1
|
Debaene C, Feys HB, Six KR. Shedding light on GPIbα shedding. Curr Opin Hematol 2024:00062752-990000000-00077. [PMID: 38728102 DOI: 10.1097/moh.0000000000000826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
PURPOSE OF REVIEW Ectodomain shedding has been investigated since the late 1980s. The abundant and platelet specific GPIbα receptor is cleaved by ADAM17 resulting in the release of its ectodomain called glycocalicin. This review will address the role of glycocalicin as an end-stage marker of platelet turnover and storage lesion and will consider a potential function as effector in processes beyond hemostasis. RECENT FINDINGS Glycocalicin has been described as a marker for platelet senescence, turnover and storage lesion but is not routinely used in a clinical setting because its diagnostic value is nondiscriminatory. Inhibition of glycocalicin shedding improves posttransfusion recovery but little is known (yet) about potential hemostatic improvements. In physiological settings, GPIbα shedding is restricted to the intracellular GPIbα receptor subpopulation suggesting a role for shedding or glycocalicin beyond hemostasis. SUMMARY So far, all evidence represents glycocalicin as an end-stage biomarker of platelet senescence and a potential trigger for platelet clearance. The extensive list of interaction partners of GPIbα in fields beyond hemostasis opens new possibilities to investigate specific effector functions of glycocalicin.
Collapse
Affiliation(s)
- Caitlin Debaene
- Transfusion Research Center, Belgian Red Cross Flanders
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hendrik B Feys
- Transfusion Research Center, Belgian Red Cross Flanders
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Katrijn R Six
- Transfusion Research Center, Belgian Red Cross Flanders
| |
Collapse
|
2
|
Shea SM, Reisz JA, Mihalko EP, Rahn KC, Rassam RMG, Chitrakar A, Gamboni F, D'Alessandro A, Spinella PC, Thomas KA. Cold-stored platelet hemostatic capacity is maintained for three weeks of storage and associated with taurine metabolism. J Thromb Haemost 2024; 22:1154-1166. [PMID: 38072374 DOI: 10.1016/j.jtha.2023.11.025] [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: 08/28/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/31/2023]
Abstract
BACKGROUND Platelet (PLT) product transfusion is a life-saving therapy for actively bleeding patients. There is an urgent need to maintain PLT function and extend shelf life to improve outcomes in these patients. Cold-stored PLT (CS-PLT) maintain hemostatic potential better than room temperature-stored PLT (RT-PLT). However, whether function in long-term CS-PLT is maintained under physiological flow regimes and/or determined by cold-induced metabolic changes is unknown. OBJECTIVES This study aimed to (i) compare the function of RT-PLT and CS-PLT under physiological flow conditions, (ii) determine whether CS-PLT maintain function after 3 weeks of storage, and (iii) identify metabolic pathways associated with the CS-PLT lesion. METHODS We performed phenotypic and functional assessments of RT- and CS-PLT (22 °C and 4 °C storage, respectively; N = 10 unique donors) at storage days 0, 5, and/or 21 via metabolomics, flow cytometry, aggregation, thrombin generation, viscoelastic testing, and a microfluidic assay to measure primary hemostatic function. RESULTS Day 21 4 °C PLT formed an occlusive thrombus under arterial shear at a similar rate to day 5 22 °C PLT. Day 21 4 °C PLTs had enhanced thrombin generation capacity compared with day 0 PLT and maintained functionality comparable to day RT-PLT across all assays performed. Key metrics from microfluidic assessment, flow cytometry, thrombin generation, and aggregation were associated with 4 °C storage, and metabolites involved in taurine and purine metabolism significantly correlated with these metrics. Taurine supplementation of PLT during storage improved hemostatic function under flow. CONCLUSION CS-PLT stored for 3 weeks maintain hemostatic activity, and storage-induced phenotype and function are associated with taurine and purine metabolism.
Collapse
Affiliation(s)
- Susan M Shea
- Department of Pediatrics, Division of Critical Care, Washington University School of Medicine, St Louis, Missouri, USA; Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. https://twitter.com/SMSheaLab
| | - Julie A Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Emily P Mihalko
- Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Katelin C Rahn
- Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rassam M G Rassam
- Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Fabia Gamboni
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. https://twitter.com/dalessandrolab
| | - Philip C Spinella
- Department of Pediatrics, Division of Critical Care, Washington University School of Medicine, St Louis, Missouri, USA; Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. https://twitter.com/PhilSpinellaMD
| | - Kimberly A Thomas
- Department of Pediatrics, Division of Critical Care, Washington University School of Medicine, St Louis, Missouri, USA; Vitalant Research Institute, Denver, Colorado, USA; Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
| |
Collapse
|
3
|
Valencia Morales DJ, Klompas AM, Torbenson JM, Finney RE, Chen D, Stubbs JR, Nuttall GA. Cold platelet transfusion: The effects of a fluid warmer on platelet function. Transfusion 2024; 64:47-52. [PMID: 38115202 DOI: 10.1111/trf.17624] [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: 03/21/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Recently the US Food and Drug Administration has granted variances to select blood centers to supply cold-stored platelet components (CSP). In hemorrhage resuscitation warming of blood components with approved fluid warming devices is common. STUDY DESIGN AND METHODS Pathogen-reduced apheresis platelet units were collected and stored in one of two ways: (1) CSP-I, (2) CSP-D. CSP-I were collected and immediately stored at 1-6°C until used. CSP-D were collected and stored at 20-24°C for 5 days and transferred to storage at 1-6°C until use. Aggregometry using arachidonic acid (AA), adenosine diphosphate (ADP) and collagen as agonists was performed on the unit samples before and after the units were infused through a Ranger blood-warming device. RESULTS CSP-I, 23 units, had very high aggregation responses to all agonists (all ≥47.6 ± 20.7). There was a statistically significant reduction in ADP-induced aggregometry results from 55.1 ± 23.2 before compared to 33.5 ± 14.6 following infusion of the PLT through the blood warmer (p < .001). There were no differences in AA and collagen aggregometry results before and after the infusion of the platelets through the blood warmer. CSP-D had 5 of the 15 units with visible clotting in the bag. The 10 CSP-Ds studied had lower aggregation than all agonists before and after infusion through the blood-warming device (all ≤49.9 ± 35.9). CONCLUSION We detected a statistically significant reduction in ADP-induced aggregometry in CSP-I run through a Ranger blood-warming device with no change with AA or collagen agonist aggregometry.
Collapse
Affiliation(s)
- Diana J Valencia Morales
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Allan M Klompas
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Division of Transfusion Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Jenna M Torbenson
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Robyn E Finney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Dong Chen
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Clinical Core Laboratory, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - James R Stubbs
- Division of Transfusion Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Gregory A Nuttall
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| |
Collapse
|
4
|
Nash J, Davies A, Saunders CV, George CE, Williams JO, James PE. Quantitative increases of extracellular vesicles in prolonged cold storage of platelets increases the potential to enhance fibrin clot formation. Transfus Med 2023; 33:467-477. [PMID: 37553476 DOI: 10.1111/tme.12989] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Platelet derived extracellular vesicles (EVs) display a pro-coagulant phenotype and are generated throughout platelet concentrate (PC) storage. Cold storage (CS) of PCs is thought to provide a superior haemostatic advantage over room temperature (RT) storage and could prolong the storage time. However, the effect of storage conditions on EV generation and PC function is unknown. We investigated EV production under CS and RT conditions and assessed whether these EVs exhibited a more pro-coagulant phenotype in model experiments. MATERIALS AND METHODS Buffy-coat-derived PCs in a platelet additive solution (PAS) to plasma ratio of approximately 65:35 were stored at RT (22 ± 2°C) or CS (4 ± 2°C) for a prolonged storage duration of 20 days. Impedance aggregometry assessed platelet function. EVs were isolated throughout storage and quantified using nanoparticle tracking analysis. EVs were applied to a coagulation assay to assess the impact on fibrin clot formation and lysis. RESULTS CS produced significantly larger EVs from day 4 onwards. EV concentration was significantly increased in CS compared to RT from day 15. EVs, regardless of storage, significantly reduced time to clot formation and maximum optical density measured compared to the no EV control. Clot formation was proportionate to the number of EV applied but was not statistically different across storage conditions when corrected for EV number. CONCLUSION EVs in CS and RT units showed similar clot formation capacity. However, the higher number of larger EVs generated in CS compared to RT suggests PC units derived from CS conditions may overall exhibit a haemostatically superior capacity compared to RT storage.
Collapse
Affiliation(s)
- J Nash
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- Component Development and Research Laboratory, Welsh Blood Service, Pontyclun, UK
| | - A Davies
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - C V Saunders
- Component Development and Research Laboratory, Welsh Blood Service, Pontyclun, UK
| | - C E George
- Component Development and Research Laboratory, Welsh Blood Service, Pontyclun, UK
| | - J O Williams
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - P E James
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| |
Collapse
|
5
|
Lorusso A, Croxon H, Faherty-O'Donnell S, Field S, Fitzpatrick Á, Farrelly A, Hervig T, Waters A. The impact of donor biological variation on the quality and function of cold-stored platelets. Vox Sang 2023; 118:730-737. [PMID: 37439150 DOI: 10.1111/vox.13495] [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: 02/17/2023] [Revised: 06/09/2023] [Accepted: 06/18/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Room temperature-stored platelets (RTPs) maximize platelet viability but limit shelf life. The aims of this study were to investigate the impact of donor variability on cold-stored platelets (CSPs) and RTP, to determine whether RTP quality markers are appropriate for CSP. MATERIALS AND METHODS Double platelet donations (n = 10) were collected from consented regular male donors stored in 100% plasma. A full blood count, donor age, weight, height and body mass index (BMI) were collected at the time of donation. Platelet donations were split equally into two bags, and assigned to non-agitated CSP or agitated RTP. The quality and function of platelets were assessed throughout the standard 7 days of storage and at expiry (day 8). Non-parametric statistical analyses were used to analyse results given the small sample size. RESULTS As expected, there were significant differences between CSP and RTP throughout storage including a reduction in CSP concentration as well as a loss of swirling. Furthermore, a significant increase in CSP exhibiting activation and apoptotic markers was observed. Platelet concentrations were further impacted by donor BMI, and donors with the highest BMI (>29) had the lowest platelet concentration and activation response at the end of CSP storage. CONCLUSION Platelet quality and functionality play a vital role in transfusion outcomes; however, blood components are inherently variable. This study demonstrated, for the first time, the specific impact of donor BMI on CSP quality and function and highlights the requirement for novel quality markers for assessing CSPs.
Collapse
Affiliation(s)
- Alice Lorusso
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Harry Croxon
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | | | - Stephen Field
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Áine Fitzpatrick
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Aileen Farrelly
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Tor Hervig
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Allison Waters
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
- UCD School of Public Health, Population Science and Physiotherapy, University College Dublin, Dublin, Ireland
| |
Collapse
|
6
|
Pereyra N, Devine DV. How do I/we forecast tomorrows' transfusion: Blood components. Transfus Clin Biol 2023; 30:43-46. [PMID: 35914702 PMCID: PMC9371792 DOI: 10.1016/j.tracli.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The current implementation of Pathogen Reduction Technologies (PRTs) offers advantages and disadvantages to transfusion medicine. PRT rollout may significantly reduce the incidence of transfusion-transmitted infections and immune reactions, while offering a 'one-size-fits-all' solution to future pathogens in blood products. However, the decrease in transfusion efficacy of PRT-treated blood products suggests that the demand for blood products may increase, further straining the already limited supply of these cells. Conversely, cold-stored platelets and whole-blood transfusions have re-emerged, potentially granting more effective transfusion options to bleeding patients. The renewed focus on donor variability, storage quality, and transfusion outcome presents another avenue through which transfusion quality and supply may be improved.
Collapse
Affiliation(s)
- Nicolas Pereyra
- Department of Biochemistry and Molecular Biology, The University of British Columbia, Canada,The University of British Columbia Centre for Blood Research, Vancouver, Canada
| | - Dana V. Devine
- Department of Biochemistry and Molecular Biology, The University of British Columbia, Canada,Department of Pathology and Laboratory Medicine, The University of British Columbia, Canada,The University of British Columbia Centre for Blood Research, Vancouver, Canada,Corresponding author at: Department of Pathology and Laboratory Medicine, University of British Columbia
| |
Collapse
|
7
|
Chen SH, Tsai SC, Lu HC. Platelets as a Gauge of Liver Disease Kinetics? Int J Mol Sci 2022; 23:ijms231911460. [PMID: 36232759 PMCID: PMC9569526 DOI: 10.3390/ijms231911460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 11/18/2022] Open
Abstract
A multitude of laboratory and clinical interferences influence the utility of platelet-based diagnostic indices, including immature platelet fraction, in longitudinal monitoring and prognostication of patients with chronic liver disease (CLD). The complex yet highly regulated molecular basis of platelet production and clearance kinetics becomes dysregulated in liver pathogenesis. These underlying molecular mechanisms, including premature platelet clearance and bone marrow suppression in parallel with the progressive (e.g., treatment-naïve) or regressive (e.g., on-treatment and off-treatment) disease courses, involved in CLDs, may further confound the changes in platelet–liver correlations over time. Platelet count and function are commonly and secondarily altered in vivo in CLDs. However, the precise characterization of platelet functions during cirrhosis, including in vitro platelet aggregation, has proven challenging due to interferences such as thrombocytopenia. A flow cytometric approach may help monitor the unstably rebalanced hyper- and hypoaggregable states in patients with cirrhosis at risk of hyperaggregable, prothrombotic, or bleeding events. Studies have attempted to stratify patients with cirrhosis by substages and prognosis through the use of novel indices such as the ratio of in vitro endogenous platelet aggregation to platelet count. This review attempts to highlight clinical and laboratory precautions in the context of platelet-assisted CLD monitoring.
Collapse
Affiliation(s)
- Sheng-Hung Chen
- Department of Medicine, China Medical University, No. 91, Xueshi Road, Taichung 404333, Taiwan
- Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, Taichung 404327, Taiwan
- Correspondence:
| | - Shih-Chang Tsai
- Department of Biological Science and Technology, China Medical University, Taichung 404333, Taiwan
| | - Hsiu-Chen Lu
- Department of Education, China Medical University Hospital, Taichung 404327, Taiwan
| |
Collapse
|
8
|
Johnson L, Roan C, Costa M, Aung HH, Marks DC. Gamma and X-ray irradiation do not affect the in vitro quality of refrigerated apheresis platelets in platelet additive solution (PAS-E). Transfusion 2022; 62 Suppl 1:S43-S52. [PMID: 35748661 DOI: 10.1111/trf.16983] [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: 01/28/2022] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Platelet refrigeration (cold storage) provides the advantages of an extended shelf life and reduces the risk of bacterial growth, compared to platelets stored at room temperature (RT). However, processing modifications, such as irradiation, may further improve the safety and/or alter the quality of cold-stored platelets. Platelet components are irradiated to prevent transfusion-associated graft versus host disease (TA-GvHD) in high-risk patients; and while irradiation has little effect on the quality of RT-stored platelet components, there is no data assessing the effect irradiation has following cold storage. STUDY DESIGN AND METHODS Triple-dose apheresis platelets were collected in 40% plasma/60% PAS-E, using the TRIMA apheresis platform, and refrigerated (2-6°C) within 8 h of collection. On day 2, one of each component was gamma or X-ray irradiated or remained non-irradiated. Platelets were tested over 21 days. RESULTS The platelet concentration decreased by approximately 20% in all groups during 21 days of storage (p > .05). Irradiation (gamma or X-ray) did not affect platelet metabolism, and the pH was maintained above the minimum specification (>6.4) for 21 days. The surface phenotype and the composition of the supernatant was similar in non-irradiated and irradiated platelets, regardless of the source of radiation. Functional responses (aggregation and clot formation) were not affected by irradiation. DISCUSSION Gamma and X-ray irradiation do not affect the in vitro quality of platelet components stored in the cold for up to 21 days. This demonstrates the acceptability of irradiating cold-stored platelets, which has the potential to improve their safety for at-risk patient cohorts.
Collapse
Affiliation(s)
- Lacey Johnson
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Christopher Roan
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Marylia Costa
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Htet Htet Aung
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
9
|
Dabigatran Acylglucuronide, the Major Metabolite of Dabigatran, Shows a Weaker Anticoagulant Effect than Dabigatran. Pharmaceutics 2022; 14:pharmaceutics14020257. [PMID: 35213990 PMCID: PMC8875894 DOI: 10.3390/pharmaceutics14020257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
Dabigatran (DAB) is an orally administered thrombin inhibitor. Both DAB and its main metabolite dabigatran acylglucuronide (DABG) have established anticoagulant effects. Here, we aimed to compare the relative anticoagulant effects of DABG and DAB in humans. Anticoagulant effects of DAB and DABG were measured in vitro using a thrombin generation assay. Additionally, their effects on other coagulation assays including PT, aPTT, TT, and fibrinogen were compared. Both DAB and DABG showed inhibitory effects on thrombin generation in a dose-dependent manner, but DABG exhibited a weaker inhibitory effect than that of DAB. The IC50 values of DAB and DABG on thrombin generation AUC were 134.1 ng/mL and 281.9 ng/mL, respectively. DABG also exhibited weaker anticoagulant effects than DAB on PT, aPTT, and TT. The results of the present study indicate that the anticoagulant effect of DABG, a main active DAB metabolite, is weaker than that of DAB.
Collapse
|
10
|
The Missing Pieces to the Cold-Stored Platelet Puzzle. Int J Mol Sci 2022; 23:ijms23031100. [PMID: 35163024 PMCID: PMC8835703 DOI: 10.3390/ijms23031100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 01/28/2023] Open
Abstract
Cold-stored platelets are making a comeback. They were abandoned in the late 1960s in favor of room-temperature stored platelets due to the need for longer post-transfusion platelet recoverability and survivability in patients with chronic thrombocytopenia. However, the current needs for platelet transfusions are rapidly changing. Today, more platelets are given to patients who are actively bleeding, such as ones receiving cardiac surgeries. It has been established that cold-stored platelets are more hemostatically effective, have reduced bacterial growth, and have longer potential shelf lives. These compelling characteristics led to the recent interest in bringing back cold-stored platelets to the blood systems. However, before reinstating cold-stored platelets in the clinics again, a thorough investigation of in vitro storage characteristics and in vivo transfusion effects is required. This review aims to provide an update on the recent research efforts into the storage characteristics and functions of cold-stored platelets using modern investigative tools. We will also discuss efforts made to improve cold-stored platelets to be a better and safer product. Finally, we will finish off with discussing the relevance of in vitro data to in vivo transfusion results and provide insights and directions for future investigations of cold-stored platelets.
Collapse
|
11
|
Martinaud C, Sugier HHR, Javaudin O, Roziers NBD, Bégué S. In vitro characteristics of cryopreserved platelet concentrates using fresh frozen or lyophilized plasma. Transfus Clin Biol 2022; 29:118-123. [PMID: 35032661 DOI: 10.1016/j.tracli.2022.01.003] [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: 10/11/2021] [Revised: 12/23/2021] [Accepted: 01/06/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Six per cent dimethyl sulfoxide (DMSO) cryopreservation of platelet concentrates (PCs) allows longer storage of PCs but requires time-consuming post-thaw washing. An alternative process based on removing supernatant before freezing has been implemented in several centres worldwide. We assessed the in vitro characteristics of cryopreserved PCs (CPPs) prepared according to this latest process using either French lyophilized plasma (FLyP) or fresh frozen plasma (FFP) for reconstitution. FLyP provides additional benefits to the process due to its logistical constraints and quick availability. MATERIALS AND METHODS Apheresis PCs (n = 16) and buffy coat PCs (n = 16) were cryopreserved in 6% DMSO. After storage at -80 °C, PCs were thawed and reconstituted with FFP or FLyP. Volume, residual leukocytes, total platelet counts (TPCs), post-thaw recovery, biochemical parameters, and DMSO concentration were assessed. Platelet functions were analysed by swirling index, viscoelastometric assay and CD62P quantification. RESULTS After reconstitution, TPC was above 2.1011/CPs; recovery was 78 ± 14% with no significant difference between FFP and FLyP. Glucose and lactate levels were not different between plasmas, whereas FLyP-CPPs exhibited a significant increase in LDH and significantly lower pH. Residual DMSO was 8 ± 4 g/L. Functional analysis revealed significant differences between FFP and FLyP-CPPs, with lower clot firmness and increased clot initiation. Activation of platelets was not higher in FLyP-CPPs. CONCLUSION Preparing CPPs according to this "new" process fulfilled the French legal criteria regardless of the type of plasma. Differences highlighted between FFP-CPPs and FLyP-CPPs were unlikely to be of clinical relevance.
Collapse
Affiliation(s)
| | - Hugo H R Sugier
- French Military Blood Institute, 1 rue Raoul Batany, 92140, Clamart, France.
| | - Olivier Javaudin
- French Military Blood Institute, 1 rue Raoul Batany, 92140, Clamart, France.
| | | | - Stéphane Bégué
- Etablissement Français du Sang, 20 avenue du Stade-de-France, 93218 La Plaine Saint-Denis, France.
| |
Collapse
|
12
|
Brown BL, Wagner SJ, Hapip CA, Fischer E, Getz TM, Thompson-Montgomery D, Turgeon A. Time from apheresis platelet donation to cold storage: Evaluation of platelet quality and bacterial growth. Transfusion 2022; 62:439-447. [PMID: 34994468 DOI: 10.1111/trf.16785] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cold storage reduces posttransfusion survival of platelets; however, it can improve platelet activation, lower risk of bacterial contamination, and extend shelf-life compared to room temperature (RT) storage. To facilitate large-scale availability, manufacturing process optimization is needed, including understanding the impact of variables on platelet potency and safety. Short time requirements from collection to storage is challenging for large blood centers to complete resuspension and qualify platelets for production. This study evaluated the impact of time from platelet component collection to cold storage on in vitro properties and bacterial growth. STUDY DESIGN AND METHODS Double-apheresis platelet components were collected from healthy donors, suspended in 65% PAS-III/35% plasma, and split into 2 equal units. One unit was placed into cold storage within 2 h and the other unit after 8 h. Eight matched pairs were evaluated for 12 in vitro parameters. Twenty-four matched pairs were evaluated with 8 bacterial strains tested in triplicate. Samples were tested throughout 21 days of storage. RESULTS In vitro properties were not different between 2 and 8 h units, and trends throughout storage were similar between arms. Time to cold storage did not significantly impact bacterial growth, with <1 log10 difference at all timepoints between units. DISCUSSION Our studies showed that extending time to cold storage from 2 to 8 h from collection did not significantly increase the bacterial growth, and the platelet component quality and function is maintained. The ability to extend the time required from collection to storage will improve blood center logistics to feasibly produce CSPs.
Collapse
Affiliation(s)
- Bethany L Brown
- American Red Cross, Holland Lab for the Biomedical Sciences, Rockville, Maryland, USA
| | - Stephen J Wagner
- American Red Cross, Holland Lab for the Biomedical Sciences, Rockville, Maryland, USA
| | - C Anne Hapip
- American Red Cross, Holland Lab for the Biomedical Sciences, Rockville, Maryland, USA
| | - Erin Fischer
- American Red Cross, Holland Lab for the Biomedical Sciences, Rockville, Maryland, USA
| | - Todd M Getz
- U.S Army Medical Research and Development Command Battlefield Resuscitation for Immediate Stabilization of Combat Casualties Portfolio Combat Casualty Care Research Program Office, USA
| | | | - Annette Turgeon
- American Red Cross, Holland Lab for the Biomedical Sciences, Rockville, Maryland, USA
| |
Collapse
|
13
|
Storage temperature determines platelet GPVI levels and function in mice and humans. Blood Adv 2021; 5:3839-3849. [PMID: 34478498 DOI: 10.1182/bloodadvances.2021004692] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/27/2021] [Indexed: 01/02/2023] Open
Abstract
Platelets are currently stored at room temperature before transfusion to maximize circulation time. This approach has numerous downsides, including limited storage duration, bacterial growth risk, and increased costs. Cold storage could alleviate these problems. However, the functional consequences of cold exposure for platelets are poorly understood. In the present study, we compared the function of cold-stored platelets (CSP) with that of room temperature-stored platelets (RSP) in vitro, in vivo, and posttransfusion. CSP formed larger aggregates under in vitro shear while generating similar contractile forces compared with RSP. We found significantly reduced glycoprotein VI (GPVI) levels after cold exposure of 5 to 7 days. After transfusion into humans, CSP were mostly equivalent to RSP; however, their rate of aggregation in response to the GPVI agonist collagen was significantly lower. In a mouse model of platelet transfusion, we found a significantly lower response rate to the GPVI-dependent agonist convulxin and significantly lower GPVI levels on the surface of transfused platelets after cold storage. In summary, our data support an immediate but short-lived benefit of cold storage and highlight the need for thorough investigations of CSP. This trial was registered at www.clinicaltrials.gov as #NCT03787927.
Collapse
|
14
|
Huish S, Green L, Kempster C, Smethurst P, Wiltshire M, Prajapati C, Allen E, Cardigan R. A comparison of platelet function in cold-stored whole blood and platelet concentrates. Transfusion 2021; 61:3224-3235. [PMID: 34622949 DOI: 10.1111/trf.16657] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/09/2021] [Accepted: 07/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is renewed interest in the use of whole blood (WB) for the resuscitation of trauma patients. Platelet function in stored WB compared to platelet concentrates is not well established and was assessed in vitro in this study. METHODS Leucocyte-depleted cold-stored WB (CS-WB) was prepared using a Terumo WB-SP Imuflex kit and held at 2-6°C alongside: (A) UK standard pooled platelets stored at 20-24°C (RT-PLTS), (B) pooled platelets stored at 2-6°C (CS-PLTS), and (C) platelet-rich plasma produced using the Terumo kit (CS-PRP), for 21 days. A series of in vitro assays were assessed platelet function. RESULTS Platelet count was retained to 57 ± 14% of starting number at day 21 in CS-WB. Over time, CS-WB platelets become more activated, with increased CD62P expression (day 1: 7 ± 3.7% vs. day 21: 59 ± 17.1%) and annexin V binding (day 1: 2 ± 0.2% vs. day 21: 21 ± 15.1%). For comparison, 18.6 ± 6% of platelets in RT-PLTS demonstrated CD62P expression at day 7, whereas annexin V binding in RT-PLTS at day 7 was 2.6 ± 0.5%. Over storage, aggregatory response to agonists decreased in all arms. Functional platelet microparticles increased steadily in CS-WB throughout storage. CONCLUSION During storage, platelet count reduced in CS-WB, whereas CD62P expression and annexin V binding increased. This was accompanied by a reduced aggregatory response, although compared to 7-day-old RT-PLTS, CS-WB maintained a maximal response to agonists for longer, suggesting that the shelf life for CS-WB can be considered for up to 21 days.
Collapse
Affiliation(s)
- Sian Huish
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | - Laura Green
- Department of Clinical, NHS Blood and Transplant, London, UK.,Blizzard Institute, Queen Mary University of London, London, UK.,Department of Haematology, Barts Health NHS Trust UK, London, UK
| | - Carly Kempster
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | - Peter Smethurst
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | - Michael Wiltshire
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | | | - Elisa Allen
- Statistics and Clinical Studies, NHS Blood and Transplant, Stoke Gifford, UK
| | - Rebecca Cardigan
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| |
Collapse
|
15
|
Tohidi-Esfahani I, Tan S, Tan CW, Johnson L, Marks DC, Chen VM. Platelet procoagulant potential is reduced in platelet concentrates ex vivo but appears restored following transfusion. Transfusion 2021; 61:3420-3431. [PMID: 34611925 DOI: 10.1111/trf.16695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/11/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The procoagulant profile of platelet concentrates (PCs) following transfusion has been difficult to evaluate due to lack of specific markers. This study aimed to characterize procoagulant platelets in PCs and the effect of transfusion. STUDY DESIGN AND METHODS Buffy coat-derived PCs from 12 donors were pooled, split, then stored conventionally, cold (2-6°C) or cryopreserved (-80°C). Procoagulant platelet profiles were assessed by flow cytometry (GSAO+ /P-selectin+ ), lactadherin-binding, and calibrated automated thrombogram, during storage, unstimulated, or after thrombin and collagen stimulation and compared with blood from healthy volunteers. Platelet activation (P-selectin) and procoagulant platelet formation potential were measured (flow cytometry) in patients receiving clinically indicated conventional PC transfusion. RESULTS Independent of significant increases with storage, procoagulant platelet proportions with and without agonist stimulation were significantly blunted in conventionally stored PCs (stimulated day 5 conventional PC 4.2 ± 1.3%, healthy volunteer blood 11.1 ± 2.9%; p < .0001). Cryopreserved PCs contained the highest proportion of procoagulant platelets (unstimulated: cryopreserved 25.6 ± 1.8% vs. day 5 conventional 0.5 ± 0.1% vs. day 14 cold-stored 5.8 ± 1.0%, p < .0001), but demonstrated minimal increase with agonist. Transfusion of PCs was associated with an increase in procoagulant platelets (2.2 ± 1.4% vs. 0.6 ± 0.2%; p = .004) and reversal of the blunted agonist response (15.8 ± 5.9% vs. 4.0 ± 1.6%; p < .0001). Procoagulant responses post-transfusion were significantly higher than healthy controls, suggesting a priming effect. The P-selectin agonist response was not restored upon transfusion (79.4 ± 13.9% vs. 82.0 ± 2.5%). CONCLUSION Storage blunts the procoagulant platelet response to agonist stimulation in PCs. Despite this, conventionally stored PCs have high procoagulant potential following transfusion, with a discordant, persistent reduction in P-selectin response.
Collapse
Affiliation(s)
- Ibrahim Tohidi-Esfahani
- ANZAC Research Institute, University of Sydney, Sydney, Australia.,Haematology Department, Concord Repatriation General Hospital, Sydney, Australia.,Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Shereen Tan
- Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Chuen Wen Tan
- ANZAC Research Institute, University of Sydney, Sydney, Australia.,Haematology Department, Singapore General Hospital, Singapore, Singapore
| | - Lacey Johnson
- Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Denese C Marks
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Vivien M Chen
- ANZAC Research Institute, University of Sydney, Sydney, Australia.,Haematology Department, Concord Repatriation General Hospital, Sydney, Australia.,Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| |
Collapse
|
16
|
Jimenez-Marco T, Castrillo A, Hierro-Riu F, Vicente V, Rivera J. Frozen and cold-stored platelets: reconsidered platelet products. Platelets 2021; 33:27-34. [PMID: 34423718 DOI: 10.1080/09537104.2021.1967917] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Platelet transfusion, both prophylactic and therapeutic, is a key element in modern medicine. Currently, the standard platelet product for clinical use is platelet concentrates at room temperature (20-24°C) under gentle agitation. As this temperature favors bacterial growth, storage is limited to 5-7 days, which result in high wastage rate, and complicates inventory and product availability at remote areas. Frozen and/or cold storage would ameliorate those disadvantages by reducing the risk of bacterial contamination and by extending the product shelf-life to weeks or even years. Consequently, the usefulness in transfusion medicine of platelet cryopreservation and refrigeration, two old and scarcely used platelet storage approaches, is reemerging. Indeed, there have been substantial recent research efforts to characterize both cold and cryopreserved platelets. Most recent studies indicate that cryopreserved and cold platelets display a pro-coagulant profile that may produce the rapid hemostatic response which is needed in bleeding patients. Thus, it seems appropriate that blood banks and blood transfusion centers explore the possibility of split platelet inventories consisting of platelets stored at room temperature and cryopreserved and cold-stored platelets.
Collapse
Affiliation(s)
- Teresa Jimenez-Marco
- Fundació Banc De Sang I Teixits De Les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (Idisba), Majorca, Spain
| | - Azucena Castrillo
- Axencia Galega De Sangue, Órganos E Tecidos. Santiago De Compostela, A Coruña, Spain
| | | | - Vicente Vicente
- Servicio De Hematología Y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional De Hemodonación, Universidad De Murcia, IMIB-Arrixaca, Murcia, Spain
| | - José Rivera
- Servicio De Hematología Y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional De Hemodonación, Universidad De Murcia, IMIB-Arrixaca, Murcia, Spain
| |
Collapse
|
17
|
Abstract
The supply of platelets for transfusion is a logistical challenge due to the physiology of platelets and current measures of transfusion performance dictating storage at 22°C and a short product shelf-life (<7 days). Demand for platelets has increased in recent years and changes in the demographics of the population may enhance this further. Many studies have been conducted to understand what the optimal dose and trigger for transfusion should be, mainly in hematology patients who are the largest cohort that receive platelets, mostly to prevent bleeding. Emerging data suggests that for bleeding patients, where immediate hemostasis is a key consideration, the current standard product may not be optimal. Alternative platelet preparation methods/storage options that may improve the hemostatic properties of platelets are under active development. In parallel with research into alternative platelet products that might enhance hemostasis, better measures for assessing bleeding risk and platelet efficacy are needed.
Collapse
|
18
|
Agey A, Reddoch-Cardenas K, McIntosh C, Sharma U, Cantu C, Cap A, Bynum J. Effects of Intercept pathogen reduction treatment on extended cold storage of apheresis platelets. Transfusion 2020; 61:167-177. [PMID: 33295030 DOI: 10.1111/trf.16096] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Platelets pose the greatest transfusion-transmitted infectious risk among blood products. Refrigeration of platelets can mitigate bacterial contamination and extend platelet shelf life. Implementation of pathogen reduction technologies (PRTs) at blood banks has become increasingly popular to protect against emerging and reemerging infectious diseases. In this study, we sought to evaluate the effects of Intercept PRT on platelets collected on different platforms and cold-stored for up to 21 days in plasma and platelet additive solution (PAS). METHODS Double-dose apheresis platelets were collected with use of a Trima or Amicus system into either 100% plasma or 65% InterSol PAS/35% plasma and split equally between two bags. One bag served as control, while the other received Intercept PRT treatment. Bags were stored unagitated in the cold and evaluated on Days 1, 7, 14, and 21 to assess platelet metabolism, activation, aggregation, and clot formation and retraction. RESULTS By Day 14 of storage, lactate levels reached approximately 13 mmol/L for all samples irrespective of Intercept treatment. Mean clot firmness dropped from the 62.2- to 67.5-mm range (Day 1) to the 28.4- to 51.3-mm range (Day 21), with no differences observed between groups. Clot weights of Intercept-treated Trima/plasma samples were significantly higher than control by Day 14 of storage (P = .004), indicating a reduced clot retraction function. Intercept treatment caused a higher incidence of plasma membrane breakdown in plasma-stored platelets (P = .0013; Trima/plasma Day 14 Control vs Intercept). CONCLUSIONS Intercept treatment of platelets and subsequent cold storage, in plasma or PAS, results in comparable platelet metabolism platelets for up to 14 days of storage but altered clotting dynamics. Pathogen-reduced platelets with an extended shelf life would be beneficial for the deployed setting and would greatly impact transfusion practice among civilian transfusion centers.
Collapse
Affiliation(s)
- Alisa Agey
- George Washington University, Washington, District of Columbia, USA
| | - Kristin Reddoch-Cardenas
- Coagulation and Blood Research Program, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Colby McIntosh
- Coagulation and Blood Research Program, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Umang Sharma
- Coagulation and Blood Research Program, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Carolina Cantu
- Coagulation and Blood Research Program, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Andrew Cap
- Coagulation and Blood Research Program, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - James Bynum
- Coagulation and Blood Research Program, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| |
Collapse
|
19
|
Frozen Platelets-Development and Future Directions. Transfus Med Rev 2020; 34:286-293. [PMID: 33317698 DOI: 10.1016/j.tmrv.2020.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 02/01/2023]
Abstract
Storage requirements and outdating of platelets represent a continued challenge for blood banks. These hurdles are confounded for rural area hospitals or in military deployments. Over 60 years of research and development into frozen platelets have generated a stable and reproducible product. Valeri's method to freeze platelets in 6% dimethyl sulfoxide (DMSO) and storage at -80°C allows for long-term storage alleviating burdens placed on blood banks. Clinical studies show that frozen platelet transfusions are safe with no related thrombotic or other serious adverse events. There are ongoing efforts to demonstrate cryopreserved platelet (CPP) superiority in efficacy studies designed in trauma or cardiac surgery patients. Technical advances in CPP manufacturing including closed system manufacturing, applications of pathogen reduction technology and potency standard characterization add to the appeal of CPP as an alternative to traditional liquid-stored platelets (LP) in settings of supply shortages, mass casualty, active bleeding, rapid provision of HLA-compatible platelets, and remote care.
Collapse
|
20
|
Platelet Biochemistry and Morphology after Cryopreservation. Int J Mol Sci 2020; 21:ijms21030935. [PMID: 32023815 PMCID: PMC7036941 DOI: 10.3390/ijms21030935] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/24/2020] [Accepted: 01/29/2020] [Indexed: 12/25/2022] Open
Abstract
Platelet cryopreservation has been investigated for several decades as an alternative to room temperature storage of platelet concentrates. The use of dimethylsulfoxide as a cryoprotectant has improved platelet storage and cryopreserved concentrates can be kept at −80 °C for two years. Cryopreserved platelets can serve as emergency backup to support stock crises or to disburden difficult logistic areas like rural or military regions. Cryopreservation significantly influences platelet morphology, decreases platelet activation and severely abrogates platelet aggregation. Recent data indicate that cryopreserved platelets have a procoagulant phenotype because thrombin and fibrin formation kicks in earlier compared to room temperature stored platelets. This happens both in static and hydrodynamic conditions. In a clinical setting, low 1-h post transfusion recoveries of cryopreserved platelets represent fast clearance from circulation which may be explained by changes to the platelet GPIbα receptor. Cryopreservation splits the concentrate in two platelet subpopulations depending on GPIbα expression levels. Further research is needed to unravel its physiological importance. Proving clinical efficacy of cryopreserved platelets is difficult because of the heterogeneity of indications and the ambiguity of outcome measures. The procoagulant character of cryopreserved platelets has increased interest for use in trauma stressing the need for double-blinded randomized clinical trials in actively bleeding patients.
Collapse
|
21
|
Delabie W, Maes W, Devloo R, Van den Hauwe MR, Vanhoorelbeke K, Compernolle V, Feys HB. The senotherapeutic nicotinamide riboside raises platelet nicotinamide adenine dinucleotide levels but cannot prevent storage lesion. Transfusion 2019; 60:165-174. [PMID: 31652008 PMCID: PMC6973138 DOI: 10.1111/trf.15556] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 08/28/2019] [Accepted: 09/19/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Supplementation of the nicotinamide adenine dinucleotide (NAD) precursor nicotinamide riboside (NR) has recently been shown to increase life‐span of cells, tissues, and entire organisms. [Correction added on 13 December 2019, after first online publication: In the preceding sentence, “adenine nicotinamide” was revised to “nicotinamide adenine.”] The impact of NR on platelet longevity has not been tested. STUDY DESIGN AND METHODS A pool‐and‐split design of buffy coat derived platelet concentrates (PCs) was used. One arm was treated with cumulative doses of NR‐triflate, the control arm with sodium triflate. Storage lesion was monitored for 23 days. Platelet metabolic and functional parameters were tested. Clearance of human platelets was measured in a mouse model of transfusion. RESULTS Total intracellular NAD levels in platelets decreased two‐fold from 4.8 ± 0.5 fmol (mean ± SD, n = 6) to 2.1 ± 1.8 fmol per 103 control cells, but increased almost 10‐fold to 41.5 ± 4.1 fmol per 103 NR treated platelets. This high intracellular NAD level had no significant impact on platelet count, mean platelet volume, swirling, nor on lactate and glucose levels. Platelet aggregation and integrin αIIbβ3 activation declined steadily and comparably in both conditions. GPIbα levels were slightly lower in NR‐treated platelets compared to control, but this was not caused by reduced receptor shedding because glycocalicin increased similarly. Apoptotic markers cytochrome c, Bcl‐xL, cleaved caspase‐3, and Bak were not different throughout storage for both conditions. Platelet survival in a mouse model of transfusion was not different between NR‐treated and control platelets. CONCLUSION Platelets carry the cellular machinery to metabolize NR into NAD at rates comparable to other eukaryotic cells. Unlike those cells, platelet life‐span cannot be prolonged using this strategy.
Collapse
Affiliation(s)
- Willem Delabie
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - Wim Maes
- Laboratory For Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Rosalie Devloo
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | | | - Karen Vanhoorelbeke
- Laboratory For Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Veerle Compernolle
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Blood Services, Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Hendrik B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Blood Services, Belgian Red Cross-Flanders, Mechelen, Belgium
| |
Collapse
|