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. 2018 Jun 8;9:703. doi: 10.3389/fphys.2018.00703

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Copyright © 2018 Leal, Adjobo-Hermans and Bosman.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Vesiculation in progress. Structure of the RBC membrane during vesiculation, showing mechanisms involved in microvesicle shedding: breakdown of the cytoskeleton by calcium-dependent proteases; lipid bilayer rearrangement due to altered phospholipid transporter activities, which results in phosphatidylserine exposure; changes in band 3 configuration and distribution due to oxidation, binding of damaged hemoglobin, and phosphorylation, leading to loss of binding to the cytoskeleton at the ankyrin complex, recognition by IgG, and vesiculation. The order and interdependence of these processes are discussed in the text. PC, phosphatidylcholine; SM, sphingomyelin; PS, phosphatidylserine; PE, phosphatidylethanolamine.