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Donnenberg AD, Kim-Shapiro DB, Kanias T, Moore LR, Kiss JE, Lee JS, Xiong Z, Wang L, Triulzi DJ, Gladwin MT. Optimizing interpretation of survival studies of fresh and aged transfused biotin-labeled RBCs. Transfusion 2023; 63:35-46. [PMID: 36494878 PMCID: PMC10069561 DOI: 10.1111/trf.17192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/09/2022] [Accepted: 09/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Ex vivo labeling with 51 chromium represents the standard method to determine red blood cell (RBC) survival after transfusion. Limitations and safety concerns spurred the development of alternative methods, including biotinylated red blood cells (BioRBC). STUDY DESIGN AND METHODS Autologous units of whole blood were divided equally into two bags and stored under standard blood bank conditions at 2 to 6°C (N = 4 healthy adult volunteers). One bag was biotinylated (15 μg/ml) on storage days 5 to 7 (fresh) and the other was biotinylated (3 μg/ml) on days 35 to 42 (aged). The proportion of circulating BioRBC was measured serially, and cell-surface biotin was quantified with reference to molecules of equivalent soluble fluorochrome. Clearance kinetics were modeled by RBC age distribution at infusion (Gaussian vs. uniform) and decay over time (constant vs. exponential). RESULTS Data were consistent with biphasic exponential clearance of cells of uniform age. Our best estimate of BioRBC clearance (half-life [T1/2 ]) was 49.7 ± 1.2 days initially, followed by more rapid clearance 82 days after transfusion (T1/2 = 15.6 ± 0.6 days). As BioRBC aged in vivo, molecules of equivalent soluble fluorochrome declined with a T1/2 of 122 ± 9 days, suggesting gradual biotin cleavage. There were no significant differences between the clearance of fresh and aged BioRBC. CONCLUSION Similar clearance kinetics of fresh and aged BioRBC may be due to the extensive washing required during biotinylation. Survival kinetics consistent with cells with uniform rather than Gaussian or other non-uniform age distributions suggest that washing, and potentially RBC culling, may extend the storage life of RBC products.
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Affiliation(s)
- Albert D. Donnenberg
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
- UPMC Hillman Cancer Center, Pittsburgh, PA
- McGowan Institute of Regenerative Medicine, Pittsburgh PA
| | | | | | | | - Joseph E. Kiss
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
- Vitalant, Pittsburgh PA
| | - Janet S. Lee
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
| | - Zeyu Xiong
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
| | - Ling Wang
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
| | - Darrell J. Triulzi
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
- Vitalant, Pittsburgh PA
| | - Mark T. Gladwin
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
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2
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Josephson CD, Glynn S, Mathew S, Birch R, Bakkour S, Kreuziger LB, Busch MP, Chapman K, Dinardo C, Hendrickson J, Hod EA, Kelly S, Luban N, Mast A, Norris P, Custer B, Sabino E, Sachais B, Spencer BR, Stone M, Kleinman S. The Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P): A research program striving to improve blood donor safety and optimize transfusion outcomes across the lifespan. Transfusion 2022; 62:982-999. [PMID: 35441384 PMCID: PMC9353062 DOI: 10.1111/trf.16869] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND The Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P) is a new iteration of prior National Heart, Lung, and Blood Institute (NHLBI) REDS programs that focus on improving transfusion recipient outcomes across the lifespan as well as the safety and availability of the blood supply. STUDY DESIGN AND METHODS The US program includes blood centers and hospitals (22 including 6 free-standing Children's hospitals) in four geographic regions. The Brazilian program has 5 participating hemocenters. A Center for Transfusion Laboratory Studies (CTLS) and a Data Coordinating Center (DCC) support synergistic studies and activities over the 7-year REDS-IV-P program. RESULTS The US is building a centralized, vein-to-vein (V2V) database, linking information collected from blood donors, their donations, the resulting manufactured components, and data extracts from hospital electronic medical records of transfused and non-transfused patients. Simultaneously, the Brazilian program is building a donor, donation, and component database. The databases will serve as the backbone for retrospective and prospective observational studies in transfusion epidemiology, transfusion recipient outcomes, blood component quality, and emerging blood safety issues. Special focus will be on preterm infants, patients with sickle cell disease, thalassemia or cancer, and the effect of donor biologic variability and component manufacturing on recipient outcomes. A rapid response capability to emerging safety threats has resulted in timely studies related to Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). CONCLUSIONS The REDS-IV-P program endeavors to improve donor-recipient-linked research with a focus on children and special populations while also maintaining the flexibility to address emerging blood safety issues.
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Affiliation(s)
- Cassandra D. Josephson
- Departments of Pathology and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Simone Glynn
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sunitha Mathew
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, USA
| | - Rebecca Birch
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, USA
| | - Sonia Bakkour
- Vitalant Research Institute, University of California San Francisco, San Francisco, California, USA
| | | | - Michael P. Busch
- Vitalant Research Institute, University of California San Francisco, San Francisco, California, USA
| | - Kathleen Chapman
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, USA
| | - Carla Dinardo
- Immunohematology, Faculdade de Medicina da Universidade de Sao and Fundacao Pro-Sangue, São Paulo, Brazil
| | - Jeanne Hendrickson
- Departments of Pediatrics and Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Eldad A. Hod
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Shannon Kelly
- Department of Pediatric Hematology & Oncology, UCSF Benioff Children’s Hospital, Oakland, California, USA
| | - Naomi Luban
- Children’s Research National Institute, Children’s National Hospital, Washington, District of Columbia, USA
| | - Alan Mast
- Versiti Blood Research Institute, Versiti, Milwaukee, Wisconsin, USA
| | - Philip Norris
- Vitalant Research Institute, University of California San Francisco, San Francisco, California, USA
| | - Brian Custer
- Vitalant Research Institute, University of California San Francisco, San Francisco, California, USA
| | - Ester Sabino
- Department of Infectious Disease, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | | | - Bryan R. Spencer
- Scientific Affairs, American Red Cross, Dedham, Massachusetts, USA
| | - Mars Stone
- Vitalant Research Institute, University of California San Francisco, San Francisco, California, USA
| | - Steve Kleinman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Victoria, British Columbia, Canada
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Ravanat C, Pongérard A, Freund M, Heim V, Rudwill F, Ziessel C, Eckly A, Proamer F, Isola H, Gachet C. Human platelets labeled at two discrete biotin densities are functional in vitro and are detected in vivo in the murine circulation: A promising approach to monitor platelet survival in vivo in clinical research. Transfusion 2021; 61:1642-1653. [PMID: 33580977 DOI: 10.1111/trf.16312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/17/2021] [Accepted: 01/17/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND The production of platelet concentrates (PCs) is evolving, and their survival capacity needs in vivo evaluation. This requires that the transfused platelets (PLTs) be distinguished from those of the recipient. Labeling at various biotin (Bio) densities allows one to concurrently trace multiple PLT populations, as reported for red blood cells. STUDY DESIGN AND METHODS A method is described to label human PLTs at two densities of Bio for future clinical trials. Injectable-grade PLTs were prepared in a sterile environment, using injectable-grade buffers and good manufacturing practices (GMP)-grade Sulfo-NHS-Biotin. Sulfo-NHS-Biotin concentrations were chosen to maintain PLT integrity and avoid potential alloimmunization while enabling the detection of circulating BioPLTs. The impact of biotinylation on human PLT recirculation was evaluated in vivo in a severe immunodeficient mouse model using ex vivo flow cytometry. RESULTS BioPLTs labeled with 1.2 or 10 μg/ml Sulfo-NHS-Biotin displayed normal ultrastructure and retained aggregation and secretion capacity and normal expression of the main surface glycoproteins. The procedure avoided detrimental PLT activation or apoptosis signals. Transfused human BioPLT populations could be distinguished from one another and from unlabeled circulating mouse PLTs, and their survival was comparable to that of unlabeled human PLTs in the mouse model. CONCLUSIONS Provided low Sulfo-NHS-Biotin concentrations (<10 μg/ml) are used, injectable-grade BioPLTs comply with safety regulations, conserve PLT integrity, and permit accurate in vivo detection. This alternative to radioisotopes, which allows one to follow different PLT populations in the same recipient, should be valuable when assessing new PC preparations and monitoring PLT survival in clinical research.
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Affiliation(s)
- Catherine Ravanat
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Anaïs Pongérard
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Monique Freund
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Véronique Heim
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Floriane Rudwill
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Catherine Ziessel
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Anita Eckly
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Fabienne Proamer
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Hervé Isola
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Christian Gachet
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
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Roubinian NH, Kanias T. Blood donor component-recipient linkages: is there fire where there is smoke? Transfusion 2020; 59:2485-2488. [PMID: 31374151 DOI: 10.1111/trf.15450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Nareg H Roubinian
- Kaiser Permanente Northern California Division of Research, Oakland, California.,Vitalant Research Institute, San Francisco, California.,University of California, San Francisco, San Francisco, California
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Donnenberg AD, Kanias T, Triulzi DJ, Dennis CJ, Meyer EM, Gladwin M. Improved quantitative detection of biotin-labeled red blood cells by flow cytometry. Transfusion 2019; 59:2691-2698. [PMID: 31172532 PMCID: PMC9236723 DOI: 10.1111/trf.15354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/18/2019] [Accepted: 04/20/2019] [Indexed: 07/28/2023]
Abstract
BACKGROUND Biotin-labeled red blood cells (BioRBC) can be tracked after transfusion, providing a convenient and safe way to measure RBC survival in vivo. RBC survival is of interest for determining optimal blood storage conditions and for assessing the impact of genetic and biologic variants in blood donors on the survival of transfused RBCs. Here we present an improved, platform-independent assay for quantifying biotin on BioRBC. This approach is also useful for detecting BioRBC in peripheral blood samples as rare events. STUDY DESIGN AND METHODS We optimized the signal-to-noise ratio of the detecting reagent (phycoerythrin-conjugated streptavidin [SA-PE]) by determining the SA-PE concentration yielding the greatest separation index between BioRBC and unlabeled RBCs. We calibrated the fluorescence intensity measurements to molecules of equivalent soluble fluorochrome (MESF), a quantitative metric of fluorochrome binding and therefore of biotin bound per RBC. We then characterized the limit of blank and limit of quantification (LoQ) for BioRBC labeled at different densities. RESULTS Biotin-labeled RBCs at sulfo-NHS-biotin concentrations of 3 to 30 μg/mL (27-271 nmol/mL RBCs) ranged from approximately 32,000 to 200,000 MESF/RBC. The LoQ ranged from one in 274,000 to one in 649,000, depending on biotin-labeling density. CONCLUSION Increased sensitivity to detect BioRBC may facilitate tracking over longer periods and/or reduction of the BioRBC dose. Total RBC-bound biotin dose has been shown to correlate with the likelihood of developing antibodies to BioRBC. Lowering the dose of labeled cells may help avoid this eventuality.
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Affiliation(s)
- Albert D. Donnenberg
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Darrell J. Triulzi
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | | | - E. Michael Meyer
- Hillman Cancer Center Cytometry Facility, Pittsburgh, Pennsylvania
| | - Mark Gladwin
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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