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Turicea B, Sahoo DK, Allbaugh RA, Stinman CC, Kubai MA. Novel treatment of infectious keratitis in canine corneas using ultraviolet C (UV-C) light. Vet Ophthalmol 2024. [PMID: 39118265 DOI: 10.1111/vop.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To investigate the therapeutic effect of 275 nm wavelength ultraviolet C (UV-C) light for treatment of bacterial keratitis in canine corneas using an affordable, broadly available modified handheld device. METHODS UV-C therapy (UVCT) was evaluated in two experiments: in vitro using triplicates of three bacterial genera (Staphylococcus, Streptococcus, Pseudomonas spp., and a mix of all species) where the UVCT was performed at a distance of 10, 15, and 20 mm with 1 or 2 doses (4 h apart) for 5, 15, or 30 s; ex vivo model where healthy canine corneal buttons were inoculated superficially and deep (330 μm) with the same bacterial isolates and treated at a 10 mm distance for 15 s with one dose of 22.5 mJ/cm2. Fluorescent marker (STYO9-PI) was used to label (green = live bacteria, red = dead bacteria), and confocal microscopy was used to image the bacteria. RESULTS In vitro results showed all plates treated with UVCT had 100% bactericidal effect for all isolates with single dose of 15 s at 10 mm distance or two doses, 4 h apart at 15 mm and was ineffective with single dose at 15-20 mm. The ex vivo results confirmed a significant decrease in bacterial load for all isolates on samples inoculated superficially but were inconclusive for intrastromal ones. CONCLUSIONS UVCT confirmed the therapeutic potential for all tested isolates, for both in vitro and ex vivo experiments using a single exposure of 15 s. While safety studies are underway, clinical trials are warranted.
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Affiliation(s)
- Bactelius Turicea
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Dipak K Sahoo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Rachel A Allbaugh
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Chloe C Stinman
- Veterinary Diagnostic Laboratory, Iowa State University, Ames, Iowa, USA
| | - Melissa A Kubai
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
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2
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Bontekoe IJ, van der Meer PF, de Laleijne-Liefting LAE, Klei TRL. The effect of near-infrared low-level light on the in vitro quality of platelets during storage. Vox Sang 2024. [PMID: 38754975 DOI: 10.1111/vox.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND AND OBJECTIVES Near-infrared (NIR) light has been successfully applied to improve the quality of mouse platelets during storage. Because it is suspected that the mitochondria contain the primary photon acceptor, we hypothesized that human platelets for transfusion may be affected similarly and could benefit from NIR light treatment. MATERIALS AND METHODS The optimal light dose was determined using portions of platelet concentrates (PCs) in PAS-E. A pool-and-split design was used to prepare PCs in PAS-E or plasma (n = 6). On day 1, one unit of both pairs was illuminated with 830 nm light (light-emitting diodes, 15 J/cm2). PCs were stored at 22°C and sampled regularly for analysis. Data were compared with their corresponding controls with a paired two-sided t-test. RESULTS Illuminated platelets in PAS-E were less activated with significantly lower CD62P expression (day 8: 10.8 ± 1.8 vs. 12.2 ± 2.6, p < 0.05) and lower Annexin A5 binding (day 8: 11.8 ± 1.9 vs. 13.1 ± 2.4, ns). They produced significantly less lactate resulting in a higher pH (days 6-10). ATP content and mitochondrial membrane potential were not affected. Although these trends were also observed for PCs in plasma, the differences did not reach statistical significance as compared with the control group. CONCLUSION Our study demonstrates that the glycolysis rate of human platelets can be modulated through the use of NIR, possibly through mitochondrial aerobic metabolism, but this requires confirmation. If NIR illumination can be further optimized, it may potentially become a useful tool in situations in which glycolysis and platelet activation are exacerbated.
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Affiliation(s)
- Ido J Bontekoe
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Pieter F van der Meer
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
- Department of Hematology, Haga Teaching Hospital, The Hague, The Netherlands
| | | | - Thomas R L Klei
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
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3
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Gravemann U, Boelke M, Könenkamp L, Söder L, Maurer M, Ziegler U, Schulze TJ, Seltsam A, Becker SC, Steffen I. West Nile and Usutu viruses are efficiently inactivated in platelet concentrates by UVC light using the THERAFLEX UV-Platelets system. Vox Sang 2024. [PMID: 38699884 DOI: 10.1111/vox.13648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND AND OBJECTIVES West Nile virus (WNV) and Usutu virus (USUV) are mosquito-borne flaviviruses (Flaviviridae) that originated in Africa, have expanded their geographical range during the last decades and caused documented infections in Europe in the last years. Acute WNV and USUV infections have been detected in asymptomatic blood donors by nucleic acid testing. Thus, inactivation of both viral pathogens before blood transfusion is necessary to ensure blood product safety. This study aimed to investigate the efficacy of the THERAFLEX UV-Platelets system to inactivate WNV and USUV in platelet concentrates (PCs). MATERIALS AND METHODS Plasma-reduced PCs were spiked with the virus suspension. Spiked PC samples were taken after spiking (load and hold sample) and after UVC illumination on the Macotronic UV illumination machine with different light doses (0.05, 0.1, 0.15 and 0.2 (standard) J/cm2). Virus loads of WNV and USUV before and after illumination were measured by titration. RESULTS Infectivity assays showed that UVC illumination inactivated WNV and USUV in a dose-dependent manner. At a UVC dose of 0.2 J/cm2, the WNV titre was reduced by a log10 factor of 3.59 ± 0.43 for NY99 (lineage 1) and 4.40 ± 0.29 for strain ED-I-33/18 (lineage 2). USUV titres were reduced at the same UVC dose by a log10 factor of 5.20 ± 0.70. CONCLUSIONS Our results demonstrate that the THERAFLEX UV-Platelets procedure is an effective technology to inactivate WNV and USUV in contaminated PCs.
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Affiliation(s)
- Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Mathias Boelke
- Institute for Parasitology, University of Veterinary Medicine, Hannover, Germany
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany
| | - Laura Könenkamp
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany
- Department of Biochemistry, University of Veterinary Medicine, Hannover, Germany
| | - Lars Söder
- Institute of Virology, University of Veterinary Medicine, Hannover, Germany
| | - Maurice Maurer
- Institute for Parasitology, University of Veterinary Medicine, Hannover, Germany
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany
| | - Ute Ziegler
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald-Island of Riems, Germany
| | - Torsten J Schulze
- German Red Cross Blood Service NSTOB, Springe, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
| | - Axel Seltsam
- Bavarian Red Cross Blood Service, Institute Nuremberg, Nuremberg, Germany
| | - Stefanie C Becker
- Institute for Parasitology, University of Veterinary Medicine, Hannover, Germany
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany
| | - Imke Steffen
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany
- Department of Biochemistry, University of Veterinary Medicine, Hannover, Germany
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4
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Rademacher MP, Rohn T, Haselbach W, Ott AT, Bringmann PW, Gilch P. Spectroscopic view on the interaction between the psoralen derivative amotosalen and DNA. Photochem Photobiol Sci 2024; 23:693-709. [PMID: 38457118 DOI: 10.1007/s43630-024-00545-2] [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: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 03/09/2024]
Abstract
Psoralens are eponymous for PUVA (psoralen plus UV-A radiation) therapy, which inter alia can be used to treat various skin diseases. Based on the same underlying mechanism of action, the synthetic psoralen amotosalen (AMO) is utilized in the pathogen reduction technology of the INTERCEPT® Blood System to inactivate pathogens in plasma and platelet components. The photophysical behavior of AMO in the absence of DNA is remarkably similar to that of the recently studied psoralen 4'-aminomethyl-4,5',8-trimethylpsoralen (AMT). By means of steady-state and time-resolved spectroscopy, intercalation and photochemistry of AMO and synthetic DNA were studied. AMO intercalates with a higher affinity into A,T-only DNA (KD = 8.9 × 10-5 M) than into G,C-only DNA (KD = 6.9 × 10-4 M). AMO covalently photobinds to A,T-only DNA with a reaction quantum yield of ΦR = 0.11. Like AMT, it does not photoreact following intercalation into G,C-only DNA. Femto- and nanosecond transient absorption spectroscopy reveals the characteristic pattern of photobinding to A,T-only DNA. For AMO and G,C-only DNA, signatures of a photoinduced electron transfer are recorded.
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Affiliation(s)
- Michelle P Rademacher
- Institut für Physikalische Chemie, Heinrich-Heine-Universität Düsseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Tim Rohn
- Institut für Physikalische Chemie, Heinrich-Heine-Universität Düsseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Wiebke Haselbach
- Institut für Physikalische Chemie, Heinrich-Heine-Universität Düsseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - A Theresa Ott
- Institut für Physikalische Chemie, Heinrich-Heine-Universität Düsseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | | | - Peter Gilch
- Institut für Physikalische Chemie, Heinrich-Heine-Universität Düsseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany.
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5
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Sun J, Dahiya N, Schmitt T, Stewart C, Anderson J, MacGregor S, Maclean M, Beger RD, Atreya CD. Metabolomics evaluation of the photochemical impact of violet-blue light (405 nm) on ex vivo platelet concentrates. Metabolomics 2023; 19:88. [PMID: 37855954 DOI: 10.1007/s11306-023-02050-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/08/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Microbicidal violet-blue light in the visible spectrum (405 nm) has been under evaluation for pathogen inactivation in ex vivo human plasma and platelets (PLTs) stored in plasma. Results to date have demonstrated that several blood-borne infectious disease-causing pathogens can be successfully reduced to significantly low levels in the light-treated plasma and PLTs. METHOD In order to evaluate whether the microbicidal 405 nm light is safe for the treatment of PLT concentrates for pathogen inactivation, LC/MS-based metabolomics analyses were performed to evaluate the overall impact of 405 nm violet-blue light treatment on ex vivo PLT concentrates suspended in plasma and on plasma itself, and to identify metabolome changes in intra-platelet and extra-cellular medium (i.e., plasma). RESULTS The metabolomics data identified that platelet activating factors (PAFs), agonists and prostaglandins, which can influence PLT basic functions such as integrity, activation, and aggregation potential were unaltered, suggesting that 405 nm light illumination is safe regarding PLT basic functions. Distinct increases in hydroxyl fatty acids and aldehydes, as well as decreases in antioxidant metabolites indicated that reactive oxygen species (ROS) were generated at high levels after only one hour of exposure to 405 nm light. Distinctly changed endogenous photosensitizer metabolites after 1 h of light exposure provided good evidence that 405 nm light was an effective microbicide acting through ROS mechanism and no external additive photosensitizers were required.
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Affiliation(s)
- Jinchun Sun
- Division of Systems Biology, National Center for Toxicological Research, United States Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA.
| | - Neetu Dahiya
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA
| | - Thomas Schmitt
- Division of Systems Biology, National Center for Toxicological Research, United States Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA
| | - Caitlin Stewart
- The Robertson Trust Laboratory for Electronic Sterilization Technologies, Department of Electronic and Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - John Anderson
- The Robertson Trust Laboratory for Electronic Sterilization Technologies, Department of Electronic and Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Scott MacGregor
- The Robertson Trust Laboratory for Electronic Sterilization Technologies, Department of Electronic and Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilization Technologies, Department of Electronic and Electrical Engineering, University of Strathclyde, Glasgow, UK
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Richard D Beger
- Division of Systems Biology, National Center for Toxicological Research, United States Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA
| | - Chintamani D Atreya
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA
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Ultraviolet Applications to Control Patulin Produced by Penicillium expansum CMP-1 in Apple Products and Study of Further Patulin Degradation Products Formation and Toxicity. FOOD BIOPROCESS TECH 2022. [DOI: 10.1007/s11947-022-02943-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Patulin is a mycotoxin whose presence in apple-derived products and fruit juices is legally regulated, being its maximum limits established in the legislation of multiple countries. However, the management of contaminated batches is still an issue for producers. This investigation aims to evaluate ultraviolet light (254 nm, UV-C254nm) irradiation to find solutions that can be applied at different stages of the apple juice production chain. In this regard, 8.8 (UV-1) and 35.1 (UV-2) kJ m−2 treatments inactivated spores of Penicillium expansum CMP-1 on the surface of apples. Although the same treatments applied to wounded apples (either before the infection or after the infection, immediately or when the lesion had appeared) did not show any effect on the growth rate of P. expansum during storage (up to 14 days, at 4 or 25 °C), they reduced patulin content per lesion size in apples treated after the infection had occurred (patulin decreased from 2.24 (control) to 0.65 µg kg−1 cm−2 (UV-2 treated apples)). Additionally, the treatment of juice with patulin with ultraviolet light up to 450.6 kJ m−2 resulted in more than 98 % reduction of patulin. Degradation products of patulin after UV-C254nm treatments were tentatively identified by HPLC–MS, and toxicity and biological activities were assessed in silico, and results indicated that such products did not pose an increased risk when compared to patulin.
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7
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Handke W, Gravemann U, Müller TH, Wagner FF, Schulze TJ, Seltsam A. New ultraviolet C light-based method for pathogen inactivation of red blood cell units. Transfusion 2022; 62:2314-2323. [PMID: 36087025 DOI: 10.1111/trf.17098] [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: 05/17/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pathogen inactivation (PI) technologies for platelet concentrates and plasma are steadily becoming more established, but new PI treatment options for red blood cells (RBCs), the most commonly used blood component, still need to be developed. We present a novel approach to inactivating pathogens in RBC units employing ultraviolet C (UVC) light. METHODS Whole blood-derived leukoreduced RBCs suspended in PAGGS-C, a third generation additive solution, served as test samples, and RBCs in PAGGS-C or SAG-M as controls. Vigorous agitation and hematocrit reduction by diluting the RBCs with additional additive solution during illumination ensured that UVC light penetrated and inactivated the nine bacteria and eight virus species tested. Bacterial and viral infectivity assays and in vitro analyses were performed to evaluate the system's PI capacity and to measure the RBC quality, metabolic, functional, and blood group serological parameters of UVC-treated versus untreated RBCs during 36-day storage. RESULTS UVC treatment of RBCs in the PAGGS-C additive solution did not alter RBC antigen expression, but significantly influenced some in vitro parameters. Compared to controls, hemolysis was higher in UVC-treated RBC units, but was still below 0.8% at 36 days of storage. Extracellular potassium increased early after PI treatment and reached ≤70 mmol/L by the end of storage. UVC-treated RBC units had higher glucose and 2,3-diphosphoglycerate levels than controls. CONCLUSION As UVC irradiation efficiently reduces the infectivity of relevant bacteria and viruses while maintaining the quality of RBCs, the proposed method offers a new approach for PI of RBC concentrates.
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Affiliation(s)
- Wiebke Handke
- Bavarian Red Cross Blood Service, Nuremberg, Germany
| | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | | | | | | | - Axel Seltsam
- Bavarian Red Cross Blood Service, Nuremberg, Germany
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8
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Cloutier M, De Korte D. Residual risks of bacterial contamination for
pathogen‐reduced
platelet components. Vox Sang 2022; 117:879-886. [DOI: 10.1111/vox.13272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/22/2021] [Accepted: 02/10/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Marc Cloutier
- Medical Affairs and Innovation Héma‐Québec Québec Canada
- Biochemistry, Microbiology and Bio‐informatics Université Laval Québec Canada
| | - Dirk De Korte
- Blood Cell Research Sanquin Research Amsterdam The Netherlands
- Product and Process Development Sanquin Blood Bank Amsterdam The Netherlands
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9
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Li M, Irsch J, Corash L, Benjamin RJ. Is pathogen reduction an acceptable alternative to irradiation for risk mitigation of transfusion-associated graft versus host disease? Transfus Apher Sci 2022; 61:103404. [DOI: 10.1016/j.transci.2022.103404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Enwemeka CS, Bumah VV, Castel JC, Suess SL. Pulsed blue light, saliva and curcumin significantly inactivate human coronavirus. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2022; 227:112378. [PMID: 35085988 PMCID: PMC8713422 DOI: 10.1016/j.jphotobiol.2021.112378] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/06/2021] [Accepted: 12/23/2021] [Indexed: 12/19/2022]
Abstract
In a recent study, we showed that pulsed blue light (PBL) inactivates as much as 52.3% of human beta coronavirus HCoV-OC43, a surrogate of SARS-CoV-2, and one of the major strains of viruses responsible for the annual epidemic of the common cold. Since curcumin and saliva are similarly antiviral and curcumin acts as blue light photosensitizer, we used Qubit fluorometry and WarmStart RT-LAMP assays to study the effect of combining 405 nm, 410 nm, 425 nm or 450 nm wavelengths of PBL with curcumin, saliva or a combination of curcumin and saliva against human beta coronavirus HCoV-OC43. The results showed that PBL, curcumin and saliva independently and collectively inactivate HCoV-OC43. Without saliva or curcumin supplementation 21.6 J/cm2 PBL reduced HCoV-OC43 RNA concentration a maximum of 32.8% (log10 = 2.13). Saliva supplementation alone inactivated the virus, reducing its RNA concentration by 61% (log10 = 2.23); with irradiation the reduction was as much as 79.1%. Curcumin supplementation alone decreased viral RNA 71.1%, and a maximum of 87.8% with irradiation. The combination of saliva and curcumin reduced viral RNA to 83.1% and decreased the RNA up to 90.2% with irradiation. The reduced levels could not be detected with qPCR. These findings show that PBL in the range of 405 nm to 450 nm wavelength is antiviral against human coronavirus HCoV-OC43, a surrogate of the COVID-19 virus. Further, it shows that with curcumin as a photosensitizer, it is possible to photodynamically inactivate the virus beyond qPCR detectable level using PBL. Since HCoV-OC43 is of the same beta coronavirus family as SARS-CoV-2, has the same genomic size, and is often used as its surrogate, these findings heighten the prospect of similarly inactivating novel coronavirus SARS-CoV-2, the virus responsible for COVID-19 pandemic.
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Affiliation(s)
- Chukuka S Enwemeka
- College of Health and Human Services, San Diego State University, San Diego, CA, USA; James Hope University, Lagos, Nigeria; Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.
| | - Violet V Bumah
- College of Health and Human Services, San Diego State University, San Diego, CA, USA; Department of Chemistry and Biochemistry, College of Sciences, San Diego State University, San Diego, CA, USA
| | | | - Samantha L Suess
- Department of Biology, College of Sciences, San Diego State University, San Diego, CA, USA
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11
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Stewart CF, Tomb RM, Ralston HJ, Armstrong J, Anderson JG, MacGregor SJ, Atreya CD, Maclean M. Violet-blue 405-nm Light-based Photoinactivation for Pathogen Reduction of Human Plasma Provides Broad Antibacterial Efficacy Without Visible Degradation of Plasma Proteins. Photochem Photobiol 2021; 98:504-512. [PMID: 34935147 DOI: 10.1111/php.13584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/15/2021] [Indexed: 11/28/2022]
Abstract
In transfusion medicine, bacterial contamination can occur in ex vivo stored blood plasma, and there are continued efforts to improve blood safety and reduce the risk of transfusion-transmitted infections. Visible 405-nm violet-blue light has demonstrated potential for in situ pathogen reduction in ex vivo stored plasma and platelet concentrates. This study investigates the broad-spectrum antibacterial efficacy and compatibility potential of 405-nm light for treatment of blood plasma. Human plasma seeded with bacteria at a range of densities (101 -103 , 104 -106 , 107 -108 CFU mL-1 ) was exposed to 360 J cm-2 405-nm light (1 h at 0.1 W cm-2 ), with this fixed dose selected based on the initial analysis of inactivation kinetics. One-dimensional protein mobility analysis and measurement of advanced oxidation protein products (AOPP) was conducted to evaluate compatibility of the antimicrobial dose with plasma proteins and, identify upper levels at which protein degradation can be detected. Broad-spectrum antibacterial efficacy was observed with a fixed treatment of 360 J cm-2 , with 98.9-100% inactivation achieved across all seeding densities for all organisms, except E. coli, which achieved 95.1-100% inactivation. At this dose (360 J cm-2 ), no signs of protein degradation occurred. Overall, 405-nm light shows promise for broad-spectrum bacterial inactivation in blood plasma, while preserving plasma protein integrity.
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Affiliation(s)
- Caitlin F Stewart
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Rachael M Tomb
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Heather J Ralston
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Jack Armstrong
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - John G Anderson
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Scott J MacGregor
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Chintamani D Atreya
- Office of Blood Research and Review, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration, Silver Spring, MD
| | - Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK.,Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
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12
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Escolar G, Diaz-Ricart M, McCullough J. Impact of different pathogen reduction technologies on the biochemistry, function, and clinical effectiveness of platelet concentrates: An updated view during a pandemic. Transfusion 2021; 62:227-246. [PMID: 34870335 PMCID: PMC9300014 DOI: 10.1111/trf.16747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/03/2021] [Accepted: 10/06/2021] [Indexed: 12/25/2022]
Abstract
Standard platelet concentrates (PCs) stored at 22°C have a limited shelf life of 5 days. Because of the storage temperature, bacterial contamination of PCs can result in life‐threatening infections in transfused patients. The potential of blood components to cause infections through contaminating pathogens or transmitting blood‐borne diseases has always been a concern. The current safety practice to prevent pathogen transmission through blood transfusion starts with a stringent screening of donors and regulated testing of blood samples to ensure that known infections cannot reach transfusion products. Pathogen reduction technologies (PRTs), initially implemented to ensure the safety of plasma products, have been adapted to treat platelet products. In addition to reducing bacterial contamination, PRT applied to PCs can extend their shelf life up to 7 days, alleviating the impact of their shortage, while providing an additional safety layer against emerging blood‐borne infectious diseases. While a deleterious action of PRTs in quantitative and qualitative aspects of plasma is accepted, the impact of PRTs on the quality, function, and clinical efficacy of PCs has been under constant examination. The potential of PRTs to prevent the possibility of new emerging diseases to reach cellular blood components has been considered more hypothetical than real. In 2019, a coronavirus‐related disease (COVID‐19) became a pandemic. This episode should help when reconsidering the possibility of future blood transmissible threats. The following text intends to evaluate the impact of different PRTs on the quality, function, and clinical effectiveness of platelets within the perspective of a developing pandemic.
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Affiliation(s)
- Gines Escolar
- Department of Hematopathology, Centre Diagnostic Biomedic, Hospital Clinic, Barcelona, Spain
| | - Maribel Diaz-Ricart
- Department of Hematopathology, Centre Diagnostic Biomedic, Hospital Clinic, Barcelona, Spain
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13
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Liu H, Wang X. Pathogen reduction technology for blood component: A promising solution for prevention of emerging infectious disease and bacterial contamination in blood transfusion services. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2021. [DOI: 10.1016/j.jpap.2021.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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14
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The role of UV and blue light in photo-eradication of microorganisms. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2021. [DOI: 10.1016/j.jpap.2021.100064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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15
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Wilson-Nieuwenhuis J, El-Mohtadi M, Edwards K, Whitehead K, Dempsey-Hibbert N. Factors Involved in the onset of infection following bacterially contaminated platelet transfusions. Platelets 2021; 32:909-918. [PMID: 32762589 DOI: 10.1080/09537104.2020.1803253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Transfusion of platelet concentrates (PCs) is associated with several adverse patient reactions, the most common of which are febrile non-hemolytic transfusion reactions (FNHTRs) and transfusion-associated bacterial-infection/transfusion-associated sepsis (T-ABI/TA-S). Diagnosis of T-ABI/T-AS requires a positive blood culture (BC) result from the transfusion recipient and also a positive identification of bacterial contamination within a test aliquot of the transfused PC. In a significant number of cases, clinical symptoms post-transfusion are reported by the clinician, yet the BCs from the patient and/or PC are negative. The topic of 'missed bacterial detection' has therefore been the focus of several primary research studies and review articles, suggesting that biofilm formation in the blood bag and the presence of viable but non-culturable (VBNC) pathogens are the major causes of this missed detection. However, platelets are emerging as key players in early host responses to infection and as such, the aforementioned biofilm formation could elicit 'platelet priming', which could lead to significant immunological reactions in the host, in the absence of planktonic bacteria in the host bloodstream. This review reflects on what is known about missed detection and relates this to the emerging understanding of the effect of bacterial contamination on the platelets themselves and the significant role played by platelets in exacerbation of an immune response to infection within the transfusion setting.
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Affiliation(s)
| | - Mohamed El-Mohtadi
- Centre for Bioscience, Manchester Metropolitan University, Manchester, UK
| | - Kurtis Edwards
- Centre for Bioscience, Manchester Metropolitan University, Manchester, UK
| | - Kathryn Whitehead
- Centre for Bioscience, Manchester Metropolitan University, Manchester, UK
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16
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Hayashi T, Oguma K, Fujimura Y, Furuta RA, Tanaka M, Masaki M, Shinbata Y, Kimura T, Tani Y, Hirayama F, Takihara Y, Takahashi K. UV light-emitting diode (UV-LED) at 265 nm as a potential light source for disinfecting human platelet concentrates. PLoS One 2021; 16:e0251650. [PMID: 34014978 PMCID: PMC8136854 DOI: 10.1371/journal.pone.0251650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/30/2021] [Indexed: 12/20/2022] Open
Abstract
The risk of sepsis through bacterial transmission is one of the most serious problems in platelet transfusion. In processing platelet concentrates (PCs), several methods have been put into practice to minimize the risk of bacterial transmission, such as stringent monitoring by cultivation assays and inactivation treatment by photoirradiation with or without chemical agents. As another potential option, we applied a light-emitting diode (LED) with a peak emission wavelength of 265 nm, which has been shown to be effective for water, to disinfect PCs. In a bench-scale UV-LED exposure setup, a 10-min irradiation, corresponding to an average fluence of 9.2 mJ/cm2, resulted in >2.0 log, 1.0 log, and 0.6 log inactivation (mean, n = 6) of Escherichia coli, Staphylococcus aureus, and Bacillus cereus, respectively, in non-diluted plasma PCs. After a 30-min exposure, platelet counts decreased slightly (18 ± 7%: mean ± SD, n = 7); however, platelet surface expressions of CD42b, CD61, CD62P, and PAC-1 binding did not change significantly (P>0.005), and agonist-induced aggregation and adhesion/aggregation under flow conditions were well maintained. Our findings indicated that the 265 nm UV-LED has high potential as a novel disinfection method to ensure the microbial safety of platelet transfusion.
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Affiliation(s)
- Tomoya Hayashi
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
- * E-mail:
| | | | | | - Rika A. Furuta
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan
| | - Mitsunobu Tanaka
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
| | - Mikako Masaki
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
| | | | - Takafumi Kimura
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
| | - Yoshihiko Tani
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan
| | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
| | | | - Koki Takahashi
- Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
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17
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Brixner V, Bug G, Pohler P, Krämer D, Metzner B, Voss A, Casper J, Ritter U, Klein S, Alakel N, Peceny R, Derigs HG, Stegelmann F, Wolf M, Schrezenmeier H, Thiele T, Seifried E, Kapels HH, Döscher A, Petershofen EK, Müller TH, Seltsam A. Efficacy of UVC-treated, pathogen-reduced platelets versus untreated platelets: a randomized controlled non-inferiority trial. Haematologica 2021; 106:1086-1096. [PMID: 33538149 PMCID: PMC8018132 DOI: 10.3324/haematol.2020.260430] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Indexed: 12/13/2022] Open
Abstract
Pathogen reduction (PR) technologies for blood components have been established to reduce the residual risk of known and emerging infectious agents. THERAFLEX UV-Platelets, a novel ultraviolet C (UVC) light-based PR technology for platelet concentrates, works without photoactive substances. This randomized, controlled, double-blind, multicenter, non-inferiority trial was designed to compare the efficacy and safety of UVC-treated platelets to that of untreated platelets in thrombocytopenic patients with hematologic-oncologic diseases. The primary objective was to determine non-inferiority of UVC-treated platelets, assessed by the 1-hour corrected count increment (CCI) in up to eight per-protocol platelet transfusion episodes. Analysis of the 171 eligible patients showed that the defined non-inferiority margin of 30% of UVC-treated platelets was narrowly missed as the mean differences in 1-hour CCI between standard platelets versus UVC-treated platelets for intention-to-treat and per-protocol analyses were 18.2% (95% Confidence Interval [CI]: 6.4-30.1) and 18.7% (95% CI: 6.3-31.1), respectively. In comparison to the control, the UVC group had a 19.2% lower mean 24-hour CCI and was treated with an about 25% higher number of platelet units, but the average number of days to the next platelet transfusion did not differ significantly between both treatment groups. The frequency of low-grade adverse events was slightly higher in the UVC group and the frequencies of refractoriness to platelet transfusion, platelet alloimmunization, severe bleeding events, and red blood cell transfusions were comparable between groups. Our study suggests that transfusion of pathogen-reduced platelets produced with the UVC technology is safe but non-inferiority was not demonstrated. (clinicaltrials gov. Identifier: DRKS00011156).
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Affiliation(s)
- Veronika Brixner
- German Red Cross Blood Transfusion Service and Goethe University Clinics, Frankfurt/Main
| | - Gesine Bug
- Department of Hematology and Oncology, University Hospital Frankfurt, Goethe University, Frankfurt/Main
| | | | - Doris Krämer
- Department of Oncology and Hematology, University Hospital, Oldenburg
| | - Bernd Metzner
- Department of Oncology and Hematology, University Hospital, Oldenburg
| | - Andreas Voss
- Department of Oncology and Hematology, University Hospital, Oldenburg
| | - Jochen Casper
- Department of Oncology and Hematology, University Hospital, Oldenburg
| | - Ulrich Ritter
- Department of Hematology and Oncology, Municipal Hospital Bremen, Bremen
| | - Stefan Klein
- Department of Hematology and Oncology, University Hospital, Mannheim
| | - Nael Alakel
- Medical Clinic I, Department of Hematology and Oncology, University Hospital, Carl Gustav Carus Faculty of Medicine, Dresden
| | - Rudolf Peceny
- Department of Hematology and Oncology, Municipal Hospital, Osnabrück
| | - Hans G Derigs
- Department of Hematology and Oncology, Municipal Hospital Frankfurt-Hoechst, Frankfurt/Main
| | | | - Martin Wolf
- Department of Hematology and Oncology, Municipal Hospital, Kassel
| | - Hubert Schrezenmeier
- Institute for Transfusion Medicine, University Hospital Ulm, Ulm, Germany; and Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessia, Ulm
| | - Thomas Thiele
- Institute for Immunology and Transfusion Medicine, University Medicine, Greifswald
| | - Erhard Seifried
- German Red Cross Blood Transfusion Service and Goethe University Clinics, Frankfurt/Main
| | | | | | | | | | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany; Bavarian Red Cross Blood Service, Nuremberg.
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18
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McDonald CP, Bearne J, Aplin K, Sawicka D. Assessing the inactivation capabilities of two commercially available platelet component pathogen inactivation systems: effectiveness at end of shelf life. Vox Sang 2021; 116:416-424. [PMID: 33616238 DOI: 10.1111/vox.13040] [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: 08/04/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES The inactivation capabilities of the two current commercially available pathogen inactivation (PI) systems for platelet components (PC), Mirasol and Intercept, were investigated by determination of the absence of viable bacteria at the end of shelf life by testing the entire contents of the PC by enrichment culture (terminal sterility). METHODS A pool-and-split method was used, with two treated units and one untreated control per inoculum concentration. Pairs of PC bags were inoculated with a single bacterial species. Three concentrations (n = 2 per concentration), which incremented tenfold, were tested initially based on published data from the manufacturer. Dependent on these results, the concentrations subsequently tested were either increased or decreased until the inactivation capability of the system was derived. Bacterial count was determined post-spiking, immediately prior to treatment (2 h from spiking), immediately after treatment and at the end of shelf life (day seven). Enrichment culture was performed immediately prior to treatment, after treatment and at the end of shelf life. RESULTS The inactivation capabilities, in CFU/ml, of Intercept and Mirasol, respectively, at the end of PC shelf life were as follows: Staphylococcus aureus ≥ 107 , <101 ; Staphylococcus epidermidis ≥106 , <102 ; Klebsiella pneumoniae 105 , <101 ; Streptococcus bovis ≥107 , 101 , Escherichia coli ≥106 , <101 ; Streptococcus pneumoniae ≥106 , 103 ; Streptococcus mitis ≥107 , 101 ; Listeria monocytogenes ≥107 , 101 ; Streptococcus dysgalactiae ≥107 , <101 ; Serratia marcescens 103 , <101 ; Pseudomonas aeruginosa 103 , Mirasol not tested; and Bacillus cereus < 102 , Mirasol not tested. CONCLUSION The inactivation capability of Intercept was greater than that of Mirasol. Inactivation capability (by terminal sterility) is the most meaningful measure to evaluate a PI system for bacteria, rather than logarithmic reduction assessed immediately after treatment by plate count. PI offers a possible alternative to bacterial screening if treatment is performed at an appropriate time dependent on the inactivation capabilities of the system.
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Affiliation(s)
- Carl P McDonald
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
| | - Jennifer Bearne
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
| | - Kate Aplin
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
| | - Danuta Sawicka
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
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The Role of Glutamine in the Prevention of Ultraviolet-C-Induced Platelet Activation. Biochem Res Int 2020. [DOI: 10.1155/2020/8853696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives. The primary function of platelets is to prevent bleeding. The use of UV-C light in the treatment of platelets has become a valuable method for preserving the efficacy of platelet concentrates in blood banks. However, its deleterious effect remains, such as the activation of platelets, thus causing the platelets to lose their physiological function. In this study, we intended to demonstrate the impact of UV-C on platelets and how the use of glutamine could mitigate the loss of physiological function of the platelets caused by UV-C. Materials and Methods. This study was conducted using mouse platelets. We assessed calcium signaling using Fura-2 AM incubation and dense granule secretion of the platelets using luminescence assay by measuring ATP. At the molecular level, the activation of integrin using PAC-1 antibody was analyzed. Phosphorylation of immune-precipitated cPLA2 was assessed using a specific antibody. All the experiments were carried out with or without glutamine in the presence of UV-C. Positive and negative controls were used in all experiments to validate the findings. Results. We have demonstrated that physiological and biochemical damage arises as a result of the exposure of platelet concentrate to UV-C and that the use of glutamine could alleviate this damage. Various experiments, thrombus formation, integrin activation, and phosphorylation of cPLA2 were preserved using 50 mM of glutamine in the presence of UV-C, which reduces 50% of platelet viability. Conclusions. Our study demonstrates that the storage of platelet concentrates under the UV-C activates their physiological process and renders them to the thrombus formation, hence decreasing their viability. The presence of a moderate amount of glutamine can alleviate the toxic effect of UV-C, and platelet concentrates could be kept viable for a long time.
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20
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Nicolau-Lapeña I, Abadias M, Viñas I, Bobo G, Lafarga T, Ribas-Agustí A, Aguiló-Aguayo I. Water UV-C treatment alone or in combination with peracetic acid: A technology to maintain safety and quality of strawberries. Int J Food Microbiol 2020; 335:108887. [PMID: 33002710 DOI: 10.1016/j.ijfoodmicro.2020.108887] [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: 03/26/2020] [Revised: 08/18/2020] [Accepted: 09/06/2020] [Indexed: 11/15/2022]
Abstract
Disinfection of fruits is one of the most important steps since they are going to be eaten fresh-or minimally-processed. This step affects quality, safety, and shelf-life of the product. Despite being a common sanitizer in the fruit industry, chlorine may react with organic matter leading to the formation of toxic by-products. Alternative sustainable disinfection strategies to chlorine are under study to minimize environmental and human health impact. Water-assisted UV-C light (WUV-C) is proposed here as an alternative sanitizing method for strawberries. In this study, strawberries were washed for 1 or 5 min in a tank with 2 or 4 lamps on, each emitting UV-C light at 17.2 W/cm2, or in a chlorine solution (200 ppm, pH 6.5). Moreover, trials with 4 lamps on, together with a washing solution consisting on peracetic acid at 40 or 80 ppm, were carried out. Overall, quality and nutritional parameters of strawberries after treatments were maintained. Changes in color were not noticeable and fruits did not lose firmness. No major changes were observed in antioxidant activity, organic acid, anthocyanin, vitamin C, and total phenolic content. Yeasts and molds were not affected by the WUV-C treatment, and 5 min were needed to significantly reduce total aerobic mesophylls population. However, reductions of artificially inoculated Listeria innocua and Salmonella Typhimurium after WUV-C treatments were comparable to those obtained with chlorine-wash, which were 3.0 log CFU / g. Moreover, WUV-C light was effective to minimize microorganisms remaining in washing water, avoiding cross-contamination and thus, allowing water recirculation. This effect was improved when combining the action of UV-C light with peracetic acid, showing the suitability of this combined treatment, understood as an alternative to chlorine sanitation, for sanitizing strawberries and keeping the populations of pathogenic bacteria in washing water lower than 0.6 ± 0.1 log CFU / mL.
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Affiliation(s)
- Iolanda Nicolau-Lapeña
- Food Technology Department, University of Lleida, Agrotecnio Center, Rovira Roure 191, 25198 Lleida, Catalonia, Spain
| | - Maribel Abadias
- IIRTA, Postharvest Programme, Edifici Fruitcentre, Parc Científic i Tecnològic Agroalimentari de Lleida, Parc de Gardeny, 25003 Lleida, Catalonia, Spain
| | - Inmaculada Viñas
- Food Technology Department, University of Lleida, Agrotecnio Center, Rovira Roure 191, 25198 Lleida, Catalonia, Spain.
| | - Gloria Bobo
- IIRTA, Postharvest Programme, Edifici Fruitcentre, Parc Científic i Tecnològic Agroalimentari de Lleida, Parc de Gardeny, 25003 Lleida, Catalonia, Spain
| | - Tomás Lafarga
- IIRTA, Postharvest Programme, Edifici Fruitcentre, Parc Científic i Tecnològic Agroalimentari de Lleida, Parc de Gardeny, 25003 Lleida, Catalonia, Spain
| | | | - Ingrid Aguiló-Aguayo
- IIRTA, Postharvest Programme, Edifici Fruitcentre, Parc Científic i Tecnològic Agroalimentari de Lleida, Parc de Gardeny, 25003 Lleida, Catalonia, Spain..
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21
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Hadi J, Dunowska M, Wu S, Brightwell G. Control Measures for SARS-CoV-2: A Review on Light-Based Inactivation of Single-Stranded RNA Viruses. Pathogens 2020; 9:E737. [PMID: 32911671 PMCID: PMC7558314 DOI: 10.3390/pathogens9090737] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 12/20/2022] Open
Abstract
SARS-CoV-2 is a single-stranded RNA virus classified in the family Coronaviridae. In this review, we summarize the literature on light-based (UV, blue, and red lights) sanitization methods for the inactivation of ssRNA viruses in different matrixes (air, liquid, and solid). The rate of inactivation of ssRNA viruses in liquid was higher than in air, whereas inactivation on solid surfaces varied with the type of surface. The efficacy of light-based inactivation was reduced by the presence of absorptive materials. Several technologies can be used to deliver light, including mercury lamp (conventional UV), excimer lamp (UV), pulsed-light, and light-emitting diode (LED). Pulsed-light technologies could inactivate viruses more quickly than conventional UV-C lamps. Large-scale use of germicidal LED is dependent on future improvements in their energy efficiency. Blue light possesses virucidal potential in the presence of exogenous photosensitizers, although femtosecond laser (ultrashort pulses) can be used to circumvent the need for photosensitizers. Red light can be combined with methylene blue for application in medical settings, especially for sanitization of blood products. Future modelling studies are required to establish clearer parameters for assessing susceptibility of viruses to light-based inactivation. There is considerable scope for improvement in the current germicidal light-based technologies and practices.
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Affiliation(s)
- Joshua Hadi
- AgResearch Ltd., Hopkirk Research Institute, Cnr University Ave and Library Road, Massey University, Palmerston North 4442, New Zealand; (J.H.); (S.W.)
| | - Magdalena Dunowska
- School of Veterinary Science, Massey University Manawatu (Turitea) Tennent Drive, Palmerston North 4474, New Zealand;
| | - Shuyan Wu
- AgResearch Ltd., Hopkirk Research Institute, Cnr University Ave and Library Road, Massey University, Palmerston North 4442, New Zealand; (J.H.); (S.W.)
| | - Gale Brightwell
- AgResearch Ltd., Hopkirk Research Institute, Cnr University Ave and Library Road, Massey University, Palmerston North 4442, New Zealand; (J.H.); (S.W.)
- New Zealand Food Safety Science and Research Centre, Massey University Manawatu (Turitea) Tennent Drive, Palmerston North 4474, New Zealand
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22
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Derraik JGB, Anderson WA, Connelly EA, Anderson YC. Rapid Review of SARS-CoV-1 and SARS-CoV-2 Viability, Susceptibility to Treatment, and the Disinfection and Reuse of PPE, Particularly Filtering Facepiece Respirators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6117. [PMID: 32842655 PMCID: PMC7504573 DOI: 10.3390/ijerph17176117] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/12/2020] [Accepted: 08/18/2020] [Indexed: 01/22/2023]
Abstract
In the COVID-19 pandemic caused by SARS-CoV-2, hospitals are often stretched beyond capacity. There are widespread reports of dwindling supplies of personal protective equipment (PPE), particularly N95-type filtering facepiece respirators (FFRs), which are paramount to protect frontline medical/nursing staff, and to minimize further spread of the virus. We carried out a rapid review to summarize the existing literature on the viability of SARS-CoV-2, the efficacy of key potential disinfection procedures against the virus (specifically ultraviolet light and heat), and the impact of these procedures on FFR performance, material integrity, and/or fit. In light of the recent discovery of SARS-CoV-2 and limited associated research, our review also focused on the closely related SARS-CoV-1. We propose a possible whole-of-PPE disinfection solution for potential reuse that could be rapidly instituted in many health care settings, without significant investments in equipment.
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Affiliation(s)
- José G. B. Derraik
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland 1023, New Zealand;
- Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, Taranaki 4310, New Zealand
- Department of Women’s and Children’s Health, Uppsala University, 751 85 Uppsala, Sweden
| | - William A. Anderson
- Department of Chemical Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Elizabeth A. Connelly
- Dermatology, Department of Medicine, Taranaki District Health Board, New Plymouth 4310, New Zealand;
| | - Yvonne C. Anderson
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland 1023, New Zealand;
- Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, Taranaki 4310, New Zealand
- Department of Paediatrics, Taranaki District Health Board, New Plymouth 4310, New Zealand
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23
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Voglau U, Müller TH, Seltsam A, Gravemann U, Handke W, Doescher A. Digital droplet polymerase chain reaction to monitor ultraviolet C treatment of single-donor and buffy coat platelet units. Transfusion 2020; 60:1821-1827. [PMID: 32537745 DOI: 10.1111/trf.15904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND UVC illumination of agitated platelet concentrates (PCs) inactivates pathogens and white blood cells by modifications of their nucleic acids. Related effects on mitochondrial DNA (mtDNA) in platelets serve as a basis for an efficient monitoring suited for routine quality control (QC) of this purely physical pathogen reduction technology. STUDY DESIGN AND METHODS Samples from PCs (n = 530) were tested with an established LightCycler PCR (LC PCR) for QC of the UVC procedure. RNR2 and TRNK/ATP8 genes were sequenced in the PCs (n = 21) with out-of-specification results in the LC PCR. A digital droplet PCR (ddPCR) was developed to minimize the outliers and cross-validated by testing the 530 PCs. The ddPCR was further evaluated in a subgroup of 300 PCs without mtDNA extraction and in samples from systematic variations of UVC dose and agitation speed. RESULTS Apheresis PCs (n = 380) resulted in 5.3% outliers in LC PCR versus only 0.7% in buffy coat pool PCs (n = 150). Sequencing of these outliers revealed single-nucleotide polymorphisms in the primer- and probe-binding sites of LC PCR. The development of a ddPCR assay with modified probe sequences reduced the outliers to 0.4%. The ddPCR analysis of PCs both with and without mtDNA extraction demonstrated low intra- and interassay variabilities and congruent results also compared to LC PCR. Experiments varying the UVC dose and the agitation speed demonstrated that the ddPCR results closely reflect functional effects of the UVC treatment. CONCLUSION The ddPCR assay offers a valid and reliable tool for QC of routine production of the UVC-treated PCs as well as for monitoring treatment conditions during optimization of the UVC procedure.
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Affiliation(s)
- Uta Voglau
- DRK-Blutspendedienst NSTOB, Institut Bremen-Oldenburg, Oldenburg, Germany
| | - Thomas H Müller
- DRK-Blutspendedienst NSTOB, Institut Springe, Springe, Germany
| | - Axel Seltsam
- DRK-Blutspendedienst NSTOB, Institut Springe, Springe, Germany
| | - Ute Gravemann
- DRK-Blutspendedienst NSTOB, Institut Springe, Springe, Germany
| | - Wiebke Handke
- DRK-Blutspendedienst NSTOB, Institut Springe, Springe, Germany
| | - Andrea Doescher
- DRK-Blutspendedienst NSTOB, Institut Bremen-Oldenburg, Oldenburg, Germany
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24
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Praditya D, Friesland M, Gravemann U, Handke W, Todt D, Behrendt P, Müller TH, Steinmann E, Seltsam A. Hepatitis E virus is effectively inactivated in platelet concentrates by ultraviolet C light. Vox Sang 2020; 115:555-561. [PMID: 32383163 DOI: 10.1111/vox.12936] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/28/2020] [Accepted: 04/15/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES As previous investigations have shown, THERAFLEX UV-Platelets, a UVC-based pathogen inactivation (PI) system, is effective against non-enveloped transfusion-relevant viruses such as hepatitis A virus (HAV), which are insensitive to most PI treatments for blood products. This study investigated the PI efficacy of THERAFLEX UV-Platelets against HEV in platelet concentrates (PCs). MATERIALS AND METHODS Buffy coat-derived PCs in additive solution were spiked with cell culture-derived HEV and treated with the THERAFLEX UV-Platelets system using various doses of UVC (0·05, 0·10, 0·15 and 0·20 (standard) J/cm2 ). Titres of infectious virus in pre- and post-treatment samples were determined using a large-volume plating assay to improve the detection limit of the virus assay. RESULTS THERAFLEX UV-Platelets dose-dependently inactivated HEV in PCs. The standard UVC dose inactivated the virus to below the limit of detection, corresponding to a mean log reduction of greater than 3·5. CONCLUSION Our study demonstrates that the THERAFLEX UV-Platelets system effectively inactivates HEV in PCs.
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Affiliation(s)
- Dimas Praditya
- Department of Molecular and Medical Virology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany.,Research Center for Biotechnology, Indonesian Institute of Science, Cibinong, Indonesia
| | - Martina Friesland
- Institute of Experimental Virology, Twincore Centre for Experimental and Clinical Infection Research, A Joint Venture Between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Hannover, Germany
| | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Wiebke Handke
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Daniel Todt
- Department of Molecular and Medical Virology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Patrick Behrendt
- Institute of Experimental Virology, Twincore Centre for Experimental and Clinical Infection Research, A Joint Venture Between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Hannover, Germany.,Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hanover, Germany.,German Centre for Infection Research, Hannover-Braunschweig, Germany
| | | | - Eike Steinmann
- Department of Molecular and Medical Virology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
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25
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New strategies for the control of infectious and parasitic diseases in blood donors: the impact of pathogen inactivation methods. EUROBIOTECH JOURNAL 2020. [DOI: 10.2478/ebtj-2020-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Around 70 infectious agents are possible threats for blood safety.
The risk for blood recipients is increasing because of new emergent agents like West Nile, Zika and Chikungunya viruses, or parasites such as Plasmodium and Trypanosoma cruzi in non-endemic regions, for instance.
Screening programmes of the donors are more and more implemented in several Countries, but these cannot prevent completely infections, especially when they are caused by new agents.
Pathogen inactivation (PI) methods might overcome the limits of the screening and different technologies have been set up in the last years.
This review aims to describe the most widely used methods focusing on their efficacy as well as on the preservation integrity of blood components.
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Maclean M, Gelderman MP, Kulkarni S, Tomb RM, Stewart CF, Anderson JG, MacGregor SJ, Atreya CD. Non-ionizing 405 nm Light as a Potential Bactericidal Technology for Platelet Safety: Evaluation of in vitro Bacterial Inactivation and in vivo Platelet Recovery in Severe Combined Immunodeficient Mice. Front Med (Lausanne) 2020; 6:331. [PMID: 32010702 PMCID: PMC6974518 DOI: 10.3389/fmed.2019.00331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/20/2019] [Indexed: 01/18/2023] Open
Abstract
Bacterial contamination of ex vivo stored platelets is a cause of transfusion-transmitted infection. Violet-blue 405 nm light has recently demonstrated efficacy in reducing the bacterial burden in blood plasma, and its operational benefits such as non-ionizing nature, penetrability, and non-requirement for photosensitizing agents, provide a unique opportunity to develop this treatment for in situ treatment of ex vivo stored platelets as a tool for bacterial reduction. Sealed bags of platelet concentrates, seeded with low-level Staphylococcus aureus contamination, were 405 nm light-treated (3–10 mWcm−2) up to 8 h. Antimicrobial efficacy and dose efficiency was evaluated by quantification of the post-treatment surviving bacterial contamination levels. Platelets treated with 10 mWcm−2 for 8 h were further evaluated for survival and recovery in severe combined immunodeficient (SCID) mice. Significant inactivation of bacteria in platelet concentrates was achieved using all irradiance levels, with 99.6–100% inactivation achieved by 8 h (P < 0.05). Analysis of applied dose demonstrated that lower irradiance levels generally resulted in significant decontamination at lower doses: 180 Jcm−2/10 mWcm−2 (P = 0.008) compared to 43.2 Jcm−2/3 mWcm−2 (P = 0.002). Additionally, the recovery of light-treated platelets, compared to non-treated platelets, in the murine model showed no significant differences (P = >0.05). This report paves the way for further comprehensive studies to test 405 nm light treatment as a bactericidal technology for stored platelets.
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Affiliation(s)
- Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies, Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, United Kingdom.,Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Monique P Gelderman
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Sandhya Kulkarni
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Rachael M Tomb
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies, Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Caitlin F Stewart
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies, Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - John G Anderson
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies, Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Scott J MacGregor
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies, Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Chintamani D Atreya
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
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Eickmann M, Gravemann U, Handke W, Tolksdorf F, Reichenberg S, Müller TH, Seltsam A. Inactivation of three emerging viruses - severe acute respiratory syndrome coronavirus, Crimean-Congo haemorrhagic fever virus and Nipah virus - in platelet concentrates by ultraviolet C light and in plasma by methylene blue plus visible light. Vox Sang 2020; 115:146-151. [PMID: 31930543 PMCID: PMC7169309 DOI: 10.1111/vox.12888] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 01/01/2023]
Abstract
Background Emerging viruses like severe acute respiratory syndrome coronavirus (SARS‐CoV), Crimean–Congo haemorrhagic fever virus (CCHFV) and Nipah virus (NiV) have been identified to pose a potential threat to transfusion safety. In this study, the ability of the THERAFLEX UV‐Platelets and THERAFLEX MB‐Plasma pathogen inactivation systems to inactivate these viruses in platelet concentrates and plasma, respectively, was investigated. Materials and methods Blood products were spiked with SARS‐CoV, CCHFV or NiV, and then treated with increasing doses of UVC light (THERAFLEX UV‐Platelets) or with methylene blue (MB) plus increasing doses of visible light (MB/light; THERAFLEX MB‐Plasma). Samples were taken before and after treatment with each illumination dose and tested for residual infectivity. Results Treatment with half to three‐fourths of the full UVC dose (0·2 J/cm2) reduced the infectivity of SARS‐CoV (≥3·4 log), CCHFV (≥2·2 log) and NiV (≥4·3 log) to the limit of detection (LOD) in platelet concentrates, and treatment with MB and a fourth of the full light dose (120 J/cm2) decreased that of SARS‐CoV (≥3·1 log), CCHFV (≥3·2 log) and NiV (≥2·7 log) to the LOD in plasma. Conclusion Our study demonstrates that both THERAFLEX UV‐Platelets (UVC) and THERAFLEX MB‐Plasma (MB/light) effectively reduce the infectivity of SARS‐CoV, CCHFV and NiV in platelet concentrates and plasma, respectively.
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Affiliation(s)
- Markus Eickmann
- Institute for Virology, Philipps University Marburg, Marburg, Germany
| | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Wiebke Handke
- German Red Cross Blood Service NSTOB, Springe, Germany
| | | | | | | | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
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Zhang Q, Wu C, Fan Y, Xu T, Meng Q, Wang S, Liu Q, Yao C, Jiang T. Nucleic acid-targeted pathogen reduction technique in red blood cells by UV-generated oxygen radicals for optimising recipient safety. Transfus Med 2019; 30:51-60. [PMID: 31823441 DOI: 10.1111/tme.12654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 10/17/2019] [Accepted: 11/25/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVES A novel pathogen reduction technique based on vacuum ultraviolet (VUV) irradiation was developed to reduce pathogen numbers in red blood cell (RBC) components. BACKGROUND Contaminated blood components pose a great risk of infection in blood recipients. The continuous development of blood screening techniques and pathogen inactivating systems has significantly reduced this risk, but many limitations remain. METHODS Escherichia coli and Bacillus cereus, and bacteriophage (BP) and Lentivirus (LV) were spiked into suspended red blood cells (sRBCs) or plasma. VUV light with maximum emission at 185 nm and an average dosage of 164 μW/cm2 was placed 5 cm above the targeted products to reduce the pathogen numbers. RESULTS Treatment for 5 minutes was effective; 3 and 10 log reductions of E coli counts were observed in sRBCs and plasma, and 2 and 3 log reductions of B cereus counts were observed in sRBCs and plasma, respectively. The BP titre was reduced by two and five log points in sRBCs and plasma, respectively; the LV titre was reduced by at least three log points in both sRBCs and plasma. VUV-based irradiation of RBCs does not cause significant structural and functional harmful effects. This novel strategy provides moderate photonic energy to generate oxygen radicals from H2 O and O2 and to selectively decrease DNA integrity of the potential pathogens. CONCLUSION The VUV-based pathogen reduction technique is a simple and fast procedure with high pathogen reduction efficacy, low toxicity and limited adverse effects on cellular blood products.
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Affiliation(s)
- Qiang Zhang
- Health Management Center, Chongqing General Hospital, Chongqing, China.,Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chunxi Wu
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yahan Fan
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ting Xu
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qiang Meng
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Shichun Wang
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qi Liu
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chunyan Yao
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tianlun Jiang
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Pathogen reduction of blood components during outbreaks of infectious diseases in the European Union: an expert opinion from the European Centre for Disease Prevention and Control consultation meeting. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 17:433-448. [PMID: 31846608 DOI: 10.2450/2019.0288-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022]
Abstract
Pathogen reduction (PR) of selected blood components is a technology that has been adopted in practice in various ways. Although they offer great advantages in improving the safety of the blood supply, these technologies have limitations which hinder their broader use, e.g. increased costs. In this context, the European Centre for Disease Prevention and Control (ECDC), in co-operation with the Italian National Blood Centre, organised an expert consultation meeting to discuss the potential role of pathogen reduction technologies (PRT) as a blood safety intervention during outbreaks of infectious diseases for which (in most cases) laboratory screening of blood donations is not available. The meeting brought together 26 experts and representatives of national competent authorities for blood from thirteen European Union and European Economic Area (EU/EEA) Member States (MS), Switzerland, the World Health Organization, the European Directorate for the Quality of Medicines and Health Care of the Council of Europe, the US Food and Drug Administration, and the ECDC. During the meeting, the current use of PRTs in the EU/EEA MS and Switzerland was verified, with particular reference to emerging infectious diseases (see Appendix). In this article, we also present expert discussions and a common view on the potential use of PRT as a part of both preparedness and response to threats posed to blood safety by outbreaks of infectious disease.
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Bieback K, Fernandez-Muñoz B, Pati S, Schäfer R. Gaps in the knowledge of human platelet lysate as a cell culture supplement for cell therapy: a joint publication from the AABB and the International Society for Cell & Gene Therapy. Transfusion 2019; 59:3448-3460. [PMID: 31412158 DOI: 10.1111/trf.15483] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Karen Bieback
- Institute for Transfusion Medicine and Immunology, Flowcore Mannheim, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen gGmbH, Mannheim, Germany
| | - Beatriz Fernandez-Muñoz
- Unidad de Producción y Reprogramación Celular (UPRC)/Laboratorio Andaluz de Reprogramación Celular (LARCEL), Sevilla, Spain.,Iniciativa Andaluza de Terapias Avanzadas, Sevilla, Spain.,IBiS, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Shibani Pati
- Blood Systems Research Institute (BSRI), Blood Systems Inc. (BSI), and the University of California at San Francisco, San Francisco, California
| | - Richard Schäfer
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Donor Service Baden-Württemberg-Hessen gGmbH, Goethe University Hospital, Frankfurt, Germany
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Wiehe A, O'Brien JM, Senge MO. Trends and targets in antiviral phototherapy. Photochem Photobiol Sci 2019; 18:2565-2612. [PMID: 31397467 DOI: 10.1039/c9pp00211a] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Photodynamic therapy (PDT) is a well-established treatment option in the treatment of certain cancerous and pre-cancerous lesions. Though best-known for its application in tumor therapy, historically the photodynamic effect was first demonstrated against bacteria at the beginning of the 20th century. Today, in light of spreading antibiotic resistance and the rise of new infections, this photodynamic inactivation (PDI) of microbes, such as bacteria, fungi, and viruses, is gaining considerable attention. This review focuses on the PDI of viruses as an alternative treatment in antiviral therapy, but also as a means of viral decontamination, covering mainly the literature of the last decade. The PDI of viruses shares the general action mechanism of photodynamic applications: the irradiation of a dye with light and the subsequent generation of reactive oxygen species (ROS) which are the effective phototoxic agents damaging virus targets by reacting with viral nucleic acids, lipids and proteins. Interestingly, a light-independent antiviral activity has also been found for some of these dyes. This review covers the compound classes employed in the PDI of viruses and their various areas of use. In the medical area, currently two fields stand out in which the PDI of viruses has found broader application: the purification of blood products and the treatment of human papilloma virus manifestations. However, the PDI of viruses has also found interest in such diverse areas as water and surface decontamination, and biosafety.
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Affiliation(s)
- Arno Wiehe
- biolitec research GmbH, Otto-Schott-Str. 15, 07745 Jena, Germany. and Institut für Chemie und Biochemie, Freie Universität Berlin, Takustr. 3, 14195 Berlin, Germany
| | - Jessica M O'Brien
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
| | - Mathias O Senge
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
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Rebulla P. The long and winding road to pathogen reduction of platelets, red blood cells and whole blood. Br J Haematol 2019; 186:655-667. [PMID: 31304588 DOI: 10.1111/bjh.16093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/22/2019] [Indexed: 02/07/2023]
Abstract
Pathogen reduction technologies (PRTs) have been developed to further reduce the current very low risks of acquiring transfusion-transmitted infections and promptly respond to emerging infectious threats. An entire portfolio of PRTs suitable for all blood components is not available, but the field is steadily progressing. While PRTs for plasma have been used for many years, PRTs for platelets, red blood cells (RBC) and whole blood (WB) were developed more slowly, due to difficulties in preserving cell functions during storage. Two commercial platelet PRTs use ultra violet (UV) A and UVB light in the presence of amotosalen or riboflavin to inactivate pathogens' nucleic acids, while a third experimental PRT uses UVC light only. Two PRTs for WB and RBC have been tested in experimental clinical trials with storage limited to 21 or 35 days, due to unacceptably high RBC storage lesion beyond these time limits. This review summarizes pre-clinical investigations and selected outcomes from clinical trials using the above PRTs. Further studies are warranted to decrease cell storage lesions after PRT treatment and to test PRTs in different medical and surgical conditions. Affordability remains a major administrative obstacle to PRT use, particularly so in geographical regions with higher risks of transfusion-transmissible infections.
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Affiliation(s)
- Paolo Rebulla
- Department of Transfusion Medicine and Haematology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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34
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Slichter SJ, Bailey SL, Gettinger I, Pellham E, Christoffel T, Castro G, Green JM, Stassinopoulos A. Pathogen reduction with amotosalen/UVA reduces platelet refractoriness in a dog platelet transfusion model. Vox Sang 2019; 114:595-604. [PMID: 31297836 DOI: 10.1111/vox.12818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/08/2019] [Accepted: 03/28/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Pathogen reduction of donor platelets with amotosalen/UVA has been shown to effectively inactivate pathogens and also contaminating white blood cells (WBCs). We wanted to determine whether WBC inactivation could also decrease alloimmune refractoriness to donor platelets. MATERIALS AND METHODS Platelets were prepared from a donor dog's whole blood, and the platelets were either transfused without modification [standard (STD) platelets] or treated with amotosalen/UVA under conditions modelling the amotosalen/UVA Blood System for human platelets (APR) using either 4 or 3 J/cm2 of UVA exposure. Platelets were transfused weekly from a single donor dog for 8 weeks or until the recipient dog became refractory to their donor's platelets. Antibody samples were drawn weekly and tested against the donor dog's platelets and WBCs (CD8 and B cells). RESULTS Only 1/7 (14%) dogs that received STD platelets accepted 8 weeks of donor transfusions. Following APR 4 J/cm2 donor transfusions, 3/9 (33%) recipients accepted their donor's transfusions, but only one recipient remained antibody negative. Following APR 3 J/cm2 donor transfusions, the same dose as used for human platelet transfusions, 7/10 (70%) recipients accepted their donor's transfusions, but only two remained antibody negative. CONCLUSION As a very high percentage of recipient dogs (70%) accepted APR 3 J/cm2 donor transfusions, these data suggest that preventing alloimmune platelet refractoriness may be another benefit of pathogen reduction using amotosalen/UVA.
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Affiliation(s)
- Sherrill J Slichter
- Bloodworks Northwest, Seattle, WA, USA.,University of Washington School of Medicine, Seattle, WA, USA
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Bieback K, Fernandez-Muñoz B, Pati S, Schäfer R. Gaps in the knowledge of human platelet lysate as a cell culture supplement for cell therapy: a joint publication from the AABB and the International Society for Cell & Gene Therapy. Cytotherapy 2019; 21:911-924. [PMID: 31307904 DOI: 10.1016/j.jcyt.2019.06.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/14/2022]
Abstract
Fetal bovine serum (FBS) is used as a growth supplement in a wide range of cell culture applications for cell-based research and therapy. However, as a xenogenic product, FBS can potentially transmit prions and adventitious viruses as well as induce undesirable immunologic reactions. In addition, the use of bovine fetuses for FBS production raises concerns as society looks for ways to replace animal testing and reduce the use of animal products for scientific purposes, in particular for the manufacture of clinical products intended for human use. Until chemically defined media are available for these purposes, human platelet lysate (hPL) has been introduced as an attractive alternative for replacing FBS as a cell culture supplement. hPL is a human product that can be produced from outdated platelets avoiding ethical, medical and animal welfare concerns. An increasing number of studies demonstrate that hPL can promote cell growth similarly or even better than FBS in specific cell types. Due to increasing interest in hPL, the AABB and the International Society of Cell Therapy (ISCT) established a joint working group to address its potential. With this article, we aim to present an overview of hPL, identifying the gaps in information on how hPL is produced and tested and the barriers to its translational use in the production of clinical-grade cell therapy products.
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Affiliation(s)
- Karen Bieback
- Institute for Transfusion Medicine and Immunology, Flowcore Mannheim, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen gGmbH, Mannheim, Germany.
| | - Beatriz Fernandez-Muñoz
- Unidad de Producción y Reprogramación Celular (UPRC)/Laboratorio Andaluz de Reprogramación Celular (LARCEL), Sevilla, Spain; Iniciativa Andaluza de Terapias Avanzadas, Sevilla, Spain; IBiS, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Shibani Pati
- Blood Systems Research Institute (BSRI), Blood Systems Inc. (BSI) and University of California San Francisco, San Francisco, California, USA
| | - Richard Schäfer
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Donor Service Baden-Württemberg-Hessen gGmbH, Goethe University Hospital, Frankfurt am Main, Germany.
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36
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Faddy HM, Fryk JJ, Hall RA, Young PR, Reichenberg S, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Marks DC. Inactivation of yellow fever virus in plasma after treatment with methylene blue and visible light and in platelet concentrates following treatment with ultraviolet C light. Transfusion 2019; 59:2223-2227. [PMID: 31050821 DOI: 10.1111/trf.15332] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 03/26/2019] [Accepted: 03/30/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Yellow fever virus (YFV) is endemic to tropical and subtropical areas in South America and Africa, and is currently a major public health threat in Brazil. Transfusion transmission of the yellow fever vaccine virus has been demonstrated, which is indicative of the potential for viral transfusion transmission. An approach to manage the potential YFV transfusion transmission risk is the use of pathogen inactivation (PI) technology systems, such as THERAFLEX MB-Plasma and THERAFLEX UV-Platelets (Macopharma). We aimed to investigate the efficacy of these PI technology systems to inactivate YFV in plasma or platelet concentrates (PCs). STUDY DESIGN AND METHODS YFV spiked plasma units were treated using THERAFLEX MB-Plasma system (visible light doses: 20, 40, 60, and 120 [standard] J/cm2 ) in the presence of methylene blue (approx. 0.8 μmol/L) and spiked PCs were treated using THERAFLEX UV-Platelets system (ultraviolet C doses: 0.05, 0.10, 0.15, and 0.20 [standard] J/cm2 ). Samples were taken before the first and after each illumination dose and tested for residual virus using a modified plaque assay. RESULTS YFV infectivity was reduced by an average of 4.77 log or greater in plasma treated with the THERAFLEX MB-Plasma system and by 4.8 log or greater in PCs treated with THERAFLEX UV-Platelets system. CONCLUSIONS Our study suggests the THERAFLEX MB-Plasma and the THERAFLEX UV-Platelets systems can efficiently inactivate YFV in plasma or PCs to a similar degree as that for other arboviruses. Given the reduction levels observed in this study, these PI technology systems could be an effective option for managing YFV transfusion-transmission risk in plasma and PCs.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul R Young
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
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Prax M, Bekeredjian-Ding I, Krut O. Microbiological Screening of Platelet Concentrates in Europe. Transfus Med Hemother 2019; 46:76-86. [PMID: 31191193 PMCID: PMC6514488 DOI: 10.1159/000499349] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/27/2019] [Indexed: 01/05/2023] Open
Abstract
The risk of transfusion-associated sepsis due to transmission of bacteria is a persistent problem in the transfusion field. Despite numerous interventions to reduce the risk, cases of bacterial sepsis following transfusion are repeatedly being reported. Especially platelet concentrates are highly susceptible to bacterial contaminations due to the growth-promoting storage conditions. In Europe, blood establishments and national authorities have implemented individual precaution measures to mitigate the risk of bacterial transmission. To obtain an overview of the different approaches, we compiled information from national authorities, blood establishments, and the current literature. Several aspects such as the shelf life of platelets, time of sampling and the applied control measures are compared between the member states. The analysis of the data revealed a broad heterogeneity of procedures on a national level ranging from platelet release without any safety testing up to mandatory screening of all platelet concentrates prior to transfusion. Despite the substantial progress made in recent years, several bacterial reports on transfusion-associated sepsis indicate that further efforts are needed to increase the safety of blood transfusions in the long term.
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Affiliation(s)
- Marcel Prax
- Division of Microbiology, Paul Ehrlich Institute, Langen, Germany
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38
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Ramirez‐Arcos S, McDonald C, Deol P, Kreuger AL, Patel N, Pidcoke H, Prax M, Seltsam A, Stassinopoulos A. Bacterial safety of blood components–a congress review of the ISBT transfusion‐transmitted infectious diseases working party, bacterial subgroup. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/voxs.12483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Axel Seltsam
- German Red Cross Blood Service NSTOB Springe Germany
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Blázquez E, Rodríguez C, Ródenas J, Navarro N, Riquelme C, Rosell R, Campbell J, Crenshaw J, Segalés J, Pujols J, Polo J. Evaluation of the effectiveness of the SurePure Turbulator ultraviolet-C irradiation equipment on inactivation of different enveloped and non-enveloped viruses inoculated in commercially collected liquid animal plasma. PLoS One 2019; 14:e0212332. [PMID: 30789926 PMCID: PMC6383881 DOI: 10.1371/journal.pone.0212332] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/31/2019] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to evaluate the effectiveness of the SurePure Turbulator ultraviolet-C (UV-C, 254 nm wavelength) irradiation equipment on inactivation of different enveloped and non-enveloped viruses in commercially collected liquid animal plasma. Specifically, Pseudorabies virus (PRV), Porcine reproductive and respiratory syndrome virus (PRRSV), Porcine epidemic diarrhea virus (PEDV), Bovine viral diarrhea virus (BVDV), Classical swine fever virus (CSFV), Swine influenza virus (SIV) as enveloped viruses and Porcine parvovirus (PPV), Swine vesicular disease virus (SVDV), Porcine circovirus type 2 (PCV-2) and Senecavirus A (SVA) as non-enveloped viruses, were inoculated in bovine or porcine plasma and subjected to different UV-C irradiation doses (0, 750, 1500, 3000, 6000 and 9000 J/L) using an UV-C device developed for opaque liquid working under turbulent flow. The enveloped viruses tested were inactivated at < 3000 J/L of UV-C, being the dose needed to inactivate 4 log TCID50 (4D) of 1612 J/L for PRV,1004 J/L for PRRSV, 1953 J/L for PEDV, 1639 J/L for SIV, 1641 J/L for CSFV and 1943 J/L for BVDV. The non-enveloped viruses tended to have higher 4D values: 2161 J/L for PPV, 3223 J/L for SVA and 3708 J/L for SVDV. Because the initial viral concentration was <4.0 Log for PCV-2, it was not possible to calculate the 4D value for this virus. In conclusion, these results demonstrated that the SurePure Turbulator UV-C treatment system is capable of inactivating significant levels of swine viruses inoculated in commercially collected porcine or bovine plasma. It was concluded that irradiation with UV-C can provide an additional redundant biosafety feature in the manufacturing process of spray-dried animal plasma.
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Affiliation(s)
- Elena Blázquez
- APC EUROPE, S.L.U. Pol. Ind. El Congost, Granollers, Spain
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | | | - Jesús Ródenas
- APC EUROPE, S.L.U. Pol. Ind. El Congost, Granollers, Spain
| | - Núria Navarro
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Cristina Riquelme
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Rosa Rosell
- Departament d’Agricultura, Ramaderia, Pesca i Alimentació (DARP) Generalitat de Catalunya, Campus de la Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | | | | | - Joaquim Segalés
- Departament de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
- UAB, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Joan Pujols
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Javier Polo
- APC EUROPE, S.L.U. Pol. Ind. El Congost, Granollers, Spain
- APC Inc, Ankeny, Iowa, United States of America
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Waters L, Padula MP, Marks DC, Johnson L. Cryopreservation of UVC pathogen-inactivated platelets. Transfusion 2019; 59:2093-2102. [PMID: 30790288 DOI: 10.1111/trf.15204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/12/2018] [Accepted: 01/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Extending the platelet (PLT) shelf life and enhancing product safety may be achieved by combining cryopreservation and pathogen inactivation (PI). Although studied individually, limited investigations into combining these treatments has been performed. The aim of this study was to investigate the effect of PI treating PLTs before cryopreservation on in vitro PLT quality and function. STUDY DESIGN AND METHODS ABO-matched buffy coat-derived PLTs in PLT additive solution (SSP+; Macopharma) were pooled and split to form matched pairs (n = 8). One unit remained untreated and the other was treated with the THERAFLEX UV-Platelets System (UVC; Macopharma). For cryopreservation, 5% to 6% dimethyl sulfoxide was added to the PLTs, and they were frozen at -80°C. After being thawed, untreated cryopreserved PLTs (CPPs) and UVC-treated CPPs (UVC-CPPs) were resuspended in plasma. In vitro quality was assessed immediately after thawing and after 24 hours of room temperature storage. RESULTS UVC-CPPs had lower in vitro recovery compared to CPPs. By flow cytometry, PLTs demonstrated a similar abundance of GPIX (CD42a), GPIIb (CD41a), and GPIbα (CD42b-HIP1), while the activation of GPIIb/IIIa (PAC-1) was increased in UVC-CPPs compared to CPPs. UVC-CPPs demonstrated greater phosphatidylserine exposure (annexin V) and microparticle shedding but similar P-selectin (CD62P) abundance compared to CPPs. UVC-CPPs displayed similar functionality to CPPs when assessed using aggregometry, thromboelastography, and thrombin generation. CONCLUSIONS This study demonstrates the feasibility of cryopreserving UVC-PI-treated PLT products. UVC-PI treatment may increase the susceptibility of PLTs to damage caused during cryopreservation, but this is more pronounced during postthaw storage at room temperature.
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Affiliation(s)
- Lauren Waters
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.,School of Life Sciences and Proteomics Core Facility, Faculty of Science, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Matthew P Padula
- School of Life Sciences and Proteomics Core Facility, Faculty of Science, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
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Gravemann U, Handke W, Müller TH, Seltsam A. Bacterial inactivation of platelet concentrates with the THERAFLEX UV-Platelets pathogen inactivation system. Transfusion 2018; 59:1324-1332. [PMID: 30588633 DOI: 10.1111/trf.15119] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The THERAFLEX UV-Platelets system (Maco Pharma) uses ultraviolet C (UVC) light for pathogen inactivation (PI) of platelet concentrates (PCs) without any additional photoactive compound. The aim of the study was to systematically investigate bacterial inactivation with this system under conditions of intended use. STUDY DESIGN AND METHODS The robustness of the system was evaluated by assessing its capacity to inactivate high concentrations of different bacterial species in accordance with World Health Organization guidelines. The optimal use of the PI system was explored in time-to-treatment experiments by testing its ability to sterilize PCs contaminated with low levels of bacteria on the day of manufacture (target concentration, 100 colony-forming units/unit). The bacteria panel used for spiking experiments in this study included the World Health Organization International Repository Platelet Transfusion Relevant Reference Strains (n = 14), commercially available strains (n = 13), and in-house clinical isolates (n = 2). RESULTS Mean log reduction factors after UVC treatment ranged from 3.1 to 7.5 and varied between different strains of the same species. All PCs (n = 12/species) spiked with up to 200 colony-forming units/bag remained sterile until the end of storage when UVC treated 6 hours after spiking. UVC treatment 8 hours after spiking resulted in single breakthrough contaminations with the fast-growing species Escherichia coli and Streptococcus pyogenes. CONCLUSION The UVC-based THERAFLEX UV-Platelets system efficiently inactivates transfusion-relevant bacterial species in PCs. The comprehensive data from this study may provide a valuable basis for the optimal use of this UVC-based PI system.
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Affiliation(s)
- Ute Gravemann
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Wiebke Handke
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Thomas H Müller
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
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Johnson L, Cameron M, Waters L, Padula MP, Marks DC. The impact of refrigerated storage of UVC pathogen inactivated platelet concentrates on in vitro
platelet quality parameters. Vox Sang 2018; 114:47-56. [DOI: 10.1111/vox.12730] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/23/2018] [Accepted: 11/03/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Lacey Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Mathew Cameron
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- School of Life Sciences and Proteomics Core Facility; Faculty of Science; University of Technology Sydney; Sydney NSW Australia
| | - Lauren Waters
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- School of Life Sciences and Proteomics Core Facility; Faculty of Science; University of Technology Sydney; Sydney NSW Australia
| | - Matthew P. Padula
- School of Life Sciences and Proteomics Core Facility; Faculty of Science; University of Technology Sydney; Sydney NSW Australia
| | - Denese C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
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Levy JH, Neal MD, Herman JH. Bacterial contamination of platelets for transfusion: strategies for prevention. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2018; 22:271. [PMID: 30367640 PMCID: PMC6204059 DOI: 10.1186/s13054-018-2212-9] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/25/2018] [Indexed: 01/07/2023]
Abstract
Platelet transfusions carry greater risks of infection, sepsis, and death than any other blood product, owing primarily to bacterial contamination. Many patients may be at particular risk, including critically ill patients in the intensive care unit. This narrative review provides an overview of the problem and an update on strategies for the prevention, detection, and reduction/inactivation of bacterial contaminants in platelets. Bacterial contamination and septic transfusion reactions are major sources of morbidity and mortality. Between 1:1000 and 1:2500 platelet units are bacterially contaminated. The skin bacterial microflora is a primary source of contamination, and enteric contaminants are rare but may be clinically devastating, while platelet storage conditions can support bacterial growth. Donor selection, blood diversion, and hemovigilance are effective but have limitations. Biofilm-producing species can adhere to biological and non-biological surfaces and evade detection. Primary bacterial culture testing of apheresis platelets is in routine use in the US. Pathogen reduction/inactivation technologies compatible with platelets use ultraviolet light-based mechanisms to target nucleic acids of contaminating bacteria and other pathogens. These methods have demonstrated safety and efficacy and represent a proactive approach for inactivating contaminants before transfusion to prevent transfusion-transmitted infections. One system, which combines ultraviolet A and amotosalen for broad-spectrum pathogen inactivation, is approved in both the US and Europe. Current US Food and Drug Administration recommendations advocate enhanced bacterial testing or pathogen reduction/inactivation strategies (or both) to further improve platelet safety. Risks of bacterial contamination of platelets and transfusion-transmitted infections have been significantly mitigated, but not eliminated, by improvements in prevention and detection strategies. Regulatory-approved technologies for pathogen reduction/inactivation have further enhanced the safety of platelet transfusions. Ongoing development of these technologies holds great promise.
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Affiliation(s)
- Jerrold H Levy
- Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA.
| | - Matthew D Neal
- University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Jay H Herman
- Thomas Jefferson University Hospital, 111 S. 11th Street, Philadelphia, PA, 19107, USA
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Lotens A, de Valensart N, Najdovski T, Acquart S, Cognasse F, Rapaille A. Influence of platelet preparation techniques on in vitro storage quality after psoralen-based photochemical treatment using new processing sets for triple-dose units. Transfusion 2018; 58:2942-2951. [PMID: 30362131 DOI: 10.1111/trf.14909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/27/2018] [Accepted: 04/28/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The INTERCEPT Blood System (IBS) for platelets (PLTs) uses a combination of psoralen and ultraviolet-A light to inactivate pathogens that may contaminate PLT concentrates (PCs). However, no data are available on the quality of IBS-treated PLTs from different apheresis and buffy-coat PC preparation platforms using the new triple storage (TS) set. STUDY DESIGN AND METHODS The objective of this study was to evaluate the TS set on three different preparation platforms compared with the large-volume (LV) set, as control. PLT in vitro metabolic and activation parameters were studied over 7 days. RESULTS Several statistical differences are observed between the two sets, particularly for pH, oxygen pressure (pO2 ), carbonic gaz pressure (pCO2 ), and bicarbonate. The three different preparation techniques influence PLT parameters, and the difference is statistically significant for all the studied parameters, except for pCO2 . The TS set has the advantage of shorter compound adsorption device time, higher PLT recoveries, and less PLT activation. CONCLUSION Results from the measured metabolic parameters and PLT variables obtained from PCs treated by LV and TS sets indicated good PLT function preservation up to 7 days of storage. The in vitro assessment results demonstrated acceptable PLT function for transfusion.
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Affiliation(s)
- Anaïs Lotens
- Service du Sang, Belgian Red Cross, Namur, Belgium
| | | | | | | | - Fabrice Cognasse
- Etablissement Français du Sang, Saint-Etienne, France.,Université de Lyon, GIMAP-EA3064, Saint-Etienne, France
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45
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Gravemann U, Handke W, Lambrecht B, Schmidt JP, Müller TH, Seltsam A. Ultraviolet C light efficiently inactivates nonenveloped hepatitis A virus and feline calicivirus in platelet concentrates. Transfusion 2018; 58:2669-2674. [PMID: 30267410 DOI: 10.1111/trf.14957] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/10/2018] [Accepted: 08/21/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Nonenveloped transfusion-transmissible viruses such as hepatitis A virus (HAV) and hepatitis E virus (HEV) are resistant to many of the common virus inactivation procedures for blood products. This study investigated the pathogen inactivation (PI) efficacy of the THERAFLEX UV-Platelets system against two nonenveloped viruses: HAV and feline calicivirus (FCV), in platelet concentrates (PCs). STUDY DESIGN AND METHODS PCs in additive solution were spiked with high titers of cell culture-derived HAV and FCV, and treated with ultraviolet C at various doses. Pre- and posttreatment samples were taken and the level of viral infectivity determined at each dose. For some samples, large-volume plating was performed to improve the detection limit of the virus assay. RESULTS THERAFLEX UV-Platelets reduced HAV titers in PCs to the limit of detection, resulting in a virus reduction factor of greater than 4.2 log steps, and reduced FCV infectivity in PCs by 3.0 ± 0.2 log steps. CONCLUSIONS THERAFLEX UV-Platelets effectively inactivates HAV and FCV in platelet units.
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Affiliation(s)
- Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Wiebke Handke
- German Red Cross Blood Service NSTOB, Springe, Germany
| | | | | | | | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
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46
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Pathogen-Inaktivierungssysteme für Thrombozytenkonzentrate. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:874-893. [PMID: 29931520 PMCID: PMC7079973 DOI: 10.1007/s00103-018-2766-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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47
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Feys HB, Van Aelst B, Compernolle V. Biomolecular Consequences of Platelet Pathogen Inactivation Methods. Transfus Med Rev 2018; 33:29-34. [PMID: 30021699 DOI: 10.1016/j.tmrv.2018.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 12/21/2022]
Abstract
Pathogen inactivation (PI) for platelet concentrates (PC) is a fairly recent development in transfusion medicine that is intended to decrease infectious disease transmission from the donor to the receiving patient. Effective inactivation of viruses, bacteria and eukaryotic parasites adds a layer of safety, protecting the blood supply against customary and emerging pathogens. Three PI methods have been described for platelets. These are based on photochemical damage of nucleic acids which prevents replication of most infectious pathogens and contaminating donor leukocytes. Because platelets do not replicate, the collateral damage to platelet function is considered low to non-existing. This is disputable however because photochemistry is not specific for nucleic acids and significantly affects platelet biomolecules as well. The impact of these biomolecular changes on platelet function and hemostasis is not well understood, but is increasingly being studied. The results of these studies can help explain current and future clinical observations with PI platelets, including the impact on transfusion yield and bleeding. This review summarizes the biomolecular effects of PI treatment on platelets. We conclude that despite a comparable principle of photochemical inactivation, all three methods affect platelets in different ways. This knowledge can help blood banks and transfusion specialists to guide their choice when considering the implementation or clinical use of PI treated platelets.
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Affiliation(s)
- Hendrik B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Britt Van Aelst
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium; Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Veerle Compernolle
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium
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48
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Eickmann M, Gravemann U, Handke W, Tolksdorf F, Reichenberg S, Müller TH, Seltsam A. Inactivation of Ebola virus and Middle East respiratory syndrome coronavirus in platelet concentrates and plasma by ultraviolet C light and methylene blue plus visible light, respectively. Transfusion 2018; 58:2202-2207. [PMID: 29732571 PMCID: PMC7169708 DOI: 10.1111/trf.14652] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Ebola virus (EBOV) and Middle East respiratory syndrome coronavirus (MERS‐CoV) have been identified as potential threats to blood safety. This study investigated the efficacy of the THERAFLEX UV‐Platelets and THERAFLEX MB‐Plasma pathogen inactivation systems to inactivate EBOV and MERS‐CoV in platelet concentrates (PCs) and plasma, respectively. STUDY DESIGN AND METHODS PCs and plasma were spiked with high titers of cell culture–derived EBOV and MERS‐CoV, treated with various light doses of ultraviolet C (UVC; THERAFLEX UV‐Platelets) or methylene blue (MB) plus visible light (MB/light; THERAFLEX MB‐Plasma), and assessed for residual viral infectivity. RESULTS UVC reduced EBOV (≥4.5 log) and MERS‐CoV (≥3.7 log) infectivity in PCs to the limit of detection, and MB/light decreased EBOV (≥4.6 log) and MERS‐CoV (≥3.3 log) titers in plasma to nondetectable levels. CONCLUSIONS Both THERAFLEX UV‐Platelets (UVC) and THERAFLEX MB‐Plasma (MB/light) effectively reduce EBOV and MERS‐CoV infectivity in platelets and plasma, respectively.
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Affiliation(s)
- Markus Eickmann
- Institute for Virology, Philipps University Marburg, Marburg, Germany
| | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Wiebke Handke
- German Red Cross Blood Service NSTOB, Springe, Germany
| | | | | | | | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
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49
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Waters L, Cameron M, Padula MP, Marks DC, Johnson L. Refrigeration, cryopreservation and pathogen inactivation: an updated perspective on platelet storage conditions. Vox Sang 2018; 113:317-328. [PMID: 29441601 DOI: 10.1111/vox.12640] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/28/2017] [Accepted: 01/15/2018] [Indexed: 01/08/2023]
Abstract
Conventional storage of platelet concentrates limits their shelf life to between 5 and 7 days due to the risk of bacterial proliferation and the development of the platelet storage lesion. Cold storage and cryopreservation of platelets may facilitate extension of the shelf life to weeks and years, and may also provide the benefit of being more haemostatically effective than conventionally stored platelets. Further, treatment of platelet concentrates with pathogen inactivation systems reduces bacterial contamination and provides a safeguard against the risk of emerging and re-emerging pathogens. While each of these alternative storage techniques is gaining traction individually, little work has been done to examine the effect of combining treatments in an effort to further improve product safety and minimize wastage. This review aims to discuss the benefits of alternative storage techniques and how they may be combined to alleviate the problems associated with conventional platelet storage.
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Affiliation(s)
- L Waters
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia.,School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - M Cameron
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia.,School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - M P Padula
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - D C Marks
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia
| | - L Johnson
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia
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50
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Kim S, Handke W, Gravemann U, Döscher A, Brixner V, Müller TH, Seltsam A. Mitochondrial DNA multiplex real-time polymerase chain reaction inhibition assay for quality control of pathogen inactivation by ultraviolet C light in platelet concentrates. Transfusion 2017; 58:758-765. [PMID: 29282743 DOI: 10.1111/trf.14464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several ultraviolet (UV) light-based pathogen inactivation (PI) technologies for platelet (PLT) products have been developed or are under development. Upon implementation of PI technologies, quality control measures are required to ensure consistent efficiency of the treatment process. Previous reports showed that amotosalen/UVA and riboflavin/UV-based PI technologies induce modifications of the PLT-derived mitochondrial DNA (mtDNA) that can be detected by polymerase chain reaction (PCR) inhibition assays. In this study, we sought to establish a PCR inhibition assay to document the impact of ultraviolet C (UVC) treatment with the THERAFLEX UV-Platelets system on the mitochondrial genome in PLT concentrates (PCs). STUDY DESIGN AND METHODS A multiplex real-time PCR inhibition assay with simultaneous short-amplicon (143 bp) and long-amplicon (794 bp) amplification was developed to detect mtDNA modifications in PLTs after UVC treatment. Assay performance was tested in UVC-treated and untreated, plasma-reduced pooled PCs, and apheresis PCs and challenged using PCs manufactured for a clinical trial under routine-like conditions. RESULTS UVC illumination of PLTs resulted in dose-dependent inhibition of mtDNA amplification for the larger amplicon. Amplification of the shorter amplicon was not affected by UVC treatment. Evaluation of 283 blinded apheresis and pooled PLT samples from routine-like PC production resulted in prediction of UVC treatment status with 100% accuracy. CONCLUSION The proposed dual-amplicon size real-time mtDNA PCR assay effectively detects nucleic acid damage induced by UVC illumination of PLTs and could be useful as an informative indicator of PI quality of the THERAFLEX UV-Platelets system.
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Affiliation(s)
- Sinyoung Kim
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany.,Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Wiebke Handke
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Andrea Döscher
- German Red Cross Blood Service NSTOB, Institute Oldenburg-Bremen, Oldenburg, Germany
| | - Veronika Brixner
- German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt, Germany
| | - Thomas H Müller
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
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