 7. This permits minimal disruption of the red blood cell pack while gradually raising the capillary tube. Alternatively, the capillary tube may be clamped in position and the plug 7 pushed through the capillary tube 2 to force the pack of red blood cells 8 upwards. This option may be used without the suction device if so desired. The fractions of red blood cells may be deposited into separate containers or optionally mixed with reagents and run sequentially in any analytical system so desired. Among the preferred assays to perform are those relating to the modification of hemoglobin such as the glycosylation mentioned previously to determine a history of hemoglobin glycosylation rates, and therefore obtain a history of blood glucose levels. Enzymes may also be assayed; pyruvate kinase slowly decreases in activity with increasing age of the erythrocyte, Seeman et al, American Journal of Hematology. 8: 31-41 (1980). Other cell types, such as the proportion of reticulocytes, may also be measured to determine blood turnover. The effectiveness of diabetic therapies may be determined by observing the plots generated by measuring glycohemoglobin in each age fraction of red blood cells. Examples of four different results are shown in Saunders, Clinical Chemistry. 37(9): 1531-3 (1991) in Figure 1. EXAMPLE Glass capillary tubes were obtained from Scientific Products catalogue B4416-10, P5214-5, Drummond (Wiretrol) , Becton Dickinson Primary Care Division glass tubes as used for QBC, and Safetec microhematocrit tubes. All capillary tubes were cleaned by soaking in sodium hydroxide saturated ethanol for fifteen minutes. The tubes were then coated internally by one of the following methods: 1. Three to five tubes were connected in series with sections of tightly fitting plastic tubing (Tygon) and the last tube in the series was connected to a Pasteur pipette. Ethanol without sodium hydroxide was drawn back and forth through the tubes ten times to wash out the residual sodium hydroxide. Then chloroform was drawn back and forth through the tubes to remove any residual ethanol. A solution of 1% polystyrene in chloroform was drawn back and forth through the tubes eight to ten times and then expelled from the tubes using air pressure. The tubes were separated, dried on a hot plate at 40°C, washed with ethanol and dried again. 2. The same steps were performed as above except that alternating air bubbles at one second intervals until about five milliliters of each solvent or solution was drawn through the tube. This method uses a one directional peristaltic pump. 3. The same steps were performed as above except for substituting Teflon, a fluoro-aliphatic resin in 1,1,1- trichloroethane (Scotch-Gard) , or 1% polyvinylpyrrolidone in water for the polystyrene. Blood was mixed with EDTA, a standard anticoagulant and capillary tubes were filled to within 2 mm of the top with samples of the blood. The bottom end was sealed with clay, as usually done for microhematocrit determination. The tubes were topped with Fluorinert (Sigma Chemicals) and them centrifuged in a standard Microhematocrit centrifuge (Adams) at a combination of 900 RPM (80 X G) for five minutes, then 7200 RPM (4000 X G) for 20 minutes and finally at 12,000 RPM (11,000 X G) for five minutes. The succion device as depicted in the figure was used to separate various fractions of red blood cells. The fractions were tested for glycohemoglobin using the methods described in Saunders, Clinical Chemistry, 37(9): 1531-3 (1991) and the pyruvate kinase activity was measured by the method of Seaman et al, American Journal of Hematology. 8: 31-41 (1980). Blood samples were generally less than 90 minutes old when used as baseline controls. In the data below, the baseline results were held constant and the effects of changing one or more variables are given with respect to that base line. The first experiment compared the results between plastic capillary tubes and glass ones. The second experiment compared the effects of sample age on the results. The third experiment compared the effects of various centrifugal forces. The fourth experiment set compared the effects of an internal coating on the glass capillary. Two such experiments were conducted. The fifth experiment compared the effects on deformability by using different chemical means for altering red blood cell membranes. With the base line control showing a gradual slope, all other readings are given in comparison. The Table 1 presents the possible result options: TABLE 1 0 no change in slope 1 steeper overall slope 2 steeper slope in less dense cells 3 steeper slope in more dense cells 4 shallower overall slope 5 shallower slope in less dense cells 6 shallower slope in more dense cells a no change in regularity b more regular increments c less regular increments The results for experiment 1 demonstrated that when one replaces plastic with glass capillary tubes one observes a shallower overall slope without change in the regularity. This gives a result of 4a. For the second experiment, whole blood samples with standard EDTA anti-coagulant were held at refrigerator temperatures for various periods of times and the standard conditions for centrifugation were applied. The capillary tubes were plain glass or 1% polystyrene treated glass. The results from various changes in the centrifugal force are displayed in Table 2 relative to each other. The experimental conditions are based on the baseline conditions with the following changes. The duration of each step on the baseline is 5 minutes, 20 minutes and 5 minutes respectively. * Starting at 155 RPM and increasing 300 RPM/ minute for 35 minutes, reaching 12,000 RPM ** Seven consecutive steps of 5 minutes each as follows: 1500, 2120, 3000, 4240, 6000, 8500, 12,000 RPM In Table 2, double time means replacing a 5 minute spin with a 10 minute spin, or 20 minutes with 40 minutes. "Continuous linear RPM change" means starting at the (slow) inertial speed of the centrifuge, 1500 RPM, and gradually increasing the RPM at 300 RPM/minute until 12,000 RPM is reached in 35 minutes. "Seven speed incremental doubling" means seven consecutive 5 minute intervals at 1500, 2120, 2000, 4242, 6000, 8500 and 12,000 RPM. Various internal coatings were used on glass capillary tubes. For this experiment, the capillary was first cleaned by applying a solution of 1% sodium hydroxide in ethanol for five minutes, followed by three rinses in absolute ethanol. The sibstance applied was dissolved at specified concentration and specified solvent as listed below. Subsequently, negative pressure was applied to the capillary to remove excess liquid, and then the capillary was dried on a hot plate. The results are shown in Table 3. TABLE 3 An experiment was conducted to demonstrate the effect of improving deformability of the red blood cells. In this experiment, the baseline was a microhematocrit capillary which was not pre-created. The experiment was performed with both untreated and polystyrene 1% pre-treated capillaries at standard 180, 7200 and 14,000 X G routine. For this experiment, whole blood samples were pre- incubated with one of several biologically active agents with specific concentration and results as indicated in Table 4. Table 4 Treatment by incubation Pre-incubations with chlorpromazine or taurocholate or a combination thereof, in the absence of an internal coating, was done to see if increasing cell deformability accounts for the working of the present invention. It was found that cell deformability alone is not sufficient to provide the separation needed for compiling an accurate history, because the effect was less than with the polystyrene coating. Combining chlorpromazine with polystyrene coating exhibited only a minor improvement over polystyrene alone. The foregoing description of the specific embodiments reveal the general nature of the invention so that others can, by applying current knowledge, readily modify and/or adapt for various applications such specific embodiments without departing from the generic concept, and, therefore, such adaptations and modifications should and are intended to be comprehended within the meaning and range of equivalents of the disclosed embodiments. It is to be understood that the phraseology or terminology employed herein is for the purpose of description and not of limitation. All references mentioned in this application are incorporated by reference.

Claims: What is claimed is: 1. A method of sorting red blood cells substantially in order of their densities and/or ages which comprises placing red blood cells of different densities or ages into a centrifuge tube means, said tube means comprising a tube having a coating on its inner surface, said tube being formed of a rigid first material which is sufficiently strong to withstand forces applied during centrifuging, and said coating comprising a second material which augments the density equilibrium of red blood cells, and centrifuging the cells until they are sorted substantially in order of their densities. 2. The method of claim 1 wherein the rigid material is glass. 3. The method of any of claims 1 :r 2 wherein the material which augments the density equilibrium of red blood cells is an organic polymer, such as one selected from the group consisting of polyethylene, polypropylene, polystyrene, polytetrafluoroethylene, polyvinyl alcohol, polyvinyl chloride, polyethylene glycols and their fatty acid esters, polycar onates, polyesters, polyis oprene , polyvinylpyrrolidone, polyisobutylene, urea formaldehyde, nylons, polyacetal, acrylic resins, ionomer resins, phenolic resins, epoxy resins and poly aryl sulfones, especially polystyrene. 4. A method for sorting red blood cells substantially in order of their densities or ages, optionally according to the method of any of claims 1-3, comprising: centrifuging red blood cells of different densities or ages for a first predetermined period of ,-ime at a first predetermined centrifugal force, and centrifuging said cells for a second predetermined period of time at a second and greater predetermined centrifugal force, and optionally centrifuging said cells for a third predetermined period of time at a third and greater predetermined centrifugal force. 5. The method of claim 4 wherein the red blood cells are centrifuged either (I) (a) at a force of about 20 to about 200 G for about five minutes, (b) at about 2,000 to about 6,000 G for about twenty minutes, and (c) at greater than about 8,000 G for about five minutes, and/or (II) such that force (a) is about 80 G, force (b) is about 4,000 G, and force (c) is about 11,000 G. 6. A method for producing fractions of red blood cells of different densities or ages comprising: centrifuging red blood cells into a pack sorted substantially in order of their densities or ages into layers of different density, optionally according to the method of any of claims 1-5, and sequentially removing by suction surface layers of red blood cells from the pack of red blood cells without disturbing the other layers in the pack. 7. The method of claim 6, further comprising immobilizing said red blood cells, preferably by freezing, while said red blood cells are in said centrifuge tube means, prior to said sequential removal, 8. A method for sorting red blood cells substantially in order of their densities or ages which comprises: pretreating whole blood with a chemical agent means, preferably chlorpromazine, to increase the deformability of the individual cells without altering their density; centrifuging the cells, optionally by the method of any of claims 1-7, until they are sorted substantially in order of their densities or ages. 9. A method according to any of claims 1-8.wherein said red blood cells originate from the same sample. 10. The method according to any of claims 1-9 wherein said second material is not albumin. 11. The method according to any of claims 1-9 wherein said second material is not a protein. 12. A centrifuge tube means comprising a tube having a coating in its inner surface, said tube being formed of a rigid first material which is sufficiently strong to withstand forces applied during centrifuging, and said coating comprising a second material augments the density equilibrium of red blood cells, wherein said second material is a material other than a protein. The capillary tube of claim wherein said rigid first material is glass and said second material is an organic polymer. 13. An apparatus for removing a surface layer of cells from a pack of red blood cells in a capillary tube comprising; tube means for inserting into said capillary tube, wherein said tube means is capable of reaching said pack of red blood cells, suction means at the opposite end from said tube means from the end inserted into the capillary tube, adjustment means for inserting the tube means into the capillary tube, wherein said tube means in combination with said suction means removes a top layer of cells of said pack of red blood cells. 14. The apparatus of claim 18 further comprising; capillary tube means for containing said pack of red blood cells, plug means at the bottom of said capillary tube means contacting said pack of red blood cells and an inner wall of said capillary tube means, and, advancement means contacting said plug means, wherein said advancement means is capable of moving said pack of red blood cells toward said tube means. 15. The apparatus of any of claims 12-14 in which the capillary tube means is a glass capillary tube having an inner surface which is coated with an organic polymer.

Inventors: SAUNDERS ALEXANDER, SUMMERFIELD FRANK W, ZAROWITZ MICHAEL ALLEN, SAUNDERS, ALEXANDER, SUMMERFIELD, FRANK, W., ZAROWITZ, MICHAEL, ALLEN
Applicants: CHRONOMED INC, CHRONOMED, INC.
Application year: 1993
Main classification: A61M1
IPC codes: A61K35, C12N15