1
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Bailey SL, Bochenek M, Chauhan A, Miller B, Stolla M. Biotin labeling allows for post-transfusion functional assessment of stored human platelets in mice. Transfusion 2024; 64:1306-1314. [PMID: 38757806 DOI: 10.1111/trf.17879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/01/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Platelet radiolabeling with radioisotopes is currently used for human platelet recovery and survival studies. Biotinylation enables ex vivo post-transfusion platelet function testing. Whether platelet biotinylation itself affects platelet function is controversial. STUDY DESIGN AND METHODS Platelet concentrates from healthy humans were stored for 6 days. Samples were obtained at 1 or 2 and 6 days, and platelets were labeled following a radiolabeling protocol using saline instead of radioactive indium-111 (sham radiolabeling [sham-RL]). Alternatively, a newly developed biotinylation protocol, a washing protocol, or an unmanipulated control sample were used. Platelet function was assessed by flow cytometry after stimulation with platelet agonists and labeling of platelets with platelet activation markers. To test whether platelets can be activated after transfusion, labeled platelets were transfused into nonobese diabetic/severe combined immunodeficiency mice, and samples were obtained 1 h after transfusion. RESULTS The activation profile of biotinylated platelets was comparable to sham-RL platelets before transfusion except for significantly less α-degranulation and more phosphatidyl serine exposure on storage day 1/2. There was no significant difference between sham-RL and biotinylated platelets on storage day 6. Sham-RL and biotinylated platelets were significantly less activatable than washed and unmanipulated control platelets. After transfusion, the activation profile of biotinylated platelets was largely indistinguishable from unmanipulated ones. DISCUSSION The decrease in activation level in biotinylated platelets we and others observed appears mainly due to the physical manipulation during the labeling process. In conclusion, biotinylated platelets allow for post-transfusion function assessment, a major advantage over radiolabeling.
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Affiliation(s)
| | - Martin Bochenek
- Bloodworks Northwest Research Institute, Seattle, Washington, USA
| | - Aastha Chauhan
- Bloodworks Northwest Research Institute, Seattle, Washington, USA
| | - Brandon Miller
- Bloodworks Northwest Research Institute, Seattle, Washington, USA
| | - Moritz Stolla
- Bloodworks Northwest Research Institute, Seattle, Washington, USA
- Department of Medicine, Division of Hematology and Oncology, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, USA
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2
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von Behren JM, Wesche J, Greinacher A, Aurich K. Indocyanine Green-Labeled Platelets for Survival and Recovery Studies. Transfus Med Hemother 2024; 51:66-75. [PMID: 38584698 PMCID: PMC10996059 DOI: 10.1159/000533623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/13/2023] [Indexed: 04/09/2024] Open
Abstract
Introduction Before being implemented in daily clinical routine, new production strategies for platelet concentrates (PCs) must be validated for their efficacy. Besides in vitro testing, the establishment of new methods requires the labeling of platelets for in vivo studies of platelets' survival and recovery. Indocyanine green (ICG) is a Food and Drug Administration-approved near-infrared (NIR) fluorescent dye for diagnostic use in vivo, suitable for non-radioactive direct cell labeling of platelets. Methods Platelets from PCs in storage solutions with different plasma concentrations were labeled with ICG up to concentrations of 200 μm. Whole blood (WB) was used as an ex vivo matrix to monitor the labeling stability of ICG-labeled platelets. The impact of labeling processes was assessed by the quantification of CD62P expression and PAC-1 binding as platelet function markers. Platelet aggregation was analyzed by light transmission aggregometry. ICG-labeling efficiency and stability of platelets were determined by flow cytometry. Results Platelets from PCs could be successfully labeled with 10 μm ICG after 1 and 4 days of storage. The best labeling efficiency of 99.8% ± 0.1% (immediately after labeling) and 81% ± 6.2% (after 24 h incubation with WB) was achieved by plasma replacement by 100% platelet additive solution for the labeling process. Since the washing process slightly impaired platelet function, ICG labeling itself did not affect platelets. Immediately after the ICG-labeling process, plasma was re-added, resulting in a recovered platelet function. Conclusion We developed a Good Manufacturing Practice compatible protocol for ICG fluorescent platelet labeling suitable for survival and recovery studies in vivo as a non-radioactive labeling alternative.
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Affiliation(s)
| | - Jan Wesche
- Universitätsmedizin Greifswald, Institut für Transfusionsmedizin, Greifswald, Germany
| | - Andreas Greinacher
- Universitätsmedizin Greifswald, Institut für Transfusionsmedizin, Greifswald, Germany
| | - Konstanze Aurich
- Universitätsmedizin Greifswald, Institut für Transfusionsmedizin, Greifswald, Germany
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3
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van Wonderen SF, van Baarle FLF, de Bruin S, Peters AL, de Korte D, van Bruggen R, Vlaar APJ. Biotinylated Platelets: A Promising Labeling Technique? Transfus Med Rev 2023:S0887-7963(23)00001-9. [PMID: 36697309 DOI: 10.1016/j.tmrv.2023.01.001] [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: 11/23/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/14/2023]
Abstract
Labeling of platelets (PLTs) is essential for research purposes, in order to measure the recovery and survival of transfused PLTs in vivo. Biotinylation is a promising new alternative to the gold standard of radioactive labeling. This review highlights 4 key publications that provide significant insights into biotin-labeled PLTs (bioPLTs). Stohlawetz et al. established that transfusion of bioPLTs in human recipients is possible. De Bruin et al. developed a standardized, reproducible protocol for biotinylation of PLTs as a promising method to trace and isolate transfused PLTs in vivo, with reduced levels of PLT activation markers. Muret et al. developed a nonwashing biotin labeling method to implement in a blood bank environment. Finally, in a preclinical study, Ravanat et al. showed that different densities of biotin can be used to concurrently monitor multiple populations of human PLTs in the circulation of the same subject. These studies have made major contributions to the development of bioPLTs as a viable option for use in human research, and indicate that bioPLTs can be safely administered, preferably at a low density of biotin.
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Affiliation(s)
- Stefan F van Wonderen
- Amsterdam UMC location University of Amsterdam, Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Floor L F van Baarle
- Amsterdam UMC location University of Amsterdam, Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Sanne de Bruin
- Amsterdam UMC location University of Amsterdam, Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Anna L Peters
- Division Vital Functions, Department of Anesthesiology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Dirk de Korte
- Department of Product and Process Development, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Robin van Bruggen
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Alexander P J Vlaar
- Amsterdam UMC location University of Amsterdam, Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands.
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4
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Muret C, Crettaz D, Martin A, Aliotta A, Bertaggia Calderara D, Alberio L, Prudent M. Two novel platelet biotinylation methods and their impact on stored platelet concentrates in a blood bank environment. Transfusion 2022; 62:2324-2333. [PMID: 36190148 DOI: 10.1111/trf.17129] [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: 04/12/2022] [Revised: 07/08/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Storage of platelet concentrates (PCs) has an impact on platelet quality and possibly affects their functions after transfusion. The influence of processing and storage conditions of PCs on their in vivo function upon transfusion is unknown. One option for investigating this question is to implement an ex vivo labeling of human platelets, to analyze them after transfusion into heathy volunteers and/or patients. In this study, we developed two labeling methods employing biotin. METHODS Two methods of biotinylation were compared to a control (standard PC). The "Bio-Wash" process used washing steps to label all platelets within the PC; for the other method, "Bio-Direct," one fifth of the PC were directly labeled without washing steps. The control and the two biotinylated PCs were analyzed over 7 days of storage. Labeling efficiency, platelet counts, phenotypes, and functions, along with time and costs, were evaluated to select the best process. RESULTS Both methods achieved a stable labeling through the storage, with similar platelet counts and metabolism in comparison to control PCs. Bio-Wash showed higher activation phenotype and lower aggregation response in comparison to the Bio-Direct method. The Bio-Direct was performed within 1.5 h versus 3 h for the Bio-Wash. However, the Bio-Direct required 12 mg of biotin instead of 8 mg for the other process. CONCLUSION We set up two methods of biotinylation that can be easily implemented in a blood bank environment. The Bio-Direct process was preferred to the Bio-Wash because of its similarity, from a functional and phenotypic point of view, with standard PCs.
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Affiliation(s)
- Charlotte Muret
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne (UNIL), Lausanne, Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Agathe Martin
- Laboratoire de Préparation Cellulaire et d'Analyses, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Alessandro Aliotta
- Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Debora Bertaggia Calderara
- Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Lorenzo Alberio
- Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Lausanne, Switzerland
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5
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Mehrizi TZ, Kafiabad SA, Eshghi P. Effects and treatment applications of polymeric nanoparticles on improving platelets' storage time: a review of the literature from 2010 to 2020. Blood Res 2021; 56:215-228. [PMID: 34880140 PMCID: PMC8721452 DOI: 10.5045/br.2021.2021094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/26/2021] [Accepted: 08/25/2021] [Indexed: 12/13/2022] Open
Abstract
Maintaining the quality of platelet products and increasing their storage time are priorities for treatment applications. The formation of platelet storage lesions that limit the storage period and preservation temperature, which can prepare a decent environment for bacterial growth, are the most important challenges that researchers are dealing with in platelet preservation. Nanotechnology is an emerging field of science that has introduced novel solutions to resolve these problems. Here, we reviewed the reported effects of polymeric nanoparticles-including chitosan, dendrimers, polyethylene glycol (PEG), and liposome-on platelets in articles from 2010 to 2020. As a result, we concluded that the presence of dendrimer nanoparticles with a smaller size, negative charge, low molecular weight, and low concentration along with PEGylation can increase the stability and survival of platelets during storage. In addition, PEGylation of platelets can also be a promising approach to improve the quality of platelet bags during storage.
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Affiliation(s)
- Tahereh Zadeh Mehrizi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Sedigheh Amini Kafiabad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences and Iran Blood Transfusion Organization, Tehran, Iran
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6
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Ercan H, Schrottmaier WC, Pirabe A, Schmuckenschlager A, Pereyra D, Santol J, Pawelka E, Traugott MT, Schörgenhofer C, Seitz T, Karolyi M, Yang JW, Jilma B, Zoufaly A, Assinger A, Zellner M. Platelet Phenotype Analysis of COVID-19 Patients Reveals Progressive Changes in the Activation of Integrin αIIbβ3, F13A1, the SARS-CoV-2 Target EIF4A1 and Annexin A5. Front Cardiovasc Med 2021; 8:779073. [PMID: 34859078 PMCID: PMC8632253 DOI: 10.3389/fcvm.2021.779073] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/22/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The fatal consequences of an infection with severe acute respiratory syndrome coronavirus 2 are not only caused by severe pneumonia, but also by thrombosis. Platelets are important regulators of thrombosis, but their involvement in the pathogenesis of COVID-19 is largely unknown. The aim of this study was to determine their functional and biochemical profile in patients with COVID-19 in dependence of mortality within 5-days after hospitalization. Methods: The COVID-19-related platelet phenotype was examined by analyzing their basal activation state via integrin αIIbβ3 activation using flow cytometry and the proteome by unbiased two-dimensional differential in-gel fluorescence electrophoresis. In total we monitored 98 surviving and 12 non-surviving COVID-19 patients over 5 days of hospital stay and compared them to healthy controls (n = 12). Results: Over the observation period the level of basal αIIbβ3 activation on platelets from non-surviving COVID-19 patients decreased compared to survivors. In line with this finding, proteomic analysis revealed a decrease in the total amount of integrin αIIb (ITGA2B), a subunit of αIIbβ3, in COVID-19 patients compared to healthy controls; the decline was even more pronounced for the non-survivors. Consumption of the fibrin-stabilizing factor coagulation factor XIIIA (F13A1) was higher in platelets from COVID-19 patients and tended to be higher in non-survivors; plasma concentrations of the latter also differed significantly. Depending on COVID-19 disease status and mortality, increased amounts of annexin A5 (ANXA5), eukaryotic initiation factor 4A-I (EIF4A1), and transaldolase (TALDO1) were found in the platelet proteome and also correlated with the nasopharyngeal viral load. Dysregulation of these proteins may play a role for virus replication. ANXA5 has also been identified as an autoantigen of the antiphospholipid syndrome, which is common in COVID-19 patients. Finally, the levels of two different protein disulfide isomerases, P4HB and PDIA6, which support thrombosis, were increased in the platelets of COVID-19 patients. Conclusion: Platelets from COVID-19 patients showed significant changes in the activation phenotype, in the processing of the final coagulation factor F13A1 and the phospholipid-binding protein ANXA5 compared to healthy subjects. Additionally, these results demonstrate specific alterations in platelets during COVID-19, which are significantly linked to fatal outcome.
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Affiliation(s)
- Huriye Ercan
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Waltraud Cornelia Schrottmaier
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Anita Pirabe
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Anna Schmuckenschlager
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - David Pereyra
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
- Division of Visceral Surgery, Department of General Surgery, General Hospital Vienna, Medical University of Vienna, Vienna, Austria
| | - Jonas Santol
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
- Division of Visceral Surgery, Department of General Surgery, General Hospital Vienna, Medical University of Vienna, Vienna, Austria
| | - Erich Pawelka
- Department of Medicine IV, Clinic Favoriten, Vienna, Austria
| | | | - Christian Schörgenhofer
- Department of Clinical Pharmacology, Medical University of Vienna, General Hospital Vienna, Vienna, Austria
| | - Tamara Seitz
- Department of Medicine IV, Clinic Favoriten, Vienna, Austria
| | - Mario Karolyi
- Department of Medicine IV, Clinic Favoriten, Vienna, Austria
| | - Jae-Won Yang
- Center for Physiology and Pharmacology, Institute of Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, General Hospital Vienna, Vienna, Austria
| | | | - Alice Assinger
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Maria Zellner
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
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7
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Ravanat C, Pongérard A, Freund M, Heim V, Rudwill F, Ziessel C, Eckly A, Proamer F, Isola H, Gachet C. Human platelets labeled at two discrete biotin densities are functional in vitro and are detected in vivo in the murine circulation: A promising approach to monitor platelet survival in vivo in clinical research. Transfusion 2021; 61:1642-1653. [PMID: 33580977 DOI: 10.1111/trf.16312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/17/2021] [Accepted: 01/17/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND The production of platelet concentrates (PCs) is evolving, and their survival capacity needs in vivo evaluation. This requires that the transfused platelets (PLTs) be distinguished from those of the recipient. Labeling at various biotin (Bio) densities allows one to concurrently trace multiple PLT populations, as reported for red blood cells. STUDY DESIGN AND METHODS A method is described to label human PLTs at two densities of Bio for future clinical trials. Injectable-grade PLTs were prepared in a sterile environment, using injectable-grade buffers and good manufacturing practices (GMP)-grade Sulfo-NHS-Biotin. Sulfo-NHS-Biotin concentrations were chosen to maintain PLT integrity and avoid potential alloimmunization while enabling the detection of circulating BioPLTs. The impact of biotinylation on human PLT recirculation was evaluated in vivo in a severe immunodeficient mouse model using ex vivo flow cytometry. RESULTS BioPLTs labeled with 1.2 or 10 μg/ml Sulfo-NHS-Biotin displayed normal ultrastructure and retained aggregation and secretion capacity and normal expression of the main surface glycoproteins. The procedure avoided detrimental PLT activation or apoptosis signals. Transfused human BioPLT populations could be distinguished from one another and from unlabeled circulating mouse PLTs, and their survival was comparable to that of unlabeled human PLTs in the mouse model. CONCLUSIONS Provided low Sulfo-NHS-Biotin concentrations (<10 μg/ml) are used, injectable-grade BioPLTs comply with safety regulations, conserve PLT integrity, and permit accurate in vivo detection. This alternative to radioisotopes, which allows one to follow different PLT populations in the same recipient, should be valuable when assessing new PC preparations and monitoring PLT survival in clinical research.
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Affiliation(s)
- Catherine Ravanat
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Anaïs Pongérard
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Monique Freund
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Véronique Heim
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Floriane Rudwill
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Catherine Ziessel
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Anita Eckly
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Fabienne Proamer
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Hervé Isola
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Christian Gachet
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand-Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
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8
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Abstract
AbstractThe characterization of platelet concentrates (PCs) in transfusion medicine has been performed with different analytical methods and platelet lesions (from biochemistry to cell biology) have been documented. In routine quality assessment and validation of manufacturing processes of PCs for transfusion purposes, only basic parameters are monitored and the platelet functions are not included. However, PCs undergo several manipulations during the processing and the basic parameters do not provide sensitive analyses to properly picture out the impact of the blood component preparation and storage on platelets. To improve the transfusion supply chain and the platelet functionalities, additional parameters should be used. The present short review will focus on the different techniques to monitor ex vivo platelet lesions from phenotype characterization to advanced omic analyses. Then, the opportunities to use these methods in quality control, process validation, development, and research will be discussed. Functional markers should be considered because they would be an advantage for the future developments in transfusion medicine.
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9
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de Bruin S, van de Weerdt EK, Sijbrands D, Vlaar R, Gouwerok E, Biemond BJ, Vlaar APJ, van Bruggen R, de Korte D. Biotinylation of platelets for transfusion purposes a novel method to label platelets in a closed system. Transfusion 2019; 59:2964-2973. [PMID: 31318461 PMCID: PMC6852179 DOI: 10.1111/trf.15451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/27/2019] [Accepted: 06/10/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Labeling of platelets (PLTs) is required to measure the recovery and survival of transfused PLTs in vivo. Currently a radioactive method is used to label PLTs. However, application of those radiolabeling methods is limited by both safety issues and the inability to isolate transfused PLTs from the circulation. Biotin‐labeled PLTs are an attractive nonradioactive option. However, no validated protocol to biotinylate PLTs is currently available for human studies. STUDY DESIGN AND METHODS Six PLT concentrates (PCs) were subaliquoted and biotinylated on Days 1 and 7 of storage. To distinguish the effect of the processing steps from the effects of biotin incubation, two control groups were used: 1) “sham” samples were processed without the biotinylation reagent and 2) control samples were assessed without any processing other than the PC isolation. For the biotinylation procedure, 50 mL of PCs was washed twice and incubated with 5 mg/L biotin for 30 minutes in a closed system. As measures of PLT activation, phosphatidylserine exposure and CD62p expression were assessed. RESULTS After biotinylation, 98.4% ± 0.9% of PLTs were labeled. PLT counts, pH, and “swirling” were within the range accepted by the Dutch blood bank for standard PLT products. Biotinylated PLTs were more activated compared than controles but not more than sham samples, but were more activated than the controls. CONCLUSION We developed a standardized and reproducible protocol according to Good Practice Guidelines standards, for biotin labeling of PLTs for clinical purposes. This method can be applied as nonradioactive alternative assess survival and recovery of transfused PLTs in vivo.
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Affiliation(s)
- Sanne de Bruin
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands.,Department of Intensive Care Medicine, University of Amsterdam, Amsterdam, The Netherlands.,Laboratory of Experimental Intensive Care and Anesthesia, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Emma K van de Weerdt
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands.,Department of Intensive Care Medicine, University of Amsterdam, Amsterdam, The Netherlands.,Laboratory of Experimental Intensive Care and Anesthesia, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Davina Sijbrands
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands
| | - Richard Vlaar
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Eric Gouwerok
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Bart J Biemond
- Department of Hematology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, University of Amsterdam, Amsterdam, The Netherlands.,Laboratory of Experimental Intensive Care and Anesthesia, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Robin van Bruggen
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Dirk de Korte
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands.,Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands
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10
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Nguyen TH, Schuster N, Greinacher A, Aurich K. Uptake Pathways of Protein-Coated Magnetic Nanoparticles in Platelets. ACS APPLIED MATERIALS & INTERFACES 2018; 10:28314-28321. [PMID: 30067021 DOI: 10.1021/acsami.8b07588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Magnetic nanoparticles have recently shown great potential in nonradioactive labeling of platelets. Platelet labeling efficiency is enhanced when particles are conjugated with proteins like human serum albumin (HSA). However, the optimal HSA density coated on particles and the uptake mechanism of single particles in platelets remain unclear. Here, we utilized single-molecule force spectroscopy (SMFS) and other complementary methods to characterize the interaction of particles when interacting with platelets and to determine the optimal HSA amount required to coat particles. An HSA concentration of 0.5-1.0 mg/mL for coating particles is most efficient for platelet labeling. Binding pathways could be elucidated by linking a single HSA particle to SMFS tips via polyethylene glycol (PEG) linkers of different lengths and allowing them to interact with immobilized platelets on the substrate. Depending on the PEG length (i.e., short ∼2 nm, medium ∼30 nm, and long ∼100 nm), particles interact differently with platelets as shown by one, two, or three force distributions, which correspond up to three different binding pathways, respectively. We propose a model that the short PEG linker allows the particle to interact only with the platelet membrane, whereas the medium and long PEG linkers promote the particle to transfer from open canalicular system to another target inside platelets. Our study optimizes magnetic platelet labeling and provides details of particle pathways in platelets.
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Affiliation(s)
- Thi-Huong Nguyen
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
- ZIK HIKE-Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases , University of Greifswald , 17489 Greifswald , Germany
| | - Nicola Schuster
- ZIK HIKE-Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases , University of Greifswald , 17489 Greifswald , Germany
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
| | - Konstanze Aurich
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
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de Back DZ, Vlaar R, Beuger B, Daal B, Lagerberg J, Vlaar APJ, de Korte D, van Kraaij M, van Bruggen R. A method for red blood cell biotinylation in a closed system. Transfusion 2018; 58:896-904. [PMID: 29446461 DOI: 10.1111/trf.14535] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Several circumstances require the accurate measurement of red blood cell (RBC) survival and clearance, such as determination of posttransfusion recovery of stored RBCs to investigate the effect of new additive solutions. To this end, biotin as a marker of RBCs to track donor RBCs in the blood of the recipient has been used in many studies. However, so far only experimental, nonvalidated, biotin-labeled red cell concentrates (RCCs) are transfused. The goal of this study was to produce a standardized biotin-labeled RCC product in a fast, simple, and sterile manner that can be used for clinical research and for the evaluation of new blood products according to Good Practice Guidelines (GPG) for blood establishments. STUDY DESIGN AND METHODS RCC fractions were labeled with two different concentrations of biotinylation reagent in a closed system, to prevent bacterial contamination of the end product. Using flow cytometry, the reproducibility and robustness of the biotin labeling was assessed, as well as the stability of the biotin label on the (un-)irradiated RCC fraction. Additionally, parameters such as phosphatidylserine (PS) exposure, sodium (Na), potassium (K), free hemoglobin, adenosine triphosphate (ATP), pH, and morphology were determined prior to and after biotin labeling to rule out detrimental effects of the labeling procedure on the RCC. RESULTS Our data show that RCCs can be labeled under sterile conditions in a closed system with two different biotinylation reagent concentrations, without affecting the biological activity. CONCLUSION An easy, rapid (<2 hr), and robust method was developed to manufacture biotin-labeled RCCs for clinical research compliant to GPG.
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Affiliation(s)
- Djuna Z de Back
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Richard Vlaar
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Boukje Beuger
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Brunette Daal
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Johan Lagerberg
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Dirk de Korte
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands.,Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Marian van Kraaij
- Departments of Donor Affairs and Transfusion Medicine, Sanquin Blood Bank, Centre of Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Robin van Bruggen
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
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12
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Aurich K, Wesche J, Palankar R, Schlüter R, Bakchoul T, Greinacher A. Magnetic Nanoparticle Labeling of Human Platelets from Platelet Concentrates for Recovery and Survival Studies. ACS APPLIED MATERIALS & INTERFACES 2017; 9:34666-34673. [PMID: 28945336 DOI: 10.1021/acsami.7b10113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Platelets are the smallest blood cells and important for hemostasis. Platelet concentrates (PC) are medicinal products transfused to prevent or treat bleeding. Typically, platelets in PCs are assessed by in vitro tests for their function. However, in vivo testing of these platelets is highly desirable. To distinguish transfused platelets from patients or probands own cells after PC transfusions within the scope of clinical studies, platelets need to be efficiently labeled with minimal preactivation prior to transfusion. Here we report on a method for improved cell uptake of ferucarbotran magnetic nanoparticles contained in Resovist, an FDA-approved MRI contrast agent, by modifying the nanoparticle shell with human serum albumin (HSA). Both HSA-ferucarbotran nanoparticles and magnetically labeled platelets were produced according to EU-GMP guidelines. Platelet function after labeling was evaluated by light transmission aggregometry and by determination of expression of CD62P as platelet activation marker. Magnetic labeling does not impair platelet function and platelets showed reasonable activation response to agonists. Platelet survival studies in NOD/SCID-mice resulted in comparable survival behavior of magnetically labeled and nonlabeled platelets. Additionally, labeled platelets can be recovered from whole blood by magnetic separation.
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Affiliation(s)
- Konstanze Aurich
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald , Sauerbruchstraße, 17475 Greifswald, Germany
| | - Jan Wesche
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald , Sauerbruchstraße, 17475 Greifswald, Germany
| | - Raghavendra Palankar
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald , Sauerbruchstraße, 17475 Greifswald, Germany
| | - Rabea Schlüter
- Imaging-Zentrum der Fachrichtung Biologie, Ernst-Moritz-Arndt-Universität Greifswald , Friedrich-Ludwig-Jahn-Straße 15, 17487 Greifswald, Germany
| | - Tamam Bakchoul
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald , Sauerbruchstraße, 17475 Greifswald, Germany
| | - Andreas Greinacher
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald , Sauerbruchstraße, 17475 Greifswald, Germany
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13
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Árnason NÁ, Sigurjónsson ÓE. New strategies to understand platelet storage lesion. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/voxs.12394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- N. Á. Árnason
- The Blood Bank Landspitali; The National University Hospital of Iceland; Reykjavik Iceland
| | - Ó. E. Sigurjónsson
- The Blood Bank Landspitali; The National University Hospital of Iceland; Reykjavik Iceland
- School of Science and Engineering; Reykjavik University; Reykjavik Iceland
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Schrottmaier WC, Kral JB, Zeitlinger M, Salzmann M, Jilma B, Assinger A. Platelet activation at the onset of human endotoxemia is undetectable in vivo. Platelets 2016; 27:479-83. [PMID: 26764560 DOI: 10.3109/09537104.2015.1119814] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Infection induces platelet activation and consumption, which leads to thrombocytopenia, enhances microvascular thrombosis, impairs microcirculation and eventually triggers disseminated intravascular coagulation (DIC). It is well characterized that endotoxemia results in a pro-inflammatory and pro-coagulatory state, which favors platelet activation. However the early, direct effects of endotoxemia on platelets have not been investigated so far. Therefore we aimed to determine the early effects of the endotoxin lipopolysaccharide (LPS) on platelet function in vivo. In a human endotoxemia model, 15 healthy volunteers were stimulated with LPS (2 ng/kg). Blood was drawn before, 10, 30 and 60 min after LPS challenge and platelet activation analyzed by flow cytometry (GPIIb/IIIa activation, surface CD62P and CD40L, intraplatelet reactive oxygen formation and platelet-leukocyte aggregates) and ELISA (sCD40L, sCD62P and CXCL4). In parallel, blood samples and platelets were spiked with LPS (50 pg/ml) in vitro and monitored over 60 min for the same platelet activation markers. In vitro platelet stimulation with LPS activated platelets independent of the presence of leukocytes and enhanced their adhesion to endothelial cells. In contrast, in vivo no increase in GPIIb/IIIa activation or surface expression of CD62P was observed. However, endotoxemia resulted in a significant drop in platelet count and elevated the plasma CXCL4 levels already 10 min after the LPS challenge. These data indicate that LPS rapidly activates platelets, leading to α-granule release and endothelial adhesion. This might explain the drop in platelet count observed at the onset of endotoxemia.
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Affiliation(s)
| | - Julia Barbara Kral
- a Centre of Physiology and Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Markus Zeitlinger
- b Department of Clinical Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Manuel Salzmann
- a Centre of Physiology and Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Bernd Jilma
- b Department of Clinical Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Alice Assinger
- a Centre of Physiology and Pharmacology , Medical University of Vienna , Vienna , Austria
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15
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Jilma-Stohlawetz P, Mannhalter C, Kaider A, Waidacher T, Jilma B, Panzer S. The association of the Thr715Pro P-selectin genotype with levels of P-selectin in platelet concentrates. Vox Sang 2014; 107:368-74. [DOI: 10.1111/vox.12175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/08/2014] [Accepted: 05/16/2014] [Indexed: 11/27/2022]
Affiliation(s)
- P. Jilma-Stohlawetz
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
| | - C. Mannhalter
- Department of Laboratory Medicine; Medical University of Vienna; Vienna Austria
| | - A. Kaider
- Section for Clinical Biometrics; Center for Medical Statistics, Informatics and Intelligent Systems; Medical University of Vienna; Vienna Austria
| | - T. Waidacher
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
| | - B. Jilma
- Department of Clinical Pharmacology; Medical University of Vienna; Vienna Austria
| | - S. Panzer
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
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16
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Hypertensive emergencies are associated with elevated markers of inflammation, coagulation, platelet activation and fibrinolysis. J Hum Hypertens 2012; 27:368-73. [DOI: 10.1038/jhh.2012.53] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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17
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Kopp CW, Gremmel T, Steiner S, Seidinger D, Minar E, Maurer G, Huber K. Platelet-monocyte cross talk and tissue factor expression in stable angina vs. unstable angina/non ST-elevation myocardial infarction. Platelets 2011; 22:530-6. [DOI: 10.3109/09537104.2011.573599] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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18
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19
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Abstract
BACKGROUND Currently only indirect measures are required for monitoring the function of platelets in platelet concentrates (PC). METHODS This is an overview on currently available commercialized methods that have been used to determine platelet function in donors, concentrates and after transfusion. We show examples for the application of the no/low shear methods light-transmission aggregometry, flow cytometry, multiple electrode aggregometry, thrombelastography and dynamic light scattering, and those applying high shear, the platelet function analyzer-100, and the cone and plate analyzer. Advantages and disadvantages of the various methods to screen donors, evaluate the haemostatic properties maintained in the PC and after transfusion are discussed, based on considerations of platelet physiology, and the feasibility of the various procedures. This survey focuses on reports from the last 10 years, as the technology for the production of PCs has advanced significantly during the last few years. CONCLUSION Specific aspects of platelet function can be assessed by the no/low shear methods, while the high shear methods provide more general analysis of platelet haemostatic competence. Yet, there is no strong evidence that the in vitro data correspond with the clinical outcome.
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Affiliation(s)
- S Panzer
- Department for Blood Group Serology and Transfusion Medicine, Medical University Vienna, Vienna, Austria.
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20
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Spiel AO, Bartko J, Schwameis M, Firbas C, Siller-Matula J, Schuetz M, Weigl M, Jilma B. Increased platelet aggregation and in vivo platelet activation after granulocyte colony-stimulating factor administration. A randomised controlled trial. Thromb Haemost 2011; 105:655-62. [PMID: 21301783 DOI: 10.1160/th10-08-0530] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 01/25/2011] [Indexed: 11/05/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF) stimulates the bone marrow to produce granulocytes and stem cells and is widely used to accelerate neutrophil recovery after chemotherapy. Interestingly, specific G-CSF receptors have been demonstrated not only on myeloid cells, but also on platelets. Data on the effects of G-CSF on platelet function are limited and partly conflicting. The objective of this study was to determine the effect of G-CSF on platelet aggregation and in vivo platelet activation. Seventy-eight, healthy volunteers were enrolled into this randomised, placebo-controlled trial. Subjects received 5 μg/kg methionyl human granulocyte colony-stimulating factor (r-metHuG-CSF, filgrastim) or placebo subcutaneously for four days. We determined platelet aggregation with a whole blood impedance aggregometer with various, clinically relevant platelet agonists (adenosine diphosphate [ADP], collagen, arachidonic acid [AA], ristocetin and thrombin receptor activating peptide 6 [TRAP]). Filgrastim injection significantly enhanced ADP (+40%), collagen (+60%) and AA (+75%)-induced platelet aggregation (all p<0.01 as compared to placebo and p<0.001 as compared to baseline). In addition, G-CSF enhanced ristocetin-induced platelet aggregation (+18%) whereas TRAP-induced platelet aggregation decreased slightly (-14%) in response to filgrastim. While baseline aggregation with all agonists was only slightly but insignificantly higher in women than in men, this sex difference was enhanced by G-CSF treatment, and became most pronounced for ADP after five days (p<0.001). Enhanced platelet aggregation translated into a 75% increase in platelet activation as measured by circulating soluble P-selectin. G-CSF enhances platelet aggregation and activation in humans. This may put patients suffering from cardiovascular disease and cancer at risk for thrombotic events.
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Affiliation(s)
- Alexander O Spiel
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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21
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van der Meer PF, Tomson B, Brand A. In vivo tracking of transfused platelets for recovery and survival studies: an appraisal of labeling methods. Transfus Apher Sci 2010; 42:53-61. [PMID: 19931490 DOI: 10.1016/j.transci.2009.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The measurement of recovery and survival of platelets is an important decisive factor when 'new' platelet products have been developed. Recovery and survival measurements are mostly performed with radioactive-labeled platelets in healthy volunteers. This approach is required by the FDA for acceptance of platelet products that differ substantially in production or storage conditions from standard methods. However, due to regulatory obstacles, such radiolabeling studies are only carried out in designated institutes. Many countries do not require radioactive labeling studies in volunteers prior to accepting new products, and rather rely on surrogate tests. Also, the European guide to the preparation of blood components does not require this step. This paper reviews alternative, non-radioactive methods, which includes biotinylation of platelets, and discrimination of transfused platelets based on HLA discrepancy. The benefits and disadvantages of these methods will be discussed.
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Affiliation(s)
- Pieter F van der Meer
- Sanquin Blood Bank South West Region, Plesmanlaan 1a, 2333 BZ Leiden, P.O. Box 2184, 2301 CD Leiden, The Netherlands.
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22
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Horvath M, Eichelberger B, Koren D, Böhm A, Ay C, Jilma B, Panzer S, Jilma-Stohlawetz P. Function of platelets in apheresis platelet concentrates and in patient blood after transfusion as assessed by Impact-R. Transfusion 2009; 50:1036-42. [PMID: 20051058 DOI: 10.1111/j.1537-2995.2009.02543.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Platelet (PLT) transfusion is a mainstream therapy for preventing or treating bleeding episodes in patients with thrombocytopenia. The efficacy is usually estimated from the corrected count increment of PLTs after transfusion, which does not assess PLT function. We therefore evaluated PLT function in blood samples of patients with thrombocytopenia before and after transfusion. STUDY DESIGN AND METHODS PLT function was assessed in 24 chemotherapy-treated patients and in the PLT concentrates (PCs) by the Impact-R (DiaMed). This device evaluates PLT adhesion and aggregation recorded as surface coverage (%) and size of aggregates (AS microm(2)). P-selectin expression was determined by flow cytometry. RESULTS The PCs were stored for a median of 70 hours before transfusion. An analysis stratified by the median storage of PCs (<70 hr or >70 hr) showed no differences in the SC, the AS, and P-selectin expression between these concentrates' groups. Transfusion resulted in an increase of adhering PLTs in the patients after transfusion. There were no differences in the AS and in P-selectin expression before and after transfusion, but the AS increased after transfusion upon ex vivo exposure to adenosine 5'-diphosphate. P-selectin expression was significantly lower in the patient group receiving PCs stored for more than 70 hours. CONCLUSION The current trial shows the feasibility of using the Impact-R to assess the function of transfused PLTs in the patient's blood stream.
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Affiliation(s)
- Michaela Horvath
- Clinical Department of Blood Group Serology and Transfusion Medicine, Medical University Vienna, Vienna, Austria
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23
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Picker SM, Schneider V, Gathof BS. Platelet function assessed by shear-induced deposition of split triple-dose apheresis concentrates treated with pathogen reduction technologies. Transfusion 2009; 49:1224-32. [DOI: 10.1111/j.1537-2995.2009.02092.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Appleman E, Sachais B, Patel R, Drobatz K, Groman R, Kennedy D, O'Donnell P, Bryan C, Callan M. Cryopreservation of Canine Platelets. J Vet Intern Med 2009; 23:138-45. [DOI: 10.1111/j.1939-1676.2008.0225.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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25
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Cauwenberghs S, van Pampus E, Curvers J, Akkerman JWN, Heemskerk JWM. Hemostatic and signaling functions of transfused platelets. Transfus Med Rev 2007; 21:287-94. [PMID: 17900490 DOI: 10.1016/j.tmrv.2007.05.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Metabolic studies have revealed a gradual impairment in platelet integrity during storage, a process termed the platelet storage lesion. Recent evidence shows that stored platelets also lose signaling responses to physiological agonists with impaired integrin activation, secretion, and aggregation of the cells. On the other hand, storage leads to a gain in platelet activation properties, such as release of microparticles and appearance of surface epitopes for their clearance by macrophages. New techniques for measuring flow-induced thrombus formation and platelet-dependent coagulation provide evidence that the hemostatic activity of platelets decreases during storage. Besides pharmacological inhibition, novel storage strategies, like metabolic suppression, should be considered to better preserve platelet functionality while limiting the expression of clearance markers. Understanding the changes that occur in association with the platelet storage lesion and the use of updated storage methods will help to generate platelets for transfusion with optimal hemostatic function and a long circulation time after transfusion.
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Affiliation(s)
- Sandra Cauwenberghs
- Department of Biochemistry (CARIM), Maastricht University and University Hospital, The Netherlands
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26
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Jilma-Stohlawetz P, Horvath M, Eichelberger B, Koren D, Jilma B, Panzer S. Platelet function under high-shear conditions from platelet concentrates. Transfusion 2007; 48:129-35. [PMID: 17894788 DOI: 10.1111/j.1537-2995.2007.01490.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Platelet (PLT) collection and storage affect the functional capacity of PLTs in PLT concentrates (PCs). Therefore, PLTs' functional quality should be studied before transfusion. STUDY DESIGN AND METHODS PCs (n = 15) were collected by a standard apheresis procedure (Trima, Gambro BCT) and were stored for 7 days. Samples were taken to assess PLT adhesion and aggregate formation by a cone and plate analyzer (Impact-R, DiaMed) on Days 1, 3, 5, and 7 after harvesting. This device allows testing PLT function under high-shear stress close to physiologic conditions. Concomitantly, P-selectin expression and the residual responsiveness to TRAP-6 were determined by flow cytometry. RESULTS PLT adhesion, as measured by surface coverage, decreased during the entire observation period; likewise, the size of aggregates was significantly lower on Days 5 and 7 compared to Day 1 (p < 0.02). P-selectin expression increased from Day 5 to Day 7 (p < 0.04), whereas TRAP-6-inducible expression remained stable until Day 5 of storage and decreased significantly on Day 7 (p = 0.04). CONCLUSIONS Our results show that high-shear-induced PLT adhesion and aggregation on the polystyrene surface deteriorate upon storage, suggesting decreased PLT function in vivo. Thus, the Impact-R may be a useful tool to assess the functional capacity of PLTs under various PLT harvesting and storage procedures.
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Affiliation(s)
- Petra Jilma-Stohlawetz
- Department of Blood Group Serology and Transfusion Medicine and Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
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27
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Büyükkağnici DI, Ilhan O, Kavas GO, Arslan O, Arat M, Dalva K, Ayyildiz E. Effects of plasma nitric oxide levels on platelet activation in single donor apheresis and random donor concentrates. Transfus Apher Sci 2007; 36:73-8. [PMID: 17236811 DOI: 10.1016/j.transci.2006.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 05/13/2006] [Indexed: 10/23/2022]
Abstract
P-selectin is an useful marker to determine platelet activation and nitric oxide inhibits platelet activation, secretion, adhesion and aggregation. The aim of this study was to investigate the relationship between nitric oxide and P-selectin values in both single donor apheresis and random donor platelet concentrates. According to the results of this study, we found that the best platelet concentrate is freshly prepared single donor apheresis concentrate and it is important to prevent activation at the beginning of the donation. Nitric oxide, which is synthesized from platelets during the storage period, is not sufficient to prevent platelet activation.
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Affiliation(s)
- Demet Iren Büyükkağnici
- Department of Pathophysiology, School of Medicine, Ankara University, Sihhiye, Ankara 06100, Turkey.
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28
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Homoncik M, Sieghart W, Formann E, Schmid M, Ferenci P, Gangl A, Jilma B, Peck-Radosavljevic M. Erythropoietin treatment is associated with more severe thrombocytopenia in patients with chronic hepatitis C undergoing antiviral therapy. Am J Gastroenterol 2006; 101:2275-82. [PMID: 17032193 DOI: 10.1111/j.1572-0241.2006.00774.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Erythropoietin (EPO) not only stimulates erythropoiesis but also thrombopoiesis. As pegylated-interferon-alpha(PEG-IFN-alpha)-induced thrombocytopenia may become a limiting factor for continuation of therapy, the present study investigated if EPO can alleviate PEG-IFN-alpha induced thrombocytopenia. Further, we hypothesize that EPO increases platelet reactivity and protease activated receptor 1 (PAR-1) expression during combination antiviral therapy. METHODS Forty patients with chronic hepatitis C received either 10,000 IU EPO 3 x/week or placebo in a randomized, placebo-controlled, double-blinded fashion for 4 wk and combination antiviral therapy with PEG-IFN-2a and ribavirin. RESULTS EPO alleviated the decrease in hemoglobin during combination antiviral therapy with ribavirin (10%vs 20%, p < 0.0001). Platelet counts decreased stronger in EPO than in placebo group on day 28 (p= 0.007). EPO induced a 40% increase in PAR-1 (p < 0.0001), which was accompanied by 100% increase in platelet reactivity (p < 0.0001). PFA-100 platelet plug formation time and PEG-IFN-alpha-induced vWF-increase were not different between study groups. CONCLUSIONS Treatment with EPO alleviated the decrease in hemoglobin but worsened PEG-IFN-alpha induced thrombocytopenia after the first 4 wk of combination therapy. EPO caused PAR-1 receptor upregulation on platelets, which promoted an increase in platelet reactivity without affecting PFA-100 platelet plug formation time. EPO is not a useful option for short-term support of platelet production during antiviral therapy.
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Affiliation(s)
- Monika Homoncik
- Department of Internal Medicine IV, Division of Gastroenterology, Medical University Vienna, Vienna, Austria
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29
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Kotzailias N, Andonovski T, Dukic A, Serebruany VL, Jilma B. Antiplatelet activity during coadministration of the selective serotonin reuptake inhibitor paroxetine and aspirin in male smokers: a randomized, placebo-controlled, double-blind trial. J Clin Pharmacol 2006; 46:468-75. [PMID: 16554456 DOI: 10.1177/0091270006286432] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Depression is associated with an increased incidence of vascular events and develops after stroke and myocardial infarction. Beside potential clinical outcome benefits of selective serotonin reuptake inhibitors for vascular diseases, bleeding events were reported. We investigated whether paroxetine and aspirin synergistically inhibit platelet function. Paroxetine (20 mg/d) was administered over 18 days to 20 men in a randomized, placebo-controlled, crossover design. Aspirin (100 mg/d) was coadministered within the last 4 study days. Platelet function was assessed by the platelet function analyzer and by flow cytometry. Paroxetine prolonged epinephrine-dependent predictive index within 14 days (P<.02). Aspirin enhanced the predictive index (P<.004 vs baseline and P>.05 between periods). A trend toward decreased thrombin receptor-activating peptide-induced CD62P expression after paroxetine was further enhanced by aspirin treatment (P>.05 between periods). The combination of paroxetine and aspirin did not further inhibit platelet plug formation under high shear stress in male smokers.
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Affiliation(s)
- Nicole Kotzailias
- Department of Clinical Pharmacology, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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30
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Warner JB, Bruin EJ, Hannig H, Hellenkamp F, Hörning A, Mittmann K, van der Steege G, de Leij LFMH, Garritsen HSP. Use of sequence variation in three highly variable regions of the mitochondrial DNA for the discrimination of allogeneic platelets. Transfusion 2006; 46:554-61. [PMID: 16584431 DOI: 10.1111/j.1537-2995.2006.00775.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Human mitochondrial DNA (mtDNA) polymorphisms can be used to detect allogeneic transfused platelets. To increase the number of informative polymorphisms we investigated three hypervariable regions (HVR1, HVR2, and HVR3) within the displacement loop (D-loop) region of the mtDNA. STUDY DESIGN AND METHODS mtDNA was obtained from 119 unrelated blood donors. Forward and reverse primers were designed and conditions optimized to amplify and sequence the template mtDNA by dye terminator cycle sequencing. RESULTS We established a sequencing protocol for all three HVRs of the mtDNA. Polymorphic sites were found in all three regions: 66 in HVR1, 44 in HVR2, and 18 in HVR3. Combining the sequence information of HVR1, -2, and -3 resulted in 105 different genotypes of which 95 were unique. We were able to discriminate between two randomly chosen individuals with a random match probability of 1.2 percent. CONCLUSION The D-loop region of mtDNA contains a wealth of informative molecular markers for chimerism and survival studies after transfusions of cellular blood components.
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Affiliation(s)
- Jessica B Warner
- Medical Biology Division, University of Groningen, the Netherlands
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Hughes DL, Evans G, Metcalfe P, Goodall AH, Williamson LM. Tracking and characterisation of transfused platelets by two colour, whole blood flow cytometry. Br J Haematol 2005; 130:791-4. [PMID: 16115139 DOI: 10.1111/j.1365-2141.2005.05671.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We describe a flow cytometric technique to study transfused platelets in patients. By selecting donor/recipient pairs discrepant for HLA-A2, transfused platelets were identified using anti-HLA-A2 with a detection limit of <5%, and accuracy within 4.3% of predicted (r2 > 0.96, P < 0.0001). In two of three episodes, transfused platelets were present in greater numbers than predicted from increment counts. Platelets with bound fibrinogen fell from 20.9 +/- 23.6% of donor platelets pretransfusion to 1.7 +/- 0.3% 1 h post-transfusion, whereas P-selectin-positive platelets fell gradually, from 24.1 +/- 6.7 to 7.3 +/- 3.3% at 6 h. This method avoids radio or chemical labelling, and could be used to assess novel platelet preparations post-transfusion.
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Affiliation(s)
- Darren L Hughes
- Department of Haematology, University of Cambridge, Cambridge, UK
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32
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Valeri CR, Macgregor H, Giorgio A, Ragno G. Comparison of radioisotope methods and a non-radioisotope method to measure platelet survival in the baboon. Transfus Apher Sci 2005; 32:275-81. [PMID: 15944113 DOI: 10.1016/j.transci.2004.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2004] [Accepted: 05/07/2004] [Indexed: 11/24/2022]
Abstract
BACKGROUND The in vivo survival of autologous fresh and preserved platelets can be measured using 51-Cr and 111-In-oxine radioisotope procedures and by a non-radioisotope procedure using biotin-X-N-hydroxysuccinimide (NHS) with detection in the flow cytometer using fluorescent streptavidin. This study was done to assess the specificity of the radioisotopes 51-Cr and 111-In-oxine and non-radioactive biotin-X-NHS to label platelets to measure their in vivo recovery and lifespan. STUDY DESIGN AND METHODS In the study reported here, aliquots of autologous platelets from the same baboon were labeled with 51-Cr, 111-In oxine and biotin-X-NHS to measure platelet survival. Both cell-associated and platelet-associated 51-Cr and 111-In oxine radioactivity were assessed to measure the in vivo recovery and lifespan of platelets. Blood volume was measured using the 125I albumin plasma volume and the total body hematocrit. RESULTS In vivo recovery values measured during the 1-3h post-infusion period and during the 8 day post-infusion period showed significant differences between the 51-Cr-labeled and the 111-In-oxine labeled platelets. In the 51-Cr-labeled platelets, the cell-associated radioactivity was about 50% higher than the platelet-associated radioactivity. In the 111-In-oxine labeled platelets, the cell-associated radioactivity was about 10% higher than the platelet-associated radioactivity. Similar in vivo recovery values were observed in the biotin-X-NHS labeled platelets and the 111-In-oxine labeled platelets assessed from the cell-associated 111-In-radioactivity. CONCLUSION The radioisotope 51-Cr and 111-In are non-specific labels for platelets, whereas biotin-X-NHS is a specific label for platelets identified in the flow cytometer with fluorescent streptavidin. The in vivo recovery values of autologous baboon platelets were similar when assessed from the cell-associated 111-In-oxine radioactivity and biotin-X-NHS labeled platelets.
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Affiliation(s)
- C Robert Valeri
- Naval Blood Research Laboratory, Boston University School of Medicine, 615 Albany Street, Boston, MA 02118, USA.
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Reiter R, Jilma-Stohlawetz P, Horvath M, Jilma B. Additive effects between platelet concentrates and desmopressin in antagonizing the platelet glycoprotein IIb/IIIa inhibitor eptifibatide. Transfusion 2005; 45:420-6. [PMID: 15752161 DOI: 10.1111/j.1537-2995.2005.04021.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Platelet (PLT) glycoprotein (GP) IIb/IIIa receptor antagonists have demonstrated efficacy in decreasing ischemic complications of percutaneous coronary intervention and/or unstable angina. In case of bleeding, the drug can be stopped and PLT transfusions can be given. STUDY DESIGN AND METHODS This crossover study tested the additive effects of PLT concentrates (PCs) after desmopressin (DDAVP) infusion in antagonizing the anti-PLT effects of GPIIb/IIIa inhibitors and aspirin. After eptifibatide and aspirin infusion (at standard dosages), 10 healthy volunteers received DDAVP or placebo. Thereafter, increasing amounts of PLTs from fresh single-donor apheresis concentrates were added in vitro to blood samples of all volunteers to increase PLT counts by 30 x 10(9), 60 x 10(9), or 120 x 10(9) per L. RESULTS Adding platelets in vitro further improved PLT function after DDAVP: it shortened collagen-adenosine diphosphate closure times (p < 0.01), to normal ranges as measured by the PLT function analyzer (PFA-100). In contrast, normal PLT function could not be restored even when PLT counts were increased by 50 percent (120 x 10(9)/L) in the placebo group. CONCLUSION Combined use of PLTs from fresh apheresis PC and DDAVP additively enhances recovery of normal PLT function after eptifibatide infusion. Such a strategy may help to avoid excessive transfusion of PC.
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Affiliation(s)
- Rosemarie Reiter
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Homoncik M, Jilma-Stohlawetz P, Schmid M, Ferlitsch A, Peck-Radosavljevic M. Erythropoietin increases platelet reactivity and platelet counts in patients with alcoholic liver cirrhosis: a randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther 2004; 20:437-43. [PMID: 15298638 DOI: 10.1111/j.1365-2036.2004.02088.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Patients with liver cirrhosis have a complex haemostasis disturbance including thrombocytopenia and abnormal bleeding time. Erythropoietin is the primary stimulator for erythrocyte production and also induces megakaryocyte formation. In healthy men erythropoietin increased platelet count and platelet reactivity. AIM As patients with liver cirrhosis often undergo invasive procedures, we were interested to study whether erythropoietin could improve platelet function in addition to thrombocytopenia. METHODS In total, 22 thrombocytopenic (platelet counts < 120 g/L) patients with alcoholic liver cirrhosis received either 100 IE/kg erythropoietin or placebo on days 1, 3 and 5 in a 2:1 randomized, placebo-controlled double-blind fashion. Platelet counts and platelet reactivity (activator-stimulated expression of P-selectin on platelets measured by flow cytometry) were determined on study days 1, 3, 5 and 9. RESULTS Median platelet count was 80 g/L which is borderline for major elective surgical interventions. Baseline values were not different between groups (P > 0.05). Treatment with erythropoietin increased platelet count by 25% (P = 0.01) and platelet reactivity twofold (P < 0.01) vs. baseline. The increase in platelet count vs. baseline was more pronounced in patients with platelet counts <80 g/L. No significant effect was observed in the placebo group. CONCLUSIONS Treatment with erythropoietin significantly increased platelet counts and platelet reactivity in patients with alcoholic liver cirrhosis. Preoperative treatment with erythropoietin is therefore expected to yield higher platelet levels and better platelet function.
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Affiliation(s)
- M Homoncik
- Clinical Pharmacology-TARGET, Vienna University School of Medicine, Wien, Austria.
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Wolzt M, Boström SL, Svensson M, Wåhlander K, Grind M, Sarich TC. Effects of the Oral Direct Thrombin Inhibitor Ximelagatran on P-Selectin Expression and Thrombin Generation in Atrial Fibrillation. PATHOPHYSIOLOGY OF HAEMOSTASIS AND THROMBOSIS 2003; 33:68-74. [PMID: 14624047 DOI: 10.1159/000073849] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2003] [Accepted: 03/24/2003] [Indexed: 11/19/2022]
Abstract
This study investigated the pharmacodynamic effects of the oral direct thrombin inhibitor ximelagatran on platelet activation and thrombin generation in patients with nonvalvular atrial fibrillation. Using an open, group-matched study design, the effects of ximelagatran (36 mg twice daily for 5 days) were studied in 12 patients with permanent nonvalvular atrial fibrillation and in 12 healthy controls. After ximelagatran for 5 days, elevated platelet P-selectin expression in atrial fibrillation patients was lowered to that during coumarin treatment or in controls but had no effect in control subjects. Using the endogenous thrombin potential as a marker, ximelagatran decreased and delayed thrombin generation in both groups. In conclusion, direct thrombin inhibition with ximelagatran reduced elevated platelet P-selectin expression and inhibited thrombin generation.
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Affiliation(s)
- Michael Wolzt
- Department of Clinical Pharmacology, University of Vienna, Vienna, Austria
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36
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Aledia AS, Tran LM, King BO, Serna DL, Eng J, Jones BU, Chen JC, Roum JH. S-nitrosoglutathione preserves platelet function during in vitro ventricular assist device circulation. ASAIO J 2003; 48:526-31. [PMID: 12296574 DOI: 10.1097/00002480-200209000-00015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Complications (severe bleeding/thromboembolism) may occur during ventricular assist device (VAD) circulation, caused mainly by platelet dysfunction from platelet activation. We hypothesized that S-nitrosoglutathione (GSNO), having platelet activity preservation properties like nitric oxide (NO), may be a titratable agent to diminish platelet activation and thus preserve platelet function. Dose-response measurement of platelet aggregation by GSNO was performed using an aggregometer. GSNO (1,000 microM) caused inhibition of collagen and ristocetin induced aggregation by approximately 50%. Next, in vitro ventricular assist device (VAD) circulation was performed (over 48 hours using human whole blood), both without (control) and with GSNO (1,000 microM), and the aggregability of perfusate was measured at 0, 0.5, 1, 3, 6, 12, 24, and 48 hours. In control VAD circuits, collagen induced platelet aggregability gradually decreased and became significantly lower after 3 hours of circulation. With GSNO, platelet function did not significantly decrease until after 12 hours. Similar results were seen for ristocetin induced aggregation; control aggregation dropped significantly after 6 hours, but not until after 24 hours with GSNO. Liquid phase measurement of total nitrogen oxides (NO(T)) confirmed added GSNO maintained high perfusate NO(T) compared with control. GSNO is effective in preserving platelet aggregation during the first 12 to 24 hours in vitro and may be effective in preserving platelet function by inhibiting platelet activation during in vivo VAD circulation.
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Affiliation(s)
- Anna S Aledia
- Department of Medicine, University of California Irvine Medical Center, Orange, USA
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37
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Homoncik M, Jilma B, Donham DC, Frossard M, Keuzer C, Sorenson JRJ. Activation of calcium-dependent calmodulin by calcium(II)3(3,5-diisopropylsalicylate)6(H2O)6 decreases thrombin receptor activating peptide-induced P-selectin expression. Blood Coagul Fibrinolysis 2003; 14:131-8. [PMID: 12632022 DOI: 10.1097/00001721-200302000-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We examined the influence of 3,5-diisopropylsalicylic acid (3,5-DIPS) and calcium(II)3 (3,5-diisopropylsalicylate)6 (H2 O)6 [Ca(II)3 (3,5-DIPS)6 ], a new activator of calcium-dependent calmodulin-triggered nitric oxide synthase, on thrombin-induced platelet P-selectin expression. Citrated whole blood samples were incubated with either ethanol vehicle, 3,5-DIPS, or Ca(II)3 (3,5-DIPS)6. These whole blood samples were also co-incubated with thrombin receptor activating peptide (TRAP) or adenosine diphosphate (ADP), to up-regulate P-selectin (CD62P) on platelets. Both TRAP and ADP up-regulated P-selectin on platelets compared with platelets in whole blood samples that were not incubated with either platelet activator. Co-incubation of whole blood samples with TRAP, ADP together with 3,5-DIPS, or Ca(II)3 (3,5-DIPS)6 revealed that Ca(II)3 (3,5-DIPS)6 caused a decrease in platelet P-selectin expression for TRAP, ADP, and no-activator co-incubated samples of whole blood. Incubation of platelets with 3,5-DIPS also caused a decrease in ADP-induced up-regulation of P-selectin but failed to affect TRAP or no-activator-treated platelets. Incubation of whole blood with Ca(II)3 (3,5-DIPS)6 induced some hemolysis. We found that hemolysis increases basal P-selectin expression on platelets. We therefore conclude that Ca(II)3 (3,5-DIPS)6 decreased not only basal, but also hemolysis-induced P-selectin expression on platelets. In contrast, incubation of haemolysed whole blood with SIN-1 (standard nitric oxide-releasing drug) had no effect on P-selectin expression. In summary, Ca(II)3 (3,5-DIPS)6, a new calmodulin-dependent nitric oxide synthase activator, decreases P-selectin expression of human platelets in response to thrombin receptor activation. Improved calcium-dependent calmodulin activators may become useful drugs for the treatment of disorders associated with platelet activation, and P-selectin may decrease expression due to hemolysis.
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Affiliation(s)
- Monika Homoncik
- Department of Clinical Pharmacology - TARGET, Department of Internal Medicine IV, Division of Gastroenterology, Vienna University Hospital School of Medicine, Vienna, Austria
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38
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Gutensohn K, Geidel K, Brockmann M, Siemensen M, Krueger W, Kroeger N, Kuehnl P. Binding of activated platelets to WBCs in vivo after transfusion. Transfusion 2002; 42:1373-80. [PMID: 12423523 DOI: 10.1046/j.1537-2995.2002.00194.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND During preparation and storage of apheresis concentrates, platelets are being activated. One of the alterations that occur during this process is an increased expression of P-selectin (CD62p) on the cytoplasmic surface of platelets. This neoepitope represents a ligand for the binding of platelets to WBCs. It has been suggested that the activation of platelets is associated with the sequestration of platelets after transfusion. In this in vivo study, the binding of platelets to WBCs was analyzed following transfusion of platelet concentrates (PCs). STUDY DESIGN AND METHODS Double apheresis concentrates were prepared with two different cell separators. One of the split products was stored for 1 to 2 days and the other one for 3 to 5 days. Flow cytometry was applied to analyze the degree of platelet activation in vitro, and also to measure the extent of platelet binding to WBC subclasses in vivo after transfusion into patients. RESULTS The results of this study show that platelet activation occurs during apheresis and storage of PCs. After transfusion of the PCs, no significant binding of platelets to T or B-cells could be detected. However, a significant binding of platelets to monocytes and neutrophil granulocytes occurs. While in Baxter PCs stored for 1-2 days the amount of platelet-leukocyte aggregates in vivo was higher compared to COBE PCs, no such difference could be detected anymore for the PCs stored for 3-5 days. CONCLUSION This study demonstrates that binding of activated platelets occurs to monocytes and neutrophil granulocytes but not to T- and B-cells in the circulation after transfusion. In addition, the interaction of platelets and WBCs is dependent on the degree of P-selectin expression. Platelets showing a higher degree of activation adhere to WBCs to a higher degree than nonactivated platelets.
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Affiliation(s)
- Kai Gutensohn
- Department of Transfusion Medicine/Transplantation Immunology, University Hospital Hamburg-Eppendorf, University of Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
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Dumont LJ, Beddard R, Whitley P, Johnson A, McNeil D, Sawyer S, Elfath MD. Autologous transfusion recovery of WBC-reduced high-concentration platelet concentrates. Transfusion 2002; 42:1333-9. [PMID: 12423518 DOI: 10.1046/j.1537-2995.2002.00222.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study evaluates the recovery and survival of high-concentration platelets (HCPs) compared to standard apheresis platelets (APCs) in a double-label autologous human system. METHODS Nine HCP units paired with APC units were stored, labeled with either 51Cr and 111In, and returned, and recovery and survival were determined. Standard in vitro platelet biochemical and functional parameters were monitored over the storage period and evaluated in a secondary analysis. RESULTS Three each HCP units containing more than 2.2 x 10(11), 1.5 x 10(11) to 2.1 x 10(11), and 0.8 x 10(11) to 1.1 x 10(11) platelets in 59.4 +/- 2.5 mL were stored for 1, 2, or 5 days, respectively, and simultaneously with matched APC units (3.8 x 10(11) platelets, 282 mL). Recoveries were 72.3 +/- 8.6, 60.8 +/- 14.6, and 52.5 +/- 6.7 percent for HCPs, respectively; and 59.4 +/- 6.4 percent for APCs (p=0.37). HCP survivals were 202.0 +/- 14.9, 204.9 +/- 10.2, and 162.6 +/- 17.0 hours; APC survivals were 155.4 +/- 20.3 hours (p=0.001). Secondary analysis with P-selectin added as a predictor in the model resulted in significant difference in recoveries for Day 1 HCPs versus Day 5 APCs (p=0.024) with no difference shown for HCPs on Days 2 or 5 versus APCs. No significant difference was found in survival (p=0.16). CONCLUSION HCPs may be stored 24 hours for high yield, 48 hours for intermediate yield, and up to 5 days for yields less than 1.6 x 10(11) platelets per bag with equivalent to superior recovery and survival of platelets in the autologous transfusion model compared to APCs.
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Affiliation(s)
- Larry J Dumont
- Gambro BCT, Inc., 10811 West CollinsAvenue, Lakewood, CO 80215, USA.
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40
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Stiegler G, Eichelberger B, Leitner G, Jilma B, Hoecker P, Panzer S. Response to vWF-coated beads and soluble p-selectin to characterize apheresis platelets: a comparison of three cell separators. Transfusion 2002; 42:375-9. [PMID: 11961245 DOI: 10.1046/j.1537-2995.2002.00041.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Plateletpheresis technologies differ among various cell separators. Differences in centrifugation force, centrifugation time, and platelet concentration in the platelet concentrate may affect platelet activation and function. STUDY DESIGN AND METHODS In a three-way crossover design, 12 donors were randomly assigned to three types of cell separators, two continuous flow systems (Amicus DN, Fenwall Division, Baxter and Spectra LRS, Gambro BCT) and one intermittent flow system (MCS+, Haemonetics). The response to vWF-coated beads was determined in the peripheral blood and fresh platelet concentrates to obtain information about the initiating step of platelet aggregation, that is, platelet adhesion. Levels of soluble p-selectin were measured as a marker of platelet activation. RESULTS Platelet yield and concentration of platelets were higher in platelet concentrates obtained with the Amicus DN than with the Spectra LRS or the MCS+. Maximal aggregation was significantly higher in platelets from the Amicus DN than in platelets from the Spectra LRS or the MCS+. Higher concentrations of soluble p-selectin were seen in platelet concentrates obtained with the Amicus DN than in concentrates from the Spectra LRS or the MCS+, but they did not differ after correction for the number of platelets per component. CONCLUSIONS Different plateletpheresis procedures induced distinct changes of platelet function. Platelets collected using the Amicus DN retained the strongest adhesion capacity irrespective of their activation.
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Affiliation(s)
- Gabriele Stiegler
- Clinic for Blood Group Serology and Transfusion Medicine, University Hospital of Vienna, Austria
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41
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Rand ML, Wang H, Mody M, Chu I, Treutiger I, Nguyen A, Packham MA, Freedman J. Concurrent measurement of the survival of two populations of rabbit platelets labeled with either two PKH lipophilic dyes or two concentrations of biotin. CYTOMETRY 2002; 47:111-7. [PMID: 11813201 DOI: 10.1002/cyto.10055] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To avoid radioisotopic labeling and permit comparison of the survival of two platelet populations concurrently in one animal, we compared simultaneous recoveries and survival times of homologous rabbit platelets labeled in vitro with the lipophilic dyes PKH26 (red fluorescing) and PKH67 (green fluorescing) and with two levels of biotin (low, 1 microg/ml; high, 10 microg/ml). METHODS Blood samples were drawn up to 96 h postinfusion and analyzed by flow cytometry. Biotin-labeled samples were incubated with phycoerythrin-streptavidin before analysis. RESULTS Recovery of PKH26-labeled platelets at 1 h was lower (37.5%) than that of PKH67-labeled platelets (47.3%; P < 0.001). Platelet survival times were 62.4 and 61.9 h. Recoveries at 1 h of platelets labeled with two levels of biotin were similar (86.6% and 84.6%) and greater than those of PKH-labeled platelets (P < 0.001). Survival of platelets labeled with biotin did not differ (low, 83.3 h; high, 85.2 h) and was longer than for PKH-labeled platelets (P < 0.01). Labeling methods did not activate platelets (measured by P-selectin expression), nor did they affect platelet responses to adenosine diphosphate (ADP), collagen, or thrombin. CONCLUSIONS Labeling with two levels of biotin is superior to labeling with PKH dyes, and is useful for measuring concurrently the survival of two differing platelet populations.
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Affiliation(s)
- M L Rand
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Pernerstorfer T, Eichler HG, Stohlawetz P, Speiser W, Jilma B. Effects of heparin and aspirin on circulating P-selectin, E-selectin and von Willebrand Factor levels in healthy men. Atherosclerosis 2001; 155:389-93. [PMID: 11254909 DOI: 10.1016/s0021-9150(00)00566-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
As thrombin stimulates P-selectin expression on platelets and its release into plasma, we hypothesized that enhancing antithrombin activity by unfractionated heparin (UFH) could decrease plasma levels of circulating (c)P-selectin, (c)E-selectin, and von Willebrand Factor (vWF). Hence the effect of UFH and aspirin were examined on these activation markers in healthy volunteers. UFH decreased cP-selectin levels by -10% (CI: -16 - (-4%); P = 0.005) at 24 h, but did not change levels of vWF-Ag. In contrast, aspirin did not affect cP-selectin levels but decreased vWF-Ag levels by -12% (CI: -18 - (-7%); P = 0.005) at 24 h. Neither drug affected cE-selectin levels. Thus, UFH decreases cP-selectin levels, which may reflect decreased platelet activation in vivo. An increase in cP-selectin under UFH therapy should alert the clinician to look for platelet destruction.
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Affiliation(s)
- T Pernerstorfer
- Department of Clinical Pharmacology-TARGET, Vienna University Hospital School of Medicine, Währinger Gürtel, A-1090, Vienna, Austria
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Garritsen HS, Hoerning A, Hellenkamp F, Cassens U, Mittmann K, Sibrowski W. Polymorphisms in the non-coding region of the human mitochondrial genome in unrelated plateletapheresis donors. Br J Haematol 2001; 112:995-1003. [PMID: 11298598 DOI: 10.1046/j.1365-2141.2001.02662.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Human mitochondrial DNA polymorphisms are unique targets to discriminate nucleated cells and platelets between donor and recipient in the setting of transplantation or transfusion. We have previously used this approach to discriminate allogeneic platelets from autologous platelets after transfusion. In the present study, we used DNA sequencing to investigate polymorphisms present in two of the hypervariable segments (HVR1 and HVR2) found within the non-coding region of the mitochondrial genome among 100 plateletapheresis donors. Alignments were made with the Cambridge Reference Sequence (CRS) for human mitochondrial DNA (mtDNA). Combining the sequencing information of HVR1 and HVR2 we could demonstrate that, of the 100 investigated mtDNA samples, none was identical to the CRS. We found a total of 2-17 polymorphisms per donor in the investigated regions, most of them were basepair substitutions (563) and insertions (151). No deletions were found. Sixty-six of the 110 detected polymorphisms were detected in more than one sample. Seven polymorphisms are newly described and have not been published in the Mitomap database. Our results demonstrate that polymerase chain reaction analysis of the many polymorphisms found in the hypervariable region of mitochondrial DNA represents a more informative target than previously described mitochondrial polymorphisms for discriminating donor-recipient cells after transfusion or transplantation.
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Affiliation(s)
- H S Garritsen
- Department of Transfusion Medicine and Transplantation Immunology, Tissue Typing Laboratory, University Hospital Münster, Domagkstr. 11, 48149 Germany.
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Jilma-Stohlawetz P, Homoncik M, Drucker C, Marsik C, Rot A, Mayr WR, Seibold B, Jilma B. Fy phenotype and gender determine plasma levels of monocyte chemotactic protein. Transfusion 2001; 41:378-81. [PMID: 11274594 DOI: 10.1046/j.1537-2995.2001.41030378.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In vitro studies indicate that the Fy blood group system antigens serve as receptors for chemokines such as monocyte chemotactic protein-1 (MCP-1) and RANTES. However, it is unclear whether subjects with the Fy(a-b-) phenotype exhibit altered clearance and hence altered plasma levels of chemo-kines, because they still express Fy on endothelial cells. STUDY DESIGN AND METHODS To clarify a possible in vivo role of Fy on RBCs in the regulation of chemo-kine levels, healthy young volunteers of common Fy phenotypes were compared in a cross-sectional study. RESULTS More than 90 percent of the 34 subjects of African origin were Fy(a-b-), one black volunteer was Fy(a+b-), and two were Fy(a-b+). As expected, all 65 white volunteers were positive for either Fy(a) and/or Fy(b). Unexpectedly, persons expressing either Fy(a) and/or Fy(b) had significantly higher plasma levels of MCP-1 than Fy(a-b-) volunteers (women: 154 vs. 110 ng/L, p<0.01; men: 179 vs. 169 ng/L, p = 0.03). Surprisingly, plasma levels of MCP-1 were found to be sex-dependent: median MCP-1 levels averaged 180 ng per L in men but only 139 ng per L in women (p<0.001). Further, MCP-1 levels decreased significantly throughout the menstrual cycle of 18 women studied longitudinally. CONCLUSION MCP-1 levels are about 30 percent higher in men than in premenopausal women, and MCP-1 levels are also higher in persons with RBCs expressing Fy antigens than in Fy(a-b-) persons. These findings have direct implications for the concept and interpretation of clinical studies measuring MCP-1 levels; the role of the observed differences in MCP-1 levels for the pathogenesis of MCP-1-dependent diseases, such as atherosclerosis, merits further investigation.
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Affiliation(s)
- P Jilma-Stohlawetz
- Department of Clinical Pharmacology (The Adhesion Research Group Elaborating Therapeutics), University Vienna, Austria
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Jilma-Stohlawetz P, Folman CC, von dem Borne AE, Pernerstorfer T, Hollenstein U, Knechtelsdorfer M, Eichler HG, Jilma B. Effects of anticoagulation on thrombopoietin release during endotoxemia. THE JOURNAL OF LABORATORY AND CLINICAL MEDICINE 2001; 137:64-9. [PMID: 11150025 DOI: 10.1067/mlc.2001.111468] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several lines of evidence suggest that coagulation may induce the release of thrombopoietin (TPO) into plasma and that TPO levels are higher in disseminated intravascular coagulation. Therefore we set out to illuminate the mechanism of TPO release in the setting of experimental endotoxemia, which induces activation of coagulation and platelets. Endotoxin (lipopolysachharide [LPS], 2 ng/kg) was infused into a total of 54 healthy men in two subsequent studies. Volunteers received infusions of unfractionated heparin, low-molecular-weight heparin, lepirudin, or placebo in a randomized, placebo-controlled fashion after bolus injection of LPS. TPO levels increased on average by 27% to 38% in all groups at 6 hours (P <.05 vs baseline), although all active drugs effectively blocked coagulation. Platelet counts dropped by about 15% at 1 hour after LPS infusion, recovered after 2 days, and exceeded baseline values by 8% to 18% after 7 days (P <.001 vs baseline for all groups). Yet lepirudin blunted the LPS-induced increase in circulating P-selectin by one half (P <.005 vs placebo), whereas both heparins did not diminish the increase in this platelet or endothelial activation marker as compared with placebo. Endotoxemia enhances TPO plasma levels independent of the degree of coagulation induction, which eventually results in increased platelet numbers. Of potential clinical interest is the observation that the direct thrombin inhibitor lepirudin, in contrast to heparins, mitigated LPS-induced platelet activation.
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Affiliation(s)
- P Jilma-Stohlawetz
- Department of Clinical Pharmacology, The Adhesion Research Group Elaborating Therapeutics, Vienna University School of Medicine, Austria
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Abstract
A recent study in dogs suggested that erythropoietin (EPO) not only promotes the synthesis of increased numbers of reticulated platelets but that these newly produced platelets are hyperreactive compared with controls. Because of the increasing use of EPO in the perioperative setting, we characterized the effects of EPO on platelet reactivity in healthy human volunteers. In a randomized, controlled trial, we studied the effects of EPO on platelet reactivity, thrombopoiesis, and endothelial activation in circumstances similar to those of autologous blood donation. Thirty healthy male volunteers received placebo or EPO (100 or 500 U/kg of body weight given intravenously) three times a week for 2 weeks and underwent phlebotomy on days 8 and 15. Thrombin receptor–activating peptide induced expression of P-selectin, and CD63 increased 2- to 3-fold during EPO treatment. The enhanced platelet reactivity was also reflected by a 50% increase in soluble P-selectin in plasma. Plasma E-selectin levels increased in a dose-dependent fashion by more than 100% during EPO treatment, indicating substantial activation of endothelial cells. A 10% to 20% increase in platelet counts was observed in both EPO groups on day 5. In the placebo group, platelets increased only several days after the first phlebotomy. The increase in platelet counts was not reflected by changes in the amounts of reticulated platelets or circulating progenitor cells. In summary, we found that EPO markedly enhances endothelial activation and platelet reactivity, which may adversely affect patients at cardiovascular risk. However, the increased platelet reactivity could be exploited in patients with platelet dysfunction.
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Jilma B, Hergovich N, Stohlawetz P, Stummvoll G, Albinni S, Simak S, Schmaldienst S, Pohanka E, Eichler HG, Kapiotis S. Effects of sodium nitroprusside on hemodialysis-induced platelet activation. Kidney Int 1999; 55:686-91. [PMID: 9987093 DOI: 10.1046/j.1523-1755.1999.00293.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hemodialysis (HD) is associated with increased platelet activation as reflected by enhanced P-selectin expression on platelets and by increased formation of heterotypic platelet-leukocyte aggregates. Both may play a pathophysiologic role in HD-associated platelet dysfunction or the propagation of atherosclerosis. As nitric oxide (NO) is a potent inhibitor of platelet activation, we were interested in whether HD-induced platelet activation could be blunted by a NO donor. METHODS After a pilot study in 12 patients to gain an estimate for the sample size, the main trial was conducted as a randomized, double-blind, placebo-controlled, two-way, cross-over study. Twelve patients received an infusion of sodium nitroprusside (1 microgram/kg/min for over 15 min) or placebo into the inlet port of the HD device. RESULTS Platelet activation increased within five minutes after start of HD (P < 0.05). Infusion of sodium nitroprusside neither decreased platelet activation (P-selectin + platelets) nor affected the number of platelet-leukocyte aggregates (CD41+ neutrophils) as measured by flow cytometry. CONCLUSION Although NO may have inhibitory effects on platelet activation in vivo, our results confirm recent findings showing that NO donors were ineffective in preventing platelet activation by extracorporeal circulation during cardiopulmonary bypass or plateletpheresis. Thus, NO donors do not appear to be ideal candidate drugs to inhibit HD-associated platelet activation.
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Affiliation(s)
- B Jilma
- Department of Clinical Pharmacology-TARGET, Vienna University Hospital School of Medicine, Austria.
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