1
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Bacterial agents (3rd section). Transfusion 2024; 64 Suppl 1:S208-S242. [PMID: 38394040 DOI: 10.1111/trf.17693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 02/25/2024]
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2
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Gori M, Bolzoni L, Scaltriti E, Andriani L, Marano V, Morabito F, Fappani C, Cereda D, Giompapa E, Chianese R, Lanzini P, Martinelli LA, Bianchi S, Amendola A, Pongolini S, Tanzi E. Listeria monocytogenes Transmission from Donated Blood to Platelet Transfusion Recipient, Italy. Emerg Infect Dis 2023; 29:2108-21011. [PMID: 37478295 PMCID: PMC10521620 DOI: 10.3201/eid2910.230746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
We report Listeria monocytogenes infection in a patient in Italy who was transfused with pooled platelet concentrate. Genomic analysis revealed that L. monocytogenes isolates from the donor blood unit, the transfused platelets, and the patient's blood culture were genetically closely related, confirming transfusion transmission. Additional surveillance and secondary bacterial screening could improve transfusion safety.
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3
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Rosell-Valle C, Martín-López M, Campos F, Chato-Astrain J, Campos-Cuerva R, Alaminos M, Santos González M. Inactivation of human plasma alters the structure and biomechanical properties of engineered tissues. Front Bioeng Biotechnol 2022; 10:908250. [PMID: 36082161 PMCID: PMC9445835 DOI: 10.3389/fbioe.2022.908250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Fibrin is widely used for tissue engineering applications. The use of blood derivatives, however, carries a high risk of transmission of infectious agents, necessitating the application of pathogen reduction technology (PRT). The impact of this process on the structural and biomechanical properties of the final products is unknown. We used normal plasma (PLc) and plasma inactivated by riboflavin and ultraviolet light exposure (PLi) to manufacture nanostructured cellularized fibrin-agarose hydrogels (NFAHs), and then compared their structural and biomechanical properties. We also measured functional protein C, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and coagulation factors [fibrinogen, Factor (F) V, FVIII, FX, FXI, FXIII] in plasma samples before and after inactivation. The use of PLi to manufacture cellularized NFAHs increased the interfibrillar spacing and modified their biomechanical properties as compared with cellularized NFAH manufactured with PLc. PLi was also associated with a significant reduction in functional protein C, FV, FX, and FXI, and an increase in the international normalized ratio (derived from the PT), APTT, and TT. Our findings demonstrate that the use of PRT for fibrin-agarose bioartificial tissue manufacturing does not adequately preserve the structural and biomechanical properties of the product. Further investigations into PRT-induced changes are warranted to determine the applications of NFAH manufactured with inactivated plasma as a medicinal product.
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Affiliation(s)
- Cristina Rosell-Valle
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
| | - María Martín-López
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
- Escuela Internacional de Doctorado Universidad de Sevilla, Seville, Spain
| | - Fernando Campos
- Tissue Engineering Group, Department of Histology, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | - Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | - Rafael Campos-Cuerva
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
- Centro de Transfusiones, Tejidos y Células de Sevilla (CTTS), Fundación Pública Andaluza para la Gestión de la Investigación en Salud en Sevilla (FISEVI), Seville, Spain
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | - Mónica Santos González
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
- Centro de Transfusiones, Tejidos y Células de Sevilla (CTTS), Fundación Pública Andaluza para la Gestión de la Investigación en Salud en Sevilla (FISEVI), Seville, Spain
- *Correspondence: Mónica Santos González,
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4
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Arghittu A, Dettori M, Deriu GM, Soddu S, Manca PC, Carboni AA, Collu I, Palmieri A, Deiana G, Azara A, Castiglia P, Masia MD. Controlling Infectious Risk in Transfusion: Assessing the Effectiveness of Skin Disinfection in Blood Donors. Healthcare (Basel) 2022; 10:healthcare10050845. [PMID: 35627982 PMCID: PMC9141022 DOI: 10.3390/healthcare10050845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 02/01/2023] Open
Abstract
Bacterial infectious risk is a major problem in transfusion medicine. The type of micro-organisms isolated during bacterial contamination of blood products indicates that the donor’s skin is its main source. In this context, the primary measures to reduce this risk are: (a) optimal disinfection of the donor’s arm and (b) satellite bag diversion of the initial volume of blood collected. This work aimed to verify the effectiveness of skin disinfection of the blood donor’s venipuncture site. Two methodological approaches were used: (a) qualitative and quantitative microbiological testing of the skin at the collection site, before and post-disinfection; (b) qualitative microbiological testing of the first deviated blood. Pre-disinfection testing showed skin microbial load values between 3 and >200 CFU/plate. More than two-thirds of the isolates were Gram-positive bacteria (77.8%) of which 57.7% were staphylococci. Among Gram-negative bacteria, Pseudomonadaceae, Enterobacteriaceae, and Acinetobacter spp. were isolated from the blood donors (BDs). Post-disinfection, a 100% reduction in microbial load was observed in 84.4% of BDs. Microbiological testing of the first blood diverted sample revealed the presence of microbial flora in 1.9% samples; of the isolates, 83.3% were non-aureus staphylococci. This study highlights the importance of the correct application of skin disinfection procedures in order to ensure blood safety.
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Affiliation(s)
- Antonella Arghittu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (I.C.); (G.D.)
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Marco Dettori
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
- Correspondence:
| | - Grazia Maria Deriu
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Serena Soddu
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Pietro Carmelo Manca
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Anna Angela Carboni
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Irene Collu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (I.C.); (G.D.)
| | - Alessandra Palmieri
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giovanna Deiana
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (I.C.); (G.D.)
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Antonio Azara
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Paolo Castiglia
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Maria Dolores Masia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
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Rosell-Valle C, Martín-López M, Campos F, Chato-Astrain J, Campos-Cuerva R, Alaminos M, Santos González M. Inactivation of human plasma alters the structure and biomechanical properties of engineered tissues. Front Bioeng Biotechnol 2022. [PMID: 36082161 DOI: 10.3389/fbioe.2022.908250/full] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Fibrin is widely used for tissue engineering applications. The use of blood derivatives, however, carries a high risk of transmission of infectious agents, necessitating the application of pathogen reduction technology (PRT). The impact of this process on the structural and biomechanical properties of the final products is unknown. We used normal plasma (PLc) and plasma inactivated by riboflavin and ultraviolet light exposure (PLi) to manufacture nanostructured cellularized fibrin-agarose hydrogels (NFAHs), and then compared their structural and biomechanical properties. We also measured functional protein C, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and coagulation factors [fibrinogen, Factor (F) V, FVIII, FX, FXI, FXIII] in plasma samples before and after inactivation. The use of PLi to manufacture cellularized NFAHs increased the interfibrillar spacing and modified their biomechanical properties as compared with cellularized NFAH manufactured with PLc. PLi was also associated with a significant reduction in functional protein C, FV, FX, and FXI, and an increase in the international normalized ratio (derived from the PT), APTT, and TT. Our findings demonstrate that the use of PRT for fibrin-agarose bioartificial tissue manufacturing does not adequately preserve the structural and biomechanical properties of the product. Further investigations into PRT-induced changes are warranted to determine the applications of NFAH manufactured with inactivated plasma as a medicinal product.
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Affiliation(s)
- Cristina Rosell-Valle
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
| | - María Martín-López
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
- Escuela Internacional de Doctorado Universidad de Sevilla, Seville, Spain
| | - Fernando Campos
- Tissue Engineering Group, Department of Histology, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | - Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | - Rafael Campos-Cuerva
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
- Centro de Transfusiones, Tejidos y Células de Sevilla (CTTS), Fundación Pública Andaluza para la Gestión de la Investigación en Salud en Sevilla (FISEVI), Seville, Spain
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | - Mónica Santos González
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC), Red Andaluza de Diseño y Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
- Centro de Transfusiones, Tejidos y Células de Sevilla (CTTS), Fundación Pública Andaluza para la Gestión de la Investigación en Salud en Sevilla (FISEVI), Seville, Spain
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A comparative study of pathogen inactivation technologies in human platelet lysate and its optimal efficiency in human placenta-derived stem cells culture. J Virol Methods 2022; 302:114478. [DOI: 10.1016/j.jviromet.2022.114478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 11/22/2022]
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Martínez-Botía P, Acebes-Huerta A, Seghatchian J, Gutiérrez L. On the Quest for In Vitro Platelet Production by Re-Tailoring the Concepts of Megakaryocyte Differentiation. ACTA ACUST UNITED AC 2020; 56:medicina56120671. [PMID: 33287459 PMCID: PMC7761839 DOI: 10.3390/medicina56120671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022]
Abstract
The demand of platelet transfusions is steadily growing worldwide, inter-donor variation, donor dependency, or storability/viability being the main contributing factors to the current global, donor-dependent platelet concentrate shortage concern. In vitro platelet production has been proposed as a plausible alternative to cover, at least partially, the increasing demand. However, in practice, such a logical production strategy does not lack complexity, and hence, efforts are focused internationally on developing large scale industrial methods and technologies to provide efficient, viable, and functional platelet production. This would allow obtaining not only sufficient numbers of platelets but also functional ones fit for all clinical purposes and civil scenarios. In this review, we cover the evolution around the in vitro culture and differentiation of megakaryocytes into platelets, the progress made thus far to bring the culture concept from basic research towards good manufacturing practices certified production, and subsequent clinical trial studies. However, little is known about how these in vitro products should be stored or whether any safety measure should be implemented (e.g., pathogen reduction technology), as well as their quality assessment (how to isolate platelets from the rest of the culture cells, debris, microvesicles, or what their molecular and functional profile is). Importantly, we highlight how the scientific community has overcome the old dogmas and how the new perspectives influence the future of platelet-based therapy for transfusion purposes.
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Affiliation(s)
- Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (A.A.-H.)
- Department of Medicine, University of Oviedo, 33003 Oviedo, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (A.A.-H.)
| | - Jerard Seghatchian
- International Consultancy in Strategic Safety/Quality Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit/Inspection, London NW3 3AA, UK;
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (A.A.-H.)
- Department of Medicine, University of Oviedo, 33003 Oviedo, Spain
- Correspondence:
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8
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Christensen C, Jonsdottir-Buch SM, Sigurjonsson OE. Effects of amotosalen treatment on human platelet lysate bioactivity: A proof-of-concept study. PLoS One 2020; 15:e0220163. [PMID: 32294080 PMCID: PMC7159197 DOI: 10.1371/journal.pone.0220163] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 03/24/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Clinical application of mesenchymal stromal cells (MSCs) usually requires an in vitro expansion step to reach clinically relevant numbers. In vitro cell expansion necessitates supplementation of basal mammalian cell culture medium with growth factors. To avoid using supplements containing animal substances, human platelet lysates (hPL) produced from expired and pathogen inactivated platelet concentrates can be used in place of fetal bovine serum. However, globally, most transfusion units are currently not pathogen inactivated. As blood banks are the sole source of platelet concentrates for hPL production, it is important to ensure product safety and standardized production methods. In this proof-of-concept study we assessed the feasibility of producing hPL from expired platelet concentrates with pathogen inactivation applied after platelet lysis by evaluating the retention of growth factors, cytokines, and the ability to support MSC proliferation and tri-lineage differentiation. METHODOLOGY/PRINCIPAL FINDINGS Bone marrow-derived MSCs (BM-MSCs) were expanded and differentiated using hPL derived from pathogen inactivated platelet lysates (hPL-PIPL), with pathogen inactivation by amotosalen/ultraviolet A treatment applied after lysis of expired platelets. Results were compared to those using hPL produced from conventional expired pathogen inactivated platelet concentrates (hPL-PIPC), with pathogen inactivation applied after blood donation. hPL-PIPL treatment had lower concentrations of soluble growth factors and cytokines than hPL-PIPC treatment. When used as supplementation in cell culture, BM-MSCs proliferated at a reduced rate, but more consistently, in hPL-PIPL than in hPL-PIPC. The ability to support tri-lineage differentiation was comparable between lysates. CONCLUSION/SIGNIFICANCE These results suggest that functional hPL can be produced from expired and untreated platelet lysates by applying pathogen inactivation after platelet lysis. When carried out post-expiration, pathogen inactivation may provide a valuable solution for further standardizing global hPL production methods, increasing the pool of starting material, and meeting future demand for animal-free supplements in human cell culturing.
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Affiliation(s)
- Christian Christensen
- The Blood Bank, The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, Biomedical Center, University of Iceland, Reykjavik, Iceland
- Platome Biotechnology, Hafnarfjörður, Iceland
| | - Sandra Mjoll Jonsdottir-Buch
- The Blood Bank, The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, Biomedical Center, University of Iceland, Reykjavik, Iceland
- Platome Biotechnology, Hafnarfjörður, Iceland
| | - Olafur Eysteinn Sigurjonsson
- The Blood Bank, The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, Biomedical Center, University of Iceland, Reykjavik, Iceland
- Platome Biotechnology, Hafnarfjörður, Iceland
- School of Science and Engineering, University of Reykjavik, Reykjavik, Iceland
- * E-mail:
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9
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Optimization of Pooling Technique for Hepatitis C Virus Nucleic Acid Testing (NAT) in Blood Banks. HEPATITIS MONTHLY 2020. [DOI: 10.5812/hepatmon.99571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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10
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Haddad A, Elgemmezi T, Chaїb M, Bou Assi T, Abu Helu R, Hmida S, Benajiba M, Ba K, Alqudah M, Abi Hanna P, Najjar O, Garraud O. Quality and safety measures in transfusion practice: The experience of eight southern/eastern Mediterranean countries. Vox Sang 2020; 115:405-423. [PMID: 32124457 DOI: 10.1111/vox.12903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Blood transfusion is inherently associated with risks, and little is known regarding the available quality and safety measures in developing countries. No studies or census has been carried out, and therefore, no data on this compelling issue are available. MATERIALS AND METHODS Data emanating from eight Arabic eastern/southern Mediterranean countries who responded to five surveys were collected and tabulated. RESULTS Asepsis during phlebotomy, screening for serological and immuno-haematological parameters and appropriate storage conditions are maintained across all countries. Variations in blood component processing exist. Universal leucoreduction is systematically applied in Lebanon. Nucleic acid testing is only performed in Egypt. Aphaeresis procedure, leucoreduction and quality control for blood components are virtually inexistent in Mauritania. Written donor questionnaire is absent in Algeria and Tunisia. Most donor deferral periods for infectious agents are inconsistent with international standards. CONCLUSION Gaps in the processing and in the quality/safety measures applied to the manufacture of blood components are quite evident in most eastern/southern Mediterranean countries. The decision of establishing an effective collaboration network and an independent body - aside from WHO - composed of specialists that oversees all transfusion activities in these countries is certainly a crucial step towards ensuring an optimum level of blood safety.
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Affiliation(s)
- Antoine Haddad
- Department of Clinical Pathology and Blood Bank, Sacré-Coeur Hospital, Lebanese University, Beirut, Lebanon.,EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | | | - Mohamed Chaїb
- Centre de Wilaya de Transfusion Sanguine de Blida, Blida, Algeria
| | - Tarek Bou Assi
- Department of Laboratory Medicine, Psychiatric Hospital of the Cross, Jaledib, Lebanon.,Department of Laboratory Medicine and Blood Bank, Saint Joseph Hospital, Dora, Lebanon
| | - Rasmi Abu Helu
- Department of Medical Laboratory Sciences, Al-Quds University, Abu-Deis, Palestine
| | - Slama Hmida
- Centre National de transfusion Sanguine, Tunis, Tunisia
| | - Mohamed Benajiba
- Centre National de Transfusion Sanguine et d'Hématologie, Rabat, Morocco
| | - Khadijetou Ba
- Faculté de Médicine, Centre National de Transfusion Sanguine, Nouakchott, Mauritanie
| | - Mohammad Alqudah
- Departments of Pathology and Microbiology. School of Medicine, Jordan University of Sciences and Technology, Jordan
| | - Pierre Abi Hanna
- Infectious diseases Department, Sacré-Coeur Hospital, Lebanese University, Beirut, Lebanon
| | | | - Olivier Garraud
- EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France.,Institut National de la Transfusion Sanguine, Paris, France.,Palliative Care Unit, The Ruffec Hospital, Ruffec, France
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11
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North AK, Mufti N, Sullivan T, Corash L. Preclinical safety assessment of pathogen reduced red blood cells treated with amustaline and glutathione. Transfusion 2020; 60:358-366. [PMID: 31930533 PMCID: PMC7027779 DOI: 10.1111/trf.15662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The nucleic acid targeted pathogen reduction (PR) system utilizing amustaline (S-303) and glutathione (GSH) is designed to inactivate blood-borne pathogens and leukocytes in red blood cell concentrates (PR-RBCC). Inactivation is attained after amustaline intercalates and forms covalent nucleic acid adducts preventing replication, transcription, and translation. After pathogen inactivation, amustaline spontaneously hydrolyzes to S-300, the primary negatively charged reaction product; amustaline is below quantifiable levels in PR-RBCC. GSH quenches free unreacted amustaline. STUDY DESIGN AND METHODS The genotoxic and carcinogenic potential of PR-RBCC, the reaction by-products, and S-300 were assessed in accordance with the International Conference on Harmonization (ICH) guidelines and performed in compliance with the Food and Drug Administration (FDA) good laboratory practice standards, 21 CFR Part 58. in vitro bacterial reverse mutagenicity and chromosomal aberration assays were performed with and without exogenous S9 metabolic activation, and in in vivo clastogenicity and carcinogenic assays using validated murine models. RESULTS PR-RBCCs were not genotoxic in vitro and in vivo and were non-carcinogenic in p53+/- transgenic mice transfused over 26 weeks. Estimated safety margins for human exposure ranged from >90 to >36 fold for 2 to 5 PR-RBCCs per day, respectively. PR-RBCCs and S-300 did not induce chromosome aberration in the in vivo murine bone marrow micronucleus assay at systemically toxic doses. CONCLUSIONS PR-RBCCs did not demonstrate genotoxicity in vitro or in vivo and were not carcinogenic in vivo. These studies support the safety of PR-RBCCs and suggest that there is no measurable genotoxic hazard associated with transfusion of PR-RBCCs.
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12
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Trakhtman P, Kumukova I, Starostin N, Borsakova D, Balashov D, Ignatova A, Kadaeva L, Novichkova G, Rumiantcev A. The pathogen‐reduced red blood cell suspension: single centre study of clinical safety and efficacy in children with oncological and haematological diseases. Vox Sang 2019; 114:223-231. [DOI: 10.1111/vox.12757] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/19/2018] [Accepted: 01/10/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Pavel Trakhtman
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Irina Kumukova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Nikolay Starostin
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Daria Borsakova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
- Laboratory of Physiology and Biophysics of the Cell Center for Theoretical Problems of Physicochemical Pharmacology Russian Academy of Sciences Moscow Russia
| | - Dmitry Balashov
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Anastasia Ignatova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Leilya Kadaeva
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Galina Novichkova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Alexander Rumiantcev
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
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Reflections on the dynamics of bacterial and viral contamination of blood components and the levels of efficacy for pathogen inactivation processes. Transfus Apher Sci 2018; 57:683-688. [DOI: 10.1016/j.transci.2018.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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14
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Salunkhe V, De Cuyper IM, Papadopoulos P, van der Meer PF, Daal BB, Villa-Fajardo M, de Korte D, van den Berg TK, Gutiérrez L. A comprehensive proteomics study on platelet concentrates: Platelet proteome, storage time and Mirasol pathogen reduction technology. Platelets 2018; 30:368-379. [PMID: 29553857 DOI: 10.1080/09537104.2018.1447658] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Platelet concentrates (PCs) represent a blood transfusion product with a major concern for safety as their storage temperature (20-24°C) allows bacterial growth, and their maximum storage time period (less than a week) precludes complete microbiological testing. Pathogen inactivation technologies (PITs) provide an additional layer of safety to the blood transfusion products from known and unknown pathogens such as bacteria, viruses, and parasites. In this context, PITs, such as Mirasol Pathogen Reduction Technology (PRT), have been developed and are implemented in many countries. However, several studies have shown in vitro that Mirasol PRT induces a certain level of platelet shape change, hyperactivation, basal degranulation, and increased oxidative damage during storage. It has been suggested that Mirasol PRT might accelerate what has been described as the platelet storage lesion (PSL), but supportive molecular signatures have not been obtained. We aimed at dissecting the influence of both variables, that is, Mirasol PRT and storage time, at the proteome level. We present comprehensive proteomics data analysis of Control PCs and PCs treated with Mirasol PRT at storage days 1, 2, 6, and 8. Our workflow was set to perform proteomics analysis using a gel-free and label-free quantification (LFQ) approach. Semi-quantification was based on LFQ signal intensities of identified proteins using MaxQuant/Perseus software platform. Data are available via ProteomeXchange with identifier PXD008119. We identified marginal differences between Mirasol PRT and Control PCs during storage. However, those significant changes at the proteome level were specifically related to the functional aspects previously described to affect platelets upon Mirasol PRT. In addition, the effect of Mirasol PRT on the platelet proteome appeared not to be exclusively due to an accelerated or enhanced PSL. In summary, semi-quantitative proteomics allows to discern between proteome changes due to Mirasol PRT or PSL, and proves to be a methodology suitable to phenotype platelets in an unbiased manner, in various physiological contexts.
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Affiliation(s)
- Vishal Salunkhe
- a Department of Blood Cell Research , Sanquin Research and Landsteiner Laboratory, Academic Medical Centre (AMC), University of Amsterdam (UvA) , Amsterdam , The Netherlands
| | - Iris M De Cuyper
- a Department of Blood Cell Research , Sanquin Research and Landsteiner Laboratory, Academic Medical Centre (AMC), University of Amsterdam (UvA) , Amsterdam , The Netherlands
| | - Petros Papadopoulos
- b Department of Hematology , Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC) , Madrid , Spain
| | - Pieter F van der Meer
- c Department of Product and Process Development , Sanquin Blood Bank , Amsterdam , The Netherlands
| | - Brunette B Daal
- c Department of Product and Process Development , Sanquin Blood Bank , Amsterdam , The Netherlands
| | - María Villa-Fajardo
- b Department of Hematology , Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC) , Madrid , Spain
| | - Dirk de Korte
- a Department of Blood Cell Research , Sanquin Research and Landsteiner Laboratory, Academic Medical Centre (AMC), University of Amsterdam (UvA) , Amsterdam , The Netherlands.,c Department of Product and Process Development , Sanquin Blood Bank , Amsterdam , The Netherlands
| | - Timo K van den Berg
- a Department of Blood Cell Research , Sanquin Research and Landsteiner Laboratory, Academic Medical Centre (AMC), University of Amsterdam (UvA) , Amsterdam , The Netherlands
| | - Laura Gutiérrez
- a Department of Blood Cell Research , Sanquin Research and Landsteiner Laboratory, Academic Medical Centre (AMC), University of Amsterdam (UvA) , Amsterdam , The Netherlands.,b Department of Hematology , Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC) , Madrid , Spain
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15
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Aubry M, Laughhunn A, Santa Maria F, Lanteri MC, Stassinopoulos A, Musso D. Amustaline (S-303) treatment inactivates high levels of Chikungunya virus in red-blood-cell components. Vox Sang 2018; 113:232-241. [PMID: 29314033 DOI: 10.1111/vox.12626] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/16/2017] [Accepted: 11/16/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Chikungunya virus (CHIKV) infections have been reported in all continents, and the potential risk for CHIKV transfusion-transmitted infections (TTIs) was demonstrated by the detection of CHIKV RNA-positive donations in several countries. TTIs can be reduced by pathogen inactivation (PI) of blood products. In this study, we evaluated the efficacy of amustaline and glutathione (S-303/GSH) to inactivate CHIKV in red-blood-cell concentrates (RBCs). MATERIAL AND METHODS Red-blood-cells were spiked with high level of CHIKV. Infectious titres and RNA loads were measured before and after PI treatment. Residual CHIKV infectivity was also assessed after five successive cell culture passages. RESULTS The mean CHIKV titres in RBCs before inactivation was 5·81 ± 0·18 log10 50% tissue culture infectious dose (TCID50 )/mL, and the mean viral RNA load was 10·49 ± 0·15 log10 genome equivalent (GEq)/mL. No CHIKV TCID was detected after S-303 treatment nor was replicative CHIKV particles and viral RNA present after five cell culture passages of samples obtained immediately after S-303 treatment. CONCLUSION Chikungunya virus was previously shown to be inactivated by the PI technology using amotosalen and ultraviolet A light for the treatment of plasma and platelets. This new study demonstrates that S-303/GSH can inactivate high titres of CHIKV in RBCs.
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Affiliation(s)
- M Aubry
- Pôle de recherche et de veille sur les maladies infectieuses émergentes, Institut Louis Malardé, Tahiti, French Polynesia.,Aix Marseille Univ, IRD (Dakar, Marseille, Papeete), AP-HM, IHU-Méditerranée Infection, UMR Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Marseille, France
| | | | | | | | | | - D Musso
- Pôle de recherche et de veille sur les maladies infectieuses émergentes, Institut Louis Malardé, Tahiti, French Polynesia.,Aix Marseille Univ, IRD (Dakar, Marseille, Papeete), AP-HM, IHU-Méditerranée Infection, UMR Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Marseille, France
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16
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Frank SM, Thakkar RN, Podlasek SJ, Ken Lee KH, Wintermeyer TL, Yang WW, Liu J, Rotello LC, Fleury TA, Wachter PA, Ishii LE, Demski R, Pronovost PJ, Ness PM. Implementing a Health System-wide Patient Blood Management Program with a Clinical Community Approach. Anesthesiology 2017; 127:754-764. [PMID: 28885446 DOI: 10.1097/aln.0000000000001851] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. METHODS We formed the Johns Hopkins Health System blood management clinical community to reduce transfusion overuse across five hospitals. This physician-led, multidisciplinary, collaborative, quality-improvement team (the clinical community) worked to implement best practices for patient blood management, which we describe in detail. Changes in blood utilization and blood acquisition costs were compared for the pre- and post-patient blood management time periods. RESULTS Across the health system, multiunit erythrocyte transfusion orders decreased from 39.7 to 20.2% (by 49%; P < 0.0001). The percentage of patients transfused decreased for erythrocytes from 11.3 to 10.4%, for plasma from 2.9 to 2.2%, and for platelets from 3.1 to 2.7%, (P < 0.0001 for all three). The number of units transfused per 1,000 patients decreased for erythrocytes from 455 to 365 (by 19.8%; P < 0.0001), for plasma from 175 to 107 (by 38.9%; P = 0.0002), and for platelets from 167 to 141 (by 15.6%; P = 0.04). Blood acquisition cost savings were $2,120,273/yr, an approximate 400% return on investment for our patient blood management efforts. CONCLUSIONS Implementing a health system-wide patient blood management program by using a clinical community approach substantially reduced blood utilization and blood acquisition costs.
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Affiliation(s)
- Steven M Frank
- From the Department of Anesthesiology and Critical Care Medicine (S.M.F., W.W.Y., P.J.P.), Department of Medicine (R.N.T., L.C.R.), Department of Pathology, Transfusion Medicine (S.J.P., J.L., T.A.F., P.M.N.), Armstrong Institute for Patient Safety and Quality (K.H.K.L., T.L.W., P.A.W., R.D., P.J.P.), and Department of Otolaryngology Head and Neck Surgery (L.E.I.), The Johns Hopkins Medical Institutions, Baltimore, Maryland
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17
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Aubry M, Laughhunn A, Santa Maria F, Lanteri MC, Stassinopoulos A, Musso D. Pathogen inactivation of Dengue virus in red blood cells using amustaline and glutathione. Transfusion 2017; 57:2888-2896. [DOI: 10.1111/trf.14318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/29/2017] [Accepted: 08/02/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Maite Aubry
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti, Polynésie Française
| | | | | | - Marion C. Lanteri
- Scientific Affairs Department; Cerus Corporation; Concord California
| | | | - Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti, Polynésie Française
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18
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Santa Maria F, Laughhunn A, Lanteri MC, Aubry M, Musso D, Stassinopoulos A. Inactivation of Zika virus in platelet components using amotosalen and ultraviolet A illumination. Transfusion 2017; 57:2016-2025. [DOI: 10.1111/trf.14161] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 12/16/2022]
Affiliation(s)
| | | | | | - Maite Aubry
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti Polynésie Française
| | - Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti Polynésie Française
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19
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Yonemura S, Doane S, Keil S, Goodrich R, Pidcoke H, Cardoso M. Improving the safety of whole blood-derived transfusion products with a riboflavin-based pathogen reduction technology. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:357-364. [PMID: 28665269 PMCID: PMC5490732 DOI: 10.2450/2017.0320-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 12/19/2016] [Indexed: 01/06/2023]
Abstract
Worldwide safety of blood has been positively impacted by technological, economic and social improvements; nevertheless, growing socio-political changes of contemporary society together with environmental changes challenge the practice of blood transfusion with a continuous source of unforeseeable threats with the emergence and re-emergence of blood-borne pathogens. Pathogen reduction (PR) is a proactive strategy to mitigate the risk of transfusion-transmitted infections. PR technologies for the treatment of single plasma units and platelet concentrates are commercially available and have been successfully implemented in more than 2 dozen countries worldwide. Ideally, all labile blood components should be PR treated to ensure a safe and sustainable blood supply in accordance with regional transfusion best practices. Recently, a device (Mirasol® Pathogen Reduction Technology System) for PR treatment of whole blood using riboflavin and UV light has received CE marking, a significant step forward in realising blood safety where WB transfusion is the norm, such as in sub-Saharan Africa and in far-forward combat situations. There is also keen interest in the ability to derive components from Mirasol®-treated whole blood, as it is seen as a more efficient and economical means to implement universal PR in the blood centre environment than treatment of components with different PR systems.
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Affiliation(s)
| | - Suzann Doane
- Terumo BCT, Lakewood, CO, United States of America
| | - Shawn Keil
- Terumo BCT, Lakewood, CO, United States of America
| | - Raymond Goodrich
- Terumo BCT, Lakewood, CO, United States of America
- Infectious Disease Research Center, Colorado State University, Fort Collins, CO, United States of America
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20
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Miranda N, Gerola AP, Novello CR, Ueda-Nakamura T, de Oliveira Silva S, Dias-Filho BP, Hioka N, de Mello JCP, Nakamura CV. Pheophorbide a, a compound isolated from the leaves of Arrabidaea chica, induces photodynamic inactivation of Trypanosoma cruzi. Photodiagnosis Photodyn Ther 2017; 19:256-265. [PMID: 28587855 DOI: 10.1016/j.pdpdt.2017.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/24/2017] [Accepted: 05/05/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Approximately 6-7 million people are infected with Trypanosoma cruzi, the etiological agent of Chagas' disease. Only two therapeutic compounds have been found to be useful against this disease: nifurtimox and benznidazole. These drugs have been effective in the acute phase of the disease but less effective in the chronic phase; they also have many side effects. Thus, the search for new compounds with trypanocidal action is necessary. Natural products can be the source of many important substances for the development of drugs to treat this infection. The present study evaluated the biological activity of an extract and fractions of Arrabidaea chica against T. cruzi and observed morphological and ultrastructural characteristics of parasites exposed to the isolated compound pheophorbide a. METHODS The crude hydroethanolic extract of A. chica was prepared. Fractions were obtained by partition and separated by liquid chromatography. RESULTS We observed a progressive increase in activity against epimastigote, trypomastigote, and amastigote forms of the parasite over the course of the fractionation process. Interestingly, we isolated a compound known as a photosensitizer that is used in photodynamic therapy. This method of treatment involving a photosensitizer, activation light and molecular oxygen is of great importance due to its selectivity. Pheophorbide a had activity against the protozoan in the presence of light and caused morphological and ultrastructural changes, demonstrating its potential in photodynamic therapy. CONCLUSIONS Based on the ability of pheophorbide a to eliminate bloodstream forms of T. cruzi, we suggest its use in blood banks for hemoprophylaxis.
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Affiliation(s)
- Nathielle Miranda
- Post-Graduate Program in Pharmaceutical Sciences, Laboratory of Technological Innovation in the Development of Drugs and Cosmetics, State University of Maringá, Maringá, Paraná, Brazil.
| | | | | | - Tânia Ueda-Nakamura
- Post-Graduate Program in Pharmaceutical Sciences, Laboratory of Technological Innovation in the Development of Drugs and Cosmetics, State University of Maringá, Maringá, Paraná, Brazil; Department of Basic Sciences of Health, State University of Maringá, Maringá, Paraná, Brazil.
| | - Sueli de Oliveira Silva
- Post-Graduate Program in Pharmaceutical Sciences, Laboratory of Technological Innovation in the Development of Drugs and Cosmetics, State University of Maringá, Maringá, Paraná, Brazil; Department of Basic Sciences of Health, State University of Maringá, Maringá, Paraná, Brazil.
| | - Benedito Prado Dias-Filho
- Post-Graduate Program in Pharmaceutical Sciences, Laboratory of Technological Innovation in the Development of Drugs and Cosmetics, State University of Maringá, Maringá, Paraná, Brazil; Department of Basic Sciences of Health, State University of Maringá, Maringá, Paraná, Brazil.
| | - Noboru Hioka
- Department of Chemistry, State University of Maringá, Maringá, Paraná, Brazil.
| | - João Carlos Palazzo de Mello
- Post-Graduate Program in Pharmaceutical Sciences, Laboratory of Technological Innovation in the Development of Drugs and Cosmetics, State University of Maringá, Maringá, Paraná, Brazil.
| | - Celso Vataru Nakamura
- Post-Graduate Program in Pharmaceutical Sciences, Laboratory of Technological Innovation in the Development of Drugs and Cosmetics, State University of Maringá, Maringá, Paraná, Brazil; Department of Basic Sciences of Health, State University of Maringá, Maringá, Paraná, Brazil.
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21
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Laughhunn A, Santa Maria F, Broult J, Lanteri MC, Stassinopoulos A, Musso D, Aubry M. Amustaline (S-303) treatment inactivates high levels of Zika virus in red blood cell components. Transfusion 2017; 57:779-789. [DOI: 10.1111/trf.13993] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/01/2016] [Accepted: 12/04/2016] [Indexed: 12/16/2022]
Affiliation(s)
| | | | - Julien Broult
- Centre de Transfusion Sanguine de la Polynésie Française, Hôpital du Taaone
| | | | | | - Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti Polynésie Française
| | - Maite Aubry
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti Polynésie Française
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22
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Musso D, Broult J, Bierlaire D, Lanteri MC, Aubry M. Prevention of transfusion-transmitted Zika virus in French Polynesia, nucleic acid testing versus pathogen inactivation. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/voxs.12335] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- D. Musso
- Pôle de recherche et de veille sur les maladies infectieuses émergentes; Institut Louis Malardé; Tahiti Polynésie Française
| | - J. Broult
- Centre de transfusion sanguine; Hôpital du Taaone; Tahiti Polynésie Française
| | - D. Bierlaire
- Unité d'hémovigilence; Hôpital du Taaone; Tahiti Polynésie Française
| | | | - M. Aubry
- Pôle de recherche et de veille sur les maladies infectieuses émergentes; Institut Louis Malardé; Tahiti Polynésie Française
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23
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Jimenez A, Shaz BH, Bloch EM. Zika Virus and the Blood Supply: What Do We Know? Transfus Med Rev 2016; 31:1-10. [PMID: 27569055 DOI: 10.1016/j.tmrv.2016.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/30/2016] [Accepted: 08/01/2016] [Indexed: 02/03/2023]
Abstract
Zika virus (ZIKV), a mosquito-borne Flavivirus and emerging infectious disease, is the focus of an international public health emergency after its rapid spread through the Americas and the Caribbean. Although most ZIKV infections are subclinical or characterized by mild febrile illness, ZIKV has been implicated in severe complications, most notably microcephaly in babies born to incident infected mothers during pregnancy. As yet, the extent to which ZIKV is transfusion transmissible remains undefined. Nonetheless, a high prevalence of asymptomatic infection during outbreaks, the demonstration of ZIKV in blood donors, and 4 possible cases of transfusion-transmitted ZIKV in Brazil have raised concern for risk to the blood supply. Consequently, a proactive response is underway by blood collection agencies, regulatory bodies, national funding agencies, and industry alike. Mitigation strategies differ between endemic and nonendemic areas. In the continental United States, the American Association of Blood Banks and Food and Drug Administration guidelines recommend travel-based deferral for those returning from affected areas, and nucleic acid testing is being initiated under an investigational new drug application in Puerto Rico and selected areas of the United States. Options are less clear for countries where autochthonous vector-borne transmission is active. The burden of Zika falls in low-resource countries where high cost and technical barriers associated with testing and pathogen reduction pose barriers to implementation. Additional strategies include maintaining selective inventory for high-risk recipients (eg, pregnant women). We review the available data as of July 2016 on ZIKV in relation to the blood supply including risk, mitigation strategies, and barriers to implementation in addition to the research that is needed to address current uncertainty.
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Affiliation(s)
| | - Beth H Shaz
- Columbia University Medical Center and New York Blood Center, New York, NY
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24
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Platelet gel: a new therapeutic tool with great potential. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 15:333-340. [PMID: 27483482 DOI: 10.2450/2016.0038-16] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/09/2016] [Indexed: 12/31/2022]
Abstract
Chronic wounds, such as diabetic foot ulcers, represent a serious clinical problem for patients and clinicians. Management of these wounds has a strong economic impact worldwide. Complications resulting from injuries are a frequent cause of morbidity and mortality. Chronic wounds lead to infections, painful dressings and prolonged hospitalisation. This results in poor patient Quality of Life and in high healthcare costs. Platelet concentrates (PC) are defined as autologous or allogeneic platelet derivatives with a platelet concentration higher than baseline. PC are widely used in different areas of Regenerative Medicine in order to enhance wound healing processes; they include platelet-rich plasma (PRP), platelet gel (PG), platelet-rich fibrin (PRF), serum eye drops (E-S), and PRP eye drops (E-PRP). This review highlights the use of platelet-rich plasma (PRP) and platelet gel (PG) preparation for clinical use.
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25
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Cicchetti A, Berrino A, Casini M, Codella P, Facco G, Fiore A, Marano G, Marchetti M, Midolo E, Minacori R, Refolo P, Romano F, Ruggeri M, Sacchini D, Spagnolo AG, Urbina I, Vaglio S, Grazzini G, Liumbruno GM. Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 14:287-386. [PMID: 27403740 PMCID: PMC4942318 DOI: 10.2450/2016.0065-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains.Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed.
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Affiliation(s)
- Americo Cicchetti
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Alexandra Berrino
- Health Technology Assessment Unit of “Gemelli” Teaching Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Marina Casini
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Paola Codella
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Giuseppina Facco
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Alessandra Fiore
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Giuseppe Marano
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Marco Marchetti
- Health Technology Assessment Unit of “Gemelli” Teaching Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuela Midolo
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Roberta Minacori
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Pietro Refolo
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Federica Romano
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Matteo Ruggeri
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Dario Sacchini
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio G. Spagnolo
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Irene Urbina
- Health Technology Assessment Unit of “Gemelli” Teaching Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Stefania Vaglio
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Giuliano Grazzini
- Italian National Blood Centre, National Institute of Health, Rome, Italy
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Abstract
Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the family Flaviviridae. ZIKV was first isolated from a nonhuman primate in 1947 and from mosquitoes in 1948 in Africa, and ZIKV infections in humans were sporadic for half a century before emerging in the Pacific and the Americas. ZIKV is usually transmitted by the bite of infected mosquitoes. The clinical presentation of Zika fever is nonspecific and can be misdiagnosed as other infectious diseases, especially those due to arboviruses such as dengue and chikungunya. ZIKV infection was associated with only mild illness prior to the large French Polynesian outbreak in 2013 and 2014, when severe neurological complications were reported, and the emergence in Brazil of a dramatic increase in severe congenital malformations (microcephaly) suspected to be associated with ZIKV. Laboratory diagnosis of Zika fever relies on virus isolation or detection of ZIKV-specific RNA. Serological diagnosis is complicated by cross-reactivity among members of the Flavivirus genus. The adaptation of ZIKV to an urban cycle involving humans and domestic mosquito vectors in tropical areas where dengue is endemic suggests that the incidence of ZIKV infections may be underestimated. There is a high potential for ZIKV emergence in urban centers in the tropics that are infested with competent mosquito vectors such as Aedes aegypti and Aedes albopictus.
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Affiliation(s)
- Didier Musso
- Unit of Emerging Infectious Diseases, Institut Louis Malardé, Tahiti, French Polynesia
| | - Duane J Gubler
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore Partnership for Dengue Control, Lyon, France
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Piccin A, Di Pierro AM, Tagnin M, Russo C, Fustos R, Corvetta D, Primerano M, Magri E, Conci V, Gentilini I, Burkia Stocker E, Negri G, Mazzoleni G, Gastl G, Fontanella F. Healing of a soft tissue wound of the neck and jaw osteoradionecrosis using platelet gel. Regen Med 2016; 11:459-63. [PMID: 27346565 DOI: 10.2217/rme-2016-0031] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Bone osteoradionecrosis is a serious complication of radiation treatment. Current treatment approaches are not curative and treatment response is often poor leading to high social and healthcare costs. CASE REPORT We report on the first case of osteoradionecrosis with successful restitutio ab integro by repeated administration of platelet gel (PLT-gel) and surgery in a critically ill patient. The administration of PLT-gel during a severe septic episode helped regeneration of bone and soft tissues, shortening the hospital stay of the patient. It was also noted that following applications of PLT-gel, both the use of morphine and the numbers of infective episodes were reduced. CONCLUSION Additional studies are needed to confirm the promising effect of PLT-gel for the treatment of osteoradionecrosis.
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Affiliation(s)
- Andrea Piccin
- Haematology Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy.,Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Department of Internal Medicine V, Innsbruck Medical University, Innsbruck, Austria
| | - Angela Maria Di Pierro
- Haematology Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy.,Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Department of Internal Medicine V, Innsbruck Medical University, Innsbruck, Austria.,Biochemistry Laboratory, San Maurizio Regional Hospital, Bolzano, Italy
| | - Mario Tagnin
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Odontostomatology Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy
| | - Carla Russo
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,ENT Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy
| | - Roland Fustos
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,ENT Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy
| | - Daisy Corvetta
- Haematology Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy.,Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Pathology Dept., San Maurizio Regional Hospital, Bolzano, Italy
| | - Marco Primerano
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Hospital Pharmacy, San Maurizio Regional Hospital, Bolzano, Italy
| | - Elena Magri
- Radiotherapy Dept, Santa Chiara Hospital, Trento, Italy
| | - Viviana Conci
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Odontostomatology Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy
| | | | - Evelyn Burkia Stocker
- Haematology Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy.,Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy
| | - Giovanni Negri
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Pathology Dept., San Maurizio Regional Hospital, Bolzano, Italy
| | - Guido Mazzoleni
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Pathology Dept., San Maurizio Regional Hospital, Bolzano, Italy
| | - Günther Gastl
- Department of Internal Medicine V, Innsbruck Medical University, Innsbruck, Austria
| | - Fabrizio Fontanella
- Interdisciplinary Medical Research Center (IMREST), Bolzano, South Tyrol, Italy.,Odontostomatology Dept, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy
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Aubry M, Richard V, Green J, Broult J, Musso D. Inactivation of Zika virus in plasma with amotosalen and ultraviolet A illumination. Transfusion 2015; 56:33-40. [PMID: 26283013 DOI: 10.1111/trf.13271] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/26/2015] [Accepted: 07/08/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) transmitted by mosquitoes. The potential for ZIKV transmission through blood transfusion was demonstrated during the ZIKV outbreak that occurred in French Polynesia from October 2013 to April 2014. Pathogen inactivation of blood products is a proactive strategy that provides the potential to reduce transfusion-transmitted diseases. Inactivation of arboviruses by amotosalen and ultraviolet A (UVA) illumination was previously demonstrated for chikungunya, West Nile, and dengue viruses. We report here the efficiency of this process for ZIKV inactivation of human plasma. STUDY DESIGN AND METHODS Plasma units were spiked with ZIKV. Viral titers and RNA loads were measured in plasma before and after amotosalen and UVA photochemical treatment. RESULTS The mean ZIKV titers and RNA loads in plasma before inactivation were respectively 6.57 log TCID50 /mL and 10.25 log copies/mL. After inactivation, the mean ZIKV RNA loads was 9.51 log copies/mL, but cell cultures inoculated with inactivated plasma did not result in infected cells and did not produce any replicative virus after one passage, nor detectable viral RNA from the second passage. CONCLUSION In this study we demonstrate that amotosalen combined with UVA light inactivates ZIKV in fresh-frozen plasma. This inactivation process is of particular interest to prevent plasma transfusion-transmitted ZIKV infections in areas such as French Polynesia, where several arboviruses are cocirculating.
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Affiliation(s)
- Maite Aubry
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé, Tahiti, French Polynesia
| | - Vaea Richard
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé, Tahiti, French Polynesia
| | | | - Julien Broult
- Centre de Transfusion Sanguine de la Polynésie Française, Hôpital Du Taaone, Tahiti, French Polynesia
| | - Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé, Tahiti, French Polynesia
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Larrea L, Ortiz-de-Salazar MI, Martínez P, Roig R. Quantitative analysis of plasma proteins in whole blood-derived fresh frozen plasma prepared with three pathogen reduction technologies. Transfus Apher Sci 2015; 52:305-10. [DOI: 10.1016/j.transci.2015.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/21/2014] [Accepted: 01/08/2015] [Indexed: 01/02/2023]
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30
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Salunkhe V, van der Meer PF, de Korte D, Seghatchian J, Gutiérrez L. Development of blood transfusion product pathogen reduction treatments: A review of methods, current applications and demands. Transfus Apher Sci 2015; 52:19-34. [DOI: 10.1016/j.transci.2014.12.016] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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De Pascale MR, Sommese L, Casamassimi A, Napoli C. Platelet derivatives in regenerative medicine: an update. Transfus Med Rev 2015; 29:52-61. [PMID: 25544600 DOI: 10.1016/j.tmrv.2014.11.001] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 11/03/2014] [Accepted: 11/09/2014] [Indexed: 12/26/2022]
Abstract
Prior preclinical and clinical studies support the use of platelet-derived products for the treatment of soft and hard tissue lesions. These regenerative effects are controlled by autocrine and paracrine biomolecules including growth factors and cytokines contained in platelet alpha granules. Each growth factor is involved in a phase of the healing process, such as inflammation, collagen synthesis, tissue granulation, and angiogenesis collectively promoting tissue restitution. Platelet derivatives have been prepared as platelet-rich plasma, platelet gel, platelet-rich fibrin, and platelet eye drops. These products vary in their structure, growth factors, composition, and cytokine concentrations. Here, we review the current use of platelet-derived biological products focusing on the rationale for their use and the main requirements for their preparation. Variation in the apparent therapeutic efficacy may have resulted from a lack of reproducible, standardized protocols for preparation. Despite several individual studies showing favorable treatment effects, some randomized controlled trials as well as meta-analyses have found no constant clinical benefit from the application of platelet-derived products for prevention of tissue lesions. Recently, 3 published studies in dentistry showed an improvement in bone density. Seven published studies showed positive results in joint regeneration. Five published studies demonstrated an improvement in the wound healing, and an improvement of eye epithelial healing was observed in 2 reports. Currently, at least 14 ongoing clinical trials in phase 3 or 4 have been designed with large groups of treated patients (n > 100). Because the rationale of the therapy with platelet-derived compounds is still debated, a definitive insight can be acquired only when these large randomized trials will be completed.
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Affiliation(s)
- Maria Rosaria De Pascale
- UOC Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy
| | - Linda Sommese
- UOC Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy
| | - Amelia Casamassimi
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy.
| | - Claudio Napoli
- UOC Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy; Institute of Diagnostic and Nuclear Development, IRCCS, Naples, Italy
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32
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Tsen SWD, Kingsley DH, Kibler K, Jacobs B, Sizemore S, Vaiana SM, Anderson J, Tsen KT, Achilefu S. Pathogen reduction in human plasma using an ultrashort pulsed laser. PLoS One 2014; 9:e111673. [PMID: 25372037 PMCID: PMC4221090 DOI: 10.1371/journal.pone.0111673] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/27/2014] [Indexed: 11/18/2022] Open
Abstract
Pathogen reduction is a viable approach to ensure the continued safety of the blood supply against emerging pathogens. However, the currently licensed pathogen reduction techniques are ineffective against non-enveloped viruses such as hepatitis A virus, and they introduce chemicals with concerns of side effects which prevent their widespread use. In this report, we demonstrate the inactivation of both enveloped and non-enveloped viruses in human plasma using a novel chemical-free method, a visible ultrashort pulsed laser. We found that laser treatment resulted in 2-log, 1-log, and 3-log reductions in human immunodeficiency virus, hepatitis A virus, and murine cytomegalovirus in human plasma, respectively. Laser-treated plasma showed ≥70% retention for most coagulation factors tested. Furthermore, laser treatment did not alter the structure of a model coagulation factor, fibrinogen. Ultrashort pulsed lasers are a promising new method for chemical-free, broad-spectrum pathogen reduction in human plasma.
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Affiliation(s)
- Shaw-Wei D. Tsen
- Department of Radiology, Washington University School of Medicine, St Louis, Missouri, United States of America
| | - David H. Kingsley
- U. S. Department of Agriculture, Agricultural Research Service, Food Safety and Intervention Technologies Research Unit, James W. W. Baker Center, Delaware State University, Dover, Delaware, United States of America
| | - Karen Kibler
- Biodesign Institute, Arizona State University, Tempe, Arizona, United States of America
| | - Bert Jacobs
- Biodesign Institute, Arizona State University, Tempe, Arizona, United States of America
| | - Sara Sizemore
- Department of Physics, Arizona State University, Tempe, Arizona, United States of America
- Center for Biophysics, Arizona State University, Tempe, Arizona, United States of America
| | - Sara M. Vaiana
- Department of Physics, Arizona State University, Tempe, Arizona, United States of America
- Center for Biophysics, Arizona State University, Tempe, Arizona, United States of America
| | - Jeanne Anderson
- Department of Hematology, Barnes Jewish Hospital, St Louis, Missouri, United States of America
| | - Kong-Thon Tsen
- Department of Physics, Arizona State University, Tempe, Arizona, United States of America
- Center for Biophysics, Arizona State University, Tempe, Arizona, United States of America
| | - Samuel Achilefu
- Department of Radiology, Washington University School of Medicine, St Louis, Missouri, United States of America
- Biochemistry and Molecular Biophysics, Washington University School of Medicine, St Louis, Missouri, United States of America
- Biomedical Engineering, Washington University School of Medicine, St Louis, Missouri, United States of America
- * E-mail:
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33
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Newbold KB, Heddle NM, Lane SJ, Arnold E, Eyles J, Webert K. Risks, benefits and the role of stakeholders in pathogen reduction technology. HEALTH RISK & SOCIETY 2014. [DOI: 10.1080/13698575.2014.943159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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34
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Shih DTB, Burnouf T. Preparation, quality criteria, and properties of human blood platelet lysate supplements for ex vivo stem cell expansion. N Biotechnol 2014; 32:199-211. [PMID: 24929129 PMCID: PMC7102808 DOI: 10.1016/j.nbt.2014.06.001] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 02/06/2023]
Abstract
Most clinical applications of human multipotent mesenchymal stromal cells (MSCs) for cell therapy, tissue engineering, regenerative medicine, and treatment of immune and inflammatory diseases require a phase of isolation and ex vivo expansion allowing a clinically meaningful cell number to be reached. Conditions used for cell isolation and expansion should meet strict quality and safety requirements. This is particularly true for the growth medium used for MSC isolation and expansion. Basal growth media used for MSC expansion are supplemented with multiple nutrients and growth factors. Fetal bovine serum (FBS) has long been the gold standard medium supplement for laboratory-scale MSC culture. However, FBS has a poorly characterized composition and poses risk factors, as it may be a source of xenogenic antigens and zoonotic infections. FBS has therefore become undesirable as a growth medium supplement for isolating and expanding MSCs for human therapy protocols. In recent years, human blood materials, and most particularly lysates and releasates of platelet concentrates have emerged as efficient medium supplements for isolating and expanding MSCs from various origins. This review analyzes the advantages and limits of using human platelet materials as medium supplements for MSC isolation and expansion. We present the modes of production of allogeneic and autologous platelet concentrates, measures taken to ensure optimal pathogen safety profiles, and methods of preparing PLs for MSC expansion. We also discuss the supply of such blood preparations. Produced under optimal conditions of standardization and safety, human platelet materials can become the future 'gold standard' supplement for ex vivo production of MSCs for translational medicine and cell therapy applications.
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Affiliation(s)
- Daniel Tzu-Bi Shih
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan; Pediatrics Department, Taipei Medical University Hospital, Taipei, Taiwan
| | - Thierry Burnouf
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
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35
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Castiglia S, Mareschi K, Labanca L, Lucania G, Leone M, Sanavio F, Castello L, Rustichelli D, Signorino E, Gunetti M, Bergallo M, Bordiga AM, Ferrero I, Fagioli F. Inactivated human platelet lysate with psoralen: a new perspective for mesenchymal stromal cell production in Good Manufacturing Practice conditions. Cytotherapy 2014; 16:750-63. [PMID: 24529555 PMCID: PMC7185570 DOI: 10.1016/j.jcyt.2013.12.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 12/20/2013] [Accepted: 12/22/2013] [Indexed: 01/14/2023]
Abstract
BACKGROUND AIMS Mesenchymal stromal cells (MSC) are ideal candidates for regenerative and immunomodulatory therapies. The use of xenogeneic protein-free Good Manufacturing Practice-compliant growth media is a prerequisite for clinical MSC isolation and expansion. Human platelet lysate (HPL) has been efficiently implemented into MSC clinical manufacturing as a substitute for fetal bovine serum (FBS). Because the use of human-derived blood materials alleviates immunologic risks but not the transmission of blood-borne viruses, the aim of our study was to test an even safer alternative than HPL to FBS: HPL subjected to pathogen inactivation by psoralen (iHPL). METHODS Bone marrow samples were plated and expanded in α-minimum essential medium with 10% of three culture supplements: HPL, iHPL and FBS, at the same time. MSC morphology, growth and immunophenotype were analyzed at each passage. Karyotype, tumorigenicity and sterility were analyzed at the third passage. Statistical analyses were performed. RESULTS The MSCs cultivated in the three different culture conditions showed no significant differences in terms of fibroblast colony-forming unit number, immunophenotype or in their multipotent capacity. Conversely, the HPL/iHPL-MSCs were smaller, more numerous, had a higher proliferative potential and showed a higher Oct-3/4 and NANOG protein expression than did FBS-MSCs. Although HPL/iHPL-MSCs exhibit characteristics that may be attributable to a higher primitive stemness than FBS-MSCs, no tumorigenic mutations or karyotype modifications were observed. CONCLUSIONS We demonstrated that iHPL is safer than HPL and represents a good, Good Manufacturing Practice-compliant alternative to FBS for MSC clinical production that is even more advantageous in terms of cellular growth and stemness.
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Affiliation(s)
- Sara Castiglia
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Katia Mareschi
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy; Department of Public Health and Pediatrics, University of Turin, Turin, Italy.
| | - Luciana Labanca
- Blood Component Production and Validation Center, City of Science and Health of Turin, S. Anna Hospital, Turin, Italy
| | - Graziella Lucania
- Blood Component Production and Validation Center, City of Science and Health of Turin, S. Anna Hospital, Turin, Italy
| | - Marco Leone
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Fiorella Sanavio
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Laura Castello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Deborah Rustichelli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Elena Signorino
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Monica Gunetti
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | | | - Anna Maria Bordiga
- Blood Component Production and Validation Center, City of Science and Health of Turin, S. Anna Hospital, Turin, Italy
| | - Ivana Ferrero
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy; Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
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Musso D, Richard V, Broult J, Cao-Lormeau VM. Inactivation of dengue virus in plasma with amotosalen and ultraviolet A illumination. Transfusion 2014; 54:2924-30. [PMID: 24845685 DOI: 10.1111/trf.12713] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/17/2014] [Accepted: 03/30/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dengue virus (DENV) is the most prevalent arbovirus in tropical and subtropical regions. Transfusion-transmitted DENV infections have already been reported and the risk for blood products to be contaminated by DENV needs to be considered in dengue-endemic areas, especially during outbreaks. Blood product inactivation processes, including amotosalen and ultraviolet A (UVA) illumination, have been developed to reduce transfusion-transmitted infections. In this study we demonstrate the efficiency of using amotosalen and UVA illumination for DENV inactivation in human plasma. STUDY DESIGN AND METHODS Plasma units from volunteer blood donors were spiked with DENV. Viral titers and viral RNA loads were measured in plasma before and after amotosalen and UVA photochemical treatment. RESULTS The mean DENV titer in plasma before inactivation was 5.61 log 50% tissue culture infectious dose (TCID50)/mL and the mean viral RNA load was 10.21 log copies/mL. In inactivated plasma, the mean DENV RNA load was 9.37 log copies/mL, but cell cultures inoculated with inactivated plasma did not result in infected cells and did not produce any replicative virus nor detectable viral RNA. CONCLUSION We report here that amotosalen combined with UVA light inactivated DENV in fresh-frozen plasma (5.61 log inactivation of viral titer). This inactivation process is an efficient method to prevent plasma transfusion-transmitted DENV infections.
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Affiliation(s)
- Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé
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Winter KM, Johnson L, Kwok M, Vidovic D, Hyland RA, Mufti N, Erickson A, Marks DC. Red blood cell in vitro quality and function is maintained after S-303 pathogen inactivation treatment. Transfusion 2014; 54:1798-807. [PMID: 24617658 DOI: 10.1111/trf.12545] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 11/10/2013] [Accepted: 11/18/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND Over the past decade there has been a growth in the development of pathogen reduction technologies to protect the blood supply from emerging pathogens. This development has proven to be difficult for red blood cells (RBCs). However the S-303 system has been shown to effectively inactivate a broad spectrum of pathogens, while maintaining RBC quality. STUDY DESIGN AND METHODS A paired three-arm study was performed to compare the in vitro quality of S-303-treated RBCs with RBCs stored at room temperature (RT) for the duration of the treatment (18-20 hr) and control RBCs stored at 2 to 6°C. Products were sampled weekly over 42 days of storage (n = 10) and tested using an array of in vitro assays to measure quality, metabolism, and functional variables. RESULTS During S-303 treatment there was a slight loss of RBCs and hemoglobin (Hb < 5 g). Hemolysis, glucose consumption, and potassium release were similar in all groups during the 42 days of storage. S-303-treated RBCs had a significantly lower lactate concentration and pH compared to the paired controls. The S-303-treated RBCs had significantly higher adenosine triphosphate than the RT and control RBCs. There was a significant loss of 2,3-diphosphoglycerate in the S-303-treated products, which was also observed in the RT RBCs. Flow cytometry analysis demonstrated similar RBC size, morphology, expression of CD47, and glycophorin A in all groups. CONCLUSION RBCs treated with S-303 for pathogen reduction had similar in vitro properties to the paired controls and were within transfusion guidelines.
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Affiliation(s)
- Kelly M Winter
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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Velthove KJ, Over J, Abbink K, Janssen MP. Viral Safety of Human Plasma–Derived Medicinal Products: Impact of Regulation Requirements. Transfus Med Rev 2013; 27:179-83. [DOI: 10.1016/j.tmrv.2013.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 05/23/2013] [Accepted: 05/24/2013] [Indexed: 01/04/2023]
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Treatment of nonhealing diabetic lower extremity ulcers with skin graft and autologous platelet gel: a case series. BIOMED RESEARCH INTERNATIONAL 2013; 2013:837620. [PMID: 23607097 PMCID: PMC3626385 DOI: 10.1155/2013/837620] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 11/24/2012] [Indexed: 11/30/2022]
Abstract
Lower extremity ulcers in diabetic patients are difficult to treat. Recently, the use of human blood platelet-derived components in this indication has been raising interest. In this study, we have evaluated the safety and efficacy of the combination of autologous platelet gel (PG) and skin graft for treating large size recalcitrant ulcers. Eight consecutive diabetic patients aged 25 to 82 with nine nonhealing lower extremity ulcers (median size of 50 cm2; range 15–150 cm2) were treated. Skin ulcer was debrided, and the wound was sprayed after 7 to 10 days with autologous platelet-rich plasma and thrombin. Thin split-thickness skin graft with multiple slits was then applied on the wound bed and fixed with staples or cat-gut sutures. There were no adverse reactions observed during the study. Eight out of 9 skin grafts took well. The interval between skin graft and complete wound healing ranged from 2 to 3 weeks in the 8 successful cases. No ulcer recurrence was noted in those patients during the follow-up period of 2 to 19 months. In this study, the combination of autologous platelet gel and skin grafting has proven beneficial to heal large-size recalcitrant ulcers.
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Ortiz A, Richa L, Defer C, Dernis D, Huart JJ, Tokarski C, Rolando C. Proteomics applied to transfusion plasma: the beginning of the story. Vox Sang 2013; 104:275-91. [PMID: 23438183 DOI: 10.1111/j.1423-0410.2012.01663.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
'Safe blood' is and has always been the major concern in transfusion medicine. Plasma can undergo virus inactivation treatments based on physicochemical, photochemical or thermal methodologies for pathogen inactivation. The validation of these treatments is essentially based on clottability assays and clotting factors' titration; however, their impact on plasma proteins at the molecular level has not yet been evaluated. Proteomics appears as particularly adapted to identify, to localize and, consequently, to correlate these modifications to the biological activity change. At the crossroads of biology and analytical sciences, proteomics is the large-scale study of proteins in tissues, physiological fluids or cells at a given moment and in a precise environment. The proteomic strategy is based on a set of methodologies involving separative techniques like mono- and bidimensional gel electrophoresis and chromatography, analytical techniques, especially mass spectrometry, and bioinformatics. Even if plasma has been extensively studied since the very beginning of proteomics, its application to transfusion medicine has just begun. In the first part of this review, we present the principles of proteomics analysis. Then, we propose a state of the art of proteomics applied to plasma analysis. Finally, the use of proteomics for the evaluation of the impact of storage conditions and pathogen inactivation treatments applied to transfusion plasma and for the evaluation of therapeutic protein fractionated is discussed.
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Affiliation(s)
- A Ortiz
- USR CNRS 3290, Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP), Université de Lille 1, Sciences et Technologie, Villeneuve d'Ascq, France
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Abedi MR, Doverud AC. Preparation and pathogen inactivation of double dose buffy coat platelet products using the INTERCEPT blood system. J Vis Exp 2012:e4414. [PMID: 23242463 DOI: 10.3791/4414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Blood centers are faced with many challenges including maximizing production yield from the blood product donations they receive as well as ensuring the highest possible level of safety for transfusion patients, including protection from transfusion transmitted diseases. This must be accomplished in a fiscally responsible manner which minimizes operating expenses including consumables, equipment, waste, and personnel costs, among others. Several methods are available to produce platelet concentrates for transfusion. One of the most common is the buffy coat method in which a single therapeutic platelet unit (≥ 2.0 x10(11) platelets per unit or per local regulations) is prepared by pooling the buffy coat layer from up to six whole blood donations. A procedure for producing "double dose" whole blood derived platelets has only recently been developed. Presented here is a novel method for preparing double dose whole blood derived platelet concentrates from pools of 7 buffy coats and subsequently treating the double dose units with the INTERCEPT Blood System for pathogen inactivation. INTERCEPT was developed to inactivate viruses, bacteria, parasites, and contaminating donor white cells which may be present in donated blood. Pairing INTERCEPT with the double dose buffy coat method by utilizing the INTERCEPT Processing Set with Dual Storage Containers (the "DS set"), allows blood centers to treat each of their double dose units in a single pathogen inactivation processing set, thereby maximizing patient safety while minimizing costs. The double dose buffy coat method requires fewer buffy coats and reduces the use of consumables by up to 50% (e.g. pooling sets, filter sets, platelet additive solution, and sterile connection wafers) compared to preparation and treatment of single dose buffy coat platelet units. Other cost savings include less waste, less equipment maintenance, lower power requirements, reduced personnel time, and lower collection cost compared to the apheresis technique.
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Affiliation(s)
- Mohammad R Abedi
- Department of Laboratory Medicine, Section for Transfusion Medicine, Örebro University Hospital.
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Pai NP, Kurji J, Singam A, Barick R, Jafari Y, Klein MB, Chhabra S, Shivkumar P. Simultaneous triple point-of-care testing for HIV, syphilis and hepatitis B virus to prevent mother-to-child transmission in India. Int J STD AIDS 2012; 23:319-24. [PMID: 22648884 DOI: 10.1258/ijsa.2011.011139] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
An innovative simultaneous triple point-of-care (STPOC) screening strategy for syphilis, hepatitis B and HIV with Determine(®) tests was offered to pregnant women presenting for antenatal care and evaluated for feasibility and preference in rural India. Of 1066 participants approached, 1046 consented, of which 1002 (96.0%) completed the strategy. Only 9% reported any history of testing in their current pregnancy. With STPOC screening, 989 women (98.7%) tested negative and 13 had preliminary positive results for infection. The total time taken was 45 minutes per participant. Mothers and infants were provided prophylaxis/treatment for HIV, syphilis and hepatitis B, with interventions initiated within 3-5 days. STPOC was preferred by 99.3% (95%CI: 98.8-99.8%) of participants, facilitated early simultaneous screening for the three infections, timely initiation of prophylaxis/treatment and was feasible in this rural setting. These data suggest that multiplexed STPOC screening for syphilis, hepatitis B and HIV in pregnancy would be desirable for women in rural India.
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Affiliation(s)
- N P Pai
- Division of Clinical Epidemiology & Division of Infectious Diseases, McGill University Health Center, Montreal, Quebec, Canada.
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Picker SM, Tauszig ME, Gathof BS. Cell quality of apheresis-derived platelets treated with riboflavin-ultraviolet light after resuspension in platelet additive solution. Transfusion 2011; 52:510-6. [PMID: 21981030 DOI: 10.1111/j.1537-2995.2011.03323.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previously, we evaluated the Mirasol pathogen reduction technology (PRT) system on platelet (PLT) function before resuspension. We now evaluated this system in the presence of PLT additive solution (PAS). STUDY DESIGN AND METHODS Double-dose PLTs (n = 15) were generated using a commercially available apheresis system (Trima, Version 5.2, CaridianBCT) allowing for the resuspension in SSP+ (MacoPharma) immediately after collection. Paired units (n = 30) were PRT treated (M) or remained untreated (C) and analyzed for metabolism (pH, pO(2) , glucose, lactate, adenosine triphosphate [ATP]), swirl, hypotonic shock response (HSR), turbidometric aggregation, CD62P expression, annexin A5 and lactate dehydrogenase (LDH) release, mitochondrial enzymatic reduction activity (MTS), transmembrane mitochondrial potential (Δψ), and surface coverage (SC) during shear-induced adhesion throughout 8 days of storage. RESULTS As seen previously, PRT treatment of PLT units, containing a mean of 3.9 × 10(11) ± 0.3 × 10(11) PLTs in 397 ± 10 mL with a 32% to 34% plasma carryover, was associated with significantly (p < 0.001) increased cell activation, acidity, and glycolytic flux. PRT treatment appeared to up regulate both oxidative pathway and adhesional properties as evidenced by significantly higher MTS reduction, oxygen consumption, and shear-induced SC on Day 1 (p ≤ 0.016). While no significant differences were found for LDH release and ATP content (except for Day 8), M units were significantly inferior (p ≤ 0.021) for aggregation (TRAP-6); for Δψ and annexin A5 release (by Day 5); and for swirl, HSR, and MTS reduction (by Day 7). CONCLUSION PRT treatment in the presence of PAS was comparable to PRT treatment before resuspension preserving ATP content and mitochondrial function.
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Affiliation(s)
- Susanne M Picker
- Transfusion Medicine, University Hospital of Cologne, Cologne, Germany
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Vamvakas EC. Meta-analysis of the studies of bleeding complications of platelets pathogen-reduced with the Intercept system. Vox Sang 2011; 102:302-16. [PMID: 21957897 DOI: 10.1111/j.1423-0410.2011.01555.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The eligibility criteria of a previously reported meta-analysis (Transfusion 2011;51:1058-1071) of randomized controlled trials (RCTs) of pathogen reduction of platelets in patients with hypoproliferative thrombocytopenia were modified to examine the impact on the findings of: (1) inclusion of a (previously excluded) RCT; (2) restriction of eligibility to RCTs of the Intercept (amotosalen-HCl/ultraviolet-A-light) system; and (3) differences in the methods used to assess bleeding complications. MATERIALS AND METHODS Five RCTs comparing the risk of all, clinically significant (grades 2 through 4) and/or severe (grades 3 and 4) bleeding complications between recipients of platelets treated with Intercept vs. standard unmanipulated platelets were included. Odds ratios (ORs) of bleeding complications of similar severity recorded during similar periods of observation were calculated across all studies and across homogeneous subsets of studies by random-effects methods. RESULTS Treatment with Intercept increased all bleeding complications when four RCTs meeting the eligibility criteria of the previous meta-analysis were integrated, but not across all the five currently available studies [summary OR=1·24; 95% confidence interval (CI), 0·79-1·93]. Clinically significant bleeding complications increased when the results of the SPRINT RCT were based on the expanded safety analysis (summary OR=1·52; 95% CI, 1·09-2·12)--but not the initial report (summary OR=1·30; 95% CI, 0·54-3·14)--of that study. CONCLUSIONS Treatment with Intercept may increase the risk of all and clinically significant (albeit not severe) bleeding complications in RCTs maintaining a platelet count of ≥10×10(9) or ≥20×10(9)/l through increased platelet transfusions.
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Affiliation(s)
- E C Vamvakas
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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Chavarin P, DePutter C, Boussoulade F, Acquart S, Vidal M, Argaud C, Fabrigli P, Garraud O. [Pathogen inactivation of platelets: organization consequences for platelet transfusion]. Transfus Clin Biol 2011; 18:472-7. [PMID: 21783400 DOI: 10.1016/j.tracli.2011.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the past few years, pathogen reduction technologies for labile blood products have been part of the enhancement of global transfusion safety regarding residual risks of transmitting infectious pathogens. Having carried out a feasibility study for the implementation of pathogen inactivation of platelet concentrates by means of the amotosalen/HCl/UVA (Intercept™) technology, and participated to a reinforced haemovigilance study, we took the opportunity to analyze the organization consequences for platelet concentrates inventory and distribution. This impact study first indicated that those novel needs forced the blood donation service, as well as the labile blood product preparation laboratory, to review and improve practices; secondly, it showed that the routine implementation has little (no major) consequence in the overall organization, independently of the economic consequences (not covered here).
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Affiliation(s)
- P Chavarin
- Établissement français du sang Auvergne-Loire, Saint-Étienne, France.
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Müller TH, Montag T, Seltsam AW. Laboratory Evaluation of the Effectiveness of Pathogen Reduction Procedures for Bacteria. ACTA ACUST UNITED AC 2011; 38:242-250. [PMID: 22016694 DOI: 10.1159/000330338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 05/05/2011] [Indexed: 11/19/2022]
Abstract
SUMMARY: Bacterial contamination remains a leading factor for transfusion-associated serious morbidity and mortality. Pathogen reduction procedures offer a pro-active approach to prevent bacterial contamination of cellular blood components and especially of platelet concentrates. In the past, the laboratory evaluation of the effectiveness of the pathogen reduction procedures to minimise the bacterial load of blood components has been primarily based on log reduction assays similar to the assessment of antiviral activities. Bacteria strains with the ability to multiply in the blood components are seeded in highest possible cell numbers, the pathogen reduction procedure is applied, and the post-treatment number of bacteria is measured. The effectiveness of the procedure is characterised by calculating the log reduction of the post- to pre-treatment bacteria titres. More recently, protocols have been developed for experiments starting with a low bacteria load and monitoring the sterility of the blood component during the entire storage period of the blood component. Results for 3 different pathogen reduction technologies in these experimental models are compared and critical determinants for the results are addressed. The heterogeneity of results observed for different strains suggests that the introduction of international transfusion-relevant bacterial reference strains may facilitate the validity of findings in pathogen reduction experiments.
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Affiliation(s)
- Thomas H Müller
- DRK-Blutspendedienst NSTOB, Institut Springe, Langen, Germany
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Schlenke P, Hagenah W, Irsch J, Sundin D, Corash L, Lin L, Kirchner H, Wagner T. Safety and clinical efficacy of platelet components prepared with pathogen inactivation in routine use for thrombocytopenic patients. Ann Hematol 2011; 90:1457-65. [DOI: 10.1007/s00277-011-1222-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 03/21/2011] [Indexed: 10/18/2022]
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North A, Ciaravino V, Mufti N, Corash L. Preclinical pharmacokinetic and toxicology assessment of red blood cells prepared with S-303 pathogen inactivation treatment. Transfusion 2011; 51:2208-18. [PMID: 21985050 DOI: 10.1111/j.1537-2995.2011.03132.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND A system has been developed to inactivate a wide spectrum of blood-borne pathogens in red blood cells (RBCs) before transfusion. The system utilizes S-303 to target nucleic acids of pathogens and white blood cells. The safety of pathogen inactivated RBC was assessed using S-303-treated RBCs (S-303 RBCs) and S-300, the primary degradation product of S-303. STUDY DESIGN AND METHODS As part of a preclinical safety evaluation program, intravenous toxicity, safety pharmacology, toxicokinetic, and pharmacokinetic studies were conducted in rats and dogs with S-303 RBCs and S-300. RESULTS Single and repeated transfusions of S-303 RBCs were well tolerated in rats and dogs at S-303 concentrations up to five times higher than that used to prepare RBCs for clinical use. For S-300, the doses ranged from the lowest level representative of a clinical exposure from transfusion of 1 unit (0.052 mg/kg/day) to up to the amount of S-300 that would result from exposure to more than 1900 units of RBCs (100 mg/kg/day). There were no related effects of S-303 RBCs or S-300 on mortality, clinical status, body weight, or clinical laboratory assessments and no evidence of organ toxicity. S-300 did not accumulate in the plasma of rats and dogs after repeated transfusions. For all the studies, plasma S-303 was consistently below the limit of quantitation. CONCLUSION The level of residual S-303 and S-300 in the treated blood component is well below that at which no adverse effects were observed. These results support further clinical development of S-303 RBCs for prevention of transfusion-transmitted infections.
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Affiliation(s)
- Anne North
- Department of Development and Clinical Research and Medical Affairs, Cerus Corp., Concord, California, USA.
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Gelderman MP, Chi X, Zhi L, Vostal JG. Ultraviolet B light-exposed human platelets mediate acute lung injury in a two-event mouse model of transfusion. Transfusion 2011; 51:2343-57. [DOI: 10.1111/j.1537-2995.2011.03135.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kanathezhath B, Walters MC. Umbilical cord blood transplantation for thalassemia major. Hematol Oncol Clin North Am 2011; 24:1165-77. [PMID: 21075286 DOI: 10.1016/j.hoc.2010.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hematopoietic cell transplantation is curative therapy for thalassemia major. Although the clinical application of hematopoietic cell transplantation has relied on marrow collected from related and unrelated donors as the primary source of donor hematopoietic cells, umbilical cord blood (UCB) is an alternative source of hematopoietic cells and represents a suitable allogeneic donor pool in the event that a marrow donor is not available. Progress in developing UCB transplantation for thalassemia is reviewed and the most likely areas of future clinical investigation are discussed.
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Affiliation(s)
- Bindu Kanathezhath
- Hematology/Oncology, Children's Hospital & Research Center Oakland, 747 52nd Street, Oakland, CA 94609, USA
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