Production of paroxysmal nocturnal hemoglobinuria‐like red blood cells by tea

Normal human red cells incubated with saline extracts of tea develop paroxysmal nocturnal hemoglobinuria‐like defects as demonstrated by positive acid and sucrose hemolysis tests. All of a variety of tea preparations tested provoked a sensitivity to complement‐dependent hemolysis and, with one exception, a moderate decrease in red cell acetylcholinesterase activity. Complement‐dependent hemolysis in tea‐incubated red cells was inhibited by antisera to C3 and to C3 activator, but not by antisera to C4. This suggests that incubation with tea may alter the red cell membrane in a way that specifically potentiates the lytic effects of the alternate pathway of complement, but not the classic pathway. Leupeptin, a protease inhibitor, also prevented complement‐dependent hemolysis of red cells incubated with tea. Although the clinical consequences of these observations are unknown, the study was initiated following a report of a young male who had developed an acute limited intravascular hemolytic episode following ingestion of large quantities of a herbal tea.