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Semmler AL, Köhler JP, Regolien L, Bayer F, Polyansky N, Gradhand E, von Knethen A, Zacharowski K, Nocke F, Ferenz KB, Schwäble J, Bonig H, Herrmann E, Hornung I, Steinbicker AU. Selective red blood cell depletion by apheresis in sheep causes severe normovolemic anemia. Curr Res Transl Med 2024; 72:103463. [PMID: 39278153 DOI: 10.1016/j.retram.2024.103463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 08/01/2024] [Accepted: 08/16/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND The setting of normovolemic anemia is required for a variety of research applications, such as testing of novel medication for anemia treatment. Unfortunately, large animal models using full blood draw and replenishment with balanced electrolyte solution (BES) lead to bleeding complications, as coagulation factors and platelets are also drawn. We therefore aimed to establish a model of selective red blood cell (RBC) depletion to the main endpoint of hemoglobin (Hgb) levels of 4-6 g dL-1 using apheresis in sheep. METHODS In vitro experiments were performed first to establish the apheresis protocol. In vivo, anesthetized ewes underwent a sham protocol without apheresis (n = 5) or apheresis (n = 4). Both groups were observed for the following six hours at a defined starting point (BE0) to compare Hgb, hematocrit (Hct), coagulation and clinical parameters. For statistical analysis, unpaired t-test with Welch`s correction was used. RESULTS Hgb levels were effectively decreased by 51 % to mean Hgb of 4.4 g dL-1 in the apheresis group compared to 9.1 g dL-1 in sham (*p < 0.0001). Hct (11.2% vs 25.1 %, *p = 0.01) and RBCs (3.7 vs 8.2 × 106/µl, *p = 0.003) also decreased. The relative number of platelets compared to baseline was different (55.6 ± 10.6% vs. 100 ± 0 %, *p = 0.004), but no hemorrhage was observed. White blood cells (WBCs), lactate, prothrombin ratio and activated partial thromboplastin time (aPTT) remained within similar ranges. CONCLUSIONS Critical normovolemic anemia without bleeding complications was successfully reached by selective RBC depletion in sheep. Investigations of physiological adaptations to severe anemia and pharmaceutical testing can be performed in large animals with depleted RBCs.
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Affiliation(s)
- Anna-Lena Semmler
- Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hessen, Sandhofstr. 1, 60528 Frankfurt, Germany
| | - Jan-Philipp Köhler
- Goethe-University Frankfurt, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Haus 13B, 60590 Frankfurt, Germany
| | - Lara Regolien
- Goethe-University Frankfurt, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Haus 13B, 60590 Frankfurt, Germany
| | - Franziska Bayer
- Central Research Facility of the Medical Faculty of the Goethe University, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Nikolay Polyansky
- Goethe-University Frankfurt, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Haus 13B, 60590 Frankfurt, Germany
| | - Elise Gradhand
- Goethe-University Frankfurt, Dr. Senckenbergisches Department of Pathology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Andreas von Knethen
- Goethe-University Frankfurt, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Haus 13B, 60590 Frankfurt, Germany
| | - Kai Zacharowski
- Goethe-University Frankfurt, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Haus 13B, 60590 Frankfurt, Germany
| | - Fabian Nocke
- Institute of Physiological Chemistry, University of Duisburg-Essen, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Katja B Ferenz
- Institute of Physiology, University of Duisburg-Essen, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany; CENIDE, University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany
| | - Joachim Schwäble
- Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hessen, Sandhofstr. 1, 60528 Frankfurt, Germany
| | - Halvard Bonig
- Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hessen, Sandhofstr. 1, 60528 Frankfurt, Germany; Goethe-University Frankfurt, Faculty of Medicine, Institute for Transfusion Medicine and Immunohematology, Sandhofstr. 1, 60528 Frankfurt, Germany
| | - Eva Herrmann
- Goethe-University Frankfurt, Department of Medicine, Institute of Biostatistics and Mathematical Modelling, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Isabelle Hornung
- Goethe-University Frankfurt, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Haus 13B, 60590 Frankfurt, Germany
| | - Andrea U Steinbicker
- Goethe-University Frankfurt, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Haus 13B, 60590 Frankfurt, Germany.
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Zhu Y, Fu W. Peripheral Blood-Derived Stem Cells for the Treatment of Cartilage Injuries: A Systematic Review. Front Bioeng Biotechnol 2022; 10:956614. [PMID: 35935493 PMCID: PMC9355401 DOI: 10.3389/fbioe.2022.956614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The treatment of cartilage damage is a hot topic at present, and cell therapy is an emerging alternative therapy. Stem cells derived from peripheral blood have become the focus of current research due to the ease of obtaining materials and a wide range of sources.Methods: We used a text search strategy using the [“mesenchymal stem cells” (MeSH term) OR “MSC” OR “BMMSC” OR “PBMSC” OR” PBMNC” OR “peripheral blood stem cells”] AND (cartilage injury [MeSH term] OR “cartilage” OR “chondral lesion”). After searching the literature, through the inclusion and exclusion criteria, the last included articles were systematically reviewed.Result: We found that peripheral blood-derived stem cells have chondrogenic differentiation ability and can induce chondrogenic differentiation and repair in vivo and have statistical significance in clinical and imaging prognosis. It is an improvement of academic differences. Compared with the bone marrow, peripheral blood is easier to obtain, widely sourced, and simple to obtain. In the future, peripheral blood will be a more potential cell source for cell therapy in the treatment of cartilage damage.Conclusion: Stem cells derived from peripheral blood can repair cartilage and are an important resource for the treatment of cartilage damage in the future. The specific mechanism and way of repairing cartilage need further study.
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