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Tran J, Jackman RP, Muench MO, Hazegh K, Bean SW, Thomas KA, Fang F, Page G, O’Connor K, Roubinian N, Anawalt BD, Kanias T. Testosterone supplementation increases red blood cell susceptibility to oxidative stress, decreases membrane deformability, and decreases survival after cold storage and transfusion. Transfusion 2024; 64:1469-1480. [PMID: 38884364 PMCID: PMC11316632 DOI: 10.1111/trf.17922] [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: 04/16/2024] [Revised: 05/29/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Blood collection from donors on testosterone therapy (TT) is restricted to red blood cell (RBC) concentrates to avoid patient exposure to supraphysiological testosterone (T). The objective of this study was to identify TT-related changes in RBC characteristics relevant to transfusion effectiveness in patients. STUDY DESIGN This was a two-part study with cohorts of patients and blood donors on TT. In part 1, we conducted longitudinal evaluation of RBCs collected before and at three time points after initiation of T. RBC assays included storage and oxidative hemolysis, membrane deformability (elongation index), and oximetry. In part 2, we evaluated the fate of transfused RBCs from TT donors in immunodeficient mice and by retrospective analyses of NIH's vein-to-vein databases. RESULTS TT increased oxidative hemolysis (1.45-fold change) and decreased RBC membrane deformability. Plasma free testosterone was positively correlated with oxidative hemolysis (r = .552) and negatively correlated with the elongation index (r = -.472). Stored and gamma-irradiated RBCs from TT donors had lower posttransfusion recovery in mice compared to controls (41.6 ± 12 vs. 55.3 ± 20.5%). Recipients of RBCs from male donors taking T had 25% lower hemoglobin increments compared to recipients of RBCs from non-TT male donors, and had increased incidence (OR, 1.80) of requiring additional RBC transfusions within 48 h of the index transfusion event. CONCLUSIONS TT is associated with altered RBC characteristics and transfusion effectiveness. These results suggest that clinical utilization of TT RBCs may be less effective in recipients who benefit from longer RBC survival, such as chronically transfused patients.
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Affiliation(s)
- Johnson Tran
- Vitalant Research Institute, San Francisco, CA, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rachael P. Jackman
- Vitalant Research Institute, San Francisco, CA, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Marcus O. Muench
- Vitalant Research Institute, San Francisco, CA, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | | | - Kimberly A. Thomas
- Vitalant Research Institute, Denver, CO, USA
- Department of Pathology, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Fang Fang
- Genomics and Translational Research Center, RTI International, NC, USA
| | - Grier Page
- Genomics and Translational Research Center, RTI International, NC, USA
- Fellow program, RTI International, Atlanta, GA, USA
| | - Kim O’Connor
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Nareg Roubinian
- Vitalant Research Institute, San Francisco, CA, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
- Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Bradley D. Anawalt
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Tamir Kanias
- Vitalant Research Institute, Denver, CO, USA
- Department of Pathology, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
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William N, Osmani R, Acker JP. Towards the crux of sex-dependent variability in red cell concentrates. Transfus Apher Sci 2023; 62:103827. [PMID: 37793959 DOI: 10.1016/j.transci.2023.103827] [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: 10/06/2023]
Abstract
Donor sex can alter the RBC 'storage lesion' progression, contributing to dissimilarities in blood product quality, and thus adverse post-transfusion reactions. The mechanisms underlying the reduced sensitivity of female RBCs to storage-induced stress are partially ascribed to the differential effects of testosterone, progesterone, and estrogen on hemolytic propensity. Contributing to this is the increased proportion of more robust, biologically 'young' subpopulations of RBCs in females. Herein, we discuss the impact of sex hormones on RBCs and the relevance of these biological subpopulations to provide further insight into sex-dependent blood product variability.
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Affiliation(s)
- Nishaka William
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Rafay Osmani
- Department of Laboratory Medicine and Pathology, University of Alberta, 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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Anastasiadi AT, Arvaniti VZ, Paronis EC, Kostomitsopoulos NG, Stamoulis K, Papassideri IS, D’Alessandro A, Kriebardis AG, Tzounakas VL, Antonelou MH. Corpuscular Fragility and Metabolic Aspects of Freshly Drawn Beta-Thalassemia Minor RBCs Impact Their Physiology and Performance Post Transfusion: A Triangular Correlation Analysis In Vitro and In Vivo. Biomedicines 2022; 10:biomedicines10030530. [PMID: 35327331 PMCID: PMC8945797 DOI: 10.3390/biomedicines10030530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/03/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023] Open
Abstract
The clarification of donor variation effects upon red blood cell (RBC) storage lesion and transfusion efficacy may open new ways for donor–recipient matching optimization. We hereby propose a “triangular” strategy for studying the links comprising the transfusion chain—donor, blood product, recipient—as exemplified in two cohorts of control and beta-thalassemia minor (βThal+) donors (n = 18 each). It was unraveled that RBC osmotic fragility and caspase-like proteasomal activity can link both donor cohorts to post-storage states. In the case of heterozygotes, the geometry, size and intrinsic low RBC fragility might be lying behind their higher post-storage resistance to lysis and recovery in mice. Moreover, energy-related molecules (e.g., phosphocreatine) and purine metabolism factors (IMP, hypoxanthine) were specifically linked to lower post-storage hemolysis and phosphatidylserine exposure. The latter was also ameliorated by antioxidants, such as urate. Finally, higher proteasomal conservation across the transfusion chain was observed in heterozygotes compared to control donors. The proposed “triangularity model” can be (a) expanded to additional donor/recipient backgrounds, (b) enriched by big data, especially in the post-transfusion state and (c) fuel targeted experiments in order to discover new quality biomarkers and design more personalized transfusion medicine schemes.
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Affiliation(s)
- Alkmini T. Anastasiadi
- Department of Biology, Section of Cell Biology and Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece; (A.T.A.); (V.-Z.A.); (I.S.P.)
| | - Vasiliki-Zoi Arvaniti
- Department of Biology, Section of Cell Biology and Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece; (A.T.A.); (V.-Z.A.); (I.S.P.)
| | - Efthymios C. Paronis
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation, Academy of Athens (BRFAA), 11527 Athens, Greece; (E.C.P.); (N.G.K.)
| | - Nikolaos G. Kostomitsopoulos
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation, Academy of Athens (BRFAA), 11527 Athens, Greece; (E.C.P.); (N.G.K.)
| | | | - Issidora S. Papassideri
- Department of Biology, Section of Cell Biology and Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece; (A.T.A.); (V.-Z.A.); (I.S.P.)
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
| | - Anastasios G. Kriebardis
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Welfare Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece;
| | - Vassilis L. Tzounakas
- Department of Biology, Section of Cell Biology and Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece; (A.T.A.); (V.-Z.A.); (I.S.P.)
- Correspondence: (V.L.T.); (M.H.A.)
| | - Marianna H. Antonelou
- Department of Biology, Section of Cell Biology and Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece; (A.T.A.); (V.-Z.A.); (I.S.P.)
- Correspondence: (V.L.T.); (M.H.A.)
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