1
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Yazdanbakhsh M, Acker JP. Advancing in vivo assessment of red blood cell transfusions: A call for radiation-free methods in transfusion medicine. Transfus Apher Sci 2024; 63:103928. [PMID: 38653627 DOI: 10.1016/j.transci.2024.103928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
RBC transfusions are a vital clinical therapy to treat anemic patients. The in vivo assessment of red blood cell (RBC) quality post-transfusion is critical to ensuring that the introduction of new RBC products meet established regulatory and clinical quality requirements. Although in vitro quality control testing is routinely performed by blood manufacturers, it is crucial that in vivo tests are performed during the evaluation and regulatory process of new RBC products. This article reviews existing in vivo techniques, like chromium-51 labelling and biotinylation, for determining the circulation and survival of RBCs, and advocates for a move to radiation-free methods. The timely need for radiation-free methods to assess emerging non-DEHP container systems is just one example of why efforts to improve the methods available for in vivo quality assessment is important in transfusion medicine. This review aims to advance our understanding of RBC transfusion in vivo quality assessment and enhance transfusion practices.
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Affiliation(s)
- Mahsa Yazdanbakhsh
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Innovation and Portfolio Management, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Jason P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Innovation and Portfolio Management, Canadian Blood Services, Edmonton, Alberta, Canada.
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2
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McCuskee S, Curtis S. Long live the red blood cell: biotin tagging in SCD. Blood Adv 2024; 8:1804-1805. [PMID: 38592713 PMCID: PMC11006811 DOI: 10.1182/bloodadvances.2023012245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
- Sarah McCuskee
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Susanna Curtis
- Department of Internal Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
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3
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Leonard AK, Furstenau D, Inam Z, Luckett C, Chu R, Demirci S, Essawi K, Gudmundsdottir B, Hinds M, DiNicola J, Li Q, Eaton WA, Cellmer T, Wang X, Thein SL, Macari ER, VanNest S, Hsieh MM, Bonner M, Pierciey FJ, Tisdale JF. In vivo measurement of RBC survival in patients with sickle cell disease before or after hematopoietic stem cell transplantation. Blood Adv 2024; 8:1806-1816. [PMID: 38181784 PMCID: PMC11006808 DOI: 10.1182/bloodadvances.2023011397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/17/2023] [Accepted: 11/11/2023] [Indexed: 01/07/2024] Open
Abstract
ABSTRACT Stable, mixed-donor-recipient chimerism after allogeneic hematopoietic stem cell transplantation (HSCT) for patients with sickle cell disease (SCD) is sufficient for phenotypic disease reversal, and results from differences in donor/recipient-red blood cell (RBC) survival. Understanding variability and predictors of RBC survival among patients with SCD before and after HSCT is critical for gene therapy research which seeks to generate sufficient corrected hemoglobin to reduce polymerization thereby overcoming the red cell pathology of SCD. This study used biotin labeling of RBCs to determine the lifespan of RBCs in patients with SCD compared with patients who have successfully undergone curative HSCT, participants with sickle cell trait (HbAS), and healthy (HbAA) donors. Twenty participants were included in the analysis (SCD pre-HSCT: N = 6, SCD post-HSCT: N = 5, HbAS: N = 6, and HbAA: N = 3). The average RBC lifespan was significantly shorter for participants with SCD pre-HSCT (64.1 days; range, 35-91) compared with those with SCD post-HSCT (113.4 days; range, 105-119), HbAS (126.0 days; range, 119-147), and HbAA (123.7 days; range, 91-147) (P<.001). RBC lifespan correlated with various hematologic parameters and strongly correlated with the average final fraction of sickled RBCs after deoxygenation (P<.001). No adverse events were attributable to the use of biotin and related procedures. Biotin labeling of RBCs is a safe and feasible methodology to evaluate RBC survival in patients with SCD before and after HSCT. Understanding differences in RBC survival may ultimately guide gene therapy protocols to determine hemoglobin composition required to reverse the SCD phenotype as it relates directly to RBC survival. This trial was registered at www.clinicaltrials.gov as #NCT04476277.
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Affiliation(s)
- Alexis K. Leonard
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
- Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Dana Furstenau
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
- Department of Pediatrics, Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Zaina Inam
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
- Center for Cancer and Blood Disorders, Children’s National Hospital, Washington, DC
| | - Christina Luckett
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Rebecca Chu
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Selami Demirci
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Khaled Essawi
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Bjorg Gudmundsdottir
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Malikiya Hinds
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Julia DiNicola
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Quan Li
- Laboratory of Chemical Physics, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - William A. Eaton
- Laboratory of Chemical Physics, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Troy Cellmer
- Laboratory of Chemical Physics, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Xunde Wang
- Sickle Cell Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Swee Lay Thein
- Sickle Cell Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | | | | | - Matthew M. Hsieh
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | | | | | - John F. Tisdale
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
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4
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Alves-Rosa MF, Tayler NM, Dorta D, Coronado LM, Spadafora C. P. falciparum Invasion and Erythrocyte Aging. Cells 2024; 13:334. [PMID: 38391947 PMCID: PMC10887143 DOI: 10.3390/cells13040334] [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: 01/16/2024] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Plasmodium parasites need to find red blood cells (RBCs) that, on the one hand, expose receptors for the pathogen ligands and, on the other hand, maintain the right geometry to facilitate merozoite attachment and entry into the red blood cell. Both characteristics change with the maturation of erythrocytes. Some Plasmodia prefer younger vs. older erythrocytes. How does the life evolution of the RBC affect the invasion of the parasite? What happens when the RBC ages? In this review, we present what is known up until now.
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Affiliation(s)
| | | | | | | | - Carmenza Spadafora
- Center of Cellular and Molecular Biology of Diseases, Instituto de Investigaciones Científicas y Servicio de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City 0843-01103, Panama; (M.F.A.-R.); (N.M.T.); (D.D.); (L.M.C.)
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5
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Pearson AB, Hückstädt LA, Kinsey ST, Schmitt TL, Robeck TR, St Leger J, Ponganis PJ, Tift MS. Relationship between red blood cell lifespan and endogenous carbon monoxide in the common bottlenose dolphin and beluga. Am J Physiol Regul Integr Comp Physiol 2024; 326:R134-R146. [PMID: 37982188 DOI: 10.1152/ajpregu.00172.2023] [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: 07/13/2023] [Revised: 10/17/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023]
Abstract
Certain deep-diving marine mammals [i.e., northern elephant seal (Mirounga angustirostris), Weddell seal (Leptonychotes weddellii)] have blood carbon monoxide (CO) levels that are comparable with those of chronic cigarette smokers. Most CO produced in humans is a byproduct of heme degradation, which is released when red blood cells (RBCs) are destroyed. Elevated CO can occur in humans when RBC lifespan decreases. The contribution of RBC turnover to CO concentrations in marine mammals is unknown. Here, we report the first RBC lifespans in two healthy marine mammal species with different diving capacities and heme stores, the shallow-diving bottlenose dolphin (Tursiops truncatus) and deep-diving beluga whale (Delphinapterus leucas), and we relate the lifespans to the levels of CO in blood and breath. The belugas, with high blood heme stores, had the longest mean RBC lifespan compared with humans and bottlenose dolphins. Both cetacean species were found to have three times higher blood CO content compared with humans. The estimated CO production rate from heme degradation indicates some marine mammals may have additional mechanisms for CO production, or delay CO removal from the body, potentially from long-duration breath-holds.NEW & NOTEWORTHY This is the first study to determine the red blood cell lifespan in a marine mammal species. High concentrations of carbon monoxide (CO) were found in the blood of bottlenose dolphins and in the blood and breath of belugas compared with healthy humans. Red blood cell turnover accounted for these high levels in bottlenose dolphins, but there may be alternative mechanisms of endogenous CO production that are contributing to the CO concentrations observed in belugas.
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Affiliation(s)
- Anna B Pearson
- Department of Biology and Marine Biology, University of North Carolina Wilmington, Wilmington, North Carolina, United States
| | - Luis A Hückstädt
- Department of Biology and Marine Biology, University of North Carolina Wilmington, Wilmington, North Carolina, United States
- Centre for Ecology and Conservation, University of Exeter, Penryn, United Kingdom
| | - Stephen T Kinsey
- Department of Biology and Marine Biology, University of North Carolina Wilmington, Wilmington, North Carolina, United States
| | - Todd L Schmitt
- SeaWorld Parks and Entertainment, San Diego, California, United States
| | - Todd R Robeck
- SeaWorld Parks and Entertainment, San Diego, California, United States
| | - Judy St Leger
- Cornell University College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
| | - Paul J Ponganis
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, United States
| | - Michael S Tift
- Department of Biology and Marine Biology, University of North Carolina Wilmington, Wilmington, North Carolina, United States
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6
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Lu Z, Li Y. New Clues to Cardiovascular Disease: Erythrocyte Lifespan. Aging Dis 2023; 14:2003-2014. [PMID: 37199588 PMCID: PMC10676783 DOI: 10.14336/ad.2023.0506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/06/2023] [Indexed: 05/19/2023] Open
Abstract
Determination of erythrocyte lifespan is an important part of the diagnosis of hemolytic diseases. Recent studies have revealed alterations in erythrocyte lifespan among patients with various cardiovascular diseases, including atherosclerotic coronary heart disease, hypertension, and heart failure. This review summarizes the progress of research on erythrocyte lifespan in cardiovascular diseases.
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Affiliation(s)
- Ziyu Lu
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yuanmin Li
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
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7
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Fasano RM, Doctor A, Stowell SR, Spinella PC, Carson JL, Maier CL, Josephson CD, Triulzi DJ. Optimizing RBC Transfusion Outcomes in Patients with Acute Illness and in the Chronic Transfusion Setting. Transfus Med Rev 2023; 37:150758. [PMID: 37743191 DOI: 10.1016/j.tmrv.2023.150758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023]
Abstract
Red blood cell (RBC) transfusion is a common clinical intervention used to treat patients with acute and chronic anemia. The decision to transfuse RBCs in the acute setting is based on several factors but current clinical studies informing optimal RBC transfusion decision making (TDM) are largely based upon hemoglobin (Hb) level. In contrast to transfusion in acute settings, chronic RBC transfusion therapy has several different purposes and is associated with distinct transfusion risks such as iron overload and RBC alloimmunization. Consequently, RBC TDM in the chronic setting requires optimizing the survival of transfused RBCs in order to reduce transfusion exposure over the lifespan of an individual and the associated transfusion complications mentioned. This review summarizes the current medical literature addressing optimal RBC-TDM in the acute and chronic transfusion settings and discusses the current gaps in knowledge which need to be prioritized in future national and international research initiatives.
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Affiliation(s)
- Ross M Fasano
- Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, GA, USA.
| | - Allan Doctor
- Division of Pediatric Critical Care Medicine and Center for Blood Oxygen Transport and Hemostasis, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sean R Stowell
- Joint Program in Transfusion Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Philip C Spinella
- Departments of Surgery and Critical Care Medicine, Pittsburgh University, Pittsburgh, PA, USA
| | - Jeffrey L Carson
- Division of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Cheryl L Maier
- Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, GA, USA
| | - Cassandra D Josephson
- Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Darrell J Triulzi
- Vitalant and Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
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8
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Yastrebova ES, Gisich AV, Nekrasov VM, Gilev KV, Strokotov DI, Chernyshev AV, Karpenko AA, Maltsev VP. A light scatter based model relating erythrocyte vesiculation to lifetime in circulation. Cytometry A 2023; 103:712-722. [PMID: 37195007 DOI: 10.1002/cyto.a.24765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 04/02/2023] [Accepted: 05/12/2023] [Indexed: 05/18/2023]
Abstract
Methods for measuring erythrocyte age distribution are not available as a simple analytical tool. Most of them utilize the fluorescence or radioactive isotopes labeling to construct the age distribution and support physicians with aging indices of donor's erythrocytes. The age distribution of erythrocyte may be a useful snapshot of patient state over 120-days period of life. Previously, we introduced the enhanced assay of erythrocytes with measurement of 48 indices in four categories: concentration/content, morphology, aging and function (10.1002/cyto.a.24554). The aging category was formed by the indices based on the evaluation of the derived age of individual cells. The derived age does not exactly mean the real age of erythrocytes and its evaluation utilizes changes of cellular morphology during a lifespan. In this study, we are introducing the improved methodological approach that allows us to retrieve the derived age of individual erythrocytes, to construct the aging distribution, and to reform the aging category consisting of eight indices. The approach is based on the analysis of the erythrocyte vesiculation. The erythrocyte morphology is analyzed by scanning flow cytometry that measures the primary characteristics (diameter, thickness, and waist) of individual cells. The surface area (S) and sphericity index (SI) are calculated from the primary characteristics and the scattering diagram SI versus S is used in the evaluation of the derived age of each erythrocyte in a sample. We developed the algorithm to evaluate the derived age that provides eight indices in the aging category based on a model using light scatter features. The novel erythrocyte indices were measured for simulated cells and blood samples of 50 donors. We determined the first-ever reference intervals for these indices.
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Affiliation(s)
- Ekaterina S Yastrebova
- Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Alla V Gisich
- Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Vyacheslav M Nekrasov
- Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Konstantin V Gilev
- Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Dmitry I Strokotov
- Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Andrei V Chernyshev
- Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Andrey A Karpenko
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Valeri P Maltsev
- Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
- Novosibirsk State University, Novosibirsk, Russian Federation
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9
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Liu R, Shao M, Ke Z, Li C, Lu F, Zhong MC, Mao Y, Wei X, Zhong Z, Zhou J. Measurement of red blood cell deformability during morphological changes using rotating-glass-plate-based scanning optical tweezers. BIOMEDICAL OPTICS EXPRESS 2023; 14:4979-4989. [PMID: 37791257 PMCID: PMC10545211 DOI: 10.1364/boe.499018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 10/05/2023]
Abstract
It is important to measure the deformability of red blood cells (RBCs) before transfusion, which is a key factor in the gas transport ability of RBCs and changes during storage of RBCs in vitro. Moreover, the morphology of RBCs also changes during storage. It is proposed that the change in morphology is related to the change in deformability. However, the efficiency of typical methods that use particles as handles is low, especially in the deformability measurement of echinocyte and spherocytes. Therefore, the deformability of RBCs with different morphologies is hard to be measured and compared in the same experiment. In this study, we developed a cost-effective and efficient rotating-glass-plate-based scanning optical tweezers device for the measurement of deformability of RBCs. The performance of this device was evaluated, and the deformability of three types of RBCs was measured using this device. Our results clearly show that the change of erythrocyte morphology from discocyte to echinocyte and spherocyte during storage in vitro is accompanied by a decrease in deformability.
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Affiliation(s)
- Rui Liu
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Meng Shao
- School of Instrument Science and Optoelectronics Engineering, Hefei University of Technology, Hefei 230009, China
| | - Zeyu Ke
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Changxu Li
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Fengya Lu
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Min-Cheng Zhong
- School of Instrument Science and Optoelectronics Engineering, Hefei University of Technology, Hefei 230009, China
| | - Yuxin Mao
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Xunbin Wei
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
- Biomedical Engineering Department, Peking University, Beijing 100081, China
| | - Zhensheng Zhong
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Jinhua Zhou
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
- 3D-Printing and Tissue Engineering Center, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei 230032, China
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10
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Donnenberg AD, Kim-Shapiro DB, Kanias T, Moore LR, Kiss JE, Lee JS, Xiong Z, Wang L, Triulzi DJ, Gladwin MT. Optimizing interpretation of survival studies of fresh and aged transfused biotin-labeled RBCs. Transfusion 2023; 63:35-46. [PMID: 36494878 PMCID: PMC10069561 DOI: 10.1111/trf.17192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/09/2022] [Accepted: 09/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Ex vivo labeling with 51 chromium represents the standard method to determine red blood cell (RBC) survival after transfusion. Limitations and safety concerns spurred the development of alternative methods, including biotinylated red blood cells (BioRBC). STUDY DESIGN AND METHODS Autologous units of whole blood were divided equally into two bags and stored under standard blood bank conditions at 2 to 6°C (N = 4 healthy adult volunteers). One bag was biotinylated (15 μg/ml) on storage days 5 to 7 (fresh) and the other was biotinylated (3 μg/ml) on days 35 to 42 (aged). The proportion of circulating BioRBC was measured serially, and cell-surface biotin was quantified with reference to molecules of equivalent soluble fluorochrome. Clearance kinetics were modeled by RBC age distribution at infusion (Gaussian vs. uniform) and decay over time (constant vs. exponential). RESULTS Data were consistent with biphasic exponential clearance of cells of uniform age. Our best estimate of BioRBC clearance (half-life [T1/2 ]) was 49.7 ± 1.2 days initially, followed by more rapid clearance 82 days after transfusion (T1/2 = 15.6 ± 0.6 days). As BioRBC aged in vivo, molecules of equivalent soluble fluorochrome declined with a T1/2 of 122 ± 9 days, suggesting gradual biotin cleavage. There were no significant differences between the clearance of fresh and aged BioRBC. CONCLUSION Similar clearance kinetics of fresh and aged BioRBC may be due to the extensive washing required during biotinylation. Survival kinetics consistent with cells with uniform rather than Gaussian or other non-uniform age distributions suggest that washing, and potentially RBC culling, may extend the storage life of RBC products.
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Affiliation(s)
- Albert D. Donnenberg
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
- UPMC Hillman Cancer Center, Pittsburgh, PA
- McGowan Institute of Regenerative Medicine, Pittsburgh PA
| | | | | | | | - Joseph E. Kiss
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
- Vitalant, Pittsburgh PA
| | - Janet S. Lee
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
| | - Zeyu Xiong
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
| | - Ling Wang
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
| | - Darrell J. Triulzi
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
- Vitalant, Pittsburgh PA
| | - Mark T. Gladwin
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA
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11
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Wang L, Yun Z, Yao J, Tang X, Feng Y, Xiang C. A novel model for hemolysis estimation in rotating impeller blood pumps considering red blood cell aging. Front Physiol 2023; 14:1174188. [PMID: 37123255 PMCID: PMC10130582 DOI: 10.3389/fphys.2023.1174188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
For blood pumps with a rotating vane-structure, hemolysis values are estimated using a stress-based power-law model. It has been reported that this method does not consider the red blood cell (RBC) membrane's shear resistance, leading to inaccurate estimation of the hemolysis value. The focus of this study was to propose a novel hemolysis model which can more accurately predict the hemolysis value when designing the axial flow blood pump. The movement behavior of a single RBC in the shear flow field was simulated at the mesoscale. The critical value of shear stress for physiological injury of RBCs was determined. According to the critical value, the equivalent treatment of RBC aging was studied. A novel hemolysis model was established considering the RBC's aging and the hemolysis' initial value. The model's validity was verified under the experimental conditions of shear stress loading and the conditions of the shear flow field of the blood pump. The results showed that compared with other hemolysis models for estimating the hemolysis value of blood pumps, the novel hemolysis model proposed in this paper could effectively reduce the estimation error of the hemolysis value and provide a reference for the optimal design of rotary vane blood pumps.
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Affiliation(s)
- Liang Wang
- School of Mechanical and Electrical Engineering, Central South University, Changsha, China
- College of Mechanical Engineering, Hunan University of Arts and Science, Changde, China
| | - Zhong Yun
- School of Mechanical and Electrical Engineering, Central South University, Changsha, China
- *Correspondence: Zhong Yun,
| | - Jinfu Yao
- School of Mechanical and Electrical Engineering, Central South University, Changsha, China
| | - Xiaoyan Tang
- School of Mechanical and Electrical Engineering, Central South University, Changsha, China
| | - Yunhao Feng
- School of Mechanical and Electrical Engineering, Central South University, Changsha, China
| | - Chuang Xiang
- College of Mechanical Engineering, Hunan University of Arts and Science, Changde, China
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12
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Yastrebova ES, Nekrasov VM, Gilev KV, Gisich AV, Abubakirova OA, Strokotov DI, Chernyshev AV, Karpenko AA, Maltsev VP. Erythrocyte lysis and angle-resolved light scattering measured by scanning flow cytometry result to 48 indices quantifying a gas exchange function of the human organism. Cytometry A 2023; 103:39-53. [PMID: 35349217 DOI: 10.1002/cyto.a.24554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 01/20/2023]
Abstract
Molecular/cell level of gas exchange function assumes the accurate measurement of erythrocyte characteristics and rate constants concerning to molecules involved into the CO2 /O2 transport. Unfortunately, common hematology analyzers provide the measurement of eight indices of erythrocytes only and say little about erythrocyte morphology and nothing about rate constants of cellular function. The aim of this study is to demonstrate the ability of the Scanning Flow Cytometer (SFC) in the complete morphological analysis of mature erythrocytes and characterization of erythrocyte function via measurement of lysing kinetics. With this study we are introducing 48 erythrocyte indices. To provide the usability of application of the SFC in clinical diagnosis, we formed four categories of indices which are as follows: content/concentration (9 indices), morphology (26 indices), age (5 indices), and function (8 indices). The erythrocytes of 39 healthy volunteers were analyzed with the SFC to fix the first-ever reference intervals for the new indices introduced. The essential measurable reliability of the presented method is expressed in terms of errors of characteristics of single erythrocytes retrieved from the solution of the inverse light-scattering problem and errors of parameters retrieved from the fitting of the experimental kinetics by molecular-kinetics model of erythrocyte lysis.
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Affiliation(s)
- Ekaterina S Yastrebova
- Cytometry and Biokinetics, Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Vyacheslav M Nekrasov
- Cytometry and Biokinetics, Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Konstantin V Gilev
- Cytometry and Biokinetics, Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Alla V Gisich
- Cytometry and Biokinetics, Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Olga A Abubakirova
- Department of Vascular and Hybrid Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Dmitry I Strokotov
- Cytometry and Biokinetics, Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Andrey V Chernyshev
- Cytometry and Biokinetics, Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation
| | - Andrey A Karpenko
- Department of Vascular and Hybrid Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Valeri P Maltsev
- Cytometry and Biokinetics, Voevodsky Institute of Chemical Kinetics and Combustion, Novosibirsk, Russian Federation.,Physical department, Novosibirsk State University, Novosibirsk, Russian Federation
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13
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Rao S, Zhang J, Lin J, Wan J, Chen Y. Association of Red Blood Cell Life Span with Abnormal Changes in Cardiac Structure and Function in Non-Dialysis Patients with Chronic Kidney Disease Stages 3-5. J Clin Med 2022; 11:jcm11247373. [PMID: 36555989 PMCID: PMC9782058 DOI: 10.3390/jcm11247373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction: With the invention and improvement of the carbon monoxide (CO) breath test, the role of shortened red blood cell life span (RBCLS) in renal anemia, an independent risk factor for cardiovascular events in patients with chronic kidney disease (CKD), is gradually attracting attention. Considering that heart failure is the leading cause of morbidity and mortality in patients with CKD, this study investigated the correlation between the RBCLS and the cardiac structure and function in non-dialysis patients with CKD stages 3−5, aiming to provide new ideas to improve the long-term prognosis of CKD patients. Methods: One hundred thirty-three non-dialysis patients with CKD stages 3−5 were tested for RBCLS. We compared the serological data, cardiac ultrasound results, and follow-up prognosis of patients with different RBCLS. Results: As the RBCLS shortened, the patients’ blood pressure, BNP, and CRP gradually increased, most significantly in patients with an RBCLS < 50 d. Patients with an RBCLS < 50 d had substantially lower hemoglobin (Hb), hematocrit, and albumin levels than those with an RBCLS ≥ 50 d. The cardiac ultrasound results show that patients with an RBCLS < 50 d had significantly larger atrial diameters than those with an RBCLS ≥ 50 d and were associated with more severe diastolic dysfunction. Patients with an RBCLS < 50 d had a 3.06 times greater risk of combined heart failure at baseline than those with an RBCLS ≥ 70 d and a higher risk of heart failure at follow-up. CKD stage 5 patients with an RBCLS < 50 d were more likely to develop heart failure and require renal replacement therapy earlier than patients with an RBCLS ≥ 50 d. Conclusions: In non-dialysis patients with CKD stages 3−5, there is a correlation between the red blood cell life span and cardiac structure and function. The RBCLS may also impact the renal prognosis of CKD patients.
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Affiliation(s)
- Siyi Rao
- Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Jing Zhang
- Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Jiaqun Lin
- Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Jianxin Wan
- Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Correspondence: (J.W.); (Y.C.)
| | - Yi Chen
- Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Correspondence: (J.W.); (Y.C.)
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14
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Gerritsma JJ, van der Bolt N, van Bruggen R, Ten Brinke A, van Dam J, Guerrero G, Vermeulen C, de Bruin S, Vlaar APJ, Biemond BJ, Nur E, van der Schoot E, Fijnvandraat K. Measurement of post-transfusion red blood cell survival kinetics in sickle cell disease and β-Thalassemia: A biotin label approach. Transfusion 2022; 62:1984-1996. [PMID: 35916478 DOI: 10.1111/trf.17033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Red blood cell (RBC) transfusions are an important treatment modality for patients with sickle cell disease (SCD) and β-thalassemia. A subgroup of these patients relies on a chronic RBC transfusion regimen. Little is known about RBC survival (RCS) of the transfused allogeneic RBCs. In this study, we aimed to study the RCS kinetics of transfused RBCs in SCD and β-thalassemia and to investigate factors that determine RCS. METHODS AND MATERIALS We performed a prospective cohort study on fourteen adults with SCD and β-thalassemia disease receiving a chronic transfusion regimen. RCS and the influence of donor and patient characteristics on RCS were assessed by simultaneous transfusion of two allogeneic RBCs using RBC biotinylation. Phenotyping of well-known RBC markers over time was performed using flow cytometry. RESULTS RCS of the two transfused RBC units was similar in most patients. Although intra-individual variation was small, inter-individual variation in RCS kinetics was observed. Most patients demonstrated a non-linear trend in RCS that was different from the observed linear RCS kinetics in healthy volunteers. After an initial slight increase in the proportion of biotinylated RBCs during the first 24 h, a rapid decrease within the first 10-12 days was followed by a slower clearance rate. CONCLUSION These are the first data to demonstrate that patient-related factors largely determine post-transfusion RCS behavior of donor RBC in SCD and β-thalassemia, while donor factors exert a negligible effect. Further assessment and modeling of RCS kinetics and its determinants in SCD and β-thalassemia patients may ultimately improve transfusion therapy.
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Affiliation(s)
- Jorn J Gerritsma
- Sanquin Research and Landsteiner Laboratory, Immunopathology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands
| | - Nieke van der Bolt
- Sanquin Research and Landsteiner Laboratory, Immunopathology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Sanquin Research and Landsteiner Laboratory, Immunohematology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Robin van Bruggen
- Sanquin Research and Landsteiner Laboratory, Blood Cell Research, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anja Ten Brinke
- Sanquin Research and Landsteiner Laboratory, Immunopathology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - John van Dam
- Sanquin Research and Landsteiner Laboratory, Molecular Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Guillermo Guerrero
- Sanquin Research and Landsteiner Laboratory, Immunohematology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Christie Vermeulen
- Sanquin Research and Landsteiner Laboratory, Product and Process Development, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sanne de Bruin
- Amsterdam UMC, University of Amsterdam, Intensive Care Medicine, Amsterdam, the Netherlands
| | - Alexander P J Vlaar
- Amsterdam UMC, University of Amsterdam, Intensive Care Medicine, Amsterdam, the Netherlands
| | - Bart J Biemond
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, the Netherlands
| | - Erfan Nur
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, the Netherlands
| | - Ellen van der Schoot
- Sanquin Research and Landsteiner Laboratory, Immunohematology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Karin Fijnvandraat
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands.,Sanquin Research and Landsteiner Laboratory, Molecular and Cellular Hemostasis, Amsterdam UMC, University of Amsterdam, Sanquin Research, Amsterdam, the Netherlands
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15
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Xu S, Zheng H, Tang Z, Gu Z, Wang M, Tang C, Xie Y, Kong M, Jing J, Su Y, Zhu Y. Antenatal Iron-Rich Food Intervention Prevents Iron-Deficiency Anemia but Does Not Affect Serum Hepcidin in Pregnant Women. J Nutr 2022; 152:1450-1458. [PMID: 35285912 DOI: 10.1093/jn/nxac065] [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: 10/20/2021] [Revised: 12/29/2021] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Limited evidence supports the efficacy of iron-rich foods (IRFs) in improving iron status during pregnancy. OBJECTIVES The study aims to evaluate the effect of IRFs on iron status and biomarkers of iron metabolism in the third trimester of pregnancy. METHODS A total of 240 pregnant women at 11-13 wk of gestation without iron-deficiency anemia (IDA) in South China were recruited to this single-blind clinical trial [non-IDA referred to both hemoglobin (Hb) ≥110g/L and serum ferritin (SF) ≥15ng/mL], randomly assigned to 1) control, 2) IRFs containing 20 mg iron/d (IRF-20), or 3) IRFs containing 40 mg iron/d (IRF-40). The IRFs were consumed 3 days a week, including pork liver, chicken/duck blood, soybean, and agaric. The IRFs started at recruitment and ended in the predelivery room. Primary outcome included anemia (Hb <110 g/L), iron deficiency (ID, definition 1: SF <15 ng/mL; definition 2: SF <12 ng/mL), and IDA (ID and Hb <110 g/L). Secondary outcome was plasma Hb and iron indices, including SF, serum hepcidin, and iron. RESULTS All participants who completed the trial with full data (n = 170) were included in the analysis. At the endline, both intervention groups showed lower ID and IDA rates than control. Specifically, IRF-40 showed a lower ID (SF <12 ng/mL) rate than control (9.0% compared with 22.8%, P = 0.022). For IDA by definition 1, the incidence in IRF-40 was lower than that in control (1.9% compared with 8.9%, P = 0.045). For IDA by definition 2, the incidence in IRF-20 was lower than that in control (3.9% compared with 17.9%, P = 0.049). Moreover, IRF-20 showed higher SF concentrations than control (P = 0.039). No effects of IRFs on anemia (P = 0.856), plasma Hb (P = 0.697), serum hepcidin (P = 0.311), and iron (P = 0.253) concentrations were observed. The assessed iron intakes were 22.2 mg/d in IRF-20 and 25.0 mg/d in IRF-40, respectively. CONCLUSIONS Antenatal IRFs reduce the risk of ID and IDA in late pregnancy, although the present results are inadequate to confirm an ideal dosage (No. ChiCTR1800017574).
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Affiliation(s)
- Suhua Xu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hao Zheng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhaoxie Tang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhuohe Gu
- Maoming Maternal and Child Health Care Hospital, Maoming, China
| | - Min Wang
- Maoming Maternal and Child Health Care Hospital, Maoming, China
| | - Cuilan Tang
- Maoming Maternal and Child Health Care Hospital, Maoming, China
| | - Yanqi Xie
- Maoming Maternal and Child Health Care Hospital, Maoming, China
| | - Minli Kong
- Maoming Maternal and Child Health Care Hospital, Maoming, China
| | - Jiajia Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yanbin Su
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Maternal and Child Health, and Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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16
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Mock DM, Stowell SR, Franco RS, Kyosseva SV, Nalbant D, Schmidt RL, Cress GA, Strauss RG, Cancelas JA, von Goetz M, North AK, Widness JA. Antibodies against biotin-labeled red blood cells can shorten posttransfusion survival. Transfusion 2022; 62:770-782. [PMID: 35274303 DOI: 10.1111/trf.16849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND In hematologic and transfusion medicine research, measurement of red blood cell (RBC) in vivo kinetics must be safe and accurate. Recent reports indicate use of biotin-labeled RBC (BioRBC) to determine red cell survival (RCS) offers substantial advantages over 51 Cr and other labeling methods. Occasional induction of BioRBC antibodies has been reported. STUDY DESIGN AND METHODS To investigate the causes and consequences of BioRBC immunization, we reexposed three previously immunized adults to BioRBC and evaluated the safety, antibody emergence, and RCS of BioRBC. RESULTS BioRBC re-exposure caused an anamnestic increase of plasma BioRBC antibodies at 5-7 days; all were subclass IgG1 and neutralized by biotinylated albumin, thus indicating structural specificity for the biotin epitope. Concurrently, specific antibody binding to BioRBC was observed in each subject. As biotin label density increased, the proportion of BioRBC that bound increased antibody also increased; the latter was associated with proportional accelerated removal of BioRBC labeled at density 6 μg/mL. In contrast, only one of three subjects exhibited accelerated removal of BioRBC density 2 μg/mL. No adverse clinical or laboratory events were observed. Among three control subjects who did not develop BioRBC antibodies following initial BioRBC exposure, re-exposure induced neither antibody emergence nor accelerated BioRBC removal. DISCUSSION We conclude re-exposure of immunized subjects to BioRBC can induce anamnestic antibody response that can cause an underestimation of RCS. To minimize chances of antibody induction and underestimation of RCS, we recommend an initial BioRBC exposure volume of ≤10 mL and label densities of ≤18 μg/mL.
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Affiliation(s)
- Donald M Mock
- Department of Biochemistry & Molecular Biology and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sean R Stowell
- Center for Transfusion and Cellular Therapies, Departments of Pathology and Laboratory Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Robert S Franco
- Division of Hematology/Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Svetlana V Kyosseva
- Department of Biochemistry & Molecular Biology and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Demet Nalbant
- Department of Pharmaceutical Sciences and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, Iowa, USA
| | - Robert L Schmidt
- Stead Family Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
| | - Gretchen A Cress
- Stead Family Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
| | - Ronald G Strauss
- Stead Family Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA.,Department of Pathology, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
| | - José A Cancelas
- Hoxworth Blood Center and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | | | | | - John A Widness
- Stead Family Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
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17
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Delaney KM, Cao C, Guillet R, Pressman EK, O'Brien KO. Fetal iron uptake from recent maternal diet and the maternal RBC iron pool. Am J Clin Nutr 2022; 115:1069-1079. [PMID: 35102365 PMCID: PMC8971007 DOI: 10.1093/ajcn/nqac020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 01/24/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND During pregnancy iron can be obtained from the diet, body iron stores, or iron released from RBC catabolism. Little is known about the relative use of these sources to support fetal iron acquisition. OBJECTIVES To describe longitudinal change in iron absorption and enrichment across gestation and partitioning of RBC iron to the fetus. METHODS Fifteen pregnant women ingested an oral stable iron isotope (57Fe) in the second trimester (T2) of pregnancy (weeks 14-16) to label the RBC pool, and a second oral stable isotope (58Fe) in the third trimester (T3) (weeks 32-35). Absorption was measured at T2 and T3. Change in RBC 57Fe enrichment was monitored (18.8-26.6 wk) to quantify net iron loss from this pool. Iron transfer to the fetus was determined based on RBC 57Fe and 58Fe enrichment in umbilical cord blood at delivery. RESULTS Iron absorption averaged 9% at T2 and increased significantly to 20% (P = 0.01) by T3. The net increase in iron absorption from T2 to T3 was strongly associated with net loss in maternal total body iron (TBI) from T2 to T3 (P = 0.01). Mean time for the labeled RBC 57Fe turnover based on change in RBC enrichment was 94.9 d (95% CI: 43.5, 207.1 d), and a greater decrease in RBC 57Fe enrichment was associated with higher iron absorption in T2 (P = 0.001). Women with a greater decrease in RBC 57Fe enrichment transferred more RBC-derived iron to their fetus (P < 0.05). CONCLUSIONS Iron absorption doubled from T2 to T3 as maternal TBI declined. Women with low TBI had a greater decrease in RBC iron enrichment and transferred more RBC-derived iron to their neonate. These findings suggest maternal RBC iron serves as a significant source of iron for the fetus, particularly in women with depleted body iron stores.
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Affiliation(s)
| | - Chang Cao
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ronnie Guillet
- Department of Pediatrics Division of Neonatology, University of Rochester School of Medicine, Rochester, NY, USA
| | - Eva K Pressman
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine, Rochester, NY, USA
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18
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Itoh S, Okada H, Koyano K, Nakamura S, Konishi Y, Iwase T, Kusaka T. Fetal and neonatal bilirubin metabolism. Front Pediatr 2022; 10:1002408. [PMID: 36824297 PMCID: PMC9941200 DOI: 10.3389/fped.2022.1002408] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/30/2022] [Indexed: 02/10/2023] Open
Abstract
Human fetal and neonatal bilirubin metabolism is centered on 4Z,15Z-bilirubin IXα (BR) due to the extremely low BR conjugating capacity of the liver. BR is a unique, highly lipophilic substance with physiological and toxic effects in the cell membranes of organs and body tissues. The fetus excretes BR through the placenta to the maternal circulation. After birth, BR is thought to act as an antioxidant against the increase in reactive oxygen species caused by the rapid increase in oxygen concentration during the adaptation process from in amniotic fluid to in air. However, bilirubin encephalopathy is a toxic effect of bilirubin. Due to the lipophilic nature of BR, it must be bound to a carrier to be distributed to various parts of the body by hydrophilic blood. This carrier of BR is human serum albumin (HSA). In humans, BR can be excreted efficiently after undergoing photochemical reactions upon high affinity binding to HSA. HSA also plays an important role in the prevention of bilirubin encephalopathy. This review focuses on the developmental and physiological role of bilirubin metabolism during the fetal and neonatal periods.
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Affiliation(s)
- Susumu Itoh
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hitoshi Okada
- Division of Analytical Technology, Department of Medical Technology, Kagawa Prefectural University of Health Sciences, Kagawa, Japan
| | - Kosuke Koyano
- Maternal Perinatal Center, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Shinji Nakamura
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yukihiko Konishi
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Takashi Iwase
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
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19
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Glassman PM, Hood ED, Ferguson LT, Zhao Z, Siegel DL, Mitragotri S, Brenner JS, Muzykantov VR. Red blood cells: The metamorphosis of a neglected carrier into the natural mothership for artificial nanocarriers. Adv Drug Deliv Rev 2021; 178:113992. [PMID: 34597748 PMCID: PMC8556370 DOI: 10.1016/j.addr.2021.113992] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/26/2021] [Accepted: 09/24/2021] [Indexed: 12/18/2022]
Abstract
Drug delivery research pursues many types of carriers including proteins and other macromolecules, natural and synthetic polymeric structures, nanocarriers of diverse compositions and cells. In particular, liposomes and lipid nanoparticles represent arguably the most advanced and popular human-made nanocarriers, already in multiple clinical applications. On the other hand, red blood cells (RBCs) represent attractive natural carriers for the vascular route, featuring at least two distinct compartments for loading pharmacological cargoes, namely inner space enclosed by the plasma membrane and the outer surface of this membrane. Historically, studies of liposomal drug delivery systems (DDS) astronomically outnumbered and surpassed the RBC-based DDS. Nevertheless, these two types of carriers have different profile of advantages and disadvantages. Recent studies showed that RBC-based drug carriers indeed may feature unique pharmacokinetic and biodistribution characteristics favorably changing benefit/risk ratio of some cargo agents. Furthermore, RBC carriage cardinally alters behavior and effect of nanocarriers in the bloodstream, so called RBC hitchhiking (RBC-HH). This article represents an attempt for the comparative analysis of liposomal vs RBC drug delivery, culminating with design of hybrid DDSs enabling mutual collaborative advantages such as RBC-HH and camouflaging nanoparticles by RBC membrane. Finally, we discuss the key current challenges faced by these and other RBC-based DDSs including the issue of potential unintended and adverse effect and contingency measures to ameliorate this and other concerns.
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Affiliation(s)
- Patrick M Glassman
- Department of Systems Pharmacology and Translational Therapeutics, Center for Targeted Therapeutics and Translational Nanomedicine of the Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Elizabeth D Hood
- Department of Systems Pharmacology and Translational Therapeutics, Center for Targeted Therapeutics and Translational Nanomedicine of the Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Laura T Ferguson
- Department of Systems Pharmacology and Translational Therapeutics, Center for Targeted Therapeutics and Translational Nanomedicine of the Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States; Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Zongmin Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Don L Siegel
- Department of Pathology & Laboratory Medicine, Division of Transfusion Medicine & Therapeutic Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02138, United States
| | - Jacob S Brenner
- Department of Systems Pharmacology and Translational Therapeutics, Center for Targeted Therapeutics and Translational Nanomedicine of the Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States; Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Vladimir R Muzykantov
- Department of Systems Pharmacology and Translational Therapeutics, Center for Targeted Therapeutics and Translational Nanomedicine of the Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
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20
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Ye L, Ji Y, Zhou C, Luo J, Zhang L, Jing L, Zhao X, Guo J, Gao Q, Peng G, Li Y, Li Y, Li J, Fan H, Yang W, Yang Y, Ma Y, Zhang F. Comparison of Levitt's CO breath test and the 15 N-glycine labeling technique for measuring the lifespan of human red blood cells. Am J Hematol 2021; 96:1232-1240. [PMID: 34265098 DOI: 10.1002/ajh.26290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/22/2021] [Accepted: 07/10/2021] [Indexed: 02/04/2023]
Abstract
The red blood cell (RBC) lifespan is an important physiological indicator of clear significance in clinical research, used for the differential diagnosis of various diseases such as anemia, compensatory phase hemolysis, and polycythemia. The 15 N-glycine labeling technique is the gold standard method for determining RBC lifespans. However, the usefulness of this technique in clinical settings is seriously hindered by the several weeks required to complete the analyses. Levitt's CO breath test is another reliable technique for determining RBC lifespans, with a simpler protocol giving much faster results, making it more useful in clinical applications. We compared the CO breath test and 15 N-glycine labeling technique for measuring the human RBC lifespan. We investigated human RBC lifespans where each subject undertook both the 15 N-glycine labeling technique and the CO breath test. The correlation between the results from these two methods was analyzed. Eight of the ten subjects successfully completed the study. The RBC lifespan values obtained by Levitt's CO breath test were lower than those obtained by the 15 N-glycine labeling technique. The RBC lifespan values determined from the 15 N-glycine labeling technique and the CO breath test were significantly correlated, with a Pearson correlation coefficient of R = 0.98 (p < 0.05), while the R2 of the linear regression equation was 0.96. The CO breath test exhibits as good performance as the 15 N-glycine labelling technique in distinguishing healthy subjects from subjects with hemolysis. The result suggests that the CO breath test is a reliable method for quickly determining human RBC lifespans in clinical applications.
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Affiliation(s)
- Lei Ye
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Yongqiang Ji
- Guangdong Breath Test Engineering and Technology Research Center Shenzhen University Shenzhen China
| | - Cong Zhou
- Guangdong Breath Test Engineering and Technology Research Center Shenzhen University Shenzhen China
| | - Junfeng Luo
- School of Medicine Sun Yat‐Sen University Guangzhou China
| | - Li Zhang
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Liping Jing
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Xin Zhao
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Jie Guo
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Qingyan Gao
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Guangxin Peng
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Yang Li
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Yuan Li
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Jianping Li
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Huihui Fan
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Wenrui Yang
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Yang Yang
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
| | - Yongjian Ma
- Guangdong Breath Test Engineering and Technology Research Center Shenzhen University Shenzhen China
| | - Fengkui Zhang
- Anemia Therapeutic Centre, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China
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21
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Bomholt T, Oturai P, Rix M, Almdal T, Knop FK, Rosthøj S, Feldt-Rasmussen B, Hornum M. Reduced erythrocyte lifespan measured by chromium-51 in patients with type 2 diabetes undergoing long-term hemodialysis. Hemodial Int 2020; 25:198-204. [PMID: 33274575 DOI: 10.1111/hdi.12908] [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: 06/05/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION A reduced erythrocyte lifespan potentially explains the low hemoglobin A1c values found in hemodialysis patients. However, data supporting this notion in patients with type 2 diabetes is unclear. We evaluated the erythrocyte lifespan in patients with type 2 diabetes undergoing long-term hemodialysis and investigated potential predictors of erythrocyte lifespan. METHODS Long-term hemodialysis patients with type 2 diabetes and type 2 diabetes patients without nephropathy (estimated glomerular filtration rate > 60 mL/min/1.73 m2 ) were included. The erythrocyte lifespan was measured using chromium-51 (51 Cr)-labeled erythrocytes. Blood radiotracer activity was measured six to nine times over a period of 3-5 weeks to determine the erythrocyte lifespan of each patient. Biochemical markers were obtained five times over 16 weeks and associated with the erythrocyte lifespan. FINDINGS Type 2 diabetes patients undergoing hemodialysis (N = 13) had a significantly shorter median erythrocyte lifespan of 49.7 (interquartile range [IQR] = 44.1-58.6) days compared with 64.2 (IQR = 62.6-83.5) days in the control group (N = 10) (P ˂ 0.001) with a difference between medians of 14.5 (95% confidence interval = 8.1-38.8) days. In the hemodialysis group, no association could be detected between the erythrocyte lifespan and markers of hemolysis, level of inflammation, or urea. DISCUSSION A reduced erythrocyte lifespan was detected in type 2 diabetes patients undergoing long-term hemodialysis. This may contribute to the reduced hemoglobin A1c values observed in the type 2 diabetic hemodialysis population. An association could not be detected between the erythrocyte lifespan and biochemical markers of hemolysis or inflammation.
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Affiliation(s)
- Tobias Bomholt
- Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter Oturai
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Rix
- Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Almdal
- Department of Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Filip K Knop
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Susanne Rosthøj
- Section of Biostatistics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bo Feldt-Rasmussen
- Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mads Hornum
- Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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22
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Effect of Red Blood Cell Aging In Vivo on Their Aggregation Properties In Vitro: Measurements with Laser Tweezers. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10217581] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Red blood cell (RBC) aggregation highly influences hemorheology and blood microcirculation in the human body. The aggregation properties of RBCs can vary due to numerous factors, including RBC age. The aim of this work was to estimate in vitro the differences in the RBC aggregation properties of different RBC age populations in single-cell experiments using laser tweezers. RBCs from five healthy volunteers were separated into four subpopulations by Percoll density gradient centrifugation. Each subpopulation of the RBC was separately resuspended in autologous plasma or dextran 70 kDa (50 mg/mL). The aggregation force between the single cells was measured with holographic laser tweezers. The obtained data demonstrated an enhancement of RBC aggregation force in doublets with age: the older the cells, the higher the aggregation force. The obtained data revealed the differences between the aggregation and aggregability of RBC in dependence of the RBC in vivo age.
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23
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Bonamente M, Spence D. A semi-analytical solution to the maximum-likelihood fit of Poisson data to a linear model using the Cash statistic. J Appl Stat 2020; 49:522-552. [PMID: 35706762 PMCID: PMC9041702 DOI: 10.1080/02664763.2020.1820960] [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: 04/07/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
Abstract
The Cash statistic, also known as the C statistic, is commonly used for the analysis of low-count Poisson data, including data with null counts for certain values of the independent variable. The use of this statistic is especially attractive for low-count data that cannot be combined, or re-binned, without loss of resolution. This paper presents a new maximum-likelihood solution for the best-fit parameters of a linear model using the Poisson-based Cash statistic. The solution presented in this paper provides a new and simple method to measure the best-fit parameters of a linear model for any Poisson-based data, including data with null counts. In particular, the method enforces the requirement that the best-fit linear model be non-negative throughout the support of the independent variable. The method is summarized in a simple algorithm to fit Poisson counting data of any size and counting rate with a linear model, by-passing entirely the use of the traditional χ 2 statistic.
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Affiliation(s)
- Massimiliano Bonamente
- Department of Physics and Astronomy, University of Alabama in Huntsville, Huntsville, AL, USA
| | - David Spence
- Department of Physics and Astronomy, University of Alabama in Huntsville, Huntsville, AL, USA
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24
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Jaspers YRJ, Ferdinandusse S, Dijkstra IME, Barendsen RW, van Lenthe H, Kulik W, Engelen M, Goorden SMI, Vaz FM, Kemp S. Comparison of the Diagnostic Performance of C26:0-Lysophosphatidylcholine and Very Long-Chain Fatty Acids Analysis for Peroxisomal Disorders. Front Cell Dev Biol 2020; 8:690. [PMID: 32903870 PMCID: PMC7438929 DOI: 10.3389/fcell.2020.00690] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/07/2020] [Indexed: 12/20/2022] Open
Abstract
Peroxisomes are subcellular organelles that are involved in various important physiological processes such as the oxidation of fatty acids and the biosynthesis of bile acids and plasmalogens. The gold standard in the diagnostic work-up for patients with peroxisomal disorders is the analysis of very long-chain fatty acid (VLCFA) levels in plasma. Alternatively, C26:0-lysophosphatidylcholine (C26:0-LPC) can be measured in dried blood spots (DBS) using liquid chromatography tandem mass spectrometry (LC-MS/MS); a fast and easy method but not yet widely used. Currently, little is known about the correlation of C26:0-LPC in DBS and C26:0-LPC in plasma, and how C26:0-LPC analysis compares to VLCFA analysis in diagnostic performance. We investigated the correlation between C26:0-LPC levels measured in DBS and plasma prepared from the same blood sample. For this analysis we included 43 controls and 38 adrenoleukodystrophy (ALD) (21 males and 17 females) and 33 Zellweger spectrum disorder (ZSD) patients. In combined control and patient samples there was a strong positive correlation between DBS C26:0-LPC and plasma C26:0-LPC, with a Spearman's rank correlation coefficient of r (114) = 0.962, p < 0.001. These data show that both plasma and DBS are suitable to determine blood C26:0-LPC levels and that there is a strong correlation between C26:0-LPC levels in both matrices. Following this, we investigated how VLCFA and C26:0-LPC analysis compare in diagnostic performance for 67 controls, 26 ALD males, 19 ALD females, and 35 ZSD patients. For C26:0-LPC, all ALD and ZSD samples had C26:0-LPC levels above the upper limit of the reference range. For C26:0, one out of 67 controls had C26:0 levels above the upper reference range. For 1 out of 26 (1/26) ALD males, 1/19 ALD females and 3/35 ZSD patients, the C26:0 concentration was within the reference range. The C26:0/C22:0 ratio was within the reference range for 0/26 ALD males, 1/19 ALD females and 2/35 ZSD patients. Overall, these data demonstrate that C26:0-LPC analysis has a superior diagnostic performance compared to VLCFA analysis (C26:0 and C26:0/C22:0 ratio) in all patient groups. Based on our results we recommend implementation of C26:0-LPC analysis in DBS and/or plasma in the diagnostic work-up for peroxisomal disorders.
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Affiliation(s)
- Yorrick R. J. Jaspers
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Sacha Ferdinandusse
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Inge M. E. Dijkstra
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Rinse Willem Barendsen
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Henk van Lenthe
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Wim Kulik
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Marc Engelen
- Department of Pediatric Neurology, Amsterdam UMC, Amsterdam Leukodystrophy Center, Emma Children’s Hospital, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands
| | - Susan M. I. Goorden
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Frédéric M. Vaz
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
| | - Stephan Kemp
- Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism, University of Amsterdam, Amsterdam, Netherlands
- Department of Pediatric Neurology, Amsterdam UMC, Amsterdam Leukodystrophy Center, Emma Children’s Hospital, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands
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Post-weaning folate deficiency induces a depression-like state via neuronal immaturity of the dentate gyrus in mice. J Pharmacol Sci 2020; 143:97-105. [PMID: 32173264 DOI: 10.1016/j.jphs.2020.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 12/21/2022] Open
Abstract
Folate deficiency has been suggested as a risk factor for depression in preclinical and clinical studies. Several hypotheses of mechanisms underlying folate deficiency-induced depressive symptoms have been proposed, but the detailed mechanisms are still unclear. In this study, we assessed whether post-weaning folate deficiency affect neurological and psychological function. The low folate diet-fed mice showed depression-like behavior in the forced swim test. In contrast, spontaneous locomotor activity, social behavior, coordinated motor skills, anxiety-like behavior and spatial memory did not differ between control and low folate diet-fed mice. In the dentate gyrus (DG) of the hippocampus, decreased number of newborn mature neurons and increased number of immature neurons were observed in low folate diet-fed mice. Staining with Golgi-Cox method revealed that dendritic complexity, spine density and the number of mature spines of neurons were markedly reduced in the DG of low folate diet-fed mice. Stress response of neurons indicated as c-Fos expression was also reduced in the DG of low folate diet-fed mice. These results suggest that reduction in the degree of maturation of newborn hippocampal neurons underlies folate deficiency-induced depressive symptoms.
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26
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Islamzada E, Matthews K, Guo Q, Santoso AT, Duffy SP, Scott MD, Ma H. Deformability based sorting of stored red blood cells reveals donor-dependent aging curves. LAB ON A CHIP 2020; 20:226-235. [PMID: 31796943 DOI: 10.1039/c9lc01058k] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A fundamental challenge in the transfusion of red blood cells (RBCs) is that a subset of donated RBC units may not provide optimal benefit to transfusion recipients. This variability stems from the inherent ability of donor RBCs to withstand the physical and chemical insults of cold storage, which ultimately dictate their survival in circulation. The loss of RBC deformability during cold storage is well-established and has been identified as a potential biomarker for the quality of donated RBCs. While RBC deformability has traditionally been indirectly inferred from rheological characteristics of the bulk suspension, there has been considerable interest in directly measuring the deformation of RBCs. Microfluidic technologies have enabled single cell measurement of RBC deformation but have not been able to consistently distinguish differences between RBCs between healthy donors. Using the microfluidic ratchet mechanism, we developed a method to sensitively and consistently analyze RBC deformability. We found that the aging curve of RBC deformability varies significantly across donors, but is consistent for each donor over multiple donations. Specifically, certain donors seem capable of providing RBCs that maintain their deformability during two weeks of cold storage in standard test tubes. The ability to distinguish between RBC units with different storage potential could provide a valuable opportunity to identify donors capable of providing RBCs that maintain their integrity, in order to reserve these units for sensitive transfusion recipients.
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Affiliation(s)
- Emel Islamzada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada and Centre for Blood Research, University of British Columbia, Canada
| | - Kerryn Matthews
- Centre for Blood Research, University of British Columbia, Canada and Department of Mechanical Engineering, University of British Columbia, Canada.
| | - Quan Guo
- Department of Mechanical Engineering, University of British Columbia, Canada.
| | - Aline T Santoso
- Centre for Blood Research, University of British Columbia, Canada and Department of Mechanical Engineering, University of British Columbia, Canada.
| | - Simon P Duffy
- Centre for Blood Research, University of British Columbia, Canada and Department of Mechanical Engineering, University of British Columbia, Canada. and British Columbia Institute of Technology, Canada
| | - Mark D Scott
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada and Centre for Blood Research, University of British Columbia, Canada and Canadian Blood Services, Canada
| | - Hongshen Ma
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada and Centre for Blood Research, University of British Columbia, Canada and Department of Mechanical Engineering, University of British Columbia, Canada. and School of Biomedical Engineering, University of British Columbia, Canada
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27
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Donnenberg AD, Kanias T, Triulzi DJ, Dennis CJ, Meyer EM, Gladwin M. Improved quantitative detection of biotin-labeled red blood cells by flow cytometry. Transfusion 2019; 59:2691-2698. [PMID: 31172532 PMCID: PMC9236723 DOI: 10.1111/trf.15354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/18/2019] [Accepted: 04/20/2019] [Indexed: 07/28/2023]
Abstract
BACKGROUND Biotin-labeled red blood cells (BioRBC) can be tracked after transfusion, providing a convenient and safe way to measure RBC survival in vivo. RBC survival is of interest for determining optimal blood storage conditions and for assessing the impact of genetic and biologic variants in blood donors on the survival of transfused RBCs. Here we present an improved, platform-independent assay for quantifying biotin on BioRBC. This approach is also useful for detecting BioRBC in peripheral blood samples as rare events. STUDY DESIGN AND METHODS We optimized the signal-to-noise ratio of the detecting reagent (phycoerythrin-conjugated streptavidin [SA-PE]) by determining the SA-PE concentration yielding the greatest separation index between BioRBC and unlabeled RBCs. We calibrated the fluorescence intensity measurements to molecules of equivalent soluble fluorochrome (MESF), a quantitative metric of fluorochrome binding and therefore of biotin bound per RBC. We then characterized the limit of blank and limit of quantification (LoQ) for BioRBC labeled at different densities. RESULTS Biotin-labeled RBCs at sulfo-NHS-biotin concentrations of 3 to 30 μg/mL (27-271 nmol/mL RBCs) ranged from approximately 32,000 to 200,000 MESF/RBC. The LoQ ranged from one in 274,000 to one in 649,000, depending on biotin-labeling density. CONCLUSION Increased sensitivity to detect BioRBC may facilitate tracking over longer periods and/or reduction of the BioRBC dose. Total RBC-bound biotin dose has been shown to correlate with the likelihood of developing antibodies to BioRBC. Lowering the dose of labeled cells may help avoid this eventuality.
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Affiliation(s)
- Albert D. Donnenberg
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Darrell J. Triulzi
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | | | - E. Michael Meyer
- Hillman Cancer Center Cytometry Facility, Pittsburgh, Pennsylvania
| | - Mark Gladwin
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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28
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Donnenberg AD, Kanias T, Triulzi DJ, Dennis CJ, Moore LR, Meyer EM, Sinchar D, Kiss JE, Normolle DP, Gladwin MT. Current good manufacturing practices-compliant manufacture and measurement of biotin-labeled red blood cells. Cytotherapy 2019; 21:793-800. [PMID: 31097327 PMCID: PMC10022648 DOI: 10.1016/j.jcyt.2019.04.052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Red blood cells (RBCs) can be labeled with N-hydroxysuccinimidobiotin (sulfo-NHS-biotin), which binds to cell surface proteins under aqueous conditions. Biotinylated RBCs can be safely infused and detected in peripheral blood samples using flow cytometry, using a fluorochrome-conjugated streptavidin (SA) detection reagent. Biotinylated RBCs have been used to track survival of transfused RBCs, and have applications in optimizing RBC storage and in understanding donor genetic, environmental and disease factors affecting RBC products. METHODS We have developed a closed-system, current good manufacturing practices (cGMP)-compliant procedure for biotinylation of RBCs and a quantitative flow cytometric assay to estimate the dose of cell-bound biotin delivered to the patient. Resulting products were characterized for variability, sterility, endotoxin, hemolysis, total dose of cell-bound biotin and stability. RESULTS The density of biotin-labeling increased as a log-linear function of sulfo-NHS-biotin-labeling concentration, with greater variability at lower concentrations. The upper estimates of biotin doses in the average product (mean RBC content = 5.55 × 1011) were 9.8 and 73.0 µg for products labeled at 3 and 15 µg sulfo-NHS-biotin/mL of total reaction mixture (27 and 135 nmol/mL packed RBCs), respectively. All products were negative for bacterial and fungal growth at 14 days and were below the limit of endotoxin detection. Biotinylated RBCs were stable in vitro for up to 50 days after labeling. DISCUSSION We have validated a closed-system procedure for biotinylating RBCs for investigational use. A standard operating procedure is presented in sufficient detail for implementation in a cGMP-compliant cell-processing facility.
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Affiliation(s)
- Albert D Donnenberg
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh, Pennsylvania, USA; University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, Pennsylvania, USA; McGowan Institute of Regenerative Medicine, Pittsburgh, Pennsylvania, USA.
| | - Tamir Kanias
- Vitalant Research Institute, Denver, Colorado, USA
| | - Darrell J Triulzi
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh, Pennsylvania, USA; Vitalant, Pittsburgh, Pennsylvania, USA
| | | | - Linda R Moore
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - E Michael Meyer
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Derek Sinchar
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh, Pennsylvania, USA
| | - Joseph E Kiss
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh, Pennsylvania, USA; Vitalant, Pittsburgh, Pennsylvania, USA
| | - Daniel P Normolle
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Mark T Gladwin
- University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh, Pennsylvania, USA
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29
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Vimonpatranon S, Chotivanich K, Sukapirom K, Lertjuthaporn S, Khowawisetsut L, Pattanapanyasat K. Enumeration of the Invasion Efficiency of Plasmodium falciparum In Vitro in Four Different Red Blood Cell Populations Using a Three-Color Flow Cytometry-Based Method. Cytometry A 2019; 95:737-745. [PMID: 30924603 DOI: 10.1002/cyto.a.23750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/28/2019] [Accepted: 03/08/2019] [Indexed: 12/18/2022]
Abstract
A novel in vitro culture system using variable concentrations of biotin/streptavidin to label red blood cells (RBCs) that allows for the simultaneous comparison of growth rates in Plasmodium falciparum malaria parasite in four heterogeneous target RBC populations is described. Donor RBCs containing both P. falciparum-infected RBCs and non-infected RBCs at 0.5% parasitemia were first labeled with 7-hydroxy-9H-(1,3-dichloro-9,9-dimethylacridin-2-one) succinimidyl ester (DDAO-SE) followed by co-culture with a mixture of equal numbers of four differentially biotin/streptavidin labeled RBC populations. After two to three schizogonic growth cycles, co-cultures were harvested and stained with streptavidin-phycoerythrin (SA-PE) followed by staining of parasite-infected RBCs with nucleic acid fluorochrome SYBR Green I. To demonstrate the application of this method, some target RBC populations that had sialic acid residues removed using neuraminidase treatment were mixed with RBC populations without enzymatic treatment and incubated with donor parasitized RBCs strain W2 (sialic acid-dependent) or 3D7 (sialic acid-independent). Significant less susceptibility to malaria parasite invasion was obtained with enzyme-treated RBC populations when compared with non-treated RBCs in blood samples from the same individual when using malaria parasite strain W2, whereas no difference in percent parasitemias was noted following infection with malaria parasite strain 3D7. This novel malaria culture method is cheap and provides increased sensitivity for direct comparison of parasite growth over time of any of the four RBC populations under identical conditions and eliminates the experimental bias due to contaminated donor RBCs. The application of biotin-labeled RBCs will therefore provide a better understanding of invasion phenotype-specific host-parasite interactions and the extent of complex malaria invasion mechanism. © 2019 International Society for Advancement of Cytometry.
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Affiliation(s)
- Sinmanus Vimonpatranon
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Center of Excellence for Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kesinee Chotivanich
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kasama Sukapirom
- Center of Excellence for Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sakaorat Lertjuthaporn
- Center of Excellence for Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ladawan Khowawisetsut
- Center of Excellence for Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kovit Pattanapanyasat
- Center of Excellence for Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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30
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Kanias T, Stone M, Page GP, Guo Y, Endres-Dighe SM, Lanteri MC, Spencer BR, Cable RG, Triulzi DJ, Kiss JE, Murphy EL, Kleinman S, Gladwin MT, Busch MP, Mast AE. Frequent blood donations alter susceptibility of red blood cells to storage- and stress-induced hemolysis. Transfusion 2018; 59:67-78. [PMID: 30474858 DOI: 10.1111/trf.14998] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 05/14/2018] [Accepted: 05/27/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Frequent whole blood donations increase the prevalence of iron depletion in blood donors, which may subsequently interfere with normal erythropoiesis. The purpose of this study was to evaluate the associations between donation frequency and red blood cell (RBC) storage stability in a racially/ethnically diverse population of blood donors. STUDY DESIGN Leukoreduced RBC concentrate-derived samples from 13,403 donors were stored for 39 to 42 days (1-6°C) and then evaluated for storage, osmotic, and oxidative hemolysis. Iron status was evaluated by plasma ferritin measurement and self-reported intake of iron supplements. Donation history in the prior 2 years was obtained for each subject. RESULTS Frequent blood donors enrolled in this study were likely to be white, male, and of older age (56.1 ± 5.0 years). Prior donation intensity was negatively associated with oxidative hemolysis (p < 0.0001) in multivariate analyses correcting for age, sex, and race/ethnicity. Increased plasma ferritin concentration was associated with increased RBC susceptibility to each of the three measures of hemolysis (p < 0.0001 for all), whereas self-reported iron intake was associated with reduced susceptibility to osmotic and oxidative hemolysis (p < 0.0001 for both). CONCLUSIONS Frequent blood donations may alter the quality of blood components by modulating RBC predisposition to hemolysis. RBCs collected from frequent donors with low ferritin have altered susceptibility to hemolysis. Thus, frequent donation and associated iron loss may alter the quality of stored RBC components collected from iron-deficient donors. Further investigation is necessary to assess posttransfusion safety and efficacy in patients receiving these RBC products.
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Affiliation(s)
- Tamir Kanias
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mars Stone
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | | | - Yuelong Guo
- RTI International, Research Triangle Park, North Carolina
| | | | - Marion C Lanteri
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | | | | | - Darrell J Triulzi
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.,The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | - Joseph E Kiss
- The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | - Edward L Murphy
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | - Steve Kleinman
- University of British Columbia, Victoria, British Columbia, Canada
| | - Mark T Gladwin
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael P Busch
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | - Alan E Mast
- Blood Research Institute, Blood Center of Wisconsin, and Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee
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Mock DM, Nalbant D, Kyosseva SV, Schmidt RL, An G, Matthews NI, Vlaar APJ, van Bruggen R, de Korte D, Strauss RG, Cancelas JA, Franco RS, Veng-Pedersen P, Widness JA. Development, validation, and potential applications of biotinylated red blood cells for posttransfusion kinetics and other physiological studies: evidenced-based analysis and recommendations. Transfusion 2018; 58:2068-2081. [PMID: 29770455 DOI: 10.1111/trf.14647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/05/2018] [Accepted: 03/18/2018] [Indexed: 12/16/2022]
Abstract
The current reference method in the United States for measuring in vivo population red blood cell (RBC) kinetics utilizes chromium-51 (51 Cr) RBC labeling for determining RBC volume, 24-hour posttransfusion RBC recovery, and long-term RBC survival. Here we provide evidence supporting adoption of a method for kinetics that uses the biotin-labeled RBCs (BioRBCs) as a superior, versatile method for both regulatory and investigational purposes. RBC kinetic analysis using BioRBCs has important methodologic, analytical, and safety advantages over 51 Cr-labeled RBCs. We critically review recent advances in labeling human RBCs at multiple and progressively lower biotin label densities for concurrent, accurate, and sensitive determination of both autologous and allogeneic RBC population kinetics. BioRBC methods valid for RBC kinetic studies, including successful variations used by the authors, are presented along with pharmacokinetic modeling approaches for the accurate determination of RBC pharmacokinetic variables in health and disease. The advantages and limitations of the BioRBC method-including its capability of determining multiple BioRBC densities simultaneously in the same individual throughout the entire RBC life span-are presented and compared with the 51 Cr method. Finally, potential applications and limitations of kinetic BioRBC determinations are discussed.
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Affiliation(s)
- Donald M Mock
- Department of Biochemistry & Molecular Biology and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Demet Nalbant
- Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Svetlana V Kyosseva
- Department of Biochemistry & Molecular Biology and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Robert L Schmidt
- Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Guohua An
- Department of Pharmaceutical Sciences and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, Iowa
| | - Nell I Matthews
- Department of Biochemistry & Molecular Biology and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Alexander P J Vlaar
- Laboratory of Experimental Intensive Care and Anesthesia, Academic Medical Center, Amsterdam, the Netherlands.,Department of Intensive Care, Academic Medical Center, Amsterdam, the Netherlands
| | - Robin van Bruggen
- Sanquin Blood Supply, Department of Blood Cell Research, Sanquin Research, Amsterdam, the Netherlands
| | - Dirk de Korte
- Sanquin Blood Supply, Department of Blood Cell Research, Sanquin Research, Amsterdam, the Netherlands
| | - Ronald G Strauss
- Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa.,Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - José A Cancelas
- Hoxworth Blood Center and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - Robert S Franco
- Division of Hematology/Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Peter Veng-Pedersen
- Department of Pharmaceutical Sciences and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, Iowa
| | - John A Widness
- Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
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32
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Zhang DL, Wu J, Shah BN, Greutélaers KC, Ghosh MC, Ollivierre H, Su XZ, Thuma PE, Bedu-Addo G, Mockenhaupt FP, Gordeuk VR, Rouault TA. Erythrocytic ferroportin reduces intracellular iron accumulation, hemolysis, and malaria risk. Science 2018; 359:1520-1523. [PMID: 29599243 DOI: 10.1126/science.aal2022] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 08/15/2017] [Accepted: 01/25/2018] [Indexed: 12/17/2022]
Abstract
Malaria parasites invade red blood cells (RBCs), consume copious amounts of hemoglobin, and severely disrupt iron regulation in humans. Anemia often accompanies malaria disease; however, iron supplementation therapy inexplicably exacerbates malarial infections. Here we found that the iron exporter ferroportin (FPN) was highly abundant in RBCs, and iron supplementation suppressed its activity. Conditional deletion of the Fpn gene in erythroid cells resulted in accumulation of excess intracellular iron, cellular damage, hemolysis, and increased fatality in malaria-infected mice. In humans, a prevalent FPN mutation, Q248H (glutamine to histidine at position 248), prevented hepcidin-induced degradation of FPN and protected against severe malaria disease. FPN Q248H appears to have been positively selected in African populations in response to the impact of malaria disease. Thus, FPN protects RBCs against oxidative stress and malaria infection.
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Affiliation(s)
- De-Liang Zhang
- Section on Human Iron Metabolism, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jian Wu
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Binal N Shah
- Sickle Cell Center, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Katja C Greutélaers
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin 13353, Germany
| | - Manik C Ghosh
- Section on Human Iron Metabolism, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - Hayden Ollivierre
- Section on Human Iron Metabolism, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - Xin-Zhuan Su
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - George Bedu-Addo
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frank P Mockenhaupt
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin 13353, Germany
| | - Victor R Gordeuk
- Sickle Cell Center, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Tracey A Rouault
- Section on Human Iron Metabolism, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
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33
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Zhang HD, Ma YJ, Liu QF, Ye TZ, Meng FY, Zhou YW, Yu GP, Yang JP, Jiang H, Wang QS, Li GP, Ji YQ, Zhu GL, Du LT, Ji KM. Human erythrocyte lifespan measured by Levitt's CO breath test with newly developed automatic instrument. J Breath Res 2018; 12:036003. [PMID: 29400658 DOI: 10.1088/1752-7163/aaacf1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Existing standard techniques for erythrocyte (RBC) lifespan measurement, such as quantitation of labeling with isotopes or biotin, are cumbersome and time-consuming. Given that endogenous CO originates mainly from degraded RBCs, a team lead by Levitt developed a CO breath test to enable more efficient RBC lifespan estimation. The purpose of this study was to evaluate the reliability of Levitt's CO breath test method with our newly developed automatic instrument. RBC lifespan measurements conducted by Levitt's CO breath test method were conducted in 109 healthy subjects and 91 patients with chronic hemolytic anemia. In healthy subjects, the RBC lifespan was 126 ± 26 days, similar to values obtained with classical standard labeling methods. RBC lifespan did not differ significantly between males and females or between juveniles and adults, and did not correlate with age. To our knowledge, this datum represents an RBC lifespan average for the largest sample to date. In subjects with hemolytic anemia, RBC lifespan was 29 ± 14 days, which is significantly shorter than that of the healthy subjects (p = 0.001). Using 75 days as a cut-off, diagnostic accuracy for hemolytic anemia in the present study sample was 100%. In conclusion, the present results indicate that Levitt's CO breath test is an ideal method for human RBC lifespan measurement, and the newly developed automatic instrument is reliable and convenient for clinical practice.
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Affiliation(s)
- Hou-De Zhang
- Institute of Breath Test Research, Shenzhen University, Shenzhen, People's Republic of China. Department of Gastroenterology, Nanshan Hospital, Guangdong Medical University, Shenzhen, People's Republic of China
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34
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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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35
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Ye L, Guo J, Jing LP, Peng GX, Zhou K, Li Y, Li Y, Li JP, Fan HH, Song L, Zhang FK, Zhang L. [The life span of red blood cell in patients with severe/very severe aplastic anemia]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2018; 39:137-142. [PMID: 29562449 PMCID: PMC7342569 DOI: 10.3760/cma.j.issn.0253-2727.2018.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Indexed: 02/03/2023]
Abstract
Objective: To explore the life span of red blood cells (RBC) in patients with severe/very severe aplastic anemia (SAA/VSAA). Methods: Clinical data of 128 SAA/VSAA patients from November 2016 to April 2017 were retrospectively analyzed, and 13 healthy volunteers in the same period was used as normal control. The endogenous Breath Carbon Monoxide (CO) test was used to detect the life span of RBC in SAA/VSAA patients, and the effect of immunosuppressive therapy (IST) on the life span of RBC in these patients was explored. Results: The mean life span of RBC in 51 untreated SAA/VSAA patients was (50.69±21.43) d, which was significantly shorter than that in normal controls[(111.85±31.55) d](t=-6.611, P<0.001). The mean life span of RBC in 77 patients treated with IST was (87.14±39.28) d. The mean life span of RBC in complete responses (CR), hematologic response (HR) and non-response (NR) patients were (106.15±32.12) d, (92.00±38.60) d and (50.44±21.56) d, respectively. The life span of RBC in patients with HR was significantly longer than that in newly diagnosed and NR patients (t=7.430, P<0.001; t=4.846, P=0.002), which was similar to that in the normal controls (t=-1.743,P=0.085). There was no statistical significance between CR patients and the normal controls in the mean life span of RBC (t=-0.558, P=0.579). No factor affecting the RBC life span was found in univariate logistical regression analyses in the newly diagnosed SAA/VSAA patients. The serum levels of IL-2R and IL-6 were much lower in HR patients than NR patients[IL-2R: 4.3×105 U/L vs 6.5×105 U/L, z=-2.733, P=0.006; IL-6: 2.6 (2.0-17.7) ng/L vs 6.1 (2.0-14.4) ng/L, z=-2.968, P=0.003]. Of the 51 newly diagnosed patients, 38 received IST and their 3-month curative effect was evaluated. Receiver operator characteristics (ROC) curve was used to analyze the predictive effect of RBC life span of untreated patients on the efficacy of IST before treatment. The cut-off point was 60 days with sensitivity of 37.5% and specificity of 86.4%. In 9 cases with life span of RBC>60 d before IST, 6 cases acquired HR, while in 29 cases with life span of RBC ≤ 60 d before IST, 10 cases acquired HR, the difference was not statistically significant (P=0.128). Conclusion: The life span of RBC in SAA/VSAA patients was shortened, which can be improved even recovered to the normal after IST. Elevated cytokines might play a role in the pathophysiology of the shortened RBC life span in SAA/VSAA.
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Affiliation(s)
- L Ye
- Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
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36
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Nalbant D, Cancelas JA, Mock DM, Kyosseva SV, Schmidt RL, Cress GA, Zimmerman MB, Strauss RG, Widness JA. In premature infants there is no decrease in 24-hour posttransfusion allogeneic red blood cell recovery after 42 days of storage. Transfusion 2017; 58:352-358. [PMID: 29193118 DOI: 10.1111/trf.14396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/31/2017] [Accepted: 09/27/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Critically ill preterm very-low-birthweight (VLBW) neonates (birthweight ≤ 1.5 kg) frequently develop anemia that is treated with red blood cell (RBC) transfusions. Although RBCs transfused to adults demonstrate progressive decreases in posttransfusion 24-hour RBC recovery (PTR24 ) during storage-to a mean of approximately 85% of the Food and Drug Administration-allowed 42-day storage-limited data in infants indicate no decrease in PTR24 with storage. STUDY DESIGN AND METHODS We hypothesized that PTR24 of allogeneic RBCs transfused to anemic VLBW newborns: 1) will be greater than PTR24 of autologous RBCs transfused into healthy adults and 2) will not decrease with increasing storage duration. RBCs were stored at 4°C for not more than 42 days in AS-3 or AS-5. PTR24 was determined in 46 VLBW neonates using biotin-labeled RBCs and in 76 healthy adults using 51 Cr-labeled RBCs. Linear mixed-model analysis was used to estimate slopes and intercepts of PTR24 versus duration of RBC storage. RESULTS For VLBW newborns, the estimated slope of PTR24 versus storage did not decrease with the duration of storage (p = 0.18) while for adults it did (p < 0.0001). These estimated slopes differed significantly in adults compared to newborns (p = 0.04). At the allowed 42-day storage limit, projected mean neonatal PTR24 was 95.9%; for adults, it was 83.8% (p = 0.0002). CONCLUSIONS These data provide evidence that storage duration of allogeneic RBCs intended for neonates can be increased without affecting PTR24 . This conclusion supports the practice of transfusing RBCs stored up to 42 days for small-volume neonatal transfusions to limit donor exposure.
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Affiliation(s)
| | - José A Cancelas
- Hoxworth Blood Center and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - Donald M Mock
- Department of Biochemistry & Molecular Biology and Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Svetlana V Kyosseva
- Department of Biochemistry & Molecular Biology and Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | | | - M Bridget Zimmerman
- College of Public Health Department of Biostatistics, University of Iowa, Iowa City, Iowa
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Liao XY, Zuo SS, Meng WT, Zhang J, Huang Q, Gou DM. Intraoperative blood salvage may shorten the lifespan of red blood cells within 3 days postoperatively: A pilot study. Medicine (Baltimore) 2017; 96:e8143. [PMID: 28953650 PMCID: PMC5626293 DOI: 10.1097/md.0000000000008143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Intraoperative blood salvage (IBS) recovers most lost blood, and is widely used in the clinic. It is unclear why IBS does not reduce long-term postoperative requirements for red blood cells (RBCs), and 1 possibility is that IBS affects RBC lifespan. METHODS Prospectively enrolled patients who underwent spine, pelvic, or femur surgery not involving allogeneic RBC transfusion were grouped based on whether they received IBS or not. Volumes of blood lost and of RBCs salvaged during surgery were recorded. Total blood cell counts, levels of plasma-free hemoglobin, and CD235a-positive granulocytes were determined perioperatively. RESULTS Although intraoperative blood loss was higher in the IBS group (n = 45) than in the non-IBS group (n = 52) (P < .001), hemoglobin levels were similar between groups (P = .125) at the end of surgery. Hemoglobin levels increased in non-IBS patients (4 ± 11 g/L), but decreased in IBS patients (-7 ± 12 g/L) over the first 3 postoperative days. Nadir hemoglobin levels after surgery were higher in the non-IBS group (107 ± 12 g/L) than in the IBS group (91 ± 12 g/L). Salvaged RBC volume correlated with hemoglobin decrease (r = 0.422, P = .004). In multivariate analysis, salvaged RBC volume was an independent risk factor for hemoglobin decrease (adjusted odds ratio 1.002, 95% confidence interval 1.001-1.004, P = .008). Flow cytometry showed the numbers of CD235a-positive granulocytes after surgery to be higher in the IBS group than in the non-IBS group (P < .05). CONCLUSION IBS may shorten the lifespan of RBCs by triggering their engulfment upon re-infusion (China Clinical Trial Registry ChiCTR-OCH-14005140).
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Affiliation(s)
- Xin-Yi Liao
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Shan-Shan Zuo
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan
| | - Wen-Tong Meng
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy
| | - Jie Zhang
- Key Laboratory of Transplant Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu
| | - Qin Huang
- Department of Anesthesiology, Hospital of Honghuagang District, Zunyi, Guizhou, China
| | - Da-Ming Gou
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi
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38
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Schmidt RL, Mock DM, Franco RS, Cohen RM, North AK, Cancelas JA, Geisen C, Strauss RG, Vlaar AP, Nalbant D, Widness JA. Antibodies to biotinylated red blood cells in adults and infants: improved detection, partial characterization, and dependence on red blood cell-biotin dose. Transfusion 2017; 57:1488-1496. [PMID: 28261808 PMCID: PMC5567754 DOI: 10.1111/trf.14075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/19/2017] [Accepted: 01/25/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Biotin-labeled red blood cells (BioRBCs) are used for in vivo kinetic studies. Because BioRBC dosing occasionally induces antibodies, a sensitive and specific anti-BioRBC detection assay is needed. STUDY DESIGN AND METHODS Aims were to 1) develop a gel card assay to evaluate existing, naturally occurring and BioRBC-induced plasma antibodies, 2) compare gel card and tube agglutination detection results, and 3) test for a relationship of antibody induction and BioRBC dose. Reagent BioRBCs were prepared using sulfo-NHS biotin ranging from densities 18 (BioRBC-18) to 1458 (BioRBC-1458) µg/mL RBCs. RESULTS Among BioRBC-exposed subjects, gel card and tube agglutination results were concordant in 21 of 22 adults and all 19 infant plasma samples. Gel card antibody detection sensitivity was more than 10-fold greater than tube agglutination. Twelve to 16 weeks after BioRBC exposure, induced anti-antibodies were detected by gel card in three of 26 adults (12%) at reagent densities BioRBC-256 or less, but in none of 41 infants. Importantly, induced anti-BioRBC antibodies were associated with higher BioRBC dose (p = 0.008); no antibodies were detected in 18 subjects who received BioRBC doses less than or equal to BioRBC-18. For noninduced BioRBC antibodies, six of 1125 naïve adults (0.3%) and none of 46 naïve infants demonstrated existing anti-BioRBC antibodies using reagent BioRBC-140 or -162. Existing anti-BioRBCs were all neutralized by biotin compounds, while induced antibodies were not. CONCLUSIONS The gel card assay is more sensitive than the tube agglutination assay. We recommend reagent BioRBC-256 for identifying anti-BioRBCs. Use of a low total RBC biotin label dose (≤ BioRBC-18) may minimize antibody induction.
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Affiliation(s)
- Robert L. Schmidt
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Donald M. Mock
- Department of Biochemistry & Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR
- Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Robert S. Franco
- Department of Internal Medicine, Division of Hematology/Oncology, University of Cincinnati College of Medicine, University of Cincinnati College of Medicine and Medical Service, Cincinnati VA Medical Center, Cincinnati, OH
| | - Robert M. Cohen
- Department of Internal Medicine, Division of Endocrinology, Diabetes & Metabolism, University of Cincinnati College of Medicine and Medical Service, Cincinnati VA Medical Center, Cincinnati, OH
| | | | - José A. Cancelas
- Hoxworth Blood Center and the Department of Pediatrics, The University of Cincinnati, Cincinnati, OH
| | - Christof Geisen
- Institut für Transfusionsmedizin und Immunhämatologie, Klinikum der Goethe Universität, Frankfurt am Main, DRK-Blutspendedienst Baden-Württemberg-Hessen, Germany
| | - Ronald G. Strauss
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR
- Department of Pathology, Carver College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Alexander P. Vlaar
- Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesia, Academic Medical Center, Amsterdam, The Netherlands
| | - Demet Nalbant
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - John A. Widness
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR
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39
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Kuruvilla DJ, Widness JA, Nalbant D, Schmidt RL, Mock DM, An G, Veng-Pedersen P. Estimation of adult and neonatal RBC lifespans in anemic neonates using RBCs labeled at several discrete biotin densities. Pediatr Res 2017; 81:905-910. [PMID: 28099421 PMCID: PMC5470643 DOI: 10.1038/pr.2017.14] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/01/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Prior conclusions that autologous neonatal red blood cells (RBC) have substantially shorter lifespans than allogeneic adult RBCs were not based on direct comparison of autologous neonatal vs. allogeneic adult RBCs performed concurrently in the same infant. Biotin labeling of autologous neonatal RBCs and allogeneic adult donor RBCs permits concurrent direct comparison of autologous vs. allogeneic RBC lifespan. METHODS RBCs from 15 allogeneic adult donors and from 15 very-low-birth-weight (VLBW) neonates were labeled at separate biotin densities and transfused simultaneously into the 15 neonates. Two mathematical models that account for the RBC differences were employed to estimate lifespans for the two RBC populations. RESULTS Mean ± SD lifespan for adult allogeneic RBC was 70.1 ± 19.1 d, which is substantially shorter than the 120 d lifespan of both autologous and adult allogeneic RBC in healthy adults. Mean ± SD lifespan for neonatal RBC was 54.2 ± 11.3 d, which is only about 30% shorter than that of the adult allogeneic RBCs. CONCLUSION This study provides evidence that extrinsic environmental factors primarily determine RBC survival (e.g., small bore of the capillaries of neonates, rate of oxygenation/deoxygenation cycles) rather than factors intrinsic to RBC.
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Affiliation(s)
- Denison J. Kuruvilla
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, USA
| | - John A. Widness
- Department of Pediatrics, College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Demet Nalbant
- Department of Pediatrics, College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Robert L. Schmidt
- Department of Pediatrics, College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Donald M. Mock
- Departments of Biochemistry & Molecular Biology and Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Guohua An
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, USA
| | - Peter Veng-Pedersen
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, USA,Corresponding Author: Peter Veng-Pedersen, Ph.D., Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, 115 S. Grand Ave. S227, Iowa City, IA 52242, USA; Tel: (319) 335-8792; Fax: (319) 335-9349;
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Understanding quasi-apoptosis of the most numerous enucleated components of blood needs detailed molecular autopsy. Ageing Res Rev 2017; 35:46-62. [PMID: 28109836 DOI: 10.1016/j.arr.2017.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/22/2016] [Accepted: 01/13/2017] [Indexed: 12/12/2022]
Abstract
Erythrocytes are the most numerous cells in human body and their function of oxygen transport is pivotal to human physiology. However, being enucleated, they are often referred to as a sac of molecules and their cellularity is challenged. Interestingly, their programmed death stands a testimony to their cell-hood. They are capable of self-execution after a defined life span by both cell-specific mechanism and that resembling the cytoplasmic events in apoptosis of nucleated cells. Since the execution process lacks the nuclear and mitochondrial events in apoptosis, it has been referred to as quasi-apoptosis or eryptosis. Several studies on molecular mechanisms underlying death of erythrocytes have been reported. The data has generated a non-cohesive sketch of the process. The lacunae in the present knowledge need to be filled to gain deeper insight into the mechanism of physiological ageing and death of erythrocytes, as well as the effect of age of organism on RBCs survival. This would entail how the most numerous cells in the human body die and enable a better understanding of signaling mechanisms of their senescence and premature eryptosis observed in individuals of advanced age.
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Leecharoenkiat K, Tanaka Y, Harada Y, Chaichompoo P, Sarakul O, Abe Y, Smith DR, Fucharoen S, Svasti S, Umemura T. Plasma microRNA-451 as a novel hemolytic marker for β0-thalassemia/HbE disease. Mol Med Rep 2017; 15:2495-2502. [PMID: 28447765 PMCID: PMC5428399 DOI: 10.3892/mmr.2017.6326] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/06/2016] [Indexed: 01/13/2023] Open
Abstract
In Southeast Asia, particularly in Thailand, β0-thalassemia/hemoglobin E (HbE) disease is a common hereditary hematological disease. It is associated with pathophysiological processes, such as the intramedullary destruction of immature erythroid cells and peripheral hemolysis of mature red blood cells. MicroRNA (miR) sequences, which are short non-coding RNA that regulate gene expression in a suppressive manner, serve a crucial role in human erythropoiesis. In the present study, the plasma levels of the erythroid-expressed miRNAs, miR‑451 and miR‑155, were analyzed in 23 patients with β0-thalassemia/HbE and 16 control subjects. Reverse transcription‑quantitative polymerase chain reaction analysis revealed significantly higher levels of plasma miR‑451 and miR‑155 in β0‑thalassemia/HbE patients when compared to the control subjects. Notably, among the β0‑thalassemia/HbE patients, a significant increase in miR‑451 levels was detected in severe cases when compared with mild cases. The levels of plasma miR‑451 correlated with reticulocyte and platelet counts. The results suggest that increased plasma miR‑451 levels may be associated with the degree of hemolysis and accelerated erythropoiesis in β0‑thalassemia/HbE patients. In conclusion, miR‑451 may represent a relevant biomarker for pathological erythropoiesis associated with β0-thalassemia/HbE.
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Affiliation(s)
- Kamonlak Leecharoenkiat
- Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - Yuka Tanaka
- Division of Medical Technology, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan
| | - Yasuko Harada
- Division of Medical Technology, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan
| | - Porntip Chaichompoo
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Orawan Sarakul
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Yasunobu Abe
- Department of Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan
| | - Duncan Richard Smith
- Molecular Pathology Laboratory, Institute of Molecular Biosciences, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
| | - Suthat Fucharoen
- Thalassemia Research Center, Institute of Molecular Biosciences, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
| | - Saovaros Svasti
- Thalassemia Research Center, Institute of Molecular Biosciences, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
| | - Tsukuru Umemura
- Division of Medical Technology, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan
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Pierigè F, Bigini N, Rossi L, Magnani M. Reengineering red blood cells for cellular therapeutics and diagnostics. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2017; 9. [DOI: 10.1002/wnan.1454] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Francesca Pierigè
- Department of Biomolecular Sciences; University of Urbino Carlo Bo; Urbino Italy
| | - Noemi Bigini
- Department of Biomolecular Sciences; University of Urbino Carlo Bo; Urbino Italy
| | - Luigia Rossi
- Department of Biomolecular Sciences; University of Urbino Carlo Bo; Urbino Italy
| | - Mauro Magnani
- Department of Biomolecular Sciences; University of Urbino Carlo Bo; Urbino Italy
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An G, Widness JA, Mock DM, Veng-Pedersen P. A Novel Physiology-Based Mathematical Model to Estimate Red Blood Cell Lifespan in Different Human Age Groups. AAPS J 2016; 18:1182-1191. [PMID: 27215601 PMCID: PMC5576059 DOI: 10.1208/s12248-016-9923-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/20/2016] [Indexed: 11/30/2022] Open
Abstract
Direct measurement of red blood cell (RBC) survival in humans has improved from the original accurate but limited differential agglutination technique to the current reliable, safe, and accurate biotin method. Despite this, all of these methods are time consuming and require blood sampling over several months to determine the RBC lifespan. For situations in which RBC survival information must be obtained quickly, these methods are not suitable. With the exception of adults and infants, RBC survival has not been extensively investigated in other age groups. To address this need, we developed a novel, physiology-based mathematical model that quickly estimates RBC lifespan in healthy individuals at any age. The model is based on the assumption that the total number of RBC recirculations during the lifespan of each RBC (denoted by N max) is relatively constant for all age groups. The model was initially validated using the data from our prior infant and adult biotin-labeled red blood cell studies and then extended to the other age groups. The model generated the following estimated RBC lifespans in 2-year-old, 5-year-old, 8-year-old, and 10-year-old children: 62, 74, 82, and 86 days, respectively. We speculate that this model has useful clinical applications. For example, HbA1c testing is not reliable in identifying children with diabetes because HbA1c is directly affected by RBC lifespan. Because our model can estimate RBC lifespan in children at any age, corrections to HbA1c values based on the model-generated RBC lifespan could improve diabetes diagnosis as well as therapy in children.
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Affiliation(s)
- Guohua An
- Division of Pharmaceutics and Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa City, Iowa, 52242, USA.
| | - John A Widness
- Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Donald M Mock
- Departments of Biochemistry and Molecular Biology and Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Peter Veng-Pedersen
- Division of Pharmaceutics and Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa City, Iowa, 52242, USA
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Abstract
Hemolysis can be an important cause of hyperbilirubinemia in premature and term neonates. It can result from genetic abnormalities intrinsic to or factors exogenous to normal to red blood cells (RBCs). Hemolysis can lead to a relatively rapid increase in total serum/plasma bilirubin, hyperbilirubinemia that is somewhat slow to fall with phototherapy, or hyperbilirubinemia that is likely to rebound after phototherapy. Laboratory methods for diagnosing hemolysis are more difficult to apply, or less conclusive, in preterm infants. Transfusion of donor RBCs can present a bilirubin load that must be metabolized. Genetic causes can be identified by next-generation sequencing panels.
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Affiliation(s)
- Robert D Christensen
- Division of Hematology/Oncology, Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Chipeta Way, Salt Lake City, UT 84108, USA; Women and Newborn's Clinical Program, Division of Neonatology, Department of Pediatrics, Intermountain Healthcare, University of Utah School of Medicine, Chipeta Way, Salt Lake City, UT 84108, USA.
| | - Hassan M Yaish
- Division of Hematology/Oncology, Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Chipeta Way, Salt Lake City, UT 84108, USA
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Shrestha RP, Horowitz J, Hollot CV, Germain MJ, Widness JA, Mock DM, Veng-Pedersen P, Chait Y. Models for the red blood cell lifespan. J Pharmacokinet Pharmacodyn 2016; 43:259-74. [PMID: 27039311 PMCID: PMC4887310 DOI: 10.1007/s10928-016-9470-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 03/06/2016] [Indexed: 10/22/2022]
Abstract
The lifespan of red blood cells (RBCs) plays an important role in the study and interpretation of various clinical conditions. Yet, confusion about the meanings of fundamental terms related to cell survival and their quantification still exists in the literature. To address these issues, we started from a compartmental model of RBC populations based on an arbitrary full lifespan distribution, carefully defined the residual lifespan, current age, and excess lifespan of the RBC population, and then derived the distributions of these parameters. For a set of residual survival data from biotin-labeled RBCs, we fit models based on Weibull, gamma, and lognormal distributions, using nonlinear mixed effects modeling and parametric bootstrapping. From the estimated Weibull, gamma, and lognormal parameters we computed the respective population mean full lifespans (95 % confidence interval): 115.60 (109.17-121.66), 116.71 (110.81-122.51), and 116.79 (111.23-122.75) days together with the standard deviations of the full lifespans: 24.77 (20.82-28.81), 24.30 (20.53-28.33), and 24.19 (20.43-27.73). We then estimated the 95th percentiles of the lifespan distributions (a surrogate for the maximum lifespan): 153.95 (150.02-158.36), 159.51 (155.09-164.00), and 160.40 (156.00-165.58) days, the mean current ages (or the mean residual lifespans): 60.45 (58.18-62.85), 60.82 (58.77-63.33), and 57.26 (54.33-60.61) days, and the residual half-lives: 57.97 (54.96-60.90), 58.36 (55.45-61.26), and 58.40 (55.62-61.37) days, for the Weibull, gamma, and lognormal models respectively. Corresponding estimates were obtained for the individual subjects. The three models provide equally excellent goodness-of-fit, reliable estimation, and physiologically plausible values of the directly interpretable RBC survival parameters.
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Affiliation(s)
- Rajiv P Shrestha
- Octet Research Inc., 101 Arch St. Suite 1950, Boston, MA, 02110, USA.
| | - Joseph Horowitz
- Department of Mathematics & Statistics, University of Massachusetts, Amherst, MA, 01003, USA
| | - Christopher V Hollot
- Department of Electrical & Computer Engineering, University of Massachusetts, Amherst, MA, 01003, USA
| | - Michael J Germain
- Renal and Transplant Associates of New England, Division of Nephrology, Baystate Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - John A Widness
- Department of Pediatrics, College of Medicine, The University of Iowa, Iowa City, IA, 52242, USA
| | - Donald M Mock
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Peter Veng-Pedersen
- Division of Pharmaceutics, College of Pharmacy, The University of Iowa, Iowa City, IA, 52242, USA
| | - Yossi Chait
- Department of Mechanical & Industrial Engineering, University of Massachusetts, Amherst, MA, 01003, USA
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A Modified Carbon Monoxide Breath Test for Measuring Erythrocyte Lifespan in Small Animals. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7173156. [PMID: 27294128 PMCID: PMC4880698 DOI: 10.1155/2016/7173156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/10/2016] [Indexed: 11/22/2022]
Abstract
This study was to develop a CO breath test for RBC lifespan estimation of small animals. The ribavirin induced hemolysis rabbit models were placed individually in a closed rebreath cage and air samples were collected for measurement of CO concentration. RBC lifespan was calculated from accumulated CO, blood volume, and hemoglobin concentration data. RBC lifespan was determined in the same animals with the standard biotin-labeling method. RBC lifespan data obtained by the CO breath test method for control (CON, 49.0 ± 5.9 d) rabbits, rabbits given 10 mg/kg·d−1 of ribavirin (RIB10, 31.0 ± 4.0 d), and rabbits given 20 mg/kg·d−1 of ribavirin (RIB20, 25.0 ± 2.9 d) were statistically similar (all p > 0.05) to and linearly correlated (r = 0.96, p < 0.01) with the RBC lifespan data obtained for the same rabbits by the standard biotin-labeling method (CON, 51.0 ± 2.7 d; RIB10, 33.0 ± 1.3 d; and RIB20, 27.0 ± 0.8 d). The CO breath test method takes less than 3 h to complete, whereas the standard method requires at least several weeks. In conclusion, the CO breath test method provides a simple and rapid means of estimating RBC lifespan and is feasible for use with small animal models.
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Peters AL, Beuger B, Mock DM, Widness JA, de Korte D, Juffermans NP, Vlaar APJ, van Bruggen R. Clearance of stored red blood cells is not increased compared with fresh red blood cells in a human endotoxemia model. Transfusion 2016; 56:1362-9. [PMID: 27040455 DOI: 10.1111/trf.13595] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND It is thought that the clearance of transfused red blood cells (RBCs) is related both to the storage time of the transfusion product and to the inflammatory status of the recipient. We investigated these effects in a randomized, "two-hit," healthy volunteer transfusion model, comparing autologous RBCs that were stored for 35 days with those that were stored for 2 days. STUDY DESIGN AND METHODS Healthy male volunteers donated 1 unit of autologous RBCs either 2 days (2D) or 35 days (35D) before the study date. The experiment was started by infusion of 2 ng/kg lipopolysaccharide ("first hit"). Two hours later, the stored RBCs ("second hit") were reinfused, followed by the labeling of RBCs with biotin. Clearance of biotin-labeled RBCs (BioRBCs) was measured during the 5-hour posttransfusion endotoxemia period along with measurements of phosphatidylserine (PS) exposure, lactadherin binding, and expression of CD47 (cluster of differentiation 47; a transmembrane protein encoded by the CD47 gene). RESULTS In the 2D stored RBCs group, 1.5% ± 3.4% of infused BioRBCs were cleared from the circulation 5 hours posttransfusion versus 4.8% ± 4.0% in the 35D stored RBCs group (p = 0.1). There were no differences in PS exposure, lactadherin binding, or CD47 expression between fresh and stored RBCs or between pretransfusion and posttransfusion measurements. CONCLUSION Our study shows a low clearance of RBCs even during endotoxemia. Furthermore, short-term clearance of BioRBCs during endotoxemia was not related to storage duration. Consistent with these observations, PS exposure, lactadherin binding, and CD47 expression did not differ between 2D and 35D stored cells before or after transfusion. We conclude that, in the presence of endotoxemia, clearance of 35D stored autologous RBCs is not increased compared with 2D stored fresh RBCs.
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Affiliation(s)
- Anna L Peters
- Laboratory of Experimental Intensive Care and Anesthesia.,Department of Intensive Care, Academic Medical Center
| | - Boukje Beuger
- Sanquin Blood Supply, Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands
| | - Donald M Mock
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - John A Widness
- Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | - Dirk de Korte
- Sanquin Blood Supply, Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Nicole P Juffermans
- Laboratory of Experimental Intensive Care and Anesthesia.,Department of Intensive Care, Academic Medical Center
| | - Alexander P J Vlaar
- Laboratory of Experimental Intensive Care and Anesthesia.,Department of Intensive Care, Academic Medical Center
| | - Robin van Bruggen
- Sanquin Blood Supply, Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands
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48
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Autologous Infant and Allogeneic Adult Red Cells Demonstrate Similar Concurrent Post-Transfusion Survival in Very Low Birth Weight Neonates. J Pediatr 2015; 167:1001-6. [PMID: 26363547 PMCID: PMC4661104 DOI: 10.1016/j.jpeds.2015.08.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/01/2015] [Accepted: 08/07/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Based on the hypothesis that neonatal autologous red blood cell (RBC) survival (RCS) is substantially shorter than adult RBC, we concurrently tracked the survival of transfused biotin-labeled autologous neonatal and allogeneic adult RBC into ventilated, very low birth weight infants. STUDY DESIGN RBC aliquots from the first clinically ordered, allogeneic adult RBC transfusion and from autologous infant blood were labeled at separate biotin densities (biotin-labeled RBC [BioRBC]) and transfused. Survival of these BioRBCs populations were concurrently followed over weeks by flow cytometric enumeration using leftover blood. Relative tracking of infant autologous and adult allogeneic BioRBC was analyzed by linear mixed modeling of batched weekly data. When possible, Kidd antigen (Jka and Jkb) mismatches between infant and donor RBCs were also used to track these 2 populations. RESULTS Contrary to our hypothesis, concurrent tracking curves of RCS of neonatal and adult BioRBC in 15 study infants did not differ until week 7, after which neonatal RCS became shortened to 59%-79% of adult enumeration values for uncertain reasons. Analysis of mismatched Kidd antigen RBC showed similar results, thus, confirming that BioRBC tracking is not perturbed by biotin RBC labeling. CONCLUSIONS This study illustrates the utility of multidensity BioRBC labeling for concurrent measurement of RCS of multiple RBC populations in vivo. The similar RCS results observed for neonatal and adult BioRBCs transfused into very low birth weight infants provides strong evidence that the circulatory environment of the newborn infant, not intrinsic infant-adult RBC differences, is the primary determinant of erythrocyte survival. TRIAL REGISTRATION Clinicaltrials.gov: NCT00731588.
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Kuruvilla DJ, Widness JA, Nalbant D, Schmidt RL, Mock DM, Veng-Pedersen P. A Method to Evaluate Fetal Erythropoiesis from Postnatal Survival of Fetal RBCs. AAPS JOURNAL 2015; 17:1246-54. [PMID: 26017162 DOI: 10.1208/s12248-015-9784-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/04/2015] [Indexed: 11/30/2022]
Abstract
Fetal RBCs are produced during a period of very rapid growth and stimulated erythropoiesis under hypoxic intrauterine conditions. Fetal RBC life span varies with gestational age (GA) and is shorter than that in healthy adults. Due to the special kinetic properties of life span-based survival of human RBCs, a mathematical model-based kinetic analysis of the survival of fetal RBCs shortly after birth provides a unique opportunity to "look backward in time" to evaluate fetal erythropoiesis. This work introduces a novel method that utilizes postnatal in vivo RBC survival data collected within 2 days after birth to study both nonsteady-state (non-SS) in utero RBC production and changing fetal RBC life span over time. The effect of changes in erythropoiesis rate and RBC life span and the effect of multiple postnatal phlebotomies on the RBC survival curves were investigated using model-based simulations. This mathematical model, which considers both changes in the rate of erythropoiesis and RBC life span and which accurately accounts for the confounding effect of multiple phlebotomies, was applied to survival curves for biotin-labeled RBCs from ten anemic very low birth weight preterm infants. The estimated mean fetal RBC production rate scaled by body weight was 1.07 × 10(7) RBCs/day g, and the mean RBC life span at birth was 52.1 days; these values are consistent with reported values. The in utero RBC life span increased at a rate of 0.51 days per day of gestation. We conclude that the proposed mathematical model and its implementation provide a flexible framework to study in utero non-SS fetal erythropoiesis in newborn infants.
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Affiliation(s)
- Denison J Kuruvilla
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, 115 S. Grand Ave. S227, Iowa City, Iowa, 52242, USA
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50
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Onozaki F, Kishino K, Muroi K. Red blood cell survival evaluated by RhD-negative cells transfused into RhD-positive patients. Transfus Apher Sci 2015; 52:317-8. [PMID: 25634789 DOI: 10.1016/j.transci.2015.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 12/23/2014] [Accepted: 01/08/2015] [Indexed: 11/18/2022]
Affiliation(s)
- F Onozaki
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, Shimotsuke, Japan
| | - K Kishino
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, Shimotsuke, Japan
| | - K Muroi
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, Shimotsuke, Japan.
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