1
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Tran J, Jackman RP, Muench MO, Hazegh K, Bean SW, Thomas KA, Fang F, Page G, O'Connor K, Roubinian NH, Anawalt BD, Kanias T. Testosterone supplementation increases red blood cell susceptibility to oxidative stress, decreases membrane deformability, and decreases survival after cold storage and transfusion. Transfusion 2024. [PMID: 38884364 DOI: 10.1111/trf.17922] [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: 04/16/2024] [Revised: 05/29/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Blood collection from donors on testosterone therapy (TT) is restricted to red blood cell (RBC) concentrates to avoid patient exposure to supraphysiological testosterone (T). The objective of this study was to identify TT-related changes in RBC characteristics relevant to transfusion effectiveness in patients. STUDY DESIGN This was a two-part study with cohorts of patients and blood donors on TT. In part 1, we conducted longitudinal evaluation of RBCs collected before and at three time points after initiation of T. RBC assays included storage and oxidative hemolysis, membrane deformability (elongation index), and oximetry. In part 2, we evaluated the fate of transfused RBCs from TT donors in immunodeficient mice and by retrospective analyses of NIH's vein-to-vein databases. RESULTS TT increased oxidative hemolysis (1.45-fold change) and decreased RBC membrane deformability. Plasma free testosterone was positively correlated with oxidative hemolysis (r = .552) and negatively correlated with the elongation index (r = -.472). Stored and gamma-irradiated RBCs from TT donors had lower posttransfusion recovery in mice compared to controls (41.6 ± 12 vs. 55.3 ± 20.5%). Recipients of RBCs from male donors taking T had 25% lower hemoglobin increments compared to recipients of RBCs from non-TT male donors, and had increased incidence (OR, 1.80) of requiring additional RBC transfusions within 48 h of the index transfusion event. CONCLUSIONS TT is associated with altered RBC characteristics and transfusion effectiveness. These results suggest that clinical utilization of TT RBCs may be less effective in recipients who benefit from longer RBC survival, such as chronically transfused patients.
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Affiliation(s)
- Johnson Tran
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rachael P Jackman
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Marcus O Muench
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | | | | | - Kimberly A Thomas
- Vitalant Research Institute, Denver, Colorado, USA
- Department of Pathology, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA
| | - Fang Fang
- Genomics and Translational Research Center, RTI International, North Carolina, USA
| | - Grier Page
- Genomics and Translational Research Center, RTI International, North Carolina, USA
- Fellow Program, RTI International, Atlanta, Georgia, USA
| | - Kim O'Connor
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Nareg H Roubinian
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - Bradley D Anawalt
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Tamir Kanias
- Vitalant Research Institute, Denver, Colorado, USA
- Department of Pathology, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA
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2
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Cheng Z, Kong Y, Xu H, Xiao L, Tian L, Liu Z. Extracellular vesicles derived from stored red blood cell suspensions enhance invasion and migration of lung cancer cells by miR1246 and miR150-3p. Vox Sang 2024. [PMID: 38839077 DOI: 10.1111/vox.13685] [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: 02/15/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND AND OBJECTIVES Aged red blood cell (RBC) transfusions in lung cancer patients are often related to cancer recurrence and shorter lifespans. Extracellular vesicles (EVs) accumulated in stored RBC suspensions may be one of the important influential factors. This study aims to investigate how EVs derived from RBC suspensions affect the progress of lung cancer through the most enriched microRNAs (miRNAs) previously reported in our research. STUDY DESIGN AND METHODS EVs derived from stored RBC suspensions in Weeks 1, 3 and 5 were harvested via ultracentrifugation. Lung adenocarcinoma H1975 cells were co-cultured with EVs and transfected with miR1246 and miR150-3p mimics to evaluate alterations in their proliferation, invasion and migration abilities in vitro. Proteomics and bioinformatics were performed to predict the signalling pathway related to invasion and migration of H1975, which were verified by western blotting (WB) and flow cytometry. RESULTS EVs derived from stored RBC suspensions in Weeks 3 and 5 could significantly enhance the invasion and migration ability of H1975 cells and also increase the expression of miR1246 and miR150-3p. After transfection with miR1246 and miR150-3p mimics, invasion, migration and proliferation of H1975 cells were obviously enhanced. Proteomics analysis demonstrated that EVs co-cultivation and miRNA transfection groups were both enriched in cell adhesion molecules. WB and cytometry indicated that integrin beta-1 (ITGB1) and Rap1b were increased. CONCLUSIONS EVs derived from stored RBC suspensions can enhance invasion and migration ability of lung cancer cells via the most accumulated miR1246 and miR150-3p, which may increase the expression of ITGB1 through Rap1 signalling pathway.
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Affiliation(s)
- Zhanrui Cheng
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China
| | - Yujie Kong
- Department of Laboratory, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Haixia Xu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China
| | - Ling Xiao
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China
| | - Li Tian
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China
| | - Zhong Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China
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3
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Liu X, Li Y, Jia J, Wang H, Xi Y, Sun A, Wang L, Deng X, Chen Z, Fan Y. Analysis of non-physiological shear stress-induced red blood cell trauma across different clinical support conditions of the blood pump. Med Biol Eng Comput 2024:10.1007/s11517-024-03121-z. [PMID: 38802609 DOI: 10.1007/s11517-024-03121-z] [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: 10/07/2023] [Accepted: 05/04/2024] [Indexed: 05/29/2024]
Abstract
Systematic research into device-induced red blood cell (RBC) damage beyond hemolysis, including correlations between hemolysis and RBC-derived extracellular vesicles, remains limited. This study investigated non-physiological shear stress-induced RBC damage and changes in related biochemical indicators under two blood pump clinical support conditions. Pressure heads of 100 and 350 mmHg, numerical simulation methods, and two in vitro loops were utilized to analyze the shear stress and changes in RBC morphology, hemolysis, biochemistry, metabolism, and oxidative stress. The blood pump created higher shear stress in the 350-mmHg condition than in the 100-mmHg condition. With prolonged blood pump operation, plasma-free hemoglobin and cholesterol increased, whereas plasma glucose and nitric oxide decreased in both loops. Notably, plasma iron and triglyceride concentrations increased only in the 350-mmHg condition. The RBC count and morphology, plasma lactic dehydrogenase, and oxidative stress across loops did not differ significantly. Plasma extracellular vesicles, including RBC-derived microparticles, increased significantly at 600 min in both loops. Hemolysis correlated with plasma triglyceride, cholesterol, glucose, and nitric oxide levels. Shear stress, but not oxidative stress, was the main cause of RBC damage. Hemolysis alone inadequately reflects overall blood pump-induced RBC damage, suggesting the need for additional biomarkers for comprehensive assessments.
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Affiliation(s)
- Xinyu Liu
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Yuan Li
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Jinze Jia
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Hongyu Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Yifeng Xi
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Anqiang Sun
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Lizhen Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Xiaoyan Deng
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Zengsheng Chen
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China.
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China.
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Murciano N, Kaestner L. The Putative Role of the Transient Receptor Potential Ion Channel of Vanilloid Type 2 in Red Blood Cell Storage Lesions. Transfus Med Hemother 2024; 51:52-54. [PMID: 38314245 PMCID: PMC10836854 DOI: 10.1159/000531282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/18/2023] [Indexed: 02/06/2024] Open
Affiliation(s)
- Nicoletta Murciano
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany
- Nanion Technologies GmbH, Munich, Germany
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany
- Experimental Physics, Saarland University, Saarbrücken, Germany
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5
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Mulatie Z, Aynalem M, Getawa S. MicroRNAs as Quality Assessment Tool in Stored Packed Red Blood Cell in Blood Banks. J Blood Med 2023; 14:99-106. [PMID: 36789373 PMCID: PMC9922504 DOI: 10.2147/jbm.s397139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
Micro-ribonucleic acids are control gene expression in cells. They represent the changed cellular states that occur can be employed as biomarkers. Red blood cells alter biochemically and morphologically while they are being stored, which could be detrimental to transfusion. The effect of storage on the erythrocyte transcriptome is not mostly investigated. Because adult erythrocytes lack a nucleus, it has long been assumed that they lack deoxyribonucleic acid and ribonucleic acid. On the other hand, erythrocytes contain a diverse range of ribonucleic acids, of which micro-ribonucleic acids are key component. Changes in this micro-ribonucleic acid protect cells from death and adenine triphosphate depletion, and they are linked to specific storage lesions. As a result, changes in micro-ribonucleic acid in stored erythrocytes may be used as a marker to assess the quality and safety of stored erythrocytes. Therefore, this review ams to review the role of microRNA in stored packed red blood cells as quality indicator. Google Scholar, PubMed, Scopus, and Z-libraries are used for searching articles and books. The article included in this paper was written in the English language and had the full article. During long storage of RBCs, miR-16-2-3p, miR-1260a, miR-1260b, miR-4443, miR-4695-3p, miR-5100, let-7b, miR-16, miRNA-1246, MiR-31-5p, miR-203a, miR-654-3p, miR-769-3p, miR-4454, miR-451a and miR-125b- 5p are up regulated. However, miR-96, miR-150, miR-196a, miR-197, miR-381 and miR-1245a are down regulated after long storage of RBCs. The changes of this microRNAs are linked to red blood cell lesions. Therefore, micro-ribonucleic acids are the potential quality indicator in stored packed red blood cells in the blood bank. Particularly, micro-ribonucleic acid-96 is the most suitable biomarker for monitoring red blood cell quality in stored packed red blood units.
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Affiliation(s)
- Zewudu Mulatie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Desie, Ethiopia,Correspondence: Zewudu Mulatie, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, P.O.box: 1145, Desie, Ethiopia, Tel +251945274251, Email
| | - Melak Aynalem
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Getawa
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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6
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Yurinskaya VE, Moshkov AV, Marakhova II, Vereninov AA. Unidirectional fluxes of monovalent ions in human erythrocytes compared with lymphoid U937 cells: Transient processes after stopping the sodium pump and in response to osmotic challenge. PLoS One 2023; 18:e0285185. [PMID: 37141334 PMCID: PMC10159352 DOI: 10.1371/journal.pone.0285185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/11/2023] [Indexed: 05/06/2023] Open
Abstract
Recently, we have developed software that allows, using a minimum of required experimental data, to find the characteristics of ion homeostasis and a list of all unidirectional fluxes of monovalent ions through the main pathways in the cell membrane both in a balanced state and during the transient processes. Our approach has been successfully validated in human proliferating lymphoid U937 cells during transient processes after stopping the Na/K pump by ouabain and for staurosporine-induced apoptosis. In present study, we used this approach to find the characteristics of ion homeostasis and the monovalent ion fluxes through the cell membrane of human erythrocytes in a resting state and during the transient processes after stopping the Na/K pump with ouabain and in response to osmotic challenge. Due to their physiological significance, erythrocytes remain the object of numerous studies, both experimental and computational methods. Calculations showed that, under physiological conditions, the K+ fluxes through electrodiffusion channels in the entire erythrocyte ion balance is small compared to the fluxes through the Na/K pump and cation-chloride cotransporters. The proposed computer program well predicts the dynamics of the erythrocyte ion balance disorders after stopping the Na/K pump with ouabain. In full accordance with predictions, transient processes in human erythrocytes are much slower than in proliferating cells such as lymphoid U937 cells. Comparison of real changes in the distribution of monovalent ions under osmotic challenge with the calculated ones indicates a change in the parameters of the ion transport pathways through the plasma membrane of erythrocytes in this case. The proposed approach may be useful in studying the mechanisms of various erythrocyte dysfunctions.
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Affiliation(s)
| | - Alexey V Moshkov
- Institute of Cytology, Russian Academy of Sciences, St-Petersburg, Russia
| | - Irina I Marakhova
- Institute of Cytology, Russian Academy of Sciences, St-Petersburg, Russia
| | - Alexey A Vereninov
- Institute of Cytology, Russian Academy of Sciences, St-Petersburg, Russia
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7
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Piwkham D, Pattanapanyasat K, Noulsri E, Klaihmon P, Bhoophong P, Prachongsai I. The in vitro red blood cell microvesiculation exerts procoagulant activity of blood cell storage in Southeast Asian ovalocytosis. Heliyon 2022; 9:e12714. [PMID: 36632113 PMCID: PMC9826842 DOI: 10.1016/j.heliyon.2022.e12714] [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: 06/17/2022] [Revised: 08/30/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023] Open
Abstract
Southeast Asian ovalocytosis (SAO) is characterized by the misfolding of band 3 protein in red blood cells (RBC). The abnormal structure of the band 3 protein results in dysmorphic RBC and related functions. Previous data showed that in vitro storage under hypothermic conditions alters band 3 protein structure and function. Microvesiculation includes shedding of RBC membranes, called RBC-derived microparticles/extracellular vesicles (RMP/EVs), and storage lesions. Unfortunately, there is no evidence of RBC microvesiculation under in vitro storage conditions in heterozygous SAO individuals. This study determined the generation of REVs and procoagulant activity during the storage of SAO blood samples in southern Thailand. Venous blood was collected from eight SAO and seven healthy individuals, preserved in citrate phosphate dextrose-adenine 1 (CPDA-1) at 4 °C for 35 days. The absolute numbers of REVs and PS-expressing RBCs were analyzed using flow cytometry. The procoagulant activity of the produced extracellular vesicles was determined by a clotting time assay. The results showed a significant increase in the number of REVs and PS-expressing RBCs in the SAO blood samples. Significantly correlated PS externalization and procoagulant activity were observed in the SAO blood samples. These lines of evidence indicate that the abnormality of the Band 3 protein is possibly involved in aberrant microvesiculation, exerting procoagulant activity in vitro. Increased pools of REV production and abnormal storage lesions in SAO blood samples should be a concern. Notably, the mechanisms underlying membrane vesiculation depend on the extent of blood cell storage under hypothermic conditions.
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Affiliation(s)
- D. Piwkham
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand,Hematology and Transfusion Science Research Center, Walailak University, Nakhon Si Thammarat, Thailand
| | - K. Pattanapanyasat
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Siriraj Center of Research Excellence in Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - E. Noulsri
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - P. Klaihmon
- Siriraj Center of Excellence for Stem Cell Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - P. Bhoophong
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand,Food Technology and Innovation Center of Excellence, Walailak University, Nakhon Si Thammarat, Thailand
| | - I. Prachongsai
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand,Hematology and Transfusion Science Research Center, Walailak University, Nakhon Si Thammarat, Thailand,Corresponding author. Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand.
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8
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Dybas J, Wajda A, Alcicek FC, Kaczmarska M, Bulat K, Szczesny-Malysiak E, Martyna A, Perez-Guaita D, Sacha T, Marzec KM. Label-free testing strategy to evaluate packed red blood cell quality before transfusion to leukemia patients. Sci Rep 2022; 12:21849. [PMID: 36528645 PMCID: PMC9759565 DOI: 10.1038/s41598-022-26309-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Patients worldwide require therapeutic transfusions of packed red blood cells (pRBCs), which is applied to the high-risk patients who need periodic transfusions due to leukemia, lymphoma, myeloma and other blood diseases or disorders. Contrary to the general hospital population where the transfusions are carried out mainly for healthy trauma patients, in case of high-risk patients the proper quality of pRBCs is crucial. This leads to an increased demand for efficient technology providing information on the pRBCs alterations deteriorating their quality. Here we present the design of an innovative, label-free, noninvasive, rapid Raman spectroscopy-based method for pRBCs quality evaluation, starting with the description of sample measurement and data analysis, through correlation of spectroscopic results with reference techniques' outcomes, and finishing with methodology verification and its application in clinical conditions. We have shown that Raman spectra collected from the pRBCs supernatant mixture with a proper chemometric analysis conducted for a minimum one ratio of integral intensities of the chosen Raman marker bands within the spectrum allow evaluation of the pRBC quality in a rapid, noninvasive, and free-label manner, without unsealing the pRBCs bag. Subsequently, spectroscopic data were compared with predefined reference values, either from pRBCs expiration or those defining the pRBCs quality, allowing to assess their utility for transfusion to patients with acute myeloid leukemia (AML) and lymphoblastic leukemia (ALL).
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Affiliation(s)
- Jakub Dybas
- grid.5522.00000 0001 2162 9631Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, 14 Bobrzyskiego St., 30-348 Krakow, Poland
| | - Aleksandra Wajda
- grid.5522.00000 0001 2162 9631Faculty of Chemistry, Jagiellonian University, 2 Gronostajowa St., 30-387 Krakow, Poland
| | - Fatih Celal Alcicek
- grid.5522.00000 0001 2162 9631Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, 14 Bobrzyskiego St., 30-348 Krakow, Poland
| | - Magdalena Kaczmarska
- grid.5522.00000 0001 2162 9631Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, 14 Bobrzyskiego St., 30-348 Krakow, Poland
| | - Katarzyna Bulat
- grid.5522.00000 0001 2162 9631Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, 14 Bobrzyskiego St., 30-348 Krakow, Poland ,grid.424613.60000 0001 2167 3632Lukasiewicz Research Network, Krakow Institute of Technology, 73 Zakopiaska St., 30-418 Krakow, Poland
| | - Ewa Szczesny-Malysiak
- grid.5522.00000 0001 2162 9631Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, 14 Bobrzyskiego St., 30-348 Krakow, Poland
| | - Agnieszka Martyna
- grid.11866.380000 0001 2259 4135Forensic Chemistry Research Group, University of Silesia in Katowice, 9 Szkolna St., 40-006 Katowice, Poland
| | - David Perez-Guaita
- Department of Analytical Chemistry, University of Valancia, Dr. Moliner 50, Burjassot, Spain
| | - Tomasz Sacha
- grid.5522.00000 0001 2162 9631Chair of Haematology, Faculty of Medicine, Jagiellonian University Medical College, 12 Sw. Anny St., 30-008 Krakow, Poland ,grid.5522.00000 0001 2162 9631Department of Haematology, Jagiellonian University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland
| | - Katarzyna M. Marzec
- grid.5522.00000 0001 2162 9631Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, 14 Bobrzyskiego St., 30-348 Krakow, Poland ,grid.424613.60000 0001 2167 3632Lukasiewicz Research Network, Krakow Institute of Technology, 73 Zakopiaska St., 30-418 Krakow, Poland
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9
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Zürn C, Höhn R, Hübner D, Umhau M, Kroll J, Kari FA, Humburger F, Maier S, Stiller B. Risk Assessment of Red Cell Transfusion in Congenital Heart Disease. Thorac Cardiovasc Surg 2022; 70:e15-e20. [PMID: 36179762 PMCID: PMC9536749 DOI: 10.1055/s-0042-1756493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The storage time of packed red blood cells (pRBC) is an indicator of
change in the product's pH, potassium, and lactate levels. Blood–gas analysis is a readily
available bedside tool on every intensive care ward to measure these factors prior to
application, thus facilitating a calculated decision on a transfusion's quantity and
duration. Our first goal is to assess the impact of storage time on pH, potassium, and lactate
levels in pRBC. The influence of those parameters in the transfused children will then be
evaluated. Methods In this retrospective study, we conducted blood–gas analyses of pRBC units
before they were administered over 4 hours to neonates, infants, and children in our
pediatric cardiac intensive care ward. All patients underwent regular blood–gas analyses
themselves, before and after transfusion. Results We observed a highly significant correlation between the storage time of
pRBC units and a drop in pH, as well as an increase in potassium and lactate of stored red
cells ( p < 0.0001). Median age of recipients with a complete blood–gas dataset
was 0.1 (interquartile range [IQR] = 0.0–0.7) years; median pRBC storage duration was 6
(IQR = 5–8) days. Further analyses showed no statistically significant effect on
children's blood gases within 4 hours after transfusion, even after stratifying for pRBC
storage time ≤7 days and >7 days. Conclusion Stored red blood cells show a rapid decrease in pH and increase in
potassium and lactate. Slow transfusion of these units had no adverse effects on the
recipients' pH, potassium, and lactate levels.
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Affiliation(s)
- Christoph Zürn
- Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Centre Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - René Höhn
- Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Centre Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - David Hübner
- Department of Machine Learning for Medical Applications, Averbis GmbH, Freiburg, Germany
| | - Markus Umhau
- Institute for Transfusion Medicine and Gene Therapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Johannes Kroll
- Department of Cardiovascular Surgery, University Heart Centre Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Fabian A Kari
- Department of Cardiovascular Surgery, University Heart Centre Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Frank Humburger
- Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Sven Maier
- Department of Cardiovascular Surgery, University Heart Centre Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Brigitte Stiller
- Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Centre Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
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10
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Bujok J, Wajman E, Trochanowska-Pauk N, Walski T. Evaluation of selected hematological, biochemical and oxidative stress parameters in stored canine CPDA-1 whole blood. BMC Vet Res 2022; 18:255. [PMID: 35778742 PMCID: PMC9248166 DOI: 10.1186/s12917-022-03353-x] [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: 03/01/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
Blood transfusions are mainly given to intensive care patients; therefore, additional complications that could arise from storage lesions in preserved blood should be avoided. It has been shown that human stored red blood cells are subject to changes that are considered to be a number of interdependent processes involving metabolic disarrangement and oxidative stress. The aim of our study was to determine alterations in selected hematological and biochemical parameters and to assess whether and when oxidative stress is a significant phenomenon in stored dog CPDA-1 whole blood. Ten ½ unit bags of whole blood donated from dogs and preserved with CPDA-1 (anticoagulant containing citrate, phosphate, dextrose and adenine) were stored for 5 weeks. Each week, a 9 ml sample was drawn aseptically to measure hematological parameters, selected metabolites, free hemoglobin content, osmotic fragility, antioxidant enzyme activity, total antioxidant capacity, malondialdehyde concentration and protein carbonyl content. The results revealed an MCV decrease in the first week of storage and then a gradual increase; osmotic fragility decreased at that time and remained low throughout the study period. Leukodepletion became significant in the fourth week of storage. The free hemoglobin concentration continuously increased, with the greatest changes observed in the last two weeks of storage. The total antioxidant capacity changed in a reverse manner. Superoxide dismutase and glutathione peroxidase activities decreased from week 0 to week 3, and catalase activity tended to decrease over time. The highest malondialdehyde concentrations in blood supernatant were measured in the first week of storage, and the carbonyl concentration increased after 35 days. Hematological changes and oxidative stress are already present in the first week of storage, resulting in depletion of the antioxidant system and subsequent accumulation of oxidation products as well as erythrocyte hemolysis, which are most pronounced at the end of the storage period.
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Affiliation(s)
- Jolanta Bujok
- Department of Animal Physiology and Biostructure, Division of Animal Physiology, Wrocław University of Environmental and Life Sciences, C.K. Norwida 31, 50-375, Wrocław, Poland.
| | - Eliza Wajman
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wrocław, Poland
| | - Natalia Trochanowska-Pauk
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wrocław, Poland.,Department of Physics and Biophysics, Wrocław University of Environmental and Life Sciences, C.K. Norwida 25, 50-375, Wrocław, Poland
| | - Tomasz Walski
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wrocław, Poland
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11
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Stevens-Hernandez CJ, Bruce LJ. Reticulocyte Maturation. MEMBRANES 2022; 12:membranes12030311. [PMID: 35323786 PMCID: PMC8953437 DOI: 10.3390/membranes12030311] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 02/04/2023]
Abstract
Changes to the membrane proteins and rearrangement of the cytoskeleton must occur for a reticulocyte to mature into a red blood cell (RBC). Different mechanisms of reticulocyte maturation have been proposed to reduce the size and volume of the reticulocyte plasma membrane and to eliminate residual organelles. Lysosomal protein degradation, exosome release, autophagy and the extrusion of large autophagic–endocytic hybrid vesicles have been shown to contribute to reticulocyte maturation. These processes may occur simultaneously or perhaps sequentially. Reticulocyte maturation is incompletely understood and requires further investigation. RBCs with membrane defects or cation leak disorders caused by genetic variants offer an insight into reticulocyte maturation as they present characteristics of incomplete maturation. In this review, we compare the structure of the mature RBC membrane with that of the reticulocyte. We discuss the mechanisms of reticulocyte maturation with a focus on incomplete reticulocyte maturation in red cell variants.
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Affiliation(s)
- Christian J. Stevens-Hernandez
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol BS34 7QH, UK;
- School of Biochemistry, University of Bristol, Bristol BS8 ITD, UK
| | - Lesley J. Bruce
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol BS34 7QH, UK;
- Correspondence:
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12
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Li H, Fang K, Peng H, He L, Wang Y. The relationship between glycosylated hemoglobin level and red blood cell storage lesion in blood donors. Transfusion 2022; 62:663-674. [PMID: 35137967 DOI: 10.1111/trf.16815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Glycosylated hemoglobin (HbA1c), not routinely screened in blood donors, is associated with morphological, biochemical, and functional abnormalities of red blood cells (RBCs) and with enhanced oxidative stress. We aimed to explore HbA1c levels in blood donors and their effect on RBC storage. STUDY DESIGN AND METHODS An analytical cross-sectional study was conducted on 875 eligible blood donors aged 18-60 years from May 1, 2021, to August 30, 2021. Two selected groups of donors (HbA1c <6.5%, n = 10; HbA1c ≥ 6.5%, n = 10) exhibiting as similar as possible baseline values (such as age, sex, and living habits, etc.) were recruited for blood donation in leukoreduced CPDA-1 units. RBC morphological, biochemical, structural, and oxidative stress states were measured during 5-35 days of storage. RESULTS Elevated HbA1c prevalence was 37%, including 31.7% (277/875) in the prediabetes range (HbA1c 5.7%-6.4%) and 5.4% (47/875) in the diabetes range (HbA1c ≥ 6.5%). Age, body mass index (BMI), smoking, and alcohol consumption were the main factors influencing the HbA1c levels. During storage, high-HbA1c group had abnormal RBC morphology, impaired membrane function, and ion imbalance (higher mean corpuscular volume, distribution width, hemolysis rate, potassium ion efflux, and phosphatidylserine exposure) as compared with low HbA1c group. Additionally, RBC oxidative stress was significantly increased in donors with high HbA1c levels during 21-35 days. DISCUSSION Blood donors proportion with abnormal HbA1c levels was relatively high, and donor HbA1c levels may be associated with stored RBCs capacity. Our study provides new insights into the different effects of donor HbA1c levels on RBC storage lesions.
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Affiliation(s)
- Hongyan Li
- Department of Blood Transfusion, Xiangya Second Hospital, Central South University, Changsha Province, China
| | - Kuiming Fang
- Department of Blood Quality Management, Yueyang Central Blood Bank, Yueyang City, Hunan Province, China
| | - Haibo Peng
- Department of Blood Quality Management, Yueyang Central Blood Bank, Yueyang City, Hunan Province, China
| | - Li He
- Department of Blood Transfusion, Xiangya Second Hospital, Central South University, Changsha Province, China
| | - Yongjun Wang
- Department of Blood Transfusion, Xiangya Second Hospital, Central South University, Changsha Province, China
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13
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Zhang Y, Huang G, Yuan Z, Zhang Y, Chen X, Huang J, Li N, Liu Z, Zhong W, Huang H, Huang C, Wei Y. Profiling and Bioinformatics Analysis Revealing Differential Circular RNA Expression about Storage Lesion Regulatory in Stored Red Blood Cells. Transfus Med Hemother 2021; 49:76-87. [DOI: 10.1159/000519626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 09/08/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction: Circular RNA (circRNA) plays an important role in regulating metabolism of red blood cells (RBCs) and their storage lesions, but the study of how circRNA expression changes in stored RBCs has rarely been conducted. Methods: The expression change of circRNA was systemically evaluated via high-throughput sequencing on healthy RBCs on day 0, 20, and 40. And then we confirmed the reliability of the high-throughput sequencing analysis by RT-qPCR characterization on selected circRNAs. A higher parental gene enrichment was used to explore circRNA function in pathways. In addition, we deciphered a dysregulated circRNA-related ceRNAs network, and identified three circRNA-miRNA-mRNA regulatory axes related to storage lesion. Results: We identified 2,586 known and 6,216 putative novel circRNAs, more than 100 circRNAs expression levels were shifted, and the number of downregulated circRNAs was greater with longer storage time. Furthermore, a higher parental gene enrichment related to circRNA was found in pathways, including cAMP signaling pathway, ubiquitin-mediated proteolysis, apoptosis, adhesion, MAPK signaling pathway, cystine methionine metabolism, RNA degradation, RNA transport, TGF-β, and actin regulatory pathway. hsa_circ_0007127-miR-513a-5p-SMAD4, hsa_circ_0000033-miR-19a-3p-VAMP3, and hsa_circ_0005546-miR-4720-CCND3 regulatory axes related to storage lesion was found. Conclusions: Through investigation in circRNAs profile and circRNA-miRNA-mRNA interactions, this study provides insights on stored RBC circRNA expression changes, which closely relate to the storage lesion of RBCs and their physiological functions.
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14
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Livshits L, Barshtein G, Arbell D, Gural A, Levin C, Guizouarn H. Do We Store Packed Red Blood Cells under "Quasi-Diabetic" Conditions? Biomolecules 2021; 11:biom11070992. [PMID: 34356616 PMCID: PMC8301930 DOI: 10.3390/biom11070992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/21/2021] [Accepted: 07/01/2021] [Indexed: 01/28/2023] Open
Abstract
Red blood cell (RBC) transfusion is one of the most common therapeutic procedures in modern medicine. Although frequently lifesaving, it often has deleterious side effects. RBC quality is one of the critical factors for transfusion efficacy and safety. The role of various factors in the cells’ ability to maintain their functionality during storage is widely discussed in professional literature. Thus, the extra- and intracellular factors inducing an accelerated RBC aging need to be identified and therapeutically modified. Despite the extensively studied in vivo effect of chronic hyperglycemia on RBC hemodynamic and metabolic properties, as well as on their lifespan, only limited attention has been directed at the high sugar concentration in RBCs storage media, a possible cause of damage to red blood cells. This mini-review aims to compare the biophysical and biochemical changes observed in the red blood cells during cold storage and in patients with non-insulin-dependent diabetes mellitus (NIDDM). Given the well-described corresponding RBC alterations in NIDDM and during cold storage, we may regard the stored (especially long-stored) RBCs as “quasi-diabetic”. Keeping in mind that these RBC modifications may be crucial for the initial steps of microvascular pathogenesis, suitable preventive care for the transfused patients should be considered. We hope that our hypothesis will stimulate targeted experimental research to establish a relationship between a high sugar concentration in a storage medium and a deterioration in cells’ functional properties during storage.
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Affiliation(s)
- Leonid Livshits
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zürich, CH-8057 Zurich, Switzerland;
| | - Gregory Barshtein
- Biochemistry Department, The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91905, Israel
- Correspondence: ; Tel.: +972-2-6758309
| | - Dan Arbell
- Pediatric Surgery Department, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel;
| | - Alexander Gural
- Department of Hematology, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel;
| | - Carina Levin
- Pediatric Hematology Unit, Emek Medical Center, Afula 1834111, Israel;
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 32000, Israel
| | - Hélène Guizouarn
- Institut de Biologie Valrose, Université Côte d’Azur, CNRS, Inserm, 28 Av. Valrose, 06100 Nice, France;
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15
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Zimna A, Kaczmarska M, Szczesny-Malysiak E, Wajda A, Bulat K, Alcicek FC, Zygmunt M, Sacha T, Marzec KM. An Insight into the Stages of Ion Leakage during Red Blood Cell Storage. Int J Mol Sci 2021; 22:ijms22062885. [PMID: 33809183 PMCID: PMC7998123 DOI: 10.3390/ijms22062885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/20/2022] Open
Abstract
Packed red blood cells (pRBCs), the most commonly transfused blood product, are exposed to environmental disruptions during storage in blood banks. In this study, temporal sequence of changes in the ion exchange in pRBCs was analyzed. Standard techniques commonly used in electrolyte measurements were implemented. The relationship between ion exchange and red blood cells (RBCs) morphology was assessed with use of atomic force microscopy with reference to morphological parameters. Variations observed in the Na+, K+, Cl−, H+, HCO3−, and lactate ions concentration show a complete picture of singly-charged ion changes in pRBCs during storage. Correlation between the rate of ion changes and blood group type, regarding the limitations of our research, suggested, that group 0 is the most sensitive to the time-dependent ionic changes. Additionally, the impact of irreversible changes in ion exchange on the RBCs membrane was observed in nanoscale. Results demonstrate that the level of ion leakage that leads to destructive alterations in biochemical and morphological properties of pRBCs depend on the storage timepoint.
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Affiliation(s)
- Anna Zimna
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, 14 Bobrzynskiego St., 30-348 Krakow, Poland; (A.Z.); (E.S.-M.); (A.W.); (K.B.); (F.C.A.)
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna St., 30-688 Krakow, Poland;
| | - Magdalena Kaczmarska
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, 14 Bobrzynskiego St., 30-348 Krakow, Poland; (A.Z.); (E.S.-M.); (A.W.); (K.B.); (F.C.A.)
- Correspondence: (M.K.); (K.M.M.); Tel.: +48-12-297-5472 (M.K.); +48-12-664-5476 (K.M.M.)
| | - Ewa Szczesny-Malysiak
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, 14 Bobrzynskiego St., 30-348 Krakow, Poland; (A.Z.); (E.S.-M.); (A.W.); (K.B.); (F.C.A.)
| | - Aleksandra Wajda
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, 14 Bobrzynskiego St., 30-348 Krakow, Poland; (A.Z.); (E.S.-M.); (A.W.); (K.B.); (F.C.A.)
- Faculty of Materials Science and Ceramics, AGH University of Science and Technology, 30 Mickiewicza St., 30-059 Krakow, Poland
| | - Katarzyna Bulat
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, 14 Bobrzynskiego St., 30-348 Krakow, Poland; (A.Z.); (E.S.-M.); (A.W.); (K.B.); (F.C.A.)
| | - Fatih Celal Alcicek
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, 14 Bobrzynskiego St., 30-348 Krakow, Poland; (A.Z.); (E.S.-M.); (A.W.); (K.B.); (F.C.A.)
| | - Malgorzata Zygmunt
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna St., 30-688 Krakow, Poland;
| | - Tomasz Sacha
- Chair of Haematology, Faculty of Medicine, Jagiellonian University Medical College, 12 sw. Anny St., 30-008 Krakow, Poland;
- Department of Haematology, Jagiellonian University Hospital, 17 Kopernika St., 31-501 Krakow, Poland
| | - Katarzyna Maria Marzec
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, 14 Bobrzynskiego St., 30-348 Krakow, Poland; (A.Z.); (E.S.-M.); (A.W.); (K.B.); (F.C.A.)
- Correspondence: (M.K.); (K.M.M.); Tel.: +48-12-297-5472 (M.K.); +48-12-664-5476 (K.M.M.)
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16
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Al Audhah N, Suhartono E, Sardjono TW, Fitri LE. Duration of Storage Reduced Erythrocytes Profiles and Plasmodium Viability in Donor Blood. J Blood Med 2021; 12:87-99. [PMID: 33654448 PMCID: PMC7910220 DOI: 10.2147/jbm.s276069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Malaria screening for blood derived from any donors prior to transfusions is a standard procedure that should be performed; but, in fact, it is not routinely conducted. In case of the blood is infected with Plasmodium spp., the survival of parasites may be depending on, or even influencing, the profile of red blood cells (RBCs). METHODS This observational longitudinal study was conducted upon 55 bags of donor blood that randomly selected. Malaria infections were detected using Rapid Diagnostic Test/RDT with thin and thick blood smear confirmation. The changes of Plasmodium spp. viability and RBCs profiles, as well as other hematological parameters, were observed from the results of routine hematological examinations which were performed on days 1,7,14 and 21 of storage. RESULTS Among 55 blood samples, there were 17 and 38 bags, respectively, positive and negative for malaria, then used for analysis as the case and control groups. There were significant decreasing values (p<0.05) of all routine blood examination parameters of donor blood, started from days 1, 7, 14, 21, and 28. There were no differences in decreasing profiles between those infected and non-infected donor blood (p>0.05). On days 21 and 28 none of the positive samples still contained parasites. CONCLUSION Erythrocytes profiles of donor blood significantly decreased with the duration of storage, but were not influenced by the presence of Plasmodium spp.
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Affiliation(s)
- Nelly Al Audhah
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Department of Parasitology, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia
| | - Eko Suhartono
- Department of Chemistry/Biochemistry, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia
| | - Teguh Wahju Sardjono
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Loeki Enggar Fitri
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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17
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Yarnoff K, Dodd-O JM. Mixing commonly used crystalloid solutions with red blood cells in five common additives does not negatively impact hemolysis, aggregometry, or deformability. Transfusion 2020; 60:2991-3000. [PMID: 33032376 DOI: 10.1111/trf.16089] [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: 12/04/2019] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Literature is beginning to challenge the belief that it is unsafe to coinfuse red blood cells (RBCs) with solutions other than isotonic saline. We recently showed that additive-free RBCs tolerated coincubation with Plasma-Lyte or catecholamines dissolved in normal saline (NS), though 5% dextrose in water (D5W) promoted hemolysis. Herein, we evaluate the effect of coincubating crystalloids on additive-preserved RBC hemolysis, aggregation, and membrane deformability. STUDY DESIGN AND METHODS RBCs were coincubated 5 minutes with plasma, NS, Plasma-Lyte, lactated Ringer's (LR) or D5W (1 mL PRBC +131.3 μL solution). Samples were then assessed for hemolysis (free hemoglobin), aggregation (critical shear stress [mPa]), and membrane deformability (elongation index [EI]). Significance (P ≤ .05) by t test or ANOVA with post-hoc Tukey-Kramer test. RESULTS Additive-prepared RBCs coincubated with crystalloid instead of plasma demonstrated: (a) no increase in hemolysis as indicated by plasma free hemoglobin levels that is likely to be clinically relevant; (b) no increase, but in some cases a decrease, in aggregation as indicated by critical shear stress; and (c) in some combinations, a deterioration in deformability. When present, the deformability decrease was likely clinically insignificant in degree, and always returned to normal when the crystalloid was subsequently diluted out with plasma. CONCLUSION Our data suggest that additive-prepared RBCs coincubated for 5 minutes with any of four common crystalloids demonstrate no clinically relevant increased lysis, increased aggregation, or decreased deformability.
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Affiliation(s)
- Kristine Yarnoff
- Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeffrey M Dodd-O
- Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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18
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Changes in Complement Levels and Activity of Red Blood Cells, Fresh Frozen Plasma, and Platelet Concentrates During Storage. Indian J Hematol Blood Transfus 2020; 37:140-146. [PMID: 33707847 DOI: 10.1007/s12288-020-01338-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 08/14/2020] [Indexed: 12/14/2022] Open
Abstract
Complement cascade plays an important role in the field of transfusion medicine. The study aimed to detect the complement levels of different blood components and different blood types to explore the risk of transfusion of stored blood. The samples including red blood cells (n = 110), fresh frozen plasma (n = 120), and platelet concentrates (n = 104) from healthy blood donors in our center were collected. Complement components (C3, C4, C3b, C3d, and CH50) were assayed to evaluate the activation of complement. The complement levels of various blood components at different storage times were observed. The differences in complement levels of four blood types in various blood components were compared. The complement levels of red blood cells in storage were low, with no significant changes (P > 0.05). C3b and C3d levels in platelets began to significantly increase after storage for 3 days (P < 0.05). The fresh frozen plasma during storage had higher complement levels, and the concentrations of C3 and C4 decreased and C3b and C3d increased at month 4 (P < 0.05). The differences in complement levels of four blood types in various blood components did not significantly change (P > 0.05), but the C3b and C3d levels of AB fresh frozen plasma remained stable during storage, which different from other blood types. The transfusion of red blood cells was relatively safe in terms of complement activation. The activation of complement proteins occurred during the storage of platelet and plasma, except group AB plasma.
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19
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Lu M, Shevkoplyas SS. Dynamics of shape recovery by stored red blood cells during washing at the single cell level. Transfusion 2020; 60:2370-2378. [PMID: 32748970 DOI: 10.1111/trf.15979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hypothermic storage transforms red blood cells (RBC) from smooth biconcave discocytes into increasingly spherical spiculated echinocytes and, ultimately, fragile spherocytes (S). Individual cells undergo this transformation at different rates, producing a heterogeneous mixture of RBCs at all stages of echinocytosis in each unit of stored blood. Here we investigated how washing (known to positively affect RBC properties) changes morphology of individual RBCs at the single-cell level. STUDY DESIGN AND METHODS We tracked the change in shape of individual RBCs (n = 2870; drawn from six 4- to 6-week-old RBC units) that were confined in an array of microfluidic wells during washing in saline (n = 1095), 1% human serum albumin (1% HSA) solution (n = 999), and the autologous storage supernatant (control, n = 776). RESULTS Shape recovery proceeded through the disappearance of spicules followed by the progressive smoothening of the RBC contour, with the majority of changes occurring within the initial 10 minutes of being exposed to the washing solution. Approximately 57% of all echinocytes recovered by at least one morphologic class when washed in 1% HSA (36% for normal saline), with 3% of cells in late-stage echinocytosis restoring their discoid shape completely. Approximately one-third of all spherocytic cells were lysed in either washing solution. Cells washed in their autologous storage supernatant continued to deteriorate during washing. CONCLUSION Our findings suggest that the replacement of storage supernatant with a washing solution during washing induces actual shape recovery for RBCs in all stages of echinocytosis, except for S that undergo lysis instead.
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Affiliation(s)
- Madeleine Lu
- Department of Biomedical Engineering, University of Houston, Houston, Texas
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20
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Kaczmarska M, Grosicki M, Bulat K, Mardyla M, Szczesny-Malysiak E, Blat A, Dybas J, Sacha T, Marzec KM. Temporal sequence of the human RBCs' vesiculation observed in nano-scale with application of AFM and complementary techniques. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2020; 28:102221. [PMID: 32438105 DOI: 10.1016/j.nano.2020.102221] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/27/2020] [Accepted: 04/26/2020] [Indexed: 12/22/2022]
Abstract
Based on the multimodal characterization of human red blood cells (RBCs), the link between the storage-related sequence of the nanoscale changes in RBC membranes in the relation to their biochemical profile as well as mechanical and functional properties was presented. On the background of the accumulation of RBCs waste products, programmed cell death and impaired rheological properties, progressive alterations in the RBC membranes including changes in their height and diameter as well as the in situ characterization of RBC-derived microparticles (RMPs) on the RBCs surface were presented. The advantage of atomic force microscopy (AFM) in RMPs visualization, even at the very early stage of vesiculation, was shown based on the results revealed by other reference techniques. The nanoscale characterization of RMPs was correlated with a decrease in cholesterol and triglycerides levels in the RBC membranes, proving the link between the lipids leakage from RBCs and the process of vesiculation.
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Affiliation(s)
- Magdalena Kaczmarska
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Marek Grosicki
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Katarzyna Bulat
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Mateusz Mardyla
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland; Faculty of Motor Rehabilitation, University of Physical Education, Krakow, Poland
| | - Ewa Szczesny-Malysiak
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Aneta Blat
- Faculty of Chemistry, Jagiellonian University, Krakow, Poland
| | - Jakub Dybas
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Tomasz Sacha
- Chair and Department of Hematology, Jagiellonian University Hospital, Krakow, Poland
| | - Katarzyna M Marzec
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland.
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Bernhardt I, Nguyen DB, Wesseling MC, Kaestner L. Intracellular Ca 2+ Concentration and Phosphatidylserine Exposure in Healthy Human Erythrocytes in Dependence on in vivo Cell Age. Front Physiol 2020; 10:1629. [PMID: 31998145 PMCID: PMC6965055 DOI: 10.3389/fphys.2019.01629] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/24/2019] [Indexed: 12/24/2022] Open
Abstract
After about 120 days of circulation in the blood stream, erythrocytes are cleared by macrophages in the spleen and the liver. The “eat me” signal of this event is thought to be the translocation of phosphatidylserine from the inner to the outer membrane leaflet due to activation of the scramblase, while the flippase is inactivated. Both processes are triggered by an increased intracellular Ca2+ concentration. Although this is not the only mechanism involved in erythrocyte clearance, in this minireview, we focus on the following questions: Is the intracellular-free Ca2+ concentration and hence phosphatidylserine exposure dependent on the erythrocyte age, i.e. is the Ca2+ concentration, progressively raising during the erythrocyte aging in vivo? Can putative differences in intracellular Ca2+ and exposure of phosphatidylserine to the outer membrane leaflet be measured in age separated cell populations? Literature research revealed less than dozen of such publications with vastly contradicting results for the Ca2+ concentrations but consistency for a lack of change for the phosphatidylserine exposure. Additionally, we performed reanalysis of published data resulting in an ostensive illustration of the situation described above. Relating these results to erythrocyte physiology and biochemistry, we can conclude that the variation of the intracellular free Ca2+ concentration is limited with 10 μM as the upper level of the concentration. Furthermore, we propose the hypothesis that variations in measured Ca2+ concentrations may to a large extent depend on the experimental conditions applied but reflect a putatively changed Ca2+ susceptibility of erythrocytes in dependence of in vivo cell age.
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Affiliation(s)
- Ingolf Bernhardt
- Laboratory of Biophysics, Faculty of Natural Science and Technology, Saarland University, Saarbrücken, Germany
| | - Duc Bach Nguyen
- Laboratory of Biophysics, Faculty of Natural Science and Technology, Saarland University, Saarbrücken, Germany
| | - Mauro C Wesseling
- Laboratory of Biophysics, Faculty of Natural Science and Technology, Saarland University, Saarbrücken, Germany
| | - Lars Kaestner
- Experimental Physics, Faculty of Natural Science and Technology, Saarland University, Saarbrücken, Germany.,Theoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg, Germany
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22
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Kaestner L, Bogdanova A, Egee S. Calcium Channels and Calcium-Regulated Channels in Human Red Blood Cells. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1131:625-648. [PMID: 31646528 DOI: 10.1007/978-3-030-12457-1_25] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Free Calcium (Ca2+) is an important and universal signalling entity in all cells, red blood cells included. Although mature mammalian red blood cells are believed to not contain organelles as Ca2+ stores such as the endoplasmic reticulum or mitochondria, a 20,000-fold gradient based on a intracellular Ca2+ concentration of approximately 60 nM vs. an extracellular concentration of 1.2 mM makes Ca2+-permeable channels a major signalling tool of red blood cells. However, the internal Ca2+ concentration is tightly controlled, regulated and maintained primarily by the Ca2+ pumps PMCA1 and PMCA4. Within the last two decades it became evident that an increased intracellular Ca2+ is associated with red blood cell clearance in the spleen and promotes red blood cell aggregability and clot formation. In contrast to this rather uncontrolled deadly Ca2+ signals only recently it became evident, that a temporal increase in intracellular Ca2+ can also have positive effects such as the modulation of the red blood cells O2 binding properties or even be vital for brief transient cellular volume adaptation when passing constrictions like small capillaries or slits in the spleen. Here we give an overview of Ca2+ channels and Ca2+-regulated channels in red blood cells, namely the Gárdos channel, the non-selective voltage dependent cation channel, Piezo1, the NMDA receptor, VDAC, TRPC channels, CaV2.1, a Ca2+-inhibited channel novel to red blood cells and i.a. relate these channels to the molecular unknown sickle cell disease conductance Psickle. Particular attention is given to correlation of functional measurements with molecular entities as well as the physiological and pathophysiological function of these channels. This view is in constant progress and in particular the understanding of the interaction of several ion channels in a physiological context just started. This includes on the one hand channelopathies, where a mutation of the ion channel is the direct cause of the disease, like Hereditary Xerocytosis and the Gárdos Channelopathy. On the other hand it applies to red blood cell related diseases where an altered channel activity is a secondary effect like in sickle cell disease or thalassemia. Also these secondary effects should receive medical and pharmacologic attention because they can be crucial when it comes to the life-threatening symptoms of the disease.
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Affiliation(s)
- Lars Kaestner
- Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany. .,Experimental Physics, Saarland University, Saarbrücken, Germany.
| | - Anna Bogdanova
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zürich Center for Integrative Human Physiology (ZIHP), University of Zürich, Zürich, Switzerland
| | - Stephane Egee
- CNRS, UMR8227 LBI2M, Sorbonne Université, Roscoff, France.,Laboratoire d'Excellence GR-Ex, Paris, France
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23
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Luan X, Wang H, Xiang Z, Ma Z, Zhao J, Feng Y, Shi Q, Yin J. Biomimicking Dual-Responsive Extracellular Matrix Restoring Extracellular Balance through the Na/K-ATPase Pathway. ACS APPLIED MATERIALS & INTERFACES 2019; 11:21258-21267. [PMID: 31117462 DOI: 10.1021/acsami.9b05420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Biomedical implant mimicking the physiological extracellular matrix (ECM) is a new strategy to modulate the cell microenvironment to improve implant integrity and longevity. However, the biomimicking ECM suffers from low sensitivity to pathological change and low efficiency to restore the physiological state in vivo. To overcome these problems, reactive oxygen species (ROS) and K+ dual-responsive micro-/nanofibers that encapsulate ascorbic acid-2-glucoside (AA-2G) are fabricated on an elastomer substrate with electrospinning to mimic the ECM. The strategy is based on the fact that ROS and K+ dual responsiveness enhance the sensitivity of the ECM to pathological changes and delivery of AA-2G from the ECM to cell membrane promotes reactivating Na/K-ATPase and shifting cellular diseased conditions to the normal state. We demonstrate that the ROS and K+-responsive tripolymer of poly(ethylene glycol)diacrylate, 1,2-ethanedithiol, and 4-nitrobenzo-18-crown-6-ether (PEGDA-EDT-BCAm) are synthesized successfully; the ECM composed of acylated poly(caprolactone)/PEGDA-EDT-BCAm/AA-2G micro-/nanofibers is prepared through reactive electrospinning; the ECM is sensitive to ROS and K+ concentration in the microenvironment to release AA-2G, which targets the membrane to remove the excessive ROS and reactivate Na/K-ATPase; as a result, the ECM reduces oxidative stress and restores the extracellular physiological state both in vitro and in vivo. This work provides basic principles to design an implant that can adjust the extracellular microenvironment while avoiding pathogenicity to improve implant integrity and longevity in vivo.
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Affiliation(s)
- Xingkun Luan
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry , Chinese Academy of Sciences , Changchun , Jilin 130022 , China
- Key Laboratory of Olefin Catalysis and Polymerization/Key Laboratory of Rubber-Plastics (QUST) of Shandong Provincial , Qingdao University of Science and Technology , Qingdao 266042 , P. R. China
| | - Haozheng Wang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry , Chinese Academy of Sciences , Changchun , Jilin 130022 , China
- Key Laboratory of Olefin Catalysis and Polymerization/Key Laboratory of Rubber-Plastics (QUST) of Shandong Provincial , Qingdao University of Science and Technology , Qingdao 266042 , P. R. China
| | - Zehong Xiang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry , Chinese Academy of Sciences , Changchun , Jilin 130022 , China
| | - Zhifang Ma
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry , Chinese Academy of Sciences , Changchun , Jilin 130022 , China
| | - Jiruo Zhao
- Key Laboratory of Olefin Catalysis and Polymerization/Key Laboratory of Rubber-Plastics (QUST) of Shandong Provincial , Qingdao University of Science and Technology , Qingdao 266042 , P. R. China
| | - Ying Feng
- Key Laboratory of Olefin Catalysis and Polymerization/Key Laboratory of Rubber-Plastics (QUST) of Shandong Provincial , Qingdao University of Science and Technology , Qingdao 266042 , P. R. China
| | - Qiang Shi
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry , Chinese Academy of Sciences , Changchun , Jilin 130022 , China
- University of Science and Technology of China , Hefei , Anhui 230026 , P. R. China
| | - Jinghua Yin
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry , Chinese Academy of Sciences , Changchun , Jilin 130022 , China
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24
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Lu M, Lezzar DL, Vörös E, Shevkoplyas SS. Traditional and emerging technologies for washing and volume reducing blood products. J Blood Med 2019; 10:37-46. [PMID: 30655711 PMCID: PMC6322496 DOI: 10.2147/jbm.s166316] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Millions of blood components including red blood cells, platelets, and granulocytes are transfused each year in the United States. The transfusion of these blood products may be associated with adverse clinical outcomes in some patients due to residual proteins and other contaminants that accumulate in blood units during processing and storage. Blood products are, therefore, often washed in normal saline or other media to remove the contaminants and improve the quality of blood cells before transfusion. While there are numerous methods for washing and volume reducing blood components, a vast majority utilize centrifugation-based processing, such as manual centrifugation, open and closed cell processing systems, and cell salvage/autotransfusion devices. Although these technologies are widely employed with a relatively low risk to the average patient, there is evidence that centrifugation-based processing may be inadequate when transfusing to immunocompromised patients, neonatal and infant patients, or patients susceptible to transfusion-related allergic reactions. Cell separation and volume reduction techniques that employ centrifugation have been shown to damage blood cells, contributing to these adverse outcomes. The limitations and disadvantages of centrifugation-based processing have spurred the development of novel centrifugation-free methods for washing and volume reducing blood components, thereby causing significantly less damage to the cells. Some of these emerging technologies are already transforming niche applications, poised to enter mainstream blood cell processing in the not too distant future.
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Affiliation(s)
- Madeleine Lu
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060, USA,
| | - Dalia L Lezzar
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060, USA,
| | - Eszter Vörös
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060, USA,
| | - Sergey S Shevkoplyas
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060, USA,
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25
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Luan X, Wang H, Xiang Z, Zhao J, Feng Y, Shi Q, Baijun liu BL, Gong Y, Wong SC, Yin J. Construction of K+ responsive surface on SEBS to reduce the hemolysis of preserved erythrocytes. RSC Adv 2019; 9:5251-5258. [PMID: 35515950 PMCID: PMC9060672 DOI: 10.1039/c8ra08215d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/05/2019] [Indexed: 02/04/2023] Open
Abstract
Hemolysis of stored erythrocytes is a big obstacle for the development of new plasticizer-free polymer containers. Hemolysis is mainly caused by cell membrane oxidation and cation leaks from the intracellular fluid during storage. To construct an anti-hemolytic surface for a plasticizer-free polymer, we fabricated 2-O-α-d-glucopyranosyl-l-ascorbic acid (AA-2G)-loaded polycaprolactone (PCL)-crown ether micro/nanofibers on the surface of styrene-b-(ethylene-co-butylene)-b-styrene (SEBS). Our strategy is based on the sensitive response of the crown ether to leaked potassium, causing the release of AA-2G, the AA-2G can then remove the excess ROS, maintaining the Na/K-pump activity and the cell integrity. We demonstrated that the PCL-crown ether micro/nanofibers have been well prepared on the surface of SEBS; the micro/nanofibers provide a sensitive response to excess K+ and trigger the rapid release of AA-2G. AA-2G then acts as an antioxidant to reduce the excess ROS and maintain the Na/K-pump activity to mitigate cation leaks, resulting in the reduced hemolysis of the preserved erythrocytes. Our work thus provides a novel method for the development of plasticizer-free polymers for the storage of erythrocytes, and has the potential to be used to fabricate long-term anti-hemolytic biomaterials for in vivo use. A K+ responsive surface was constructed on a SEBS substrate to release anti-oxidants to reduce hemolysis of the preserved red blood cells.![]()
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Affiliation(s)
- Xingkun Luan
- Shandong Provincial Key Laboratory of Olefin Catalysis and Polymerization
- Key Laboratory of Rubber-Plastics (QUST)
- Ministry of Education/Shandong
- Qindao University of Science and Technology
- Qingdao 266042
| | - Haozheng Wang
- Shandong Provincial Key Laboratory of Olefin Catalysis and Polymerization
- Key Laboratory of Rubber-Plastics (QUST)
- Ministry of Education/Shandong
- Qindao University of Science and Technology
- Qingdao 266042
| | - Zehong Xiang
- State Key Laboratory of Polymer Physics and Chemistry
- Changchun Institute of Applied Chemistry
- Chinese Academy of Sciences
- Changchun 130022
- P. R. China
| | - Jiruo Zhao
- Shandong Provincial Key Laboratory of Olefin Catalysis and Polymerization
- Key Laboratory of Rubber-Plastics (QUST)
- Ministry of Education/Shandong
- Qindao University of Science and Technology
- Qingdao 266042
| | - Ying Feng
- Shandong Provincial Key Laboratory of Olefin Catalysis and Polymerization
- Key Laboratory of Rubber-Plastics (QUST)
- Ministry of Education/Shandong
- Qindao University of Science and Technology
- Qingdao 266042
| | - Qiang Shi
- State Key Laboratory of Polymer Physics and Chemistry
- Changchun Institute of Applied Chemistry
- Chinese Academy of Sciences
- Changchun 130022
- P. R. China
| | | | - Yumei Gong
- School of Textile and Material Engineering
- Dalian Polytechnic University
- Dalian 116034
- P. R. China
| | | | - Jinghua Yin
- State Key Laboratory of Polymer Physics and Chemistry
- Changchun Institute of Applied Chemistry
- Chinese Academy of Sciences
- Changchun 130022
- P. R. China
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26
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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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27
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Thielen AJF, Meulenbroek EM, Baas I, Bruggen R, Zeerleder SS, Wouters D. Complement Deposition and IgG Binding on Stored Red Blood Cells Are Independent of Storage Time. Transfus Med Hemother 2018; 45:378-384. [PMID: 30574054 DOI: 10.1159/000486759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 01/11/2018] [Indexed: 12/14/2022] Open
Abstract
Background In the Netherlands, red blood cells (RBCs) are allowed to be stored up to 35 days at 2-6 °C in saline-adenine-glucose-mannitol (SAGM). During storage, RBCs undergo several changes that are collectively known as storage lesion. We investigated to what extent complement deposition and antibody binding occurred during RBC storage and investigated phagocytic uptake in vitro. Methods RBCs were stored for different lengths of time at 2-6 °C in SAGM. Complement deposition and antibody binding were assessed upon storage and after incubation with serum. M1- and M2-type macrophages were generated from blood monocytes to investigate RBC phagocytosis. Results No complement deposition was directly observed on stored RBCs, while incubation of RBCs with serum resulted in variable donor-dependent C3 deposition and IgG binding, both independent of storage time. Only 1-4% phagocytosis of stored RBCs by macrophages was observed. Conclusion RBCs are susceptible to complement deposition and antibody binding independent of storage time. Limited phagocytic uptake by macrophages was observed in vitro.
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Affiliation(s)
- Astrid J F Thielen
- Department of Immunopathology, Sanquin Research, Amsterdam, the Netherlands
| | | | - Inge Baas
- Department of Immunopathology, Sanquin Research, Amsterdam, the Netherlands
| | - Robin Bruggen
- Department of Immunopathology, Sanquin Research, Amsterdam, the Netherlands
| | - Sacha S Zeerleder
- Department of Immunopathology, Sanquin Research, Amsterdam, the Netherlands
| | - Diana Wouters
- Department of Immunopathology, Sanquin Research, Amsterdam, the Netherlands
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28
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Koch CG, Duncan AI, Figueroa P, Dai L, Sessler DI, Frank SM, Ness PM, Mihaljevic T, Blackstone EH. Real Age: Red Blood Cell Aging During Storage. Ann Thorac Surg 2018; 107:973-980. [PMID: 30342044 DOI: 10.1016/j.athoracsur.2018.08.073] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/10/2018] [Accepted: 08/20/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND During cold storage, some red blood cell (RBC) units age more rapidly than others. Yet, the Food and Drug Administration has set a uniform storage limit of 42 days. Objectives of this review are to present evidence for an RBC storage lesion and suggest that functional measures of stored RBC quality-which we call real age-may be more appropriate than calendar age. METHODS During RBC storage, biochemical substances and byproducts accumulate and RBC shape alters. Factors that influence the rate of degradation include donor characteristics, bio-preservation conditions, and vesiculation. Better understanding of markers of RBC quality may lead to standardized, quantifiable, and operationally practical measures to improve donor selection, assess quality of an RBC unit, improve storage conditions, and test efficacy of the transfused product. RESULTS The conundrum is that clinical trials of younger versus older RBC units have not aligned with in vitro aging data; that is, the units transfused were not old enough. In vitro changes are considerable beyond 28 to 35 days, and average storage age for older transfused units was 14 to 21 days. CONCLUSIONS RBC product real age varies by donor characteristics, storage conditions, and biological changes during storage. Metrics to measure temporal changes in quality of the stored RBC product may be more appropriate than the 42-day expiration date. Randomized trials and observational studies are focused on average effect, but, in the evolving age of precision medicine, we must acknowledge that vulnerable populations and individuals may be harmed by aging blood.
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Affiliation(s)
- Colleen G Koch
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland.
| | - Andra I Duncan
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio
| | | | - Lu Dai
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio
| | - Daniel I Sessler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | - Steven M Frank
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland
| | - Paul M Ness
- Department of Transfusion Medicine, Johns Hopkins Medicine, Baltimore, Maryland
| | - Tomislav Mihaljevic
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Eugene H Blackstone
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
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29
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Abstract
Supplemental Digital Content is available in the text
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30
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Prudent M, Delobel J, Hübner A, Benay C, Lion N, Tissot JD. Proteomics of Stored Red Blood Cell Membrane and Storage-Induced Microvesicles Reveals the Association of Flotillin-2 With Band 3 Complexes. Front Physiol 2018; 9:421. [PMID: 29780325 PMCID: PMC5945891 DOI: 10.3389/fphys.2018.00421] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/04/2018] [Indexed: 12/15/2022] Open
Abstract
The storage of erythrocyte concentrates (ECs) induces lesions that notably affect metabolism, protein activity, deformability of red blood cells (RBCs), as well as the release of oxygen. Band 3 is one of the proteins affected during the ex vivo aging of RBCs. This membrane protein is an anion transporter, an anchor site for the cytoskeleton and other membrane proteins as well as a binding site for glycolytic enzymes and bears blood group antigens. In the present study, band 3 complexes were isolated from RBCs stored for 7 and 42 days in average (n = 3), as well as from microvesicles (n = 3). After extraction of membrane proteins with a deoxycholate containing buffer, band 3 complexes were co-immunoprecipitated on magnetic beads coated with two anti-band 3 antibodies. Both total membrane protein extracts and eluates (containing band 3 complexes) were separated on SDS-PAGE and analyzed by bottom-up proteomics. It revealed that three proteins were present or absent in band 3 complexes stemming from long-stored or short-stored ECs, respectively, whereas the membrane protein contents remained equivalent. These potential markers for storage-induced RBC aging are adenylosuccinate lyase (ADSL), α-adducin and flotillin-2, and were further analyzed using western blots. ADSL abundance tended to increase during storage in both total membrane protein and band 3 complexes, whereas α-adducin mainly tended to stay onto the membrane extract. Interestingly, flotillin-2 was equivalently present in total membrane proteins whereas it clearly co-immunoprecipitated with band 3 complexes during storage (1.6-fold-change, p = 0.0024). Moreover, flotillin-2 was enriched (almost threefold) in RBCs compared to microvesicles (MVs) (p < 0.001) and the amount found in MVs was associated to band 3 complexes. Different types of band 3 complexes are known to exist in RBCs and further studies will be required to better understand involvement of this protein in microvesiculation during the storage of RBCs.
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Affiliation(s)
- Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Julien Delobel
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland
| | - Aurélie Hübner
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland
| | - Corinne Benay
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
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31
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Time-Course Investigation of Small Molecule Metabolites in MAP-Stored Red Blood Cells Using UPLC-QTOF-MS. Molecules 2018; 23:molecules23040923. [PMID: 29659551 PMCID: PMC6017316 DOI: 10.3390/molecules23040923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/08/2018] [Accepted: 04/12/2018] [Indexed: 01/04/2023] Open
Abstract
Red blood cells (RBCs) are routinely stored for 35 to 42 days in most countries. During storage, RBCs undergo biochemical and biophysical changes known as RBC storage lesion, which is influenced by alternative storage additive solutions (ASs). Metabolomic studies have been completed on RBCs stored in a number of ASs, including SAGM, AS-1, AS-3, AS-5, AS-7, PAGGGM, and MAP. However, the reported metabolome analysis of laboratory-made MAP-stored RBCs was mainly focused on the time-dependent alterations in glycolytic intermediates during storage. In this study, we investigated the time-course of alterations in various small molecule metabolites in RBCs stored in commercially used MAP for 49 days using ultra-high performance liquid chromatography quadruple time-of-flight mass spectrometry (UPLC-QTOF-MS). These alterations indicated that RBC storage lesion is related to multiple pathways including glycolysis, pentose phosphate pathway, glutathione homeostasis, and purine metabolism. Thus, our findings might be useful for understanding the complexity of metabolic mechanisms of RBCs in vitro aging and encourage the deployment of systems biology methods to blood products in transfusion medicine.
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32
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Yurkovich JT, Bordbar A, Sigurjónsson ÓE, Palsson BO. Systems biology as an emerging paradigm in transfusion medicine. BMC SYSTEMS BIOLOGY 2018. [PMID: 29514691 PMCID: PMC5842607 DOI: 10.1186/s12918-018-0558-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Blood transfusions are an important part of modern medicine, delivering approximately 85 million blood units to patients annually. Recently, the field of transfusion medicine has started to benefit from the “omic” data revolution and corresponding systems biology analytics. The red blood cell is the simplest human cell, making it an accessible starting point for the application of systems biology approaches. In this review, we discuss how the use of systems biology has led to significant contributions in transfusion medicine, including the identification of three distinct metabolic states that define the baseline decay process of red blood cells during storage. We then describe how a series of perturbations to the standard storage conditions characterized the underlying metabolic phenotypes. Finally, we show how the analysis of high-dimensional data led to the identification of predictive biomarkers. The transfusion medicine community is in the early stages of a paradigm shift, moving away from the measurement of a handful of chosen variables to embracing systems biology and a cell-scale point of view.
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Affiliation(s)
- James T Yurkovich
- Department Bioengineering, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093, USA.,Bioinformatics and Systems Biology Program, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093, USA
| | - Aarash Bordbar
- Sinopia Biosciences, 600 W Broadway Suite 700, San Diego, 92101, USA
| | - Ólafur E Sigurjónsson
- School of Science and Engineering, Reykjavík University, Hringbraut 101, Reykjavík, 101, Iceland.,The Blood Bank, Landspítali-University Hospital, 9500 Gilman Drive, Reykjavík, 101, Iceland
| | - Bernhard O Palsson
- Department Bioengineering, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093, USA. .,Bioinformatics and Systems Biology Program, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093, USA. .,Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093, USA.
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Oliveira LR, Simionatto M, Cruz BR, Bittencourt JIM, Krum EA, Moss MF, Borato DCK. Stability of complete blood count in different storage conditions using the ABX PENTRA 60 analyzer. Int J Lab Hematol 2018. [PMID: 29512875 DOI: 10.1111/ijlh.12797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Sample stability is essential to obtain reliable results in the clinical laboratory. This study was conducted to investigate the reliability of hematological parameters using ABX Pentra 60 in samples stored for up to 72 hours at different temperatures. METHODS A total of 651 blood samples were analyzed at different analysis times: 2, 24, 48, and 72 hours and forms and storage: room temperature (25°C) and at 4°C. The imprecision of the results was evaluated by the analytical coefficient of variation (CVa%) obtained by the typical error (TE) and Kruskal-Wallis analysis, to compare the averages. The reliability of the results was evaluated by the CVa (%) within the maximum allowable analytical variation and by the difference of means of the results in relation to the baseline sample (2 hours). RESULTS Red blood count, hemoglobin, and MCH parameters showed stability up to 72 hours at room temperature and at 4°C. The other complete blood count parameters showed imprecision results emitted by the ABX Pentra 60 from 24 hours of sample storage, independent of the storage temperature. In addition, there were significant oscillations in the mean values, particularly for the samples stored at room temperature, with the exception of platelet parameters that exhibited mean changes also at 4°C. CONCLUSION The results demonstrate the importance of the clinical analyst's knowledge about the behavior of the CBC parameters over time under different storage conditions, and mainly the imprecision of the hematological equipment used, for the suitable interpretation of the results.
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Affiliation(s)
- L R Oliveira
- Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, PR, Brazil
| | - M Simionatto
- Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, PR, Brazil
| | - B R Cruz
- Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, PR, Brazil
| | - J I M Bittencourt
- Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, PR, Brazil
| | - E A Krum
- Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, PR, Brazil
| | - M F Moss
- Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, PR, Brazil
| | - D C K Borato
- Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, PR, Brazil
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Red blood cells ageing markers: a multi-parametric analysis. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2018; 15:239-248. [PMID: 28518051 DOI: 10.2450/2017.0318-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/05/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Red blood cells collected in citrate-phosphate-dextrose can be stored for up to 42 days at 4 °C in saline-adenine-glucose-mannitol additive solution. During this controlled, but nevertheless artificial, ex vivo ageing, red blood cells accumulate lesions that can be reversible or irreversible upon transfusion. The aim of the present study is to follow several parameters reflecting cell metabolism, antioxidant defences, morphology and membrane dynamics during storage. MATERIALS AND METHODS Five erythrocyte concentrates were followed weekly during 71 days. Extracellular glucose and lactate concentrations, total antioxidant power, as well as reduced and oxidised intracellular glutathione levels were quantified. Microvesiculation, percentage of haemolysis and haematologic parameters were also evaluated. Finally, morphological changes and membrane fluctuations were recorded using label-free digital holographic microscopy. RESULTS The antioxidant power as well as the intracellular glutathione concentration first increased, reaching maximal values after one and two weeks, respectively. Irreversible morphological lesions appeared during week 5, where discocytes began to transform into transient echinocytes and finally spherocytes. At the same time, the microvesiculation and haemolysis started to rise exponentially. After six weeks (expiration date), intracellular glutathione was reduced by 25%, reflecting increasing oxidative stress. The membrane fluctuations showed decreased amplitudes during shape transition from discocytes to spherocytes. DISCUSSION Various types of lesions accumulated at different chemical and cellular levels during storage, which could impact their in vivo recovery after transfusion. A marked effect was observed after four weeks of storage, which corroborates recent clinical data. The prolonged follow-up period allowed the capture of deep storage lesions. Interestingly, and as previously described, the severity of the changes differed among donors.
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35
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Consequences of dysregulated complement regulators on red blood cells. Blood Rev 2018; 32:280-288. [PMID: 29397262 DOI: 10.1016/j.blre.2018.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 12/07/2017] [Accepted: 01/25/2018] [Indexed: 02/07/2023]
Abstract
The complement system represents the first line of defense that is involved in the clearance of pathogens, dying cells and immune complexes via opsonization, induction of an inflammatory response and the formation of a lytic pore. Red blood cells (RBCs) are very important for the delivery of oxygen to tissues and are continuously in contact with complement proteins in the blood plasma. To prevent complement activation on RBCs, various complement regulatory proteins can be found in plasma and on the cell membrane. RBCs are special cells without a nucleus and having a slightly different make-up of complement regulators than nucleated cells, as membrane cofactor protein (MCP) is not expressed and complement receptor 1 (CR1) is highly expressed. Decreased expression and/or function of complement regulatory proteins may result in unwanted complement activation and accelerated removal of RBCs. This review describes complement regulation on RBCs and the consequences when this regulation is out of balance.
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Abstract
BACKGROUND During storage, packed red blood cells (pRBCs) undergo a number of biochemical, metabolic, and morphologic changes, collectively known as the "storage lesion." We aimed to determine the effect of cryopreservation on the red blood cell storage lesion compared with traditional 4°C storage. METHODS Previously cryopreserved human pRBCs were compared with age-matched never-frozen pRBCs obtained from the local blood bank. The development of the red cell storage lesion was evaluated after 7, 14, 21, 28, and 42 days of storage at 4°C in AS-3 storage medium. We measured physiological parameters including cell counts, lactic acid, and potassium concentrations as well as signs of eryptosis including loss of phosphatidylserine (PS) asymmetry, microparticle production, and osmotic fragility in hypotonic saline. RESULTS Compared with controls, previously cryopreserved pRBC at 7 days of storage in AS-3 showed lower red cell counts (3.7 vs. 5.3 × 10 cells/μL, P < 0.01), hemoglobin (Hgb) (12.0 vs. 16.5 g/dL, P < 0.01), hematocrit (33.0% vs. 46.5%, P < 0.01), and pH (6.27 vs. 6.72, P < 0.01). Over 28 days of storage, storage cryopreserved pRBC developed increased cell-free Hgb (0.7 vs. 0.3 g/dL, P < 0.01), greater PS exposure (10.1% vs. 3.3%, P < 0.01), and microparticle production (30,836 vs. 1,802 MP/μL, P < 0.01). Previously cryopreserved cells were also less resistant to osmotic stress. CONCLUSION The red blood cell storage lesion is accelerated in previously cryopreserved pRBC after thawing. Biochemical deterioration of thawed and deglycerolized red cells suggests that storage time before transfusion should be limited to achieve similar risk profiles as never-frozen standard liquid storage pRBC units.
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Jani VP, Yalcin O, Williams AT, Popovsky MA, Cabrales P. Rat red blood cell storage lesions in various additive solutions. Clin Hemorheol Microcirc 2018; 67:45-57. [PMID: 28598831 DOI: 10.3233/ch-170248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Small rodent models are routinely used to evaluate the safety and efficacy of blood transfusions. Limited comprehensive literature exists about effect of different storage solutions in rat red blood cells (RBCs) characteristics. RBCs undergo time dependent biochemical and biophysical changes during storage known as hypothermic storage lesions (HSLs). OBJECTIVE This study evaluates the effects of RBC additive solutions (AS) during storage of rat RBCs. METHODS Blood was leukoreduced and stored as per manufacturer instructions at 4°C up to 42-days. Three solutions, CPDA-1; AS-1; and AS-7 (SOLX), were evaluated. Biochemical parameters measured included extracellular K+, pH, hemolysis, 2,3-diphosphoglycerate (2,3-DPG), oxygen affinity, ATP, and lactate. Mechanical properties measured included RBC deformability, elongation index (EI), RBC membrane shear elastic modulus (SEM), mean corpuscular volume (MCV), viscosity, and aggregability. RESULTS There were no differences in biochemical or mechanical parameters at baseline or after one week of storage. However, after two weeks, AS-7 preserved biochemical and mechanical properties as compared to CPDA-1 and AS-1. Changes were observed to be significant after 14-days of storage. AS-7 prevented extracellular K+ increase, reduced acidosis, showed lower hemolysis, preserved ATP and 2,3-DPG levels (consequently oxygen affinity), and reduced lactate. AS-7, when compared to CPDA-1 and AS-1, prevented the reduction in RBC deformability and was found to preserve the EI at multiple shear stresses, the membrane SEM, the aggregability and viscosity. DISCUSSION Rat RBCs stored with AS-7 presented reduced changes in biochemical and mechanical parameters, when compared with rat RBCs stored in CPDA-1 and AS-1, after as early as two weeks of storage.
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Affiliation(s)
- Vivek P Jani
- Department of Bioengineering, University of California, San Diego, CA, USA
| | - Ozlem Yalcin
- Department of Bioengineering, University of California, San Diego, CA, USA.,School of Medicine, Koç University, Sariyer, Istanbul, Turkey
| | | | | | - Pedro Cabrales
- Department of Bioengineering, University of California, San Diego, CA, USA
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Jones AR, Frazier SK. Consequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model. Crit Care Nurse 2017; 37:18-30. [PMID: 28365647 DOI: 10.4037/ccn2017965] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Transfusion of blood components is often required in resuscitation of patients with major trauma. Packed red blood cells and platelets break down and undergo chemical changes during storage (known as the storage lesion) that lead to an inflammatory response once the blood components are transfused to patients. Although some evidence supports a detrimental association between transfusion and a patient's outcome, the mechanisms connecting transfusion of stored components to outcomes remain unclear. The purpose of this review is to provide critical care nurses with a conceptual model to facilitate understanding of the relationship between the storage lesion and patients' outcomes after trauma; outcomes related to trauma, hemorrhage, and blood component transfusion are grouped according to those occurring in the short-term (≤30 days) and the long-term (>30 days). Complete understanding of these clinical implications is critical for practitioners in evaluating and treating patients given transfusions after traumatic injury.
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Affiliation(s)
- Allison R Jones
- Allison R. Jones is an assistant professor, Department of Acute, Chronic, and Continuing Care, School of Nursing, University of Alabama, Birmingham, Alabama. She has a clinical background in emergency and trauma nursing. In research, she focuses on the consequences of blood component storage and transfusion, with particular interest in transfusion after trauma. .,Susan K. Frazier is the director of the PhD program, a codirector of the RICH Heart Program, and an associate professor, College of Nursing, University of Kentucky, Lexington, Kentucky. Her research focuses on cardiopulmonary interactions in a variety of critically ill patients, including patients with acute heart failure, acute decompensated heart failure, acute respiratory distress syndrome, chronic obstructive pulmonary disease, and multiple trauma.
| | - Susan K Frazier
- Allison R. Jones is an assistant professor, Department of Acute, Chronic, and Continuing Care, School of Nursing, University of Alabama, Birmingham, Alabama. She has a clinical background in emergency and trauma nursing. In research, she focuses on the consequences of blood component storage and transfusion, with particular interest in transfusion after trauma.,Susan K. Frazier is the director of the PhD program, a codirector of the RICH Heart Program, and an associate professor, College of Nursing, University of Kentucky, Lexington, Kentucky. Her research focuses on cardiopulmonary interactions in a variety of critically ill patients, including patients with acute heart failure, acute decompensated heart failure, acute respiratory distress syndrome, chronic obstructive pulmonary disease, and multiple trauma
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Abstract
PURPOSE OF REVIEW Red blood cell transfusion is a common treatment for anaemia worldwide, but concerns continue to be raised about adverse effects of cellular blood components, which are biological products. One hypothesis for the adverse effects associated with blood transfusion is the harmful effects of storage on red cells that have been demonstrated in laboratory and animal studies. Over the past few years, a number of more significant randomized controlled trials comparing 'fresh' versus 'older' blood have been published in an attempt to address the clinical consequences of storage age, with two further large trials ongoing. RECENT FINDINGS These recent trials enrolled approximately 4000 participants across a variety of populations - cardiac surgical, critically ill, paediatric and acute hospitalized in-patients. All trials achieved statistically significant separation of red cell storage duration between both groups. The results of all these trials have found no clinical benefit to using fresher red cells when compared with older or standard-issue red cells. However, certain subgroups of patients either receiving red cells stored at more extreme ages of storage or those with additional risks for impaired microcirculations (critically ill elderly, severe sepsis and major haemorrhage) were either underrepresented or not included in these trials. SUMMARY At present, on the basis of recent trials, there is no indication for blood transfusion services to implement preferential utilization of fresher red cell units.
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Sandlin RD, Wong KHK, Boneschansker L, Carey TR, Miller KL, Rose G, Haber DA, Maheswaran S, Irimia D, Stott SL, Toner M. Preservative solution that stabilizes erythrocyte morphology and leukocyte viability under ambient conditions. Sci Rep 2017; 7:5658. [PMID: 28720788 PMCID: PMC5515929 DOI: 10.1038/s41598-017-05978-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/07/2017] [Indexed: 01/04/2023] Open
Abstract
The deterioration of whole blood ex vivo represents a logistical hurdle in clinical and research settings. Here, a cocktail preservative is described that stabilizes leukocyte viability and erythrocyte morphology in whole blood under ambient storage. Neutrophil biostabilization was explored using a sophisticated microfluidic assay to examine the effectiveness of caspase inhibition to stabilize purified neutrophils. Following 72 h ambient storage, neutrophils remained fully functional to migrate towards chemical cues and maintained their ability to undergo NETosis after stimulation. Furthermore, stored neutrophils exhibited improved CD45 biomarker retention and reduced apoptosis and mortality compared to untreated controls. To stabilize erythrocyte morphology, a preservative solution was formulated using Taguchi methods of experimental design, and combined with the caspase inhibitor to form a whole blood cocktail solution, CSWB. CSWB was evaluated in blood from healthy donors and from women with metastatic breast cancer stored under ambient conditions for 72 h. CSWB-treated samples showed a significant improvement in erythrocyte morphology compared to untreated controls. Leukocytes in CSWB-treated blood exhibited significantly higher viability and CD45 biomarker retention compared to untreated controls. This 72 h shelf life under ambient conditions represents an opportunity to transport isolates or simply ease experimental timelines where blood degradation is problematic.
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Affiliation(s)
- Rebecca D Sandlin
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Keith H K Wong
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Leo Boneschansker
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Thomas R Carey
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Kathleen L Miller
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Gregory Rose
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Daniel A Haber
- Cancer Center & Department of Medicine, Massachusetts, MA General Hospital, Harvard Medical School, Boston, MA, 02114, USA.,Howard Hughes Medical Institute, Chevy Chase, MD, 20815, USA
| | - Shyamala Maheswaran
- Cancer Center & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Daniel Irimia
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Shannon L Stott
- Cancer Center, Department of Medicine, & BioMEMS Resource Center, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
| | - Mehmet Toner
- BioMEMS Resource Center, Center for Engineering in Medicine, & Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
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Jones AR, Brown MR, Vance DE. From Donor to Recipient: Considerations for Blood Transfusion Outcomes Research. Biol Res Nurs 2017; 19:491-498. [PMID: 28712305 DOI: 10.1177/1099800417716542] [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: 01/28/2023]
Abstract
Donated blood can be broken down into blood components for use in patient care. This article focuses primarily on packed red blood cells (PRBCs), as they experience breakdown during storage that may adversely impact patient outcomes. Patients require PRBC transfusions for a number of clinical reasons. Although transfusions of PRBCs provide some clinical benefit, they are also associated with increased morbidity and mortality across multiple patient populations, albeit the mechanisms underlying this relationship remain unclear. With an aging, more acutely ill population requiring aggressive treatment and a lack of transfusion alternatives, research focused on PRBCs has gained momentum. Proper interpretation of research findings on the part of clinicians depends on accurate data collection that includes aspects of both the transfused blood components and the recipients. The purpose of this article is to examine stored PRBC factors, blood-donor characteristics, transfusion-specific factors, and patient-specific characteristics as they relate to patient outcomes research. Challenges associated with performing and interpreting outcomes of transfusion-related research are presented. Implications of current evidence for patient care, such as awareness of benefits as well as risks associated with blood component transfusion, are also provided.
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Affiliation(s)
- Allison R Jones
- 1 School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michelle R Brown
- 2 Clinical Laboratory Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David E Vance
- 1 School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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David M, Levy E, Feldman Y, Ben Ishai P, Zelig O, Yedgar S, Barshtein G. The dielectric spectroscopy of human red blood cells: the differentiation of old from fresh cells. Physiol Meas 2017; 38:1335-1348. [DOI: 10.1088/1361-6579/aa707a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Duration of red blood cell storage and inflammatory marker generation. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:145-152. [PMID: 28263172 DOI: 10.2450/2017.0343-16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 12/16/2016] [Indexed: 02/08/2023]
Abstract
Red blood cell (RBC) transfusion is a life-saving treatment for several pathologies. RBCs for transfusion are stored refrigerated in a preservative solution, which extends their shelf-life for up to 42 days. During storage, the RBCs endure abundant physicochemical changes, named RBC storage lesions, which affect the overall quality standard, the functional integrity and in vivo survival of the transfused RBCs. Some of the changes occurring in the early stages of the storage period (for approximately two weeks) are reversible but become irreversible later on as the storage is extended. In this review, we aim to decipher the duration of RBC storage and inflammatory marker generation. This phenomenon is included as one of the causes of transfusion-related immunomodulation (TRIM), an emerging concept developed to potentially elucidate numerous clinical observations that suggest that RBC transfusion is associated with increased inflammatory events or effects with clinical consequence.
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Said AS, Spinella PC, Hartman ME, Steffen KM, Jackups R, Holubkov R, Wallendorf M, Doctor A. RBC Distribution Width: Biomarker for Red Cell Dysfunction and Critical Illness Outcome? Pediatr Crit Care Med 2017. [PMID: 27832023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
OBJECTIVES RBC distribution width is reported to be an independent predictor of outcome in adults with a variety of conditions. We sought to determine if RBC distribution width is associated with morbidity or mortality in critically ill children. DESIGN Retrospective observational study. SETTING Tertiary PICU. PATIENTS All admissions to St. Louis Children's Hospital PICU between January 1, 2005, and December 31, 2012. INTERVENTIONS We collected demographics, laboratory values, hospitalization characteristics, and outcomes. We calculated the relative change in RBC distribution width from admission RBC distribution width to the highest RBC distribution width during the first 7 days of hospitalization. Our primary outcome was ICU mortality or use of extracorporeal membrane oxygenation as a composite. Secondary outcomes were ICU- and ventilator-free days. MEASUREMENTS AND MAIN RESULTS We identified 3,913 eligible subjects with an estimated mortality (by Pediatric Index of Mortality 2) of 2.94% ± 9.25% and an actual ICU mortality of 2.91%. For the study cohort, admission RBC distribution width was 14.12% ± 1.89% and relative change in RBC distribution width was 2.63% ± 6.23%. On univariate analysis, both admission RBC distribution width and relative change in RBC distribution width correlated with mortality or the use of extracorporeal membrane oxygenation (odds ratio, 1.19 [95% CI, 1.12-1.27] and odds ratio, 1.06 [95% CI, 1.04-1.08], respectively; p < 0.001). After adjusting for confounding variables, including severity of illness, both admission RBC distribution width (odds ratio, 1.13; 95% CI, 1.03-1.24) and relative change in RBC distribution width (odds ratio, 1.04; 95% CI, 1.01-1.07) remained independently associated with ICU mortality or the use of extracorporeal membrane oxygenation. Admission RBC distribution width and relative change in RBC distribution width both weakly correlated with fewer ICU- (r = 0.038) and ventilator-free days (r = 0.05) (p < 0.001). CONCLUSIONS Independent of illness severity in critically ill children, admission RBC distribution width is associated with ICU mortality and morbidity. These data suggest that RBC distribution width may be a biomarker for RBC injury that is of sufficient magnitude to influence critical illness outcome, possibly via oxygen delivery impairment.
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Affiliation(s)
- Ahmed S Said
- 1Department of Pediatrics, Washington University in St. Louis, St. Louis, MO. 2Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO. 3Department of Biostatistics, Washington University in St. Louis, St. Louis, MO. 4Department of Biochemistry & Molecular Biophysics, Washington University in St. Louis, St. Louis, MO. 5Department of Pediatrics, University of Utah, Salt Lake City, UT
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Abstract
OBJECTIVES RBC distribution width is reported to be an independent predictor of outcome in adults with a variety of conditions. We sought to determine if RBC distribution width is associated with morbidity or mortality in critically ill children. DESIGN Retrospective observational study. SETTING Tertiary PICU. PATIENTS All admissions to St. Louis Children's Hospital PICU between January 1, 2005, and December 31, 2012. INTERVENTIONS We collected demographics, laboratory values, hospitalization characteristics, and outcomes. We calculated the relative change in RBC distribution width from admission RBC distribution width to the highest RBC distribution width during the first 7 days of hospitalization. Our primary outcome was ICU mortality or use of extracorporeal membrane oxygenation as a composite. Secondary outcomes were ICU- and ventilator-free days. MEASUREMENTS AND MAIN RESULTS We identified 3,913 eligible subjects with an estimated mortality (by Pediatric Index of Mortality 2) of 2.94% ± 9.25% and an actual ICU mortality of 2.91%. For the study cohort, admission RBC distribution width was 14.12% ± 1.89% and relative change in RBC distribution width was 2.63% ± 6.23%. On univariate analysis, both admission RBC distribution width and relative change in RBC distribution width correlated with mortality or the use of extracorporeal membrane oxygenation (odds ratio, 1.19 [95% CI, 1.12-1.27] and odds ratio, 1.06 [95% CI, 1.04-1.08], respectively; p < 0.001). After adjusting for confounding variables, including severity of illness, both admission RBC distribution width (odds ratio, 1.13; 95% CI, 1.03-1.24) and relative change in RBC distribution width (odds ratio, 1.04; 95% CI, 1.01-1.07) remained independently associated with ICU mortality or the use of extracorporeal membrane oxygenation. Admission RBC distribution width and relative change in RBC distribution width both weakly correlated with fewer ICU- (r = 0.038) and ventilator-free days (r = 0.05) (p < 0.001). CONCLUSIONS Independent of illness severity in critically ill children, admission RBC distribution width is associated with ICU mortality and morbidity. These data suggest that RBC distribution width may be a biomarker for RBC injury that is of sufficient magnitude to influence critical illness outcome, possibly via oxygen delivery impairment.
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Buckley K, Atkins CG, Chen D, Schulze HG, Devine DV, Blades MW, Turner RFB. Non-invasive spectroscopy of transfusable red blood cells stored inside sealed plastic blood-bags. Analyst 2017; 141:1678-85. [PMID: 26844844 DOI: 10.1039/c5an02461g] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
After being separated from (donated) whole blood, red blood cells are suspended in specially formulated additive solutions and stored (at 4 °C) in polyvinyl chloride (PVC) blood-bags until they are needed for transfusion. With time, the prepared red cell concentrate (RCC) is known to undergo biochemical changes that lower effectiveness of the transfusion, and thus regulations are in place that limit the storage period to 42 days. At present, RCC is not subjected to analytical testing prior to transfusion. In this study, we use Spatially Offset Raman Spectroscopy (SORS) to probe, non-invasively, the biochemistry of RCC inside sealed blood-bags. The retrieved spectra compare well with conventional Raman spectra (of sampled aliquots) and are dominated by features associated with hemoglobin. In addition to the analytical demonstration that SORS can be used to retrieve RCC spectra from standard clinical blood-bags without breaking the sterility of the system, the data reveal interesting detail about the oxygenation-state of the stored cells themselves, namely that some blood-bags unexpectedly contain measurable amounts of deoxygenated hemoglobin after weeks of storage. The demonstration that chemical information can be obtained non-invasively using spectroscopy will enable new studies of RCC degeneration, and points the way to a Raman-based instrument for quality-control in a blood-bank or hospital setting.
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Affiliation(s)
- K Buckley
- Michael Smith Laboratories, The University of British Columbia, 2185 East Mall, Vancouver, BC, Canada V6 T 1Z4.
| | - C G Atkins
- Michael Smith Laboratories, The University of British Columbia, 2185 East Mall, Vancouver, BC, Canada V6 T 1Z4. and Department of Chemistry, The University of British Columbia, 2036 Main Mall, Vancouver, BC, Canada V6 T 1Z1.
| | - D Chen
- Department of Pathology and Laboratory Medicine, The University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6 T 2B5 and Centre for Blood Research, The University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC, Canada V6 T 1Z3
| | - H G Schulze
- Michael Smith Laboratories, The University of British Columbia, 2185 East Mall, Vancouver, BC, Canada V6 T 1Z4.
| | - D V Devine
- Department of Pathology and Laboratory Medicine, The University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6 T 2B5 and Centre for Blood Research, The University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC, Canada V6 T 1Z3
| | - M W Blades
- Department of Chemistry, The University of British Columbia, 2036 Main Mall, Vancouver, BC, Canada V6 T 1Z1.
| | - R F B Turner
- Michael Smith Laboratories, The University of British Columbia, 2185 East Mall, Vancouver, BC, Canada V6 T 1Z4. and Department of Chemistry, The University of British Columbia, 2036 Main Mall, Vancouver, BC, Canada V6 T 1Z1. and Department of Electrical and Computer Engineering, The University of British Columbia, 2332 Main Mall, Vancouver, BC, Canada V6 T 1Z4
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Atkins CG, Schulze HG, Chen D, Devine DV, Blades MW, Turner RFB. Using Raman spectroscopy to assess hemoglobin oxygenation in red blood cell concentrate: an objective proxy for morphological index to gauge the quality of stored blood? Analyst 2017; 142:2199-2210. [DOI: 10.1039/c7an00349h] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A relationship has been found between hemoglobin oxygenation of stored red blood cells (measured using Raman spectroscopy) and a morphological index.
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Affiliation(s)
- Chad G. Atkins
- Michael Smith Laboratories
- The University of British Columbia
- Vancouver
- Canada
- Department of Chemistry
| | - H. Georg Schulze
- Michael Smith Laboratories
- The University of British Columbia
- Vancouver
- Canada
| | - Deborah Chen
- Department of Pathology and Laboratory Medicine
- The University of British Columbia
- Vancouver
- Canada
- Centre for Blood Research
| | - Dana V. Devine
- Department of Pathology and Laboratory Medicine
- The University of British Columbia
- Vancouver
- Canada
- Centre for Blood Research
| | - Michael W. Blades
- Department of Chemistry
- The University of British Columbia
- Vancouver
- Canada
| | - Robin F. B. Turner
- Michael Smith Laboratories
- The University of British Columbia
- Vancouver
- Canada
- Department of Chemistry
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Almizraq RJ, Seghatchian J, Acker JP. Extracellular vesicles in transfusion-related immunomodulation and the role of blood component manufacturing. Transfus Apher Sci 2016; 55:281-291. [DOI: 10.1016/j.transci.2016.10.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Heinz JA, Pashmakova MB, Wilson CR, Johnson MC, Minnard HM, Bishop MA, Barr JW. Biochemical evaluation of the effects of storage on feline erythrocytes. J Small Anim Pract 2016; 57:637-643. [PMID: 27739591 DOI: 10.1111/jsap.12585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/13/2016] [Accepted: 06/30/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To describe the biochemical changes that occur during storage of feline packed red blood cells. METHODS Feline packed red blood cells were obtained from the manufacturer via overnight delivery immediately following collection. Bag spikes were placed using aseptic technique and samples were drawn on days 1, 4, 7, 14, 21, 28 and 35. Sodium, potassium, chloride, glucose, lactate, pH and ammonia were measured at each time point. Aerobic and anaerobic bacterial cultures were submitted following collection on day 35. RESULTS There were statistically significant increases in the median concentrations of lactate and ammonia within the first 2 weeks of storage to a concentration of 12·38 mmol/L and 447·96 µmol/L, respectively. Glucose concentrations decreased significantly by day 28 to a mean of 1·86 mmol/L. Median sodium and chloride concentrations increased throughout the course of storage to a concentration of 158·20 and 131·00 mmol/L, respectively. Mean potassium concentrations decreased to a concentration of 2·40 mmol/L. CLINICAL SIGNIFICANCE These results show that biochemical derangements within feline packed red blood cells are progressive, with some alterations, such as lactate and ammonia, occurring early within the storage periods, while others, including glucose and electrolytes, are slower to develop. Additional prospective research evaluating the clinical effects of these biochemical alterations is required.
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Affiliation(s)
- J A Heinz
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA.
| | - M B Pashmakova
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
| | - C R Wilson
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
| | - M C Johnson
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
| | - H M Minnard
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
| | - M A Bishop
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
| | - J W Barr
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
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50
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Osei-Hwedieh DO, Kanias T, Croix CS, Jessup M, Xiong Z, Sinchar D, Franks J, Xu Q, M Novelli E, Sertorio JT, Potoka K, Binder RJ, Basu S, Belanger AM, Kim-Shapiro DB, Triulzi D, Lee JS, Gladwin MT. Sickle Cell Trait Increases Red Blood Cell Storage Hemolysis and Post-Transfusion Clearance in Mice. EBioMedicine 2016; 11:239-248. [PMID: 27523807 PMCID: PMC5049931 DOI: 10.1016/j.ebiom.2016.08.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 07/27/2016] [Accepted: 08/03/2016] [Indexed: 11/17/2022] Open
Abstract
Background Transfusion of blood at the limits of approved storage time is associated with lower red blood cell (RBC) post-transfusion recovery and hemolysis, which increases plasma cell-free hemoglobin and iron, proposed to induce endothelial dysfunction and impair host defense. There is noted variability among donors in the intrinsic rate of storage changes and RBC post-transfusion recovery, yet genetic determinants that modulate this process are unclear. Methods We explore RBC storage stability and post-transfusion recovery in murine models of allogeneic and xenogeneic transfusion using blood from humanized transgenic sickle cell hemizygous mice (Hbatm1PazHbbtm1TowTg(HBA-HBBs)41Paz/J) and human donors with a common genetic mutation sickle cell trait (HbAS). Findings Human and transgenic HbAS RBCs demonstrate accelerated storage time-dependent hemolysis and reduced post-transfusion recovery in mice. The rapid post-transfusion clearance of stored HbAS RBC is unrelated to macrophage-mediated uptake or intravascular hemolysis, but by enhanced sequestration in the spleen, kidney and liver. HbAS RBCs are intrinsically different from HbAA RBCs, with reduced membrane deformability as cells age in cold storage, leading to accelerated clearance of transfused HbAS RBCs by entrapment in organ microcirculation. Interpretation The common genetic variant HbAS enhances RBC storage dysfunction and raises provocative questions about the use of HbAS RBCs at the limits of approved storage. Sickle cell trait (HbAS) RBC exhibit increased resistance to osmotic shock compared to normal (HbAA) RBCs. HbAS RBC show accelerated storage-related aging and post-transfusion clearance after cold storage compared to HbAA RBC. Reduced post-transfusion survival of stored HbAS RBCs is not due to intravascular hemolysis but due to tissue sequestration.
In allogeneic transfusions, red blood cells (RBCs) are collected and stored for up to 42 days. Historically, donor RBC genetic background is only considered in the context of major Rh and ABO blood groups. This study shows that donor-specific genetic factors such as sickle cell trait, the benign heterozygote state of sickle cell disease, accelerate storage-related hemolysis and reduces RBC post-transfusion survival in mice. Impaired post-transfusion recovery is due to enhanced sequestration in organ microcirculation. Further studies are warranted to determine an appropriate earlier outdate for HbAS RBC units, particularly in malaria-endemic regions where sickle cell trait prevalence is high.
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Affiliation(s)
- David O Osei-Hwedieh
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States; Department of Molecular Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tamir Kanias
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Claudette St Croix
- Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, PA, United States
| | - Morgan Jessup
- Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zeyu Xiong
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Derek Sinchar
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jonathan Franks
- Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, PA, United States
| | - Qinzi Xu
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Enrico M Novelli
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jonas T Sertorio
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Karin Potoka
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Robert J Binder
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Swati Basu
- Department of Physics, Wake Forest University, Winston-Salem, NC, United States
| | - Andrea M Belanger
- Department of Physics, Wake Forest University, Winston-Salem, NC, United States
| | | | - Darrell Triulzi
- Institute for Transfusion Medicine, ITxM, Pittsburgh, PA, United States
| | - Janet S Lee
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States; Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
| | - Mark T Gladwin
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States; Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States; Department of Molecular Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, United States.
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