Neonatal RBCs can undergo receptor-mediated endocytosis; normal adult RBCs cannot. Previously, we showed that drug-induced endocytosis, which can occur in adult RBCs exposed to amphipathic cations like primaquine, is greatly enhanced in all density-defined fractions of neonatal RBCs. To investigate the similarities and differences between receptor- mediated endocytosis and drug-induced endocytosis, we characterized transferrin receptor-mediated endocytosis in neonatal RBCs and compared it with drug-induced endocytosis. Primaquine drug-induced endocytosis is dependent on RBC ATP levels, is invariably preceded by stomatocytosis, and is inhibited by vanadate. In contrast, receptor- mediated endocytosis of transferrin is not preceded by stomatocytosis, is not nearly so dependent on ATP levels as is drug-induced endocytosis, and is not inhibited by vanadate. Furthermore, receptor- mediated endocytosis is quantitatively blocked by preincubation of neonatal RBCs with sodium cyanide, whereas cyanide does not inhibit drug-induced endocytosis in either adult or neonatal RBCs. Morphologic observation of the neonatal RBCs established the fact that only puckered RBCs that exhibited brilliant cresyl blue staining reticulum were capable of undergoing receptor-mediated endocytosis of transferrin. These characteristics identify them as motile R-1 reticulocytes. Reticulocytes in normal adult RBCs were incapable of exhibiting this phenomenon. Thus, receptor-mediated endocytosis, a property of motile reticulocytes in neonatal RBCs, differs from drug- induced endocytosis in its energy requirements, response to inhibitors, and morphologic concomitants.

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