1
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Gao Y, Ikeda‐Imafuku M, Zhao Z, Joshi M, Mitragotri S. A polymer-based systemic hemostat for managing uncontrolled bleeding. Bioeng Transl Med 2023; 8:e10516. [PMID: 37206230 PMCID: PMC10189483 DOI: 10.1002/btm2.10516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 05/21/2023] Open
Abstract
Uncontrolled bleeding is a life-threatening emergency that requires immediate intervention. Currently available on-site bleeding interventions largely rely on the use of tourniquets, pressure dressing, and other topical hemostatic agents, which can only treat bleeding injuries that are known, accessible, and potentially compressible. Synthetic hemostats that are stable at room temperature, easy to carry, field-usable, and able to stop internal bleeding at multiple or unknown sources, are still lacking. We recently developed a hemostatic agent via polymer peptide interfusion (HAPPI), which can selectively bind to activated platelets and injury sites after intravascular administration. Here we report that HAPPI is highly effective in treating multiple lethal traumatic bleeding conditions in normal as well as hemophilia models via either systemic administration or topical application. In a rat liver traumatic model, intravenous injection of HAPPI resulted in a significant decrease in blood loss and a four-fold reduction in mortality rate within 2 h after injury. When applied topically on liver punch biopsy wounds in heparinized rats, HAPPI achieved a 73% of reduction in blood loss and a five-fold increase in survival rate. HAPPI also exhibited hemostatic efficacy in hemophilia A mice by reducing blood loss. Further, HAPPI worked synergistically with rFVIIa to induce immediate hemostasis and 95% reduction in total blood loss compared to the saline-treated group in hemophelia mice models. These results demonstrate that HAPPI is a promising field-usable hemostatic agent for a broad range of different hemorrhagic conditions.
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Affiliation(s)
- Yongsheng Gao
- John A. Paulson School of Engineering and Applied Sciences, Harvard UniversityAllstonMassachusetts02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMassachusetts02115USA
| | - Mayumi Ikeda‐Imafuku
- John A. Paulson School of Engineering and Applied Sciences, Harvard UniversityAllstonMassachusetts02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMassachusetts02115USA
| | - Zongmin Zhao
- John A. Paulson School of Engineering and Applied Sciences, Harvard UniversityAllstonMassachusetts02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMassachusetts02115USA
| | - Maithili Joshi
- John A. Paulson School of Engineering and Applied Sciences, Harvard UniversityAllstonMassachusetts02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMassachusetts02115USA
| | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied Sciences, Harvard UniversityAllstonMassachusetts02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMassachusetts02115USA
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2
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Ahmed H, Khan EA, Stokke BT. Microfluidic dual picoinjection based encapsulation of hemoglobin in alginate microcapsules reinforced by a poly(L-lysine)- g-poly(ethylene glycol). SOFT MATTER 2022; 19:69-79. [PMID: 36468540 DOI: 10.1039/d2sm01045c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Hemoglobin (Hb) encapsulation inside polysaccharide hydrogels has been considered a possible red blood cell (RBC) surrogate in transfusiology. Here we report on the microfluidic dual picoinjection assisted synthesis of Hb encapsulated alginate-poly(L-lysine)-g-poly(ethylene glycol) beads. This process is realized by the on-chip injections of blended Hb alginate solutions in emulsified aqueous calcium chloride (CaCl2) droplets followed by a subsequent injection of an aqueous PLL-g-PEG into each emulsified aqueous droplet. The proposed fabrication approach was realized using a flow-focusing and two picoinjection sites in a single PDMS device. Aqueous CaCl2 solution was emulsified and infused with Hb-alginate solution as the squeezed droplet passed through the first picoinjection site. The injection of PLL-g-PEG to reinforce the microgel and minimize the protein leaching was realized in the second picoinjection site located downstream from the first in the same microfluidic channel. In this process, monodisperse Hb-alginate-PLL-g-PEG particles with a diameter around the size of RBCs (9 μm) were obtained with around 80% of the 7.5 mg ml-1 Hb included in the injected aqueous alginate retaining in the obtained microparticles. Microparticles with Hb loading (32.8 pg per bead) and retention (28.8 pg per bead) over a week of storage at 4 °C are in accordance with the average amount of Hb per RBC. The Hb-alginate-PLL-g-PEG microbeads fabricated in the size range of RBCs are significant for further exploration.
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Affiliation(s)
- Husnain Ahmed
- Biophysics and Medical Technology, Department of Physics, NTNU, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway.
| | | | - Bjørn Torger Stokke
- Biophysics and Medical Technology, Department of Physics, NTNU, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway.
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3
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McRae HL, Milito C, Klapheke CA, Refaai MA. Evaluation of solvent/detergent‐treated plasma safety and efficacy in orthotopic liver transplant and thrombotic thrombocytopenic purpura patients: A single center experience. Transfusion 2021; 62:429-438. [DOI: 10.1111/trf.16777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/03/2021] [Accepted: 11/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Hannah L. McRae
- Department of Pathology and Laboratory Medicine, Transfusion Medicine Unit University of Rochester Medical Center Rochester New York USA
| | - Chelsea Milito
- Department of Pathology and Laboratory Medicine, Transfusion Medicine Unit University of Rochester Medical Center Rochester New York USA
| | - Catherine A. Klapheke
- Department of Pathology and Laboratory Medicine, Transfusion Medicine Unit University of Rochester Medical Center Rochester New York USA
| | - Majed A. Refaai
- Department of Pathology and Laboratory Medicine, Transfusion Medicine Unit University of Rochester Medical Center Rochester New York USA
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4
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He Y, Xu F, Ibrahim Z, Feyissa Q, Reed JL, Vostal JG. Viral reduction of human blood by ultraviolet A-photosensitized vitamin K5. J Med Virol 2021; 93:5134-5140. [PMID: 33837954 DOI: 10.1002/jmv.27008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/09/2022]
Abstract
Blood product transfusion can transmit viral pathogens. Pathogen reduction methods for blood products have been developed but, so far, are not available for whole blood. We evaluated if vitamin K5 (VK5) and ultraviolet A (UVA) irradiation could be used for virus inactivation in plasma and whole blood. Undiluted human plasma and whole blood diluted to 20% were spiked with high levels of vaccinia or Zika viruses. Infectious titers were measured by standard TCID50 assay before and after VK5/UVA treatments. Up to 3.6 log of vaccinia and 3.2 log of Zika were reduced in plasma by the combination of 500 μM VK5 and 3 J/cm2 UVA, and 3.1 log of vaccinia and 2.9 log of Zika were reduced in diluted human blood (20%) by the combination of 500 μM VK5 and 70 J/cm2 UVA. At end of whole blood treatment, hemolysis increased from 0.18% to 0.41% but remained below 1% hemolysis, which is acceptable to the Food and Drug Administration for red cell transfusion products. No significant alteration of biochemical parameters of red blood cells occurred with treatment. Our results provide proof of the concept that a viral pathogen reduction method based on VK5/UVA may be developed for whole blood.
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Affiliation(s)
- Yong He
- Division of Plasma Protein Therapeutics, OTAT, CBER, FDA, Silver Spring, Maryland, USA
| | - Fei Xu
- Division of Blood Components and Devices, OBRR, CBER, FDA, Silver Spring, Maryland, USA
| | - Zina Ibrahim
- Division of Blood Components and Devices, OBRR, CBER, FDA, Silver Spring, Maryland, USA
| | - Qinati Feyissa
- Division of Blood Components and Devices, OBRR, CBER, FDA, Silver Spring, Maryland, USA
| | - Jennifer L Reed
- Division of Plasma Protein Therapeutics, OTAT, CBER, FDA, Silver Spring, Maryland, USA
| | - Jaroslav G Vostal
- Division of Blood Components and Devices, OBRR, CBER, FDA, Silver Spring, Maryland, USA
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5
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Abstract
In blood, the primary role of red blood cells (RBCs) is to transport oxygen via highly regulated mechanisms involving hemoglobin (Hb). Hb is a tetrameric porphyrin protein comprising of two α- and two β-polypeptide chains, each containing an iron-containing heme group capable of binding one oxygen molecule. In military as well as civilian traumatic exsanguinating hemorrhage, rapid loss of RBCs can lead to suboptimal tissue oxygenation and subsequent morbidity and mortality. In such cases, transfusion of whole blood or RBCs can significantly improve survival. However, blood products including RBCs present issues of limited availability and portability, need for type matching, pathogenic contamination risks, and short shelf-life, causing substantial logistical barriers to their prehospital use in austere battlefield and remote civilian conditions. While robust research is being directed to resolve these issues, parallel research efforts have emerged toward bioengineering of semisynthetic and synthetic surrogates of RBCs, using various cross-linked, polymeric, and encapsulated forms of Hb. These Hb-based oxygen carriers (HBOCs) can potentially provide therapeutic oxygenation when blood or RBCs are not available. Several of these HBOCs have undergone rigorous preclinical and clinical evaluation, but have not yet received clinical approval in the USA for human use. While these designs are being optimized for clinical translations, several new HBOC designs and molecules have been reported in recent years, with unique properties. The current article will provide a comprehensive review of such HBOC designs, including current state-of-the-art and novel molecules in development, along with a critical discussion of successes and challenges in this field.
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6
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Lu M, Dai T, Hu S, Zhang Q, Bhayana B, Wang L, Wu MX. Antimicrobial blue light for decontamination of platelets during storage. JOURNAL OF BIOPHOTONICS 2020; 13:e201960021. [PMID: 31407467 PMCID: PMC7083650 DOI: 10.1002/jbio.201960021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 05/28/2023]
Abstract
Platelet (PLT) storage is currently limited to 5 days in clinics in the United States, in part, due to an increasing risk for microbial contamination over time. In light of well-documented antimicrobial activity of blue light (405-470 nm), we investigated potentials to decontaminate microbes during PLT storage by antimicrobial blue light (aBL). We found that PLTs produced no detectable levels of porphyrins or their derivatives, the chromophores that specifically absorb blue light, in marked contrast to microbes that generated porphyrins abundantly. The difference formed a basis with which aBL selectively inactivated contaminated microbes prior to and during the storage, without incurring any harm to PLTs. In accordance with this, when contamination with representative microbes was simulated in PLT concentrates supplemented with 65% of PLT additive solution in a standard storage bag, all "contaminated" microbes tested were completely inactivated after exposure of the bag to 405 nm aBL at 75 J/cm2 only once. While killing microbes efficiently, this dose of aBL irradiation exerted no adverse effects on the viability, activation or aggregation of PLTs ex vivo and could be used repeatedly during PLT storage. PLT survival in vivo was also unaltered by aBL irradiation after infusion of aBL-irradiated mouse PLTs into mice. The study provides proof-of-concept evidence for a potential of aBL to decontaminate PLTs during storage.
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Affiliation(s)
- Min Lu
- Department of Dermatology, Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - TianHong Dai
- Department of Dermatology, Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - SiSi Hu
- Department of Dermatology, Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Qi Zhang
- Department of Dermatology, Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Brijesh Bhayana
- Department of Dermatology, Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Li Wang
- Department of Dermatology, Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Mei X. Wu
- Department of Dermatology, Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
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7
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Sousa V, Gomes ATPC, Freitas A, Faustino MAF, Neves MGPMS, Almeida A. Photodynamic Inactivation of Candida albicans in Blood Plasma and Whole Blood. Antibiotics (Basel) 2019; 8:antibiotics8040221. [PMID: 31766190 PMCID: PMC6963715 DOI: 10.3390/antibiotics8040221] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022] Open
Abstract
The few approved disinfection techniques for blood derivatives promote damage in the blood components, representing risks for the transfusion receptor. Antimicrobial photodynamic therapy (aPDT) seems to be a promising approach for the photoinactivation of pathogens in blood, but only three photosensitizers (PSs) have been approved, methylene blue (MB) for plasma and riboflavin and amotosalen for plasma and platelets. In this study, the efficiency of the porphyrinic photosensitizer Tri-Py(+)-Me and of the porphyrinic formulation FORM was studied in the photoinactivation of Candida albicans in plasma and in whole blood and the results were compared to the ones obtained with the already approved PS MB. The results show that FORM and Tri-Py(+)-Me are promising PSs to inactivate C. albicans in plasma. Although in whole blood the inactivation rates obtained were higher than the ones obtained with MB, further improvements are required. None of these PSs had promoted hemolysis at the isotonic conditions when hemolysis was evaluated in whole blood and after the addition of treated plasma with these PSs to concentrates of red blood cells.
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Affiliation(s)
- Vera Sousa
- Department of Biology & CESAM, University of Aveiro, Aveiro 3810-193, Portugal;
| | - Ana T. P. C. Gomes
- Department of Biology & CESAM, University of Aveiro, Aveiro 3810-193, Portugal;
- Correspondence: (A.T.P.C.G.); (M.A.F.F.); (A.A.)
| | - Américo Freitas
- Clinical Analysis Laboratory Avelab, Rua Cerâmica do Vouga, Aveiro 3800-011, Portugal;
| | - Maria A. F. Faustino
- Department of Chemistry & QOPNA and LAQV-REQUIMTE, University of Aveiro, Aveiro 3810-193, Portugal;
- Correspondence: (A.T.P.C.G.); (M.A.F.F.); (A.A.)
| | - Maria G. P. M. S. Neves
- Department of Chemistry & QOPNA and LAQV-REQUIMTE, University of Aveiro, Aveiro 3810-193, Portugal;
| | - Adelaide Almeida
- Department of Biology & CESAM, University of Aveiro, Aveiro 3810-193, Portugal;
- Correspondence: (A.T.P.C.G.); (M.A.F.F.); (A.A.)
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8
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Wiehe A, O'Brien JM, Senge MO. Trends and targets in antiviral phototherapy. Photochem Photobiol Sci 2019; 18:2565-2612. [PMID: 31397467 DOI: 10.1039/c9pp00211a] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Photodynamic therapy (PDT) is a well-established treatment option in the treatment of certain cancerous and pre-cancerous lesions. Though best-known for its application in tumor therapy, historically the photodynamic effect was first demonstrated against bacteria at the beginning of the 20th century. Today, in light of spreading antibiotic resistance and the rise of new infections, this photodynamic inactivation (PDI) of microbes, such as bacteria, fungi, and viruses, is gaining considerable attention. This review focuses on the PDI of viruses as an alternative treatment in antiviral therapy, but also as a means of viral decontamination, covering mainly the literature of the last decade. The PDI of viruses shares the general action mechanism of photodynamic applications: the irradiation of a dye with light and the subsequent generation of reactive oxygen species (ROS) which are the effective phototoxic agents damaging virus targets by reacting with viral nucleic acids, lipids and proteins. Interestingly, a light-independent antiviral activity has also been found for some of these dyes. This review covers the compound classes employed in the PDI of viruses and their various areas of use. In the medical area, currently two fields stand out in which the PDI of viruses has found broader application: the purification of blood products and the treatment of human papilloma virus manifestations. However, the PDI of viruses has also found interest in such diverse areas as water and surface decontamination, and biosafety.
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Affiliation(s)
- Arno Wiehe
- biolitec research GmbH, Otto-Schott-Str. 15, 07745 Jena, Germany. and Institut für Chemie und Biochemie, Freie Universität Berlin, Takustr. 3, 14195 Berlin, Germany
| | - Jessica M O'Brien
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
| | - Mathias O Senge
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
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9
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Ngatchou W, Dreezen I, Kamdem F, Imandy G, Okalla C, Nkana A, Hacquebard JP, Origer P, Sango J, Lemogoum D, Mouliom S, Dzudie A, Ngote H, Hentchoya R, Metogo J, Germay O, Priso EB, Jansens JL, Luma H, Najdovski T. [Platelet collection in cardiac surgery: first experience with apheresis at the General Hospital in Douala]. Pan Afr Med J 2019; 31:41. [PMID: 30918567 PMCID: PMC6430850 DOI: 10.11604/pamj.2018.31.41.16571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/15/2018] [Indexed: 11/11/2022] Open
Abstract
Cardiac surgery with extracorporeal circulation (ECC) is usually associated with the loss of a significant amount of blood. Adequate prophylaxis against blood loss and good perioperative hemostasis are known as processes limiting postoperative bleeding. Until now, the need for platelets in patients operated with extracorporeal circulation in our Department has been compensated for by total blood transfusion or platelet concentrates collected from several donors. We here report our first experience with platelet concentrate collection by apheresis at the General Hospital in Douala.
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Affiliation(s)
- William Ngatchou
- Département de Chirurgie, Faculté de Médecine et de Science Pharmaceutique de Douala, Cameroun
| | | | - Felicité Kamdem
- Service de Médecine et Spécialité Faculté de Médecine et Science Pharmaceutique de Douala, Cameroun.,Service de Médecine Hôpital Général de Douala, Cameroun
| | | | | | - Albert Nkana
- Service de Médecine et Spécialité Faculté de Médecine et Science Pharmaceutique de Douala, Cameroun
| | - Jean Pierre Hacquebard
- Service d'Anesthésie CHU St Pierre de Bruxelles, Université Libre de Bruxelles, Belgique
| | - Pierre Origer
- Service d'Anesthésie CHU St Pierre de Bruxelles, Université Libre de Bruxelles, Belgique
| | - Joseph Sango
- Département de Chirurgie, Faculté de Médecine et de Science Pharmaceutique de Douala, Cameroun
| | - Daniel Lemogoum
- Service de Médecine et Spécialité Faculté de Médecine et Science Pharmaceutique de Douala, Cameroun
| | | | | | - Henri Ngote
- Service de Médecine Hôpital Général de Douala, Cameroun
| | - Romuald Hentchoya
- Service d'Anesthésie Réanimation Hôpital Général de Douala, Cameroun
| | - Junette Metogo
- Département de Chirurgie, Faculté de Médecine et de Science Pharmaceutique de Douala, Cameroun.,Service d'Anesthésie Réanimation Hôpital Général de Douala, Cameroun
| | - Olivier Germay
- Service d'Anesthésie CHU St Pierre de Bruxelles, Université Libre de Bruxelles, Belgique
| | | | - Jean Luc Jansens
- Hôpital Erasme de Bruxelles, Université Libre de Bruxelles, Belgique
| | - Henry Luma
- Service de Médecine Hôpital Général de Douala, Cameroun.,Direction de Hôpital Général de Douala, Cameroun
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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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11
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Hickman DA, Pawlowski CL, Shevitz A, Luc NF, Kim A, Girish A, Marks J, Ganjoo S, Huang S, Niedoba E, Sekhon UDS, Sun M, Dyer M, Neal MD, Kashyap VS, Sen Gupta A. Intravenous synthetic platelet (SynthoPlate) nanoconstructs reduce bleeding and improve 'golden hour' survival in a porcine model of traumatic arterial hemorrhage. Sci Rep 2018; 8:3118. [PMID: 29449604 PMCID: PMC5814434 DOI: 10.1038/s41598-018-21384-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/02/2018] [Indexed: 12/14/2022] Open
Abstract
Traumatic non-compressible hemorrhage is a leading cause of civilian and military mortality and its treatment requires massive transfusion of blood components, especially platelets. However, in austere civilian and battlefield locations, access to platelets is highly challenging due to limited supply and portability, high risk of bacterial contamination and short shelf-life. To resolve this, we have developed an I.V.-administrable 'synthetic platelet' nanoconstruct (SynthoPlate), that can mimic and amplify body's natural hemostatic mechanisms specifically at the bleeding site while maintaining systemic safety. Previously we have reported the detailed biochemical and hemostatic characterization of SynthoPlate in a non-trauma tail-bleeding model in mice. Building on this, here we sought to evaluate the hemostatic ability of SynthoPlate in emergency administration within the 'golden hour' following traumatic hemorrhagic injury in the femoral artery, in a pig model. We first characterized the storage stability and post-sterilization biofunctionality of SynthoPlate in vitro. The nanoconstructs were then I.V.-administered to pigs and their systemic safety and biodistribution were characterized. Subsequently we demonstrated that, following femoral artery injury, bolus administration of SynthoPlate could reduce blood loss, stabilize blood pressure and significantly improve survival. Our results indicate substantial promise of SynthoPlate as a viable platelet surrogate for emergency management of traumatic bleeding.
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Affiliation(s)
- DaShawn A Hickman
- Department of Pathology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Christa L Pawlowski
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Andrew Shevitz
- University Hospitals of Cleveland, Division of Vascular Surgery, Cleveland, OH, 44106, USA
| | - Norman F Luc
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Ann Kim
- University Hospitals of Cleveland, Division of Vascular Surgery, Cleveland, OH, 44106, USA
| | - Aditya Girish
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Joyann Marks
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Simi Ganjoo
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Stephanie Huang
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Edward Niedoba
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Ujjal D S Sekhon
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Michael Sun
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Mitchell Dyer
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Matthew D Neal
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Vikram S Kashyap
- University Hospitals of Cleveland, Division of Vascular Surgery, Cleveland, OH, 44106, USA
| | - Anirban Sen Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA.
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12
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Hally C, Rodríguez-Amigo B, Bresolí-Obach R, Planas O, Nos J, Boix-Garriga E, Ruiz-González R, Nonell S. Photodynamic Therapy. THERANOSTICS AND IMAGE GUIDED DRUG DELIVERY 2018. [DOI: 10.1039/9781788010597-00086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Photodynamic therapy is a clinical technique for the treatment of cancers, microbial infections and other medical conditions by means of light-induced generation of reactive oxygen species using photosensitising drugs. The intrinsic fluorescence of many such drugs make them potential theranostic agents for simultaneous diagnosis and therapy. This chapter reviews the basic chemical and biological aspects of photodynamic therapy with an emphasis on its applications in theranostics. The roles of nanotechnology is highlighted, as well as emerging trends such as photoimmunotherapy, image-guided surgery and light- and singlet-oxygen dosimetry.
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Affiliation(s)
- Cormac Hally
- Institut Químic de Sarrià, Universitat Ramon Llull Via Augusta 390 08017 Barcelona Spain
| | | | - Roger Bresolí-Obach
- Institut Químic de Sarrià, Universitat Ramon Llull Via Augusta 390 08017 Barcelona Spain
| | - Oriol Planas
- Institut Químic de Sarrià, Universitat Ramon Llull Via Augusta 390 08017 Barcelona Spain
| | - Jaume Nos
- Institut Químic de Sarrià, Universitat Ramon Llull Via Augusta 390 08017 Barcelona Spain
| | - Ester Boix-Garriga
- Institut Químic de Sarrià, Universitat Ramon Llull Via Augusta 390 08017 Barcelona Spain
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne Geneva Switzerland
| | - Rubén Ruiz-González
- Institut Químic de Sarrià, Universitat Ramon Llull Via Augusta 390 08017 Barcelona Spain
| | - Santi Nonell
- Institut Químic de Sarrià, Universitat Ramon Llull Via Augusta 390 08017 Barcelona Spain
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13
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Hickman DA, Pawlowski CL, Sekhon UDS, Marks J, Gupta AS. Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2018; 30:10.1002/adma.201700859. [PMID: 29164804 PMCID: PMC5831165 DOI: 10.1002/adma.201700859] [Citation(s) in RCA: 278] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/18/2017] [Indexed: 05/03/2023]
Abstract
Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders. In contrast, treatment of internal noncompressible hemorrhage still heavily depends on transfusion of whole blood or blood's hemostatic components (platelets, fibrinogen, and coagulation factors). Transfusion of platelets poses significant challenges of limited availability, high cost, contamination risks, short shelf-life, low portability, performance variability, and immunological side effects, while use of fibrinogen or coagulation factors provides only partial mechanisms for hemostasis. With such considerations, significant interdisciplinary research endeavors have been focused on developing materials and technologies that can be manufactured conveniently, sterilized to minimize contamination and enhance shelf-life, and administered intravenously to mimic, leverage, and amplify physiological hemostatic mechanisms. Here, a comprehensive review regarding the various topical, intracavitary, and intravenous hemostatic technologies in terms of materials, mechanisms, and state-of-art is provided, and challenges and opportunities to help advancement of the field are discussed.
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Affiliation(s)
- DaShawn A Hickman
- Case Western Reserve University School of Medicine, Department of Pathology, Cleveland, Ohio 44106, USA
| | - Christa L Pawlowski
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
| | - Ujjal D S Sekhon
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
| | - Joyann Marks
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
| | - Anirban Sen Gupta
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
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14
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Sen Gupta A. Bio-inspired nanomedicine strategies for artificial blood components. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2017; 9:10.1002/wnan.1464. [PMID: 28296287 PMCID: PMC5599317 DOI: 10.1002/wnan.1464] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/23/2017] [Accepted: 01/29/2017] [Indexed: 11/12/2022]
Abstract
Blood is a fluid connective tissue where living cells are suspended in noncellular liquid matrix. The cellular components of blood render gas exchange (RBCs), immune surveillance (WBCs) and hemostatic responses (platelets), and the noncellular components (salts, proteins, etc.) provide nutrition to various tissues in the body. Dysfunction and deficiencies in these blood components can lead to significant tissue morbidity and mortality. Consequently, transfusion of whole blood or its components is a clinical mainstay in the management of trauma, surgery, myelosuppression, and congenital blood disorders. However, donor-derived blood products suffer from issues of shortage in supply, need for type matching, high risks of pathogenic contamination, limited portability and shelf-life, and a variety of side-effects. While robust research is being directed to resolve these issues, a parallel clinical interest has developed toward bioengineering of synthetic blood substitutes that can provide blood's functions while circumventing the above problems. Nanotechnology has provided exciting approaches to achieve this, using materials engineering strategies to create synthetic and semi-synthetic RBC substitutes for enabling oxygen transport, platelet substitutes for enabling hemostasis, and WBC substitutes for enabling cell-specific immune response. Some of these approaches have further extended the application of blood cell-inspired synthetic and semi-synthetic constructs for targeted drug delivery and nanomedicine. The current study provides a comprehensive review of the various nanotechnology approaches to design synthetic blood cells, along with a critical discussion of successes and challenges of the current state-of-art in this field. WIREs Nanomed Nanobiotechnol 2017, 9:e1464. doi: 10.1002/wnan.1464 For further resources related to this article, please visit the WIREs website.
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Affiliation(s)
- Anirban Sen Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
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15
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Abstract
A wide variety of clinical conditions, associated with low circulating platelet counts, require platelet transfusion in order to normalize hemostatic function. Although single-donor apheresis platelets bear the lowest risk of transfusion-transmitted infections, pathogen reduction technologies (PRT) are being implemented worldwide to reduce this risk further through inactivation of known, emergent and as yet to be discovered nucleic acid-based pathogens. Human blood platelets are now known to harbor a diverse transcriptome, important to their function and comprised of >5000 protein-coding messenger RNAs and different classes of non-coding RNAs, including microRNAs. Our appreciation of the nucleic acid-dependent functions of platelets is likely to increase. On the other hand, the side effects of PRT on platelet function are underappreciated. Recent evidences suggest that PRT may compromise platelets' responsiveness to agonists, and induce platelet activation. For instance, platelets have the propensity to release proinflammatory microparticles (MPs) upon activation, and the possibility that PRT may enhance the production of platelet MPs in platelet concentrates (PCs) appears likely. With this in mind, it would be timely and appropriate to investigate other means to inactivate pathogens more specifically, or to modify the currently available PRT so to better preserve the platelet function and improve the safety of PCs; platelets' perspective to PRT deserves to be considered.
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Affiliation(s)
- Abdimajid Osman
- a Department of Clinical Chemistry , Region Östergötland , Linköping , Sweden.,b Department of Clinical and Experimental Medicine , University of Linköping , Linköping , Sweden
| | - Walter E Hitzler
- c Transfusion Center, University Medical Center of the Johannes Gutenberg University Mainz , Hochhaus Augustusplatz , Mainz , Germany
| | - Patrick Provost
- d CHUQ Research Center/CHUL , 2705 Blvd Laurier, Quebec , QC , Canada.,e Faculty of Medicine , Université Laval , Quebec , QC , Canada
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16
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Duration of red blood cell storage and inflammatory marker generation. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:145-152. [PMID: 28263172 DOI: 10.2450/2017.0343-16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 12/16/2016] [Indexed: 02/08/2023]
Abstract
Red blood cell (RBC) transfusion is a life-saving treatment for several pathologies. RBCs for transfusion are stored refrigerated in a preservative solution, which extends their shelf-life for up to 42 days. During storage, the RBCs endure abundant physicochemical changes, named RBC storage lesions, which affect the overall quality standard, the functional integrity and in vivo survival of the transfused RBCs. Some of the changes occurring in the early stages of the storage period (for approximately two weeks) are reversible but become irreversible later on as the storage is extended. In this review, we aim to decipher the duration of RBC storage and inflammatory marker generation. This phenomenon is included as one of the causes of transfusion-related immunomodulation (TRIM), an emerging concept developed to potentially elucidate numerous clinical observations that suggest that RBC transfusion is associated with increased inflammatory events or effects with clinical consequence.
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17
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An effective and potentially safe blood disinfection protocol using tetrapyrrolic photosensitizers. Future Med Chem 2017; 9:365-379. [DOI: 10.4155/fmc-2016-0217] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aim: Conventional disinfection techniques, considered safe for plasma, are usually associated with collateral damages on concentrated platelets and erythrocytes. Alternative methods are required and antimicrobial photodynamic therapy (aPDT) seems promising. In this study the effectiveness of two photosensitizers (PS), a porphyrin and a phthalocyanine, to disinfect blood products was evaluated. Results: The cationic porphyrin was more effective in the photoinactivation of bacteria. Also, no significant osmotic stress was found for samples treated with PS at 5.0 µM in isotonic conditions after antimicrobial photodynamic therapy. Conclusion: Effective reduction of Gram-positive bacteria at 5.0 µM of PS provided promising indications toward its safe use to disinfect blood samples. For Gram-negative bacteria, lower PS concentrations, between 5.0 and 10 µM, must be tested.
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Qadri SM, Chen D, Schubert P, Perruzza DL, Bhakta V, Devine DV, Sheffield WP. Pathogen inactivation by riboflavin and ultraviolet light illumination accelerates the red blood cell storage lesion and promotes eryptosis. Transfusion 2016; 57:661-673. [DOI: 10.1111/trf.13959] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 12/23/2022]
Affiliation(s)
- Syed M. Qadri
- Centre for Innovation, Canadian Blood Services; McMaster University; Hamilton Ontario Canada
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
| | - Deborah Chen
- Centre for Innovation, Canadian Blood Services; University of British Columbia; Vancouver British Columbia Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Peter Schubert
- Centre for Innovation, Canadian Blood Services; University of British Columbia; Vancouver British Columbia Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Darian L. Perruzza
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
| | - Varsha Bhakta
- Centre for Innovation, Canadian Blood Services; McMaster University; Hamilton Ontario Canada
| | - Dana V. Devine
- Centre for Innovation, Canadian Blood Services; University of British Columbia; Vancouver British Columbia Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - William P. Sheffield
- Centre for Innovation, Canadian Blood Services; McMaster University; Hamilton Ontario Canada
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
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19
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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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20
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Tormey CA, Santhanakrishnan M, Smith NH, Liu J, Marschner S, Goodrich RP, Hendrickson JE. Riboflavin-ultraviolet light pathogen reduction treatment does not impact the immunogenicity of murine red blood cells. Transfusion 2015; 56:863-72. [DOI: 10.1111/trf.13432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Christopher A. Tormey
- Department of Laboratory Medicine
- VA Connecticut Healthcare System; West Haven Connecticut
| | | | - Nicole H. Smith
- Departments of Pediatrics and Pathology; Emory University School of Medicine; Atlanta Georgia
| | | | | | | | - Jeanne E. Hendrickson
- Department of Laboratory Medicine
- Departments of Pediatrics and Pathology; Emory University School of Medicine; Atlanta Georgia
- Department of Pediatrics; Yale University School of Medicine; New Haven Connecticut
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21
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Multilayer-strategy to enhance optimal safety of the blood supply: The role of pathogen inactivation for optimizing recipient safety and helping health care cost containment. Transfus Apher Sci 2015; 52:233-6. [DOI: 10.1016/j.transci.2015.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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de Sousa G, Seghatchian J. Highlights of PBTI Coimbra Conference on PRT of Plasma & Current Opinions on Pathogen Reduction Treatment of Blood Components. Transfus Apher Sci 2015; 52:228-32. [DOI: 10.1016/j.transci.2015.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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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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24
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Pathogenesis of non-antibody mediated transfusion-related acute lung injury from bench to bedside. Blood Rev 2015; 29:51-61. [DOI: 10.1016/j.blre.2014.09.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/02/2014] [Indexed: 12/11/2022]
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25
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Tynngård N, Trinks M, Berlin G. In vitro function of platelets treated with ultraviolet C light for pathogen inactivation: a comparative study with nonirradiated and gamma-irradiated platelets. Transfusion 2014; 55:1169-77. [DOI: 10.1111/trf.12963] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/28/2014] [Accepted: 11/03/2014] [Indexed: 01/02/2023]
Affiliation(s)
- Nahreen Tynngård
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Department of Clinical Chemistry; Linköping University; Linköping Sweden
| | - Marie Trinks
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Gösta Berlin
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
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26
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Chen Z, Schubert P, Culibrk B, Devine DV. p38MAPK is involved in apoptosis development in apheresis platelet concentrates after riboflavin and ultraviolet light treatment. Transfusion 2014; 55:848-57. [PMID: 25385501 DOI: 10.1111/trf.12905] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 08/29/2014] [Accepted: 09/08/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND Pathogen inactivation (PI) accelerates the platelet (PLT) storage lesion, including apoptotic-like changes. Proteomic studies have shown that phosphorylation levels of several kinases increase in PLTs after riboflavin and UV light (RF-PI) treatment. Inhibition of p38MAPK improved in vitro PLT quality, but the biochemical basis of this kinase's contribution to PLT damage requires further analysis. STUDY DESIGN AND METHODS In a pool-and-split design, apheresis PLT concentrates were either treated or kept untreated with or without selected kinase inhibitors. Samples were analyzed throughout 7 days of storage, monitoring in vitro quality variables including phosphatidylserine exposure, degranulation, and glucose metabolism. Changes in the protein expression of Bax, Bak, and Bcl-xL and the activities of caspase-3 and -9 were determined by immunoblot analysis and flow cytometry, respectively. RESULTS The expression levels of the proapoptotic proteins Bax and Bak, but not the antiapoptotic protein Bcl-xL, were significantly increased after the RF-PI treatment. This trend was reversed in the presence of p38MAPK inhibitor SB203580. As a result of increasing proapoptotic protein levels, caspase-3 and -9 activities were significantly increased in RF-PI treatment during storage compared with control (p < 0.05). Similarly, p38MAPK inhibition significantly reduced these caspase activities compared with vehicle control after RF-PI treatment (p < 0.05). CONCLUSION These findings revealed that p38MAPK is involved in signaling leading to apoptosis triggered by RF-PI. Elucidation of the biochemical processes influenced by PI is a necessary step in the development of strategies to improve the PLT quality and ameliorate the negative effects of PI treatment.
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Affiliation(s)
- Zhongming Chen
- Canadian Blood Services, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Schubert
- Canadian Blood Services, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brankica Culibrk
- Canadian Blood Services, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dana V Devine
- Canadian Blood Services, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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27
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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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28
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Prudent M, Tissot JD, Lion N. Proteomics of blood and derived products: what’s next? Expert Rev Proteomics 2014; 8:717-37. [DOI: 10.1586/epr.11.58] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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29
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Sobral PM, Barros AEDL, Gomes AMAS, do Bonfim CV. Viral inactivation in hemotherapy: systematic review on inactivators with action on nucleic acids. Rev Bras Hematol Hemoter 2013; 34:231-5. [PMID: 23049426 PMCID: PMC3459627 DOI: 10.5581/1516-8484.20120056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 04/04/2012] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to conduct a systematic review on the photoinactivators used in hemotherapy, with action on viral genomes. The SciELO, Science Direct, PubMed and Lilacs databases were searched for articles. The inclusion criterion was that these should be articles on inactivators with action on genetic material that had been published between 2000 and 2010. The key words used in identifying such articles were "hemovigilance", "viral inactivation", "photodynamics", "chemoprevention" and "transfusion safety". Twenty-four articles on viral photoinactivation were found with the main photoinactivators covered being: methylene blue, amotosalen HCl, S-303 frangible anchor linker effector (FRALE), riboflavin and inactin. The results showed that methylene blue has currently been studied least, because it diminishes coagulation factors and fibrinogen. Riboflavin has been studied most because it is a photoinactivator of endogenous origin and has few collateral effects. Amotosalen HCl is effective for platelets and is also used on plasma, but may cause changes both to plasma and to platelets, although these are not significant for hemostasis. S-303 FRALE may lead to neoantigens in erythrocytes and is less indicated for red-cell treatment; in such cases, PEN 110 is recommended. Thus, none of the methods for pathogen reduction is effective for all classes of agents and for all blood components, but despite the high cost, these photoinactivators may diminish the risk of blood-transmitted diseases.
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30
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31
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Modery-Pawlowski CL, Tian LL, Ravikumar M, Wong TL, Gupta AS. In vitro and in vivo hemostatic capabilities of a functionally integrated platelet-mimetic liposomal nanoconstruct. Biomaterials 2013; 34:3031-41. [DOI: 10.1016/j.biomaterials.2012.12.045] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 12/22/2012] [Indexed: 10/27/2022]
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32
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Modery-Pawlowski CL, Tian LL, Pan V, Sen Gupta A. Synthetic Approaches to RBC Mimicry and Oxygen Carrier Systems. Biomacromolecules 2013; 14:939-48. [DOI: 10.1021/bm400074t] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
| | - Lewis L. Tian
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland Ohio 44106,
United States
| | - Victor Pan
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland Ohio 44106,
United States
| | - Anirban Sen Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland Ohio 44106,
United States
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33
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Marrocco C, D'Alessandro A, Girelli G, Zolla L. Proteomic analysis of platelets treated with gamma irradiation versus a commercial photochemical pathogen reduction technology. Transfusion 2013; 53:1808-20. [DOI: 10.1111/trf.12060] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 09/20/2012] [Accepted: 10/12/2012] [Indexed: 12/18/2022]
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34
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Modery-Pawlowski CL, Tian LL, Pan V, McCrae KR, Mitragotri S, Sen Gupta A. Approaches to synthetic platelet analogs. Biomaterials 2013; 34:526-41. [DOI: 10.1016/j.biomaterials.2012.09.074] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 09/29/2012] [Indexed: 11/15/2022]
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35
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Liu X, Zhao X, Wang X, Zhang J, Huang Y, Mo Q, Qian K, Zhu Y. Photochemically Inactivated Hepatitis B Virus Promotes Upregulation of Th1-Type Cytokines. Photochem Photobiol 2012; 88:1287-92. [DOI: 10.1111/j.1751-1097.2012.01170.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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36
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Tagny CT, Kouao MD, Touré H, Gargouri J, Fazul AS, Ouattara S, Anani L, Othmani H, Feteke L, Dahourou H, Mbensa GO, Molé S, Nébié Y, Mbangue M, Toukam M, Boulahi MO, Andriambelo LV, Rakoto O, Baby M, Yahaya R, Bokilo A, Senyana F, Mbanya D, Shiboski C, Murphy EL, Lefrère JJ. Transfusion safety in francophone African countries: an analysis of strategies for the medical selection of blood donors. Transfusion 2011; 52:134-43. [PMID: 22014098 DOI: 10.1111/j.1537-2995.2011.03391.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The goal of selecting a healthy blood donor is to safeguard donors and reduce the risks of infections and immunologic complications for recipients. STUDY DESIGN AND METHODS To evaluate the blood donor selection process, a survey was conducted in 28 blood transfusion centers located in 15 francophone African countries. Data collected included availability of blood products, risk factors for infection identified among blood donor candidates, the processing of the information collected before blood collection, the review process for the medical history of blood donor candidates, and deferral criteria for donor candidates. RESULTS During the year 2009, participating transfusion centers identified 366,924 blood donor candidates. A mean of 13% (range, 0%-36%) of the donor candidates were excluded based solely on their medical status. The main risk factors for blood-borne infections were having multiple sex partners, sexual intercourse with occasional partners, and religious scarification. Most transfusion centers collected this information verbally instead of having a written questionnaire. The topics least addressed were the possible complications relating to the donation, religious scarifications, and history of sickle cell anemia and hemorrhage. Only three centers recorded the temperature of the blood donors. The deferral criteria least reported were sickle cell anemia, piercing, scarification, and tattoo. CONCLUSIONS The medical selection process was not performed systemically and thoroughly enough, given the regional epidemiologic risks. It is essential to identify the risk factors specific to francophone African countries and modify the current medical history questionnaires to develop a more effective and relevant selection process.
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37
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Bloch EM, Vermeulen M, Murphy E. Blood transfusion safety in Africa: a literature review of infectious disease and organizational challenges. Transfus Med Rev 2011; 26:164-80. [PMID: 21872426 DOI: 10.1016/j.tmrv.2011.07.006] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Blood safety remains an important public health concern in Africa where lack of availability or provision of unsafe blood adversely impacts morbidity and mortality in the region. In recognition of this shortfall, the World Health Organization (WHO) established a goal of regional blood safety by 2012 through improved "organization and management, blood donor recruitment and collection, testing of donor blood as well as appropriate clinical use of blood" (Tagny et al: Transfusion. 2008;48:1256-1261; Tapko et al: Status of Blood Safety in the WHO African Region: Report of the 2006 Survey http://www.afro.who.int/en/divisions-a-programmes/dsd/health-technologies-a-laboratories.html. Brazzaville, Republic of Congo: WHO Regional Office for Africa; 2006). Although there has been substantial progress toward meeting these objectives, there are continued obstacles to both development and sustainability. In a setting where transfusion oversight is still being improved, transfusion-transmitted infections are of real concern. The high prevalence of some transfusion-transmissible agents such as hepatitis B virus and HIV in the general population means that some infected blood units escape detection by even well-performed laboratory testing, resulting in potential downstream transmission to patients. The spectrum of transfusion-transmitted infection include conventional as well as exotic pathogens, many of which are endemic to the region, thereby imparting ongoing challenges to recruitment and testing strategies.
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Affiliation(s)
- Evan M Bloch
- Blood Systems Research Institute, San Francisco, CA 94118, USA.
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Schubert P, Culibrk B, Coupland D, Scammell K, Gyongyossy-Issa M, Devine DV. Riboflavin and ultraviolet light treatment potentiates vasodilator-stimulated phosphoprotein Ser-239 phosphorylation in platelet concentrates during storage. Transfusion 2011; 52:397-408. [DOI: 10.1111/j.1537-2995.2011.03287.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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39
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Seghatchian J, Hervig T, Putter JS. Effect of pathogen inactivation on the storage lesion in red cells and platelet concentrates. Transfus Apher Sci 2011; 45:75-84. [DOI: 10.1016/j.transci.2011.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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40
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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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41
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Störmer M, Arroyo A, Brachert J, Carrero H, Devine D, Epstein JS, Gabriel C, Gelber C, Goodrich R, Hanschmann KM, Heath DG, Jacobs MR, Keil S, de Korte D, Lambrecht B, Lee CK, Marcelis J, Marschner S, McDonald C, McGuane S, McKee M, Müller TH, Muthivhi T, Pettersson A, Radziwon P, Ramirez-Arcos S, Reesink HW, Rojo J, Rood I, Schmidt M, Schneider CK, Seifried E, Sicker U, Wendel S, Wood EM, Yomtovian RA, Montag T. Establishment of the first international repository for transfusion-relevant bacteria reference strains: ISBT working party transfusion-transmitted infectious diseases (WP-TTID), subgroup on bacteria. Vox Sang 2011; 102:22-31. [PMID: 21732948 DOI: 10.1111/j.1423-0410.2011.01510.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bacterial contamination of platelet concentrates (PCs) still remains a significant problem in transfusion with potential important clinical consequences, including death. The International Society of Blood Transfusion Working Party on Transfusion-Transmitted Infectious Diseases, Subgroup on Bacteria, organised an international study on Transfusion-Relevant Bacteria References to be used as a tool for development, validation and comparison of both bacterial screening and pathogen reduction methods. MATERIAL AND METHODS Four Bacteria References (Staphylococcus epidermidis PEI-B-06, Streptococcus pyogenes PEI-B-20, Klebsiella pneumoniae PEI-B-08 and Escherichia coli PEI-B-19) were selected regarding their ability to proliferate to high counts in PCs and distributed anonymised to 14 laboratories in 10 countries for identification, enumeration and bacterial proliferation in PCs after low spiking (0·3 and 0·03 CFU/ml), to simulate contamination occurring during blood donation. RESULTS Bacteria References were correctly identified in 98% of all 52 identifications. S. pyogenes and E. coli grew in PCs in 11 out of 12 laboratories, and K. pneumoniae and S. epidermidis replicated in all participating laboratories. The results of bacterial counts were very consistent between laboratories: the 95% confidence intervals were for S. epidermidis: 1·19-1·32 × 10(7) CFU/ml, S. pyogenes: 0·58-0·69 × 10(7) CFU/ml, K. pneumoniae: 18·71-20·26 × 10(7) CFU/ml and E. coli: 1·78-2·10 × 10(7) CFU/ml. CONCLUSION The study was undertaken as a proof of principle with the aim to demonstrate (i) the quality, stability and suitability of the bacterial strains for low-titre spiking of blood components, (ii) the property of donor-independent proliferation in PCs, and (iii) their suitability for worldwide shipping of deep frozen, blinded pathogenic bacteria. These aims were successfully fulfilled. The WHO Expert Committee Biological Standardisation has approved the adoption of these four bacteria strains as the first Repository for Transfusion-Relevant Bacteria Reference Strains and, additionally, endorsed as a project the addition of six further bacteria strain preparations suitable for control of platelet contamination as the next step of enlargement of the repository.
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Affiliation(s)
- M Störmer
- Paul Ehrlich Institute, Langen, Germany.
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42
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Wainwright M, Baptista MS. The application of photosensitisers to tropical pathogens in the blood supply. Photodiagnosis Photodyn Ther 2011; 8:240-8. [PMID: 21864797 DOI: 10.1016/j.pdpdt.2011.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 04/13/2011] [Accepted: 04/15/2011] [Indexed: 12/23/2022]
Abstract
The onset of the HIV pandemic led both to significant alterations in blood collection and screening practice and to the development of more sophisticated methods of inactivation of infectious agents from the blood supply. Photodynamic (i.e. light activated) pathogen inactivation is one such method currently in limited use in various European states. The approach is based on the generation of a burst of reactive oxygen and nitrogen species, resulting in the activation of several cell death mechanisms. However, its application to tropical pathogens is perhaps less appreciated, despite the fact that the efficacies of photoantimicrobial agents such as methylene blue were originally reported following screening against organisms such as Trypanosoma cruzi and viruses such as those responsible for dengue and yellow fever. Since the objective of pathogen inactivation is to remove both established and emerging infective agents, it is necessary for photoantimicrobial agents to be broad-spectrum in activity. While this is demonstrable in plasma and platelet fractions, the application to red blood cells is currently under investigation.
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Affiliation(s)
- Mark Wainwright
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, United Kingdom. mark
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43
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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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44
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Clément S. [Techniques of preparation and indications of labile blood products]. Transfus Clin Biol 2011; 18:250-61. [PMID: 21474355 DOI: 10.1016/j.tracli.2011.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 02/28/2011] [Indexed: 11/23/2022]
Abstract
Labile blood products are obtained from samples of whole blood or aphaeresis. The techniques of preparation evolve with technological advances, which allow both an increasing automation and an intensification of the sanitary safety of the blood products. Over the last ten years, thanks to the availability of new technologies, several measures have been introduced in order to reduce the risk of transmission of pathogens and prevent the onset of transfusion-related acute lung injury (TRALI): leukoreduction, use of platelet storage solutions, inactivation of plasma and presumably of platelets in a very near future. The control of transfusion risk also depends on proper use of labile blood products. To assist the prescriber in his treatment options and to standardize practices, the French Agency for Sanitary Safety of Health Products has issued recommendations in terms of utilization of blood products that are detailed in this review of major labile blood products available.
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Affiliation(s)
- S Clément
- Plateau technique de production des PSL, EFS Rhône-Alpes, 1390, rue Centrale, 01708 Beynost, France.
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45
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Protéomique et médecine transfusionnelle. Transfus Clin Biol 2011; 18:79-96. [DOI: 10.1016/j.tracli.2011.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 02/17/2011] [Indexed: 01/02/2023]
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Seghatchian J, Struff WG, Reichenberg S. Main Properties of the THERAFLEX MB-Plasma System for Pathogen Reduction. Transfus Med Hemother 2011; 38:55-64. [PMID: 21779206 PMCID: PMC3132980 DOI: 10.1159/000323786] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 12/23/2010] [Indexed: 11/19/2022] Open
Abstract
Methylene blue (MB) treated plasma has been in clinical use for 18 years. The current THERAFLEX MB-Plasma has a number of improved features compared with the original Springe methodology. This overview embodies: the biochemical characteristics of MB, the mechanism of the technology, toxicology, pathogen reduction capacity, current position in clinical setting and status within Europe. The THERAFLEX MB (TMB) procedure is a robust, well standardised system lending itself to transfusion setting and meets the current guidelines. The pathogen kill power of the TMB system, like the other available technologies, is not limitless, probably in order of 6 log for most enveloped viruses and considerably less for non-enveloped ones. It does not induce either new antigen or grossly reducing the function and life span of active principle in fresh frozen plasma (FFP). The removal of the residual MB at the end of the process has the beneficial effect of reducing potential toxic impacts. Clinical haemovigilance data, so far, indicate that cell-free MB plasma is effective in all therapeutic setting requiring FFP, besides inconsistent thrombotic thrombocytopenia purpura data, without serious side-effects or toxicity. The current system is in continuous improvement e.g. regarding virus reduction range, illumination device, software used, and process integration in the blood bank setting.
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Affiliation(s)
- Jerard Seghatchian
- Blood Components Technology & Haemostasis/Thrombosis Consultancy, London, UK
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47
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Zhang B, Zheng L, Huang Y, Mo Q, Wang X, Qian K. Detection of Nucleic Acid Lesions During Photochemical Inactivation of RNA Viruses by Treatment with Methylene Blue and Light Using Real-time PCR. Photochem Photobiol 2011; 87:365-9. [DOI: 10.1111/j.1751-1097.2010.00870.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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48
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Effects of use of riboflavin and ultraviolet light for pathogen inactivation on quality of platelet concentrates. VOJNOSANIT PREGL 2011; 68:489-94. [DOI: 10.2298/vsp1106489s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Pathogen inactivation in blood and blood products is one of
the major means to achieve a zero risk blood supply and improve transfusion
safety. Riboflavin (vitamin B2) activated by ultraviolet (UV) light, produces
active oxygen which damages cell membrane and prevents replication of the
carrier of diseases (viruses, bacteria, protozoa) in all blood products. The
aim of this study was to establish the influence of the process of pathogens
photoinactivation using riboflavin and UV rays on the biochemical and
functional characteristics of platelet concentrates prepared from ?buffy
coat?. Methods. The examination included 80 platelet concentrates prepared
from ?buffy coat?, which was separated from whole blood donated by voluntary
blood donors around 6 hours from the moment of collection. Concentrates were
pooled, filtered and separated unton two groups: one consisted of 10 control
units and the other of 10 examined units (pooled platelet concentrates).
Examined units of the platelets were treated by riboflavin (35 mL) and UV
rays (6.24 J/mL, 265-370 nm) on Mirasol aparature (Caridian BCT
Biotechnologies, USA) in approximate duration of 6 min. A total of 35 mL of
saline solution was added to the control units. The samples for examining
were taken from the control and examined units initially (K0, I0), after the
addition of saline (K1) and riboflavin (I1), after illumination (I2), first
day of storage (K3, I3) and the fifth day of storage (K4, I4). The following
parameters were measured: platelet count and platelet yield, residual
erythrocyte and leukocyte count, pH, pO2, pCO2 and bacterial contamination.
Results. All the measured parameters showed a statistically significant
decrease comparing to K0 and I0; all the results of the first day of platelet
storage showed statistically significant decrease comparing to K1 and I1, and
all the results of the fifth day of platelet storage (K4, I4) showed a
statistically significant decrease comparing to K1 and K3 and to I1 and I3.
There was no the mentioned difference in the measured parameters between K4
and I4 (the end of storage - the fifth day). All the platelet units were
sterile till the seventh day, when the investigation ended. Conclusion.
Platelet concentrates inactivated by riboflavin and UV rays (Mirasol PRT
sistem, Caridian BCT, USA) keep all the characteristics assessed by the Guide
to the preparation, use and quality assurance of blood components (Council of
Europe), during the whole storage period (five days). The obtained data were
correlated with existing up to date literature and demonstrated that Mirasol
treated platelets were safe and could be incorporated effectively in the
routine blood bank and transfusion setting.
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49
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Hervig T, Seghatchian J, Apelseth TO. Current debate on pathogen inactivation of platelet concentrates – To use or not to use? Transfus Apher Sci 2010; 43:411-414. [DOI: 10.1016/j.transci.2010.10.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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50
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Cazenave JP, Folléa G, Bardiaux L, Boiron JM, Lafeuillade B, Debost M, Lioure B, Harousseau JL, Tabrizi R, Cahn JY, Michallet M, Ambruso D, Schots R, Tissot JD, Sensebé L, Kondo T, McCullough J, Rebulla P, Escolar G, Mintz P, Heddle N, Goodrich R, Bruhwyler J, Le C, Cook R, Stouch B. A randomized controlled clinical trial evaluating the performance and safety of platelets treated with MIRASOL pathogen reduction technology. Transfusion 2010; 50:2362-75. [DOI: 10.1111/j.1537-2995.2010.02694.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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