1
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D'Alessandro A, Hod EA. Red Blood Cell Storage: From Genome to Exposome Towards Personalized Transfusion Medicine. Transfus Med Rev 2023; 37:150750. [PMID: 37574398 PMCID: PMC10834861 DOI: 10.1016/j.tmrv.2023.150750] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/02/2023] [Accepted: 06/04/2023] [Indexed: 08/15/2023]
Abstract
Over the last decade, the introduction of omics technologies-especially high-throughput genomics and metabolomics-has contributed significantly to our understanding of the role of donor genetics and nongenetic determinants of red blood cell storage biology. Here we briefly review the main advances in these areas, to the extent these contributed to the appreciation of the impact of donor sex, age, ethnicity, but also processing strategies and donor environmental, dietary or other exposures - the so-called exposome-to the onset and severity of the storage lesion. We review recent advances on the role of genetically encoded polymorphisms on red cell storage biology, and relate these findings with parameters of storage quality and post-transfusion efficacy, such as hemolysis, post-transfusion intra- and extravascular hemolysis and hemoglobin increments. Finally, we suggest that the combination of these novel technologies have the potential to drive further developments towards personalized (or precision) transfusion medicine approaches.
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Affiliation(s)
- Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Eldad A Hod
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA
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2
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Marin M, Peltier S, Hadjou Y, Georgeault S, Dussiot M, Roussel C, Hermine O, Roingeard P, Buffet PA, Amireault P. Storage-Induced Micro-Erythrocytes Can Be Quantified and Sorted by Flow Cytometry. Front Physiol 2022; 13:838138. [PMID: 35283784 PMCID: PMC8906515 DOI: 10.3389/fphys.2022.838138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Refrigerated storage of red cell concentrates before transfusion is associated with progressive alterations of red blood cells (RBC). Small RBC (type III echinocytes, sphero-echinocytes, and spherocytes) defined as storage-induced micro-erythrocytes (SME) appear during pretransfusion storage. SME accumulate with variable intensity from donor to donor, are cleared rapidly after transfusion, and their proportion correlates with transfusion recovery. They can be rapidly and objectively quantified using imaging flow cytometry (IFC). Quantifying SME using flow cytometry would further facilitate a physiologically relevant quality control of red cell concentrates. RBC stored in blood bank conditions were stained with a carboxyfluorescein succinimidyl ester (CFSE) dye and incubated at 37°C. CFSE intensity was assessed by flow cytometry and RBC morphology evaluated by IFC. We observed the accumulation of a CFSE high RBC subpopulation by flow cytometry that accounted for 3.3 and 47.2% at day 3 and 42 of storage, respectively. IFC brightfield images showed that this CFSE high subpopulation mostly contains SME while the CFSE low subpopulation mostly contains type I and II echinocytes and discocytes. Similar numbers of SME were quantified by IFC (based on projected surface area) and by flow cytometry (based on CFSE intensity). IFC and scanning electron microscopy showed that ≥95% pure subpopulations of CFSE high and CFSE low RBC were obtained by flow cytometry-based sorting. SME can now be quantified using a common fluorescent dye and a standard flow cytometer. The staining protocol enables specific sorting of SME, a useful tool to further characterize this RBC subpopulation targeted for premature clearance after transfusion.
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Affiliation(s)
- Mickaël Marin
- INSERM, BIGR, Université de Paris and Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Sandy Peltier
- INSERM, BIGR, Université de Paris and Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Youcef Hadjou
- INSERM, BIGR, Université de Paris and Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Sonia Georgeault
- Plateforme des Microscopies, Infrastructures de Recherche en Biologie Santé et Agronomie, Programme Pluriformation Analyse des Systèmes Biologiques, Tours, France
| | - Michaël Dussiot
- Laboratoire d'Excellence GR-Ex, Paris, France.,U1163, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, INSERM, Université de Paris, Paris, France
| | - Camille Roussel
- INSERM, BIGR, Université de Paris and Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,AP-HP, Laboratoire d'Hématologie, Hôpital Necker-Enfants Malades, Paris, France
| | - Olivier Hermine
- Laboratoire d'Excellence GR-Ex, Paris, France.,U1163, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, INSERM, Université de Paris, Paris, France.,Département d'Hématologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Roingeard
- Plateforme des Microscopies, Infrastructures de Recherche en Biologie Santé et Agronomie, Programme Pluriformation Analyse des Systèmes Biologiques, Tours, France.,U1259, Centre Hospitalier Régional Universitaire de Tours, Morphogenèse et Antigénicité du VIH et des Virus des Hépatites, INSERM, Université de Tours, Tours, France
| | - Pierre A Buffet
- INSERM, BIGR, Université de Paris and Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,AP-HP, Paris, France
| | - Pascal Amireault
- INSERM, BIGR, Université de Paris and Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,U1163, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, INSERM, Université de Paris, Paris, France
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3
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Li ZZ, Jia DL, Wang H, Zhou XF, Cheng Y, Duan LS, Yin L, Wei HW, Guo W, Guo JR. To Research the Effects of Storage Time on Autotransfusion based on Erythrocyte Oxygen-Carrying Capacity and Oxidative Damage Characteristics. Cell Transplant 2021; 30:9636897211005683. [PMID: 34000850 PMCID: PMC8135200 DOI: 10.1177/09636897211005683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Autotransfusion refers to a blood transfusion method in which the blood or blood components of the patient are collected under certain conditions, returned to himself when the patient needs surgery or emergency after a series of storing and processing. Although autotransfusion can avoid blood-borne diseases and adverse reactions related to allogeneic blood transfusion, a series of structural and functional changes of erythrocytes will occur during extension of storage time, thus affecting the efficacy of clinical blood transfusion. Our research was aimed to explore the change of erythrocyte oxygen-carrying capacity in different storage time, such as effective oxygen uptake (Q), P50, 2,3-DPG, Na+-K+-ATPase, to detect membrane potential, the change of Ca2+, and reactive oxygen species (ROS) change of erythrocytes. At the same time, Western blot was used to detect the expression of Mitofusin 1 (Mfn1) and Mitofusin 2 (Mfn2) proteins on the cytomembrane, from the perspective of oxidative stress to explore the function change of erythrocytes after different storage time. This study is expected to provide experimental data for further clarifying the functional status of erythrocytes with different preservation time in patients with autotransfusion, achieving accurate infusion of erythrocytes and improving the therapeutic effect of autologous blood transfusion, which has important clinical application value.
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Affiliation(s)
- Zhen-Zhou Li
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China.,Ningxia Medical University, Gongli Hospital of Shanghai Pudong New Area Training Base, Shanghai, P.R. China
| | - Dong-Lin Jia
- Department of Pain Medicine, Peking University Third Hospital, Beijing, China
| | - Huan Wang
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Xiao-Fang Zhou
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Yong Cheng
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Li-Shuang Duan
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Lei Yin
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Han-Wei Wei
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Wei Guo
- Department of Intensive Care Unit, Anhui Provincial Lujiang County People's Hospital, Hefei, P.R. China
| | - Jian-Rong Guo
- Department of Anesthesiology, Shanghai Gongli Hospital, the Second Military Medical University, Shanghai, P. R. China.,Ningxia Medical University, Gongli Hospital of Shanghai Pudong New Area Training Base, Shanghai, P.R. China
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4
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Rapid clearance of storage-induced microerythrocytes alters transfusion recovery. Blood 2021; 137:2285-2298. [PMID: 33657208 DOI: 10.1182/blood.2020008563] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/16/2021] [Indexed: 12/19/2022] Open
Abstract
Permanent availability of red blood cells (RBCs) for transfusion depends on refrigerated storage, during which morphologically altered RBCs accumulate. Among these, a subpopulation of small RBCs, comprising type III echinocytes, spheroechinocytes, and spherocytes and defined as storage-induced microerythrocytes (SMEs), could be rapidly cleared from circulation posttransfusion. We quantified the proportion of SMEs in RBC concentrates from healthy human volunteers and assessed correlation with transfusion recovery, investigated the fate of SMEs upon perfusion through human spleen ex vivo, and explored where and how SMEs are cleared in a mouse model of blood storage and transfusion. In healthy human volunteers, high proportion of SMEs in long-stored RBC concentrates correlated with poor transfusion recovery. When perfused through human spleen, 15% and 61% of long-stored RBCs and SMEs were cleared in 70 minutes, respectively. High initial proportion of SMEs also correlated with high retention of RBCs by perfused human spleen. In the mouse model, SMEs accumulated during storage. Transfusion of long-stored RBCs resulted in reduced posttransfusion recovery, mostly due to SME clearance. After transfusion in mice, long-stored RBCs accumulated predominantly in spleen and were ingested mainly by splenic and hepatic macrophages. In macrophage-depleted mice, splenic accumulation and SME clearance were delayed, and transfusion recovery was improved. In healthy hosts, SMEs were cleared predominantly by macrophages in spleen and liver. When this well-demarcated subpopulation of altered RBCs was abundant in RBC concentrates, transfusion recovery was diminished. SME quantification has the potential to improve blood product quality assessment. This trial was registered at www.clinicaltrials.gov as #NCT02889133.
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5
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Marabi PM, Musyoki SK, Amayo A. Evaluation of cellular changes in blood stored for transfusion at Bungoma County Referral Hospital, Kenya. Pan Afr Med J 2021; 38:280. [PMID: 34122707 PMCID: PMC8179984 DOI: 10.11604/pamj.2021.38.280.22327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 02/23/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction during the storage of transfusion blood, it may undergo a series of cellular changes that in speculation could be the reason behind the risk of using prolonged stored blood. It's important therefore to monitor the cellular changes that may reduce its survival and function. The objective was to assess the cellular changes in whole blood stored for transfusion at Bungoma county referral hospital. Methods a single center, prospective and observational study design involving 20 randomly selected donor blood units in citrate phosphate dextrose adenine (CPDA-1) anticoagulant was employed, cellular changes were evaluated for 35 days. The changes were tested using the Celtac F Haematology analyzer. Statistical Analysis of variance was employed in the descriptive statistics. All the investigation was executed using statistical package for social sciences (SPSS V.23). Results were regarded as significant at P<0.05. Results were presented in tables and charts. Results at the end of the 35 days blood storage at blood bank conditions, WBC, RBC, platelets counts and MCHC decreased significantly (P<0.0001, =0.0182, <0.0001, =0.0035). The MCV, HCT and MCH increased significantly (P <0.0001, =0.0003, =0.0115) while HGB had insignificant variance (P =0.4185). Conclusion platelets, WBC, RBC counts, and indices are significantly altered in stored blood especially when stored over two weeks based on most of the cellular components analyzed in this study. The study, therefore, recommends the utilization of fresh blood to avoid the adverse outcome of cellular changes of reserved blood.
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Affiliation(s)
- Phidelis Maruti Marabi
- Bungoma County Referral Hospital, Bungoma, Kenya.,School of Health Sciences, Kisii University, Kisii, Kenya
| | | | - Angela Amayo
- Department of Human Pathology, University of Nairobi, Nairobi, Kenya
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6
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Bertolone L, Shin HK, Stefanoni D, Baek JH, Gao Y, Morrison EJ, Nemkov T, Thomas T, Francis RO, Hod EA, Zimring JC, Yoshida T, Karafin M, Schwartz J, Hudson KE, Spitalnik SL, Buehler PW, D'Alessandro A. ZOOMICS: Comparative Metabolomics of Red Blood Cells From Old World Monkeys and Humans. Front Physiol 2020; 11:593841. [PMID: 33192610 PMCID: PMC7645159 DOI: 10.3389/fphys.2020.593841] [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: 08/11/2020] [Accepted: 09/29/2020] [Indexed: 12/14/2022] Open
Abstract
As part of the ZOOMICS project, we set out to investigate common and diverging metabolic traits in the blood metabolome across various species by taking advantage of recent developments in high-throughput metabolomics. Here we provide the first comparative metabolomics analysis of fresh and stored human (n = 21, 10 males, 11 females), olive baboon (n = 20), and rhesus macaque (n = 20) red blood cells at baseline and upon 42 days of storage under blood bank conditions. The results indicated similarities and differences across species, which ultimately resulted in a differential propensity to undergo morphological alterations and lyse as a function of the duration of refrigerated storage. Focusing on purine oxidation, carboxylic acid, fatty acid, and arginine metabolism further highlighted species-specific metabolic wiring. For example, through a combination of steady state measurements and 13C615N4-arginine tracing experiments, we report an increase in arginine catabolism into ornithine in humans, suggestive of species-specific arginase 1 activity and nitric oxide synthesis—an observation that may impact the translatability of cardiovascular disease studies carried out in non-human primates (NHPs). Finally, we correlated metabolic measurements to storage-induced morphological alterations via scanning electron microscopy and hemolysis, which were significantly lower in human red cells compared to both NHPs.
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Affiliation(s)
- Lorenzo Bertolone
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States
| | - Hye K Shin
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Davide Stefanoni
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States
| | - Jin Hyen Baek
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Yamei Gao
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Evan J Morrison
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States
| | - Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States
| | - Tiffany Thomas
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States
| | - Richard O Francis
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States
| | - Eldad A Hod
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States
| | - James C Zimring
- Department of Pathology, University of Virginia, Charloteseville, VA, United States
| | | | - Matthew Karafin
- Blood Center of Wisconsin, Milwaukee, WI, United States.,Department of Pathology and Laboratory Medicine, Milwaukee, WI, United States
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States
| | - Krystalyn E Hudson
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States
| | - Steven L Spitalnik
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States
| | - Paul W Buehler
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Pediatrics, Center for Blood Oxygen Transport and Hemostasis, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States.,Division of Hematology, Department of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States
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7
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Hsieh C, Rajashekaraiah V. Effects of rejuvenation on young and old erythrocytes of banked blood towards the end of storage period. AMERICAN JOURNAL OF BLOOD RESEARCH 2020; 10:161-171. [PMID: 33224560 PMCID: PMC7675119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
The effects of rejuvenation on the subpopulation of stored erythrocytes have not been explored. This study aims at determining the influence of rejuvenation on young and old erythrocytes of stored blood. Prior studies have shown the disappearance of young cells after day 20 of storage. Blood was stored in CPDA-1 for 35 days and erythrocytes were isolated on 25th, 30th and 35th day, revitalized using rejuvenation solution (PIPA), and separated into young and old erythrocytes using Percoll-BSA density gradient. Erythrocyte, oxidative stress and antioxidant capacity markers were assessed in the hemolysate. Young erythrocytes could be isolated beyond day 20 of storage, after rejuvenation. Antioxidant capacity of both youngRej (rejuvenated young cells) and oldRej (rejuvenated old cells) increased while superoxides decreased resulting in lower levels of protein oxidation & lipid peroxidation. Rejuvenation reduced storage lesion and maintained membrane sulfhydryls in both young and old erythrocytes, however, it could not restore sialic acids. Rejuvenation had more impact on youngRej. A higher young: old cell ratio would be beneficial for transfusion. This study gives a comparative analysis of rejuvenation on erythrocyte aging in banked blood, thus opening new avenues towards better blood bank practices.
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Affiliation(s)
- Carl Hsieh
- Department of Biotechnology, School of Sciences, Block I, JAIN (Deemed-to-be University) #18/3, 9th Main, 3rd Block, Jayanagar 560011, Bengaluru, India
| | - Vani Rajashekaraiah
- Department of Biotechnology, School of Sciences, Block I, JAIN (Deemed-to-be University) #18/3, 9th Main, 3rd Block, Jayanagar 560011, Bengaluru, India
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8
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Mykhailova O, Olafson C, Turner TR, DʼAlessandro A, Acker JP. Donor-dependent aging of young and old red blood cell subpopulations: Metabolic and functional heterogeneity. Transfusion 2020; 60:2633-2646. [PMID: 32812244 DOI: 10.1111/trf.16017] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Characteristics of red blood cells (RBCs) are influenced by donor variability. This study assessed quality and metabolomic variables of RBC subpopulations of varied biologic age in red blood cell concentrates (RCCs) from male and female donors to evaluate their contribution to the storage lesion. STUDY DESIGN AND METHODS Red blood cell concentrates from healthy male (n = 6) and female (n = 4) donors were Percoll separated into less dense ("young", Y-RCCs) and dense ("old", O-RCCs) subpopulations, which were assessed weekly for 28 days for changes in hemolysis, mean cell volume (MCV), hemoglobin concentration (MCHC), hemoglobin autofluorescence (HGB), morphology index (MI), oxygen affinity (p50), rigidity, intracellular reactive oxygen species (ROS), calcium ([Ca2+ ]), and mass spectrometry-based metabolomics. RESULTS Young RCCs having disc-to-discoid morphology showed higher MCV and MI, but lower MCHC, HGB, and rigidity than O-RCCs, having discoid-to-spheroid shape. By Day 14, Y-RCCs retained lower hemolysis and rigidity and higher p50 compared to O-RCCs. Donor sex analyses indicated that females had higher MCV, HGB, ROS, and [Ca2+ ] and lower hemolysis than male RBCs, in addition to having a decreased rate of change in hemolysis by Day 28. Metabolic profiling indicated a significant sex-related signature across all groups with increased markers of high membrane lipid remodeling and antioxidant capacity in Y-RCCs, whereas O-RCCs had increased markers of oxidative stress and decreased coping capability. CONCLUSION The structural, functional, and metabolic dissimilarities of Y-RCCs and O-RCCs from female and male donors demonstrate RCC heterogeneity, where RBCs from females contribute less to the storage lesion and age slower than males.
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Affiliation(s)
- Olga Mykhailova
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Carly Olafson
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Tracey R Turner
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Angelo DʼAlessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jason P Acker
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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9
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Modelling of Red Blood Cell Morphological and Deformability Changes during In-Vitro Storage. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Storage lesion is a critical issue facing transfusion treatments, and it adversely affects the quality and viability of stored red blood cells (RBCs). RBC deformability is a key indicator of cell health. Deformability measurements of each RBC unit are a key challenge in transfusion medicine research and clinical haematology. In this paper, a numerical study, inspired from the previous research for RBC deformability and morphology predictions, is conducted for the first time, to investigate the deformability and morphology characteristics of RBCs undergoing storage lesion. This study investigates the evolution of the cell shape factor, elongation index and membrane spicule details, where applicable, of discocyte, echinocyte I, echinocyte II, echinocyte III and sphero-echinocyte morphologies during 42 days of in-vitro storage at 4 °C in saline-adenine-glucose-mannitol (SAGM). Computer simulations were performed to investigate the influence of storage lesion-induced membrane structural defects on cell deformability and its recoverability during optical tweezers stretching deformations. The predicted morphology and deformability indicate decreasing quality and viability of stored RBCs undergoing storage lesion. The loss of membrane structural integrity due to the storage lesion further degrades the cell deformability and recoverability during mechanical deformations. This numerical approach provides a potential framework to study the RBC deformation characteristics under varying pathophysiological conditions for better diagnostics and treatments.
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10
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Hsieh C, Prabhu NCS, Rajashekaraiah V. Age-Related Modulations in Erythrocytes under Blood Bank Conditions. Transfus Med Hemother 2019; 46:257-266. [PMID: 31700508 DOI: 10.1159/000501285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/29/2019] [Indexed: 01/24/2023] Open
Abstract
Background During storage of erythrocytes, storage lesions are formed that reduce the safety and efficacy of the stored blood. Thus, there is a need to understand the changes that occur during storage. Most studies have focused on storage of a mixed population of erythrocytes. The aim of this study is to analyze the changes in young and old erythrocytes over the course if storage. Materials and Methods Blood was collected from the blood bank at the Kempegowda Institute of Medical Sciences (KIMS) Hospital (Bengaluru, India) and stored for 35 days in CPDA-1 at 4°C. Every 5 days, erythrocytes were separated based on the blood's age using a Percoll-BSA gradient. Young and old erythrocytes obtained were used for analysis of the following oxidative stress (OS) markers: hemoglobin (Hb), hemolysis, mechanical fragility, antioxidant enzymes (superoxide dismutase and catalase [CAT]), superoxides, sialic acid, glutamic oxaloacetate transaminase (GOT), glucose, plasma membrane redox system (PMRS), total antioxidant capacity-cupric ion reducing antioxidant capacity assay (TAC<sub>CUPRAC</sub>), lactate dehydrogenase (LDH), lipid peroxidation products (malondialdehyde [MDA] and conjugate dienes), and protein oxidation products (advanced oxidation protein products and protein sulfhydryls). Result Young cells had higher amounts of Hb, sialic acid, GOT, LDH, TAC<sub>CUPRAC</sub>, CAT, and superoxides compared to old cells. Old cells, however, had higher PMRS and MDA levels with respect to young cells. Discussion Young cells could endure OS during storage more efficiently than old cells. In conclusion, the efficacy of stored blood depends on the ratio of young cells in the population. This study highlights the prospects of storing young erythrocytes for a prolonged shelf life of blood.
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Affiliation(s)
- Carl Hsieh
- Department of Biotechnology, School of Sciences, Block I, JAIN (Deemed-to-be University), Bengaluru, India
| | | | - Vani Rajashekaraiah
- Department of Biotechnology, School of Sciences, Block I, JAIN (Deemed-to-be University), Bengaluru, India
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11
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Yoshida T, Prudent M, D’Alessandro A. Red blood cell storage lesion: causes and potential clinical consequences. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 17:27-52. [PMID: 30653459 PMCID: PMC6343598 DOI: 10.2450/2019.0217-18] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/06/2018] [Indexed: 11/21/2022]
Abstract
Red blood cells (RBCs) are a specialised organ that enabled the evolution of multicellular organisms by supplying a sufficient quantity of oxygen to cells that cannot obtain oxygen directly from ambient air via diffusion, thereby fueling oxidative phosphorylation for highly efficient energy production. RBCs have evolved to optimally serve this purpose by packing high concentrations of haemoglobin in their cytosol and shedding nuclei and other organelles. During their circulatory lifetimes in humans of approximately 120 days, RBCs are poised to transport oxygen by metabolic/redox enzymes until they accumulate damage and are promptly removed by the reticuloendothelial system. These elaborate evolutionary adaptions, however, are no longer effective when RBCs are removed from the circulation and stored hypothermically in blood banks, where they develop storage-induced damages ("storage lesions") that accumulate over the shelf life of stored RBCs. This review attempts to provide a comprehensive view of the literature on the subject of RBC storage lesions and their purported clinical consequences by incorporating the recent exponential growth in available data obtained from "omics" technologies in addition to that published in more traditional literature. To summarise this vast amount of information, the subject is organised in figures with four panels: i) root causes; ii) RBC storage lesions; iii) physiological effects; and iv) reported outcomes. The driving forces for the development of the storage lesions can be roughly classified into two root causes: i) metabolite accumulation/depletion, the target of various interventions (additive solutions) developed since the inception of blood banking; and ii) oxidative damages, which have been reported for decades but not addressed systemically until recently. Downstream physiological consequences of these storage lesions, derived mainly by in vitro studies, are described, and further potential links to clinical consequences are discussed. Interventions to postpone the onset and mitigate the extent of the storage lesion development are briefly reviewed. In addition, we briefly discuss the results from recent randomised controlled trials on the age of stored blood and clinical outcomes of transfusion.
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Affiliation(s)
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
- Faculté de Biologie et de Médicine, Université de Lausanne, Lausanne, Switzerland
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics University of Colorado, Denver, CO, United States of America
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Gehrke S, Srinivasan AJ, Culp-Hill R, Reisz JA, Ansari A, Gray A, Landrigan M, Welsby I, D'Alessandro A. Metabolomics evaluation of early-storage red blood cell rejuvenation at 4°C and 37°C. Transfusion 2018; 58:1980-1991. [PMID: 29687892 DOI: 10.1111/trf.14623] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Refrigerated red blood cell (RBC) storage results in the progressive accumulation of biochemical and morphological alterations collectively referred to as the storage lesion. Storage-induced metabolic alterations can be in part reversed by rejuvenation practices. However, rejuvenation requires an incubation step of RBCs for 1 hour at 37°C, limiting the practicality of providing "on-demand," rejuvenated RBCs. We tested the hypothesis that the addition of rejuvenation solution early in storage as an adjunct additive solution would prevent-in a time window consistent with the average age of units transfused to sickle cell recipients at Duke (15 days)-many of the adverse biochemical changes that can be reversed via standard rejuvenation, while obviating the incubation step. STUDY DESIGN AND METHODS Metabolomics analyses were performed on cells and supernatants from AS-1 RBC units (n = 4), stored for 15 days. Units were split into pediatric bag aliquots and stored at 4°C. These were untreated controls, washed with or without rejuvenation, performed under either standard (37°C) or cold (4°C) conditions. RESULTS All three treatments removed most metabolic storage by-products from RBC supernatants. However, only standard and cold rejuvenation provided significant metabolic benefits as judged by the reactivation of glycolysis and regeneration of adenosine triphosphate and 2,3-diphosphoglycerate. Improvements in energy metabolism also translated into increased capacity to restore the total glutathione pool and regenerate oxidized vitamin C in its reduced (ascorbate) form. CONCLUSION Cold and standard rejuvenation of 15-day-old RBCs primes energy and redox metabolism of stored RBCs, while providing a logistic advantage for routine blood bank processing workflows.
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Affiliation(s)
- Sarah Gehrke
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado
| | | | - Rachel Culp-Hill
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado
| | - Julie A Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado
| | - Andrea Ansari
- Duke University School of Medicine, Durham, North Carolina
| | - Alan Gray
- Zimmer Biomet, Braintree, Massachusetts
| | | | - Ian Welsby
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado
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Urbina A, Palomino F. In vitro kinetics of reticulocyte subtypes: maturation after red blood cell storage in additive solution-1 (AS-1). Hematol Transfus Cell Ther 2018. [PMCID: PMC6738486 DOI: 10.1016/j.htct.2017.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Reticulocytes are immature red blood cells containing RNA remnants. Their population kinetics has been documented under various in vivo and in vitro conditions, including after storage of red blood cells in blood banks. The purpose of this study was to describe the influence of blood bank storage on the kinetics of reticulocyte disappearance by in vitro culturing. Method Samples of reticulocyte-enriched fractions (Percoll density-gradient) were obtained over different storage times from six red blood cell units stored in additive solution-1 (AS-1). Reticulocyte fractions were then cultured in enriched media at 37 °C and analyzed by flow cytometry with thiazole orange taking into account hemolysis. Results Density-gradient enriched reticulocyte fractions were obtain from standard red blood cell units with <1% of reticulocytes. An exponential drop of reticulocytes was observed in cultures. The time taken for reticulocyte disappearance in cultures was shorter with increased blood bank storage time (144 ± 46 h at 0.5 weeks of storage and 15 ± 14 h in the sixth week). High fluorescence reticulocytes disappeared completely in 42.5 ± 8.5 h, medium fluorescence reticulocytes in 73.4 ± 20.8 h and low fluorescence reticulocytes in 269.9 ± 98.8 h in red blood cell units stored for half a week. These times significantly decreased in red blood cell units stored for more time. Conclusion In vitro reticulocyte disappearance was significantly faster after prolonged storage of red blood cell units at 4 °C. The in vitro half-life at 0.5 weeks of storage was not significantly different from the values reported for fresh venous blood, but after the sixth week of storage, the half-lives were shorter. The possible explanation is that blood bank storage does not cause irreversible damage to the human reticulocyte maturational machinery.
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Orbach A, Zelig O, Yedgar S, Barshtein G. Biophysical and Biochemical Markers of Red Blood Cell Fragility. Transfus Med Hemother 2017. [PMID: 28626369 DOI: 10.1159/000452106] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Red blood cells (RBCs) undergo a natural aging process occurring in the blood circulation throughout the RBC lifespan or during routine cold storage in the blood bank. The aging of RBCs is associated with the elevation of mechanical fragility (MF) or osmotic fragility (OF) of RBCs, which can lead to cell lysis. The present study was undertaken to identify RBC properties that characterize their susceptibility to destruction under osmotic/mechanical stress. METHODS RBCs were isolated from freshly donated blood or units of packed RBCs (PRBCs) and suspended in albumin-supplemented phosphate-buffered saline (PBS). In addition, PRBCs were separated by filtration through a microsphere column into two fractions: enriched with rigid (R-fraction) and deformable (D-fraction) cells. The RBCs were subjected to determination of deformability, MF and OF, moreover, the level of cell surface phosphatidylserine (PS) and the stomatin level in isolated RBC membranes were measured. RESULTS In the RBC population, the cells that were susceptible to mechanical and osmotic stress were characterized by low deformability and increased level of surface PS. The OF/MF was higher in the R-fraction than in the D-fraction. Stomatin was depleted in destroyed cells and in the R-fraction. CONCLUSION RBC deformability, the levels of surface PS, and membrane stomatin can be used as markers of RBC fragility.
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Affiliation(s)
- Ariel Orbach
- Department of Biochemistry, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Orly Zelig
- Blood Bank, Hadassah University Hospital, Jerusalem, Israel
| | - Saul Yedgar
- Department of Biochemistry, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Gregory Barshtein
- Department of Biochemistry, Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Tzounakas VL, Kriebardis AG, Georgatzakou HT, Foudoulaki-Paparizos LE, Dzieciatkowska M, Wither MJ, Nemkov T, Hansen KC, Papassideri IS, D'Alessandro A, Antonelou MH. Glucose 6-phosphate dehydrogenase deficient subjects may be better "storers" than donors of red blood cells. Free Radic Biol Med 2016; 96:152-65. [PMID: 27094493 DOI: 10.1016/j.freeradbiomed.2016.04.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 04/04/2016] [Accepted: 04/09/2016] [Indexed: 02/04/2023]
Abstract
Storage of packed red blood cells (RBCs) is associated with progressive accumulation of lesions, mostly triggered by energy and oxidative stresses, which potentially compromise the effectiveness of the transfusion therapy. Concerns arise as to whether glucose 6-phosphate dehydrogenase deficient subjects (G6PD(-)), ~5% of the population in the Mediterranean area, should be accepted as routine donors in the light of the increased oxidative stress their RBCs suffer from. To address this question, we first performed morphology (scanning electron microscopy), physiology and omics (proteomics and metabolomics) analyses on stored RBCs from healthy or G6PD(-) donors. We then used an in vitro model of transfusion to simulate transfusion outcomes involving G6PD(-) donors or recipients, by reconstituting G6PD(-) stored or fresh blood with fresh or stored blood from healthy volunteers, respectively, at body temperature. We found that G6PD(-) cells store well in relation to energy, calcium and morphology related parameters, though at the expenses of a compromised anti-oxidant system. Additional stimuli, mimicking post-transfusion conditions (37°C, reconstitution with fresh healthy blood, incubation with oxidants) promoted hemolysis and oxidative lesions in stored G6PD(-) cells in comparison to controls. On the other hand, stored healthy RBC units showed better oxidative parameters and lower removal signaling when reconstituted with G6PD(-) fresh blood compared to control. Although the measured parameters of stored RBCs from the G6PD deficient donors appeared to be acceptable, the results from the in vitro model of transfusion suggest that G6PD(-) RBCs could be more susceptible to hemolysis and oxidative stresses post-transfusion. On the other hand, their chronic exposure to oxidative stress might make them good recipients, as they better tolerate exposure to oxidatively damaged long stored healthy RBCs.
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Affiliation(s)
- Vassilis L Tzounakas
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece
| | - Anastasios G Kriebardis
- Laboratory of Hematology and Transfusion Medicine, Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological and Educational Institute of Athens, Athens 12210, Greece
| | - Hara T Georgatzakou
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece
| | | | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA
| | - Matthew J Wither
- Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA
| | - Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA
| | - Kirk C Hansen
- Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA
| | - Issidora S Papassideri
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA.
| | - Marianna H Antonelou
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece.
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Tzounakas VL, Kriebardis AG, Papassideri IS, Antonelou MH. Donor-variation effect on red blood cell storage lesion: A close relationship emerges. Proteomics Clin Appl 2016; 10:791-804. [PMID: 27095294 DOI: 10.1002/prca.201500128] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/24/2016] [Accepted: 04/11/2016] [Indexed: 12/20/2022]
Abstract
Although the molecular pathways leading to the progressive deterioration of stored red blood cells (RBC storage lesion) and the clinical relevance of storage-induced changes remain uncertain, substantial donor-specific variability in RBC performance during storage, and posttransfusion has been established ("donor-variation effect"). In-bag hemolysis and numerous properties of the RBC units that may affect transfusion efficacy have proved to be strongly donor-specific. Donor-variation effect may lead to the production of highly unequal blood labile products even when similar storage strategy and duration are applied. Genetic, undiagnosed/subclinical medical conditions and lifestyle factors that affect RBC characteristics at baseline, including RBC lifespan, energy metabolism, and sensitivity to oxidative stress, are all likely to influence the storage capacity of individual donors' cells, although not evident by the donor's health or hematological status at blood donation. Consequently, baseline characteristics of the donors, such as membrane peroxiredoxin-2 and serum uric acid concentration, have been proposed as candidate biomarkers of storage quality. This review article focuses on specific factors that might contribute to the donor-variation effect and emphasizes the emerging need for using omics-based technologies in association with in vitro and in vivo transfusion models and clinical trials to discover biomarkers of storage quality and posttransfusion recovery in donor blood.
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Affiliation(s)
- Vassilis L Tzounakas
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens, Greece
| | - Anastasios G Kriebardis
- Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological and Educational Institute of Athens, Greece
| | | | - Marianna H Antonelou
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens, Greece
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Huang YX, Tuo WW, Wang D, Kang LL, Chen XY, Luo M. Restoring the youth of aged red blood cells and extending their lifespan in circulation by remodelling membrane sialic acid. J Cell Mol Med 2016; 20:294-301. [PMID: 26576513 PMCID: PMC4727560 DOI: 10.1111/jcmm.12721] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/19/2015] [Indexed: 11/29/2022] Open
Abstract
Membrane sialic acid (SA) plays an important role in the survival of red blood cells (RBCs), the age-related reduction in SA content negatively impacts both the structure and function of these cells. We have therefore suggested that remodelling the SA in the membrane of aged cells would help recover cellular functions characteristic of young RBCs. We developed an effective method for the re-sialylation of aged RBCs by which the cells were incubated with SA in the presence of cytidine triphosphate (CTP) and α-2,3-sialytransferase. We found that RBCs could be re-sialylated if they had available SA-binding groups and after the re-sialylation, aged RBCs could restore their membrane SA to the level in young RBCs. Once the membrane SA was restored, the aged RBCs showed recovery of their biophysical and biochemical properties to similar levels as in young RBCs. Their life span in circulation was also extended to twofold. Our findings indicate that remodelling membrane SA not only helps restore the youth of aged RBCs, but also helps recover injured RBCs.
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Affiliation(s)
- Yao-Xiong Huang
- Department of Biomedical Engineering, Ji Nan University, Guang Zhou, China
| | - Wei-Wei Tuo
- Department of Biomedical Engineering, Ji Nan University, Guang Zhou, China
| | - Di Wang
- Department of Biomedical Engineering, Ji Nan University, Guang Zhou, China
| | - Li-Li Kang
- Department of Biomedical Engineering, Ji Nan University, Guang Zhou, China
| | - Xing-Yao Chen
- Department of Biomedical Engineering, Ji Nan University, Guang Zhou, China
| | - Man Luo
- Department of Biomedical Engineering, Ji Nan University, Guang Zhou, China
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Bayer SB, Hampton MB, Winterbourn CC. Accumulation of oxidized peroxiredoxin 2 in red blood cells and its prevention. Transfusion 2015; 55:1909-18. [DOI: 10.1111/trf.13039] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/09/2015] [Accepted: 01/16/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Simone B. Bayer
- Department of Pathology, Centre for Free Radical Research; University of Otago; Christchurch New Zealand
| | - Mark B. Hampton
- Department of Pathology, Centre for Free Radical Research; University of Otago; Christchurch New Zealand
| | - Christine C. Winterbourn
- Department of Pathology, Centre for Free Radical Research; University of Otago; Christchurch New Zealand
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