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Khan MS, Liu C, Meng F, Yang M, Zhou K, Hu R, Wang X, Dai K. X-rays Stimulate Granular Secretions and Activate Protein Kinase C Signaling in Human Platelets. Curr Issues Mol Biol 2023; 45:6024-6039. [PMID: 37504296 PMCID: PMC10378519 DOI: 10.3390/cimb45070380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
X-rays can induce morphological as well as functional changes in cells. Platelets are anuclear cellular fragments originating from megakaryocytes and are the major regulators in hemostasis and thrombosis. Platelet products are irradiated to avoid medical complications associated with platelet transfusion. So far, gamma, UV, and laser radiation have been used for this purpose. However, scientists are divided about the effects of radiation on platelet quality. The present study was designed to explore the possible effects of X-rays in washed human platelets and understand the molecular mechanism behind them. In the present study, we exposed washed human platelets to 10 or 30 Gy X-rays at 0.25 Gy/min. Flow cytometry, aggregometry, and western blot were performed to investigate the effect of X-rays on platelet degranulation, integrin activation, platelet aggregation, and apoptosis. It was found that X-rays immediately induced granular secretions with no effect on GP IIb/IIIa activation. Not surprisingly, due to granule secretions in irradiated platelets, platelet aggregation was significantly reduced. In contrast to granular secretions and platelet aggregation, X-rays induced mitochondrial transmembrane potential depolarization in a time-dependent manner to induce apoptosis and activated protein kinase C (PKC) signaling. This study revealed and explained the molecular mechanism activated by X-rays in washed human platelets. Here we also introduced Gö 6983, a PKC inhibitor, as an agent that counteracts X-ray-induced changes and maintains the integrity of platelets.
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Affiliation(s)
- Muhammad Shoaib Khan
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
| | - Chunliang Liu
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
| | - Fanbi Meng
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
| | - Mengnan Yang
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
| | - Kangxi Zhou
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
| | - Renping Hu
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
| | - Xuexiang Wang
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
| | - Kesheng Dai
- Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Medical College, Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China
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Snyder EL, Wheeler AP, Refaai M, Cohn CS, Poisson J, Fontaine M, Sehl M, Nooka AK, Uhl L, Spinella P, Fenelus M, Liles D, Coyle T, Becker J, Jeng M, Gehrie EA, Spencer BR, Young P, Johnson A, O'Brien JJ, Schiller GJ, Roback JD, Malynn E, Jackups R, Avecilla ST, Lin J, Liu K, Bentow S, Peng H, Varrone J, Benjamin RJ, Corash LM. Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components. Transfusion 2022; 62:1365-1376. [PMID: 35748490 PMCID: PMC9544211 DOI: 10.1111/trf.16987] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Platelet transfusion carries risk of transfusion-transmitted infection (TTI). Pathogen reduction of platelet components (PRPC) is designed to reduce TTI. Pulmonary adverse events (AEs), including transfusion-related acute lung injury and acute respiratory distress syndrome (ARDS) occur with platelet transfusion. STUDY DESIGN An open label, sequential cohort study of transfusion-dependent hematology-oncology patients was conducted to compare pulmonary safety of PRPC with conventional PC (CPC). The primary outcome was the incidence of treatment-emergent assisted mechanical ventilation (TEAMV) by non-inferiority. Secondary outcomes included: time to TEAMV, ARDS, pulmonary AEs, peri-transfusion AE, hemorrhagic AE, transfusion reactions (TRs), PC and red blood cell (RBC) use, and mortality. RESULTS By modified intent-to-treat (mITT), 1068 patients received 5277 PRPC and 1223 patients received 5487 CPC. The cohorts had similar demographics, primary disease, and primary therapy. PRPC were non-inferior to CPC for TEAMV (treatment difference -1.7%, 95% CI: (-3.3% to -0.1%); odds ratio = 0.53, 95% CI: (0.30, 0.94). The cumulative incidence of TEAMV for PRPC (2.9%) was significantly less than CPC (4.6%, p = .039). The incidence of ARDS was less, but not significantly different, for PRPC (1.0% vs. 1.8%, p = .151; odds ratio = 0.57, 95% CI: (0.27, 1.18). AE, pulmonary AE, and mortality were not different between cohorts. TRs were similar for PRPC and CPC (8.3% vs. 9.7%, p = .256); and allergic TR were significantly less with PRPC (p = .006). PC and RBC use were not increased with PRPC. DISCUSSION PRPC demonstrated reduced TEAMV with no excess treatment-related pulmonary morbidity.
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Affiliation(s)
| | | | - Majed Refaai
- University of Rochester Medical CenterRochesterNew YorkUSA
| | - Claudia S. Cohn
- University of Minnesota Medical CenterMinneapolisMinnesotaUSA
| | | | | | - Mary Sehl
- UCLA Medical CenterLos AngelesCaliforniaUSA
| | | | - Lynne Uhl
- Harvard University – Beth Israel Deaconess HospitalBostonMassachusettsUSA
| | - Philip Spinella
- University of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Maly Fenelus
- Memorial‐Sloan Kettering Medical CenterNew YorkNew YorkUSA
| | - Darla Liles
- East Carolina University Medical CenterGreenvilleNorth CarolinaUSA
| | | | | | | | | | | | - Pampee Young
- Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Andrew Johnson
- University of Minnesota Medical CenterMinneapolisMinnesotaUSA
| | | | | | | | - Elizabeth Malynn
- Harvard University – Beth Israel Deaconess HospitalBostonMassachusettsUSA
| | | | | | | | - Kathy Liu
- Cerus CorporationConcordCaliforniaUSA
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Hosseini E, Kianinodeh F, Ghasemzadeh M. Irradiation of platelets in Transfusion Medicine: risk and benefit judgments. Platelets 2021; 33:666-678. [PMID: 34697994 DOI: 10.1080/09537104.2021.1990250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Irradiation of platelet products is generally used to prevent transfusion-associated graft-versus-host disease (TA-GvHD) as well as transfusion-transmitted infections. As an essential prerequisite, gamma-irradiation of blood products prior to transfusion is required in patients who may develop TA-GVHD. Most studies suggest that gamma irradiation has no significant effect on the quality of platelet products; however, more recent studies have shown that the oxidative effects of gamma irradiation can lead to the induction of platelet storage lesion (PSL) and to some extent reduce the efficiency of transfused platelets. As the second widely used irradiation technique, UV-illumination was primarily introduced to reduce the growth of infectious agents during platelet storage, with the advantage that this method can also prevent TA-GvHD. However, the induction of oxidative conditions and platelet pre-activation that lead to PSL is more pronounced after UV-based methods of pathogen reduction. Since these lesions are large enough to clearly affect the post-transfusion platelet recovery and survival, more studies are needed to improve the safety and effectiveness of pathogen reduction technologies (PRTs). Therefore, pointing to other benefits of PRTs, such as preventing TA-GvHD or prolonging the shelf life of products by eliminating the possibility of pathogen growth during storage, does not yet seem to justify their widespread use due to above-mentioned effects. Even for gamma-irradiated platelets, some researchers have suggested that due to decreased 1-hour post-transfusion increments and increased risk of platelet refractoriness, their use should be limited to the patients who may develop TA-GVHD. It is noteworthy that due to the effect of X-rays in preventing TA-GvHD, some recent studies are underway to examine its effects on the quality and effectiveness of platelet products and determine whether X-rays can be used as a more appropriate and cost-effective alternative to gamma radiation. The review presented here provides a detailed description about irradiation-based technologies for platelet products, including their applications, mechanistic features, advantages, and disadvantages.
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Affiliation(s)
- Ehteramolsadat Hosseini
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Fatemeh Kianinodeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mehran Ghasemzadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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Zeeuw van der Laan EA, van der Velden S, Porcelijn L, Semple JW, van der Schoot CE, Kapur R. Evaluation of Platelet Responses in Transfusion-Related Acute Lung Injury (TRALI). Transfus Med Rev 2020; 34:227-233. [PMID: 33036839 PMCID: PMC7493815 DOI: 10.1016/j.tmrv.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/29/2022]
Abstract
Platelets are versatile cells which are capable of eliciting nonhemostatic immune functions, especially under inflammatory conditions. Depending on the specific setting, platelets may be either protective or pathogenic in acute lung injury and acute respiratory distress syndrome (ARDS). Their role in transfusion-related acute lung injury (TRALI) is less well defined; however, it has been hypothesized that recipient platelets and transfused platelets both play a pathogenic role in TRALI. Overall, despite conflicting findings, it appears that recipient platelets may play a pathogenic role in antibody-mediated TRALI; however, their contribution appears to be limited. It is imperative to first validate the involvement of recipient platelets by standardizing the animal models, methods, reagents, and readouts for lung injury and taking the animal housing environment into consideration. For the involvement of transfused platelets in TRALI, it appears that predominantly lipids such as ceramide in stored platelets are able to induce TRALI in animal models. These studies will also need to be validated, and moreover, the platelet-derived lipid-mediated mechanisms leading to TRALI will need to be investigated.
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Affiliation(s)
- Eveline A.N. Zeeuw van der Laan
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Saskia van der Velden
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, the Netherlands
| | - John W. Semple
- Division of Hematology and Transfusion Medicine, Lund University, Lund, Sweden
| | - C. Ellen van der Schoot
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Rick Kapur
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
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Jutzi M, Mansouri Taleghani B, Rueesch M, Amsler L, Buser A. Nationwide Implementation of Pathogen Inactivation for All Platelet Concentrates in Switzerland. Transfus Med Hemother 2018; 45:151-156. [PMID: 29928168 DOI: 10.1159/000489900] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/02/2018] [Indexed: 01/19/2023] Open
Abstract
Introduction Bacterial contamination of platelet concentrates (PCs) has been identified as the most prevalent transfusion-associated infectious risk. To prevent PC-related septic transfusion reactions, the Intercept® pathogen inactivation procedure was introduced for all PCs in Switzerland in 2011. Methods Based on numbers of transfused units and mandatorily reported adverse events with high imputability, we compare the risks associated with transfusion of conventional PCs (cPCs) and pathogen-inactivated PCs (PI-PCs). Results From 2005 to 2011, a total of 158,502 cPCs have been issued in Switzerland, and 16 transfusion-transmitted bacterial infections (including 3 fatalities) were reported. This corresponds to a morbidity and mortality rate of ca. 1:9,900 and 1:52,800, respectively. From 2011 to 2016, a total of 205,574 PI-PCs have been issued, and no transfusion-transmitted bacterial infection was reported. Despite continuously increasing transfusion reaction rates per 1,000 RBC and plasma issued between 2008 and 2016, we observed reductions of 66% for life-threatening and fatal reactions and of 26% for all high-imputability transfusion reactions related to PI-PCs as compared to cPCs. No increased rates of bleeding or clinical observations of ineffectiveness of PI-PCs have been reported. After implementation of PI-PCs, the annual increase in platelet usage per 1,000 inhabitants decelerated. Discussion Swiss hemovigilance data confirm a favorable safety profile of the nationwide introduced Intercept pathogen inactivation procedure and its reliable prevention of septic transfusion reactions and fatalities due to bacterially contaminated PCs.
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Affiliation(s)
- Markus Jutzi
- Interregional Blood Transfusion SRC Ltd., Bern, Switzerland
| | - Behrouz Mansouri Taleghani
- University Clinic of Hematology and Central Hematology Laboratory, Division of Transfusion Medicine, Bern University Hospital, Inselspital, Bern, Switzerland
| | - Morven Rueesch
- Blood Transfusion Service, Swiss Red Cross, Bern, Switzerland
| | - Lorenz Amsler
- Division Safety of Medicines, Swissmedic, Bern, Switzerland
| | - Andreas Buser
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, and Department of Hematology, University Hospital Basel, Basel, Switzerland
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Xie R, Yang Y, Zhu Y, Gao L, Jiang X, Sun J, Bian M, Yang J. Microparticles in red cell concentrates prime polymorphonuclear neutrophils and cause acute lung injury in a two-event mouse model. Int Immunopharmacol 2018; 55:98-104. [DOI: 10.1016/j.intimp.2017.11.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 12/31/2022]
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Seltsam A. Pathogen Inactivation of Cellular Blood Products-An Additional Safety Layer in Transfusion Medicine. Front Med (Lausanne) 2017; 4:219. [PMID: 29255710 PMCID: PMC5722787 DOI: 10.3389/fmed.2017.00219] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/20/2017] [Indexed: 01/23/2023] Open
Abstract
In line with current microbial risk reduction efforts, pathogen inactivation (PI) technologies for blood components promise to reduce the residual risk of known and emerging infectious agents. The implementation of PI of labile blood components is slowly but steadily increasing. This review discusses the relevance of PI for the field of transfusion medicine and describes the available and emerging PI technologies that can be used to treat cellular blood products such as platelet and red blood cell units. In collaboration with the French medical device manufacturer Macopharma, the German Red Cross Blood Services developed a new UVC light-based PI method for platelet units, which is currently being investigated in clinical trials.
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Affiliation(s)
- Axel Seltsam
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
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Mo Q, Huang Y, Wang L, Cheng Z, Wu X, Jia Y, Wang X, Zhang B. Photochemical inactivation of lymphocytes by riboflavin with visible light for TA-GVHD prevention. Journal of Photochemistry and Photobiology B: Biology 2017; 174:276-83. [DOI: 10.1016/j.jphotobiol.2017.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 08/01/2017] [Accepted: 08/06/2017] [Indexed: 11/15/2022]
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9
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McVey MJ, Kim M, Tabuchi A, Srbely V, Japtok L, Arenz C, Rotstein O, Kleuser B, Semple JW, Kuebler WM. Acid sphingomyelinase mediates murine acute lung injury following transfusion of aged platelets. Am J Physiol Lung Cell Mol Physiol 2017; 312:L625-L637. [DOI: 10.1152/ajplung.00317.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 11/22/2022] Open
Abstract
Pulmonary complications from stored blood products are the leading cause of mortality related to transfusion. Transfusion-related acute lung injury is mediated by antibodies or bioactive mediators, yet underlying mechanisms are incompletely understood. Sphingolipids such as ceramide regulate lung injury, and their composition changes as a function of time in stored blood. Here, we tested the hypothesis that aged platelets may induce lung injury via a sphingolipid-mediated mechanism. To assess this hypothesis, a two-hit mouse model was devised. Recipient mice were treated with 2 mg/kg intraperitoneal lipopolysaccharide (priming) 2 h before transfusion of 10 ml/kg stored (1–5 days) platelets treated with or without addition of acid sphingomyelinase inhibitor ARC39 or platelets from acid sphingomyelinase-deficient mice, which both reduce ceramide formation. Transfused mice were examined for signs of pulmonary neutrophil accumulation, endothelial barrier dysfunction, and histological evidence of lung injury. Sphingolipid profiles in stored platelets were analyzed by mass spectrophotometry. Transfusion of aged platelets into primed mice induced characteristic features of lung injury, which increased in severity as a function of storage time. Ceramide accumulated in platelets during storage, but this was attenuated by ARC39 or in acid sphingomyelinase-deficient platelets. Compared with wild-type platelets, transfusion of ARC39-treated or acid sphingomyelinase-deficient aged platelets alleviated lung injury. Aged platelets elicit lung injury in primed recipient mice, which can be alleviated by pharmacological inhibition or genetic deletion of acid sphingomyelinase. Interventions targeting sphingolipid formation represent a promising strategy to increase the safety and longevity of stored blood products.
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Affiliation(s)
- Mark J. McVey
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
- Departments of Anesthesia and Physiology, University of Toronto, and Department of Anesthesia and Pain Medicine Sickkids Hospital, Toronto, Ontario, Canada
| | - Michael Kim
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Arata Tabuchi
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Victoria Srbely
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Lukasz Japtok
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Christoph Arenz
- Institute for Chemistry, Humboldt University, Berlin, Germany
| | - Ori Rotstein
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Surgery University of Toronto, Toronto, Ontario, Canada
| | - Burkhard Kleuser
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - John W. Semple
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
- Departments of Pharmacology, Medicine, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Wolfgang M. Kuebler
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Surgery University of Toronto, Toronto, Ontario, Canada
- Department of Physiology University of Toronto, Toronto, Ontario, Canada
- Institute of Physiology, Charité-Univcersitätsmedizin Berlin, Germany; and
- German Heart Institute, Berlin, Germany
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Juffermans NP, Vlaar AP. Transfusion and Acute Respiratory Distress Syndrome: Pathogenesis and Potential Mechanisms. Respir Med 2017. [DOI: 10.1007/978-3-319-41912-1_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- A. L. Peters
- Laboratory of Experimental Intensive Care and Anesthesiology/Department of Intensive Care; Academic Medical Centre; Amsterdam The Netherlands
| | - A. P. J. Vlaar
- Laboratory of Experimental Intensive Care and Anesthesiology/Department of Intensive Care; Academic Medical Centre; Amsterdam The Netherlands
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Caudrillier A, Mallavia B, Rouse L, Marschner S, Looney MR. Transfusion of Human Platelets Treated with Mirasol Pathogen Reduction Technology Does Not Induce Acute Lung Injury in Mice. PLoS One 2015; 10:e0133022. [PMID: 26176623 PMCID: PMC4503436 DOI: 10.1371/journal.pone.0133022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 06/22/2015] [Indexed: 12/24/2022] Open
Abstract
Pathogen reduction technology (PRT) has been developed in an effort to make the blood supply safer, but there is controversy as to whether it may induce structural or functional changes to platelets that could lead to acute lung injury after transfusion. In this study, we used a commercial PRT system to treat human platelets that were then transfused into immunodeficient mice, and the development of acute lung injury was determined. P-selectin expression was higher in the Mirasol PRT-treated platelets compared to control platelets on storage day 5, but not storage day 1. Transfusion of control vs. Mirasol PRT-treated platelets (day 5 of storage, 109 platelets per mouse) into NOD/SCID mice did not result in lung injury, however transfusion of storage day 5 platelets treated with thrombin receptor-activating peptide increased both extravascular lung water and lung vascular permeability. Transfusion of day 1 platelets did not produce lung injury in any group, and LPS priming 24 hours before transfusion had no effect on lung injury. In a model of transfusion-related acute lung injury, NOD/SCID mice were susceptible to acute lung injury when challenged with H-2Kd monoclonal antibody vs. isotype control antibody. Using lung intravital microscopy, we did not detect a difference in the dynamic retention of platelets in the lung circulation in control vs. Mirasol PRT-treated groups. In conclusion, Mirasol PRT produced an increase in P-selectin expression that is storage-dependent, but transfusion of human platelets treated with Mirasol PRT into immunodeficient mice did not result in greater platelet retention in the lungs or the development of acute lung injury.
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Affiliation(s)
- Axelle Caudrillier
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Beñat Mallavia
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Lindsay Rouse
- Terumo BCT, Inc., Lakewood, Colorado, United States of America
| | | | - Mark R. Looney
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
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Abstract
Transfusion-related acute lung injury (TRALI), a syndrome of respiratory distress caused by blood transfusion, is the leading cause of transfusion-related mortality. The majority of TRALI cases have been related to passive infusion of human leucocyte antigen (HLA) and human neutrophil antigen (HNA) antibodies in donor blood. In vitro, ex vivo and in vivo animal models have provided insight in TRALI pathogenesis. The various classes of antibodies implicated in TRALI appear to have different pathophysiological mechanisms for the induction of TRALI involving endothelial cells, neutrophils, monocytes and, as very recently has been discovered, lymphocytes. The HLA and HNA-antibodies are found mainly in blood from multiparous women as they have become sensitized during pregnancy. The incidence of TRALI has decreased rapidly following the introduction of a male-only strategy for plasma donation. This review focuses on pre-clinical and clinical studies investigating the pathophysiology of antibody-mediated TRALI.
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Affiliation(s)
- Anna L Peters
- Laboratory of Experimental Intensive Care and Anaesthesia/Intensive Care, Academic Medical Centre, Amsterdam, The Netherlands
| | - Danielle Van Stein
- Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - Alexander P J Vlaar
- Laboratory of Experimental Intensive Care and Anaesthesia/Intensive Care, Academic Medical Centre, Amsterdam, The Netherlands
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Abonnenc M, Sonego G, Crettaz D, Aliotta A, Prudent M, Tissot JD, Lion N. In vitro study of platelet function confirms the contribution of the ultraviolet B (UVB) radiation in the lesions observed in riboflavin/UVB-treated platelet concentrates. Transfusion 2015; 55:2219-30. [DOI: 10.1111/trf.13123] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/24/2015] [Accepted: 02/28/2015] [Indexed: 12/23/2022]
Affiliation(s)
- Mélanie Abonnenc
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Giona Sonego
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Alessandro Aliotta
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
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Peters AL, van Hezel ME, Juffermans NP, Vlaar AP. Pathogenesis of non-antibody mediated transfusion-related acute lung injury from bench to bedside. Blood Rev 2015; 29:51-61. [DOI: 10.1016/j.blre.2014.09.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/02/2014] [Indexed: 12/11/2022]
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Affiliation(s)
- D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney New South Wales Australia
| | - H. M. Faddy
- Research and Development; Australian Red Cross Blood Service; Brisbane Queensland Australia
| | - L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney New South Wales Australia
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Zhi L, Chi X, Vostal JG. In vitro and in vivo characterization of ultraviolet light C-irradiated human platelets in a 2 event mouse model of transfusion. PLoS One 2013; 8:e79869. [PMID: 24224014 DOI: 10.1371/journal.pone.0079869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 09/27/2013] [Indexed: 12/11/2022] Open
Abstract
UV-based pathogen reduction technologies have been developed in recent years to inactivate pathogens and contaminating leukocytes in platelet transfusion products in order to prevent transfusion-transmitted infections and alloimmunization. UVC-based technology differs from UVA or UVB-based technologies in that it uses a specific wavelength at 254 nm without the addition of any photosensitizers. Previously, it was reported that UVC irradiation induces platelet aggregation and activation. To understand if UVC-induced changes of platelet quality correlate with potential adverse events when these platelets are transfused into animals, we used a 2-event SCID mouse model in which the predisposing event was LPS treatment and the second event was infusion of UVC-irradiated platelets. We analyzed lung platelet accumulation, protein content in bronchoalveolar lavage fluid as an indication of lung injury, and macrophage inflammatory protein-2 (MIP-2) release in mice received UVC-irradiated or untreated control platelets. Our results showed UVC-irradiated platelets accumulated in lungs of the mice in a dose-dependent manner. High-doses of UVC-irradiated platelets were sequestered in the lungs to a similar level as we previously reported for UVB-irradiated platelets. Unlike UVB-platelets, UVC-platelets did not lead to lung injury or induce MIP-2 release. This could potentially be explained by our observation that although UVC treatment activated platelet surface αIIbβ3, it failed to activate platelet cells. It also suggests lung platelet accumulation and subsequent lung damage are due to different and separate mechanisms which require further investigation.
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Bosch-Marcé M, Mohan KV, Gelderman MP, Ryan PL, Russek-Cohen E, Atreya CD. Preclinical safety evaluation of human platelets treated with antimicrobial peptides in severe combined immunodeficient mice. Transfusion 2013; 54:569-76. [DOI: 10.1111/trf.12318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 05/08/2013] [Accepted: 05/13/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Marta Bosch-Marcé
- Section of Cell Biology, Laboratory of Cellular Hematology, Division of Hematology; Food and Drug Administration; Bethesda Maryland
- Division of Biostatistics, Center for Biologics Evaluation and Research; Food and Drug Administration; Bethesda Maryland
| | - Ketha V.K. Mohan
- Section of Cell Biology, Laboratory of Cellular Hematology, Division of Hematology; Food and Drug Administration; Bethesda Maryland
- Division of Biostatistics, Center for Biologics Evaluation and Research; Food and Drug Administration; Bethesda Maryland
| | - Monique P. Gelderman
- Section of Cell Biology, Laboratory of Cellular Hematology, Division of Hematology; Food and Drug Administration; Bethesda Maryland
- Division of Biostatistics, Center for Biologics Evaluation and Research; Food and Drug Administration; Bethesda Maryland
| | - Patricia L. Ryan
- Section of Cell Biology, Laboratory of Cellular Hematology, Division of Hematology; Food and Drug Administration; Bethesda Maryland
- Division of Biostatistics, Center for Biologics Evaluation and Research; Food and Drug Administration; Bethesda Maryland
| | - Estelle Russek-Cohen
- Section of Cell Biology, Laboratory of Cellular Hematology, Division of Hematology; Food and Drug Administration; Bethesda Maryland
- Division of Biostatistics, Center for Biologics Evaluation and Research; Food and Drug Administration; Bethesda Maryland
| | - Chintamani D. Atreya
- Section of Cell Biology, Laboratory of Cellular Hematology, Division of Hematology; Food and Drug Administration; Bethesda Maryland
- Division of Biostatistics, Center for Biologics Evaluation and Research; Food and Drug Administration; Bethesda Maryland
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Abstract
BACKGROUND Platelet (PLT) storage at room temperature (RT) is limited to 5 days to prevent growth of bacteria, if present, to high levels. Storage in cold temperatures would reduce bacterial proliferation, but cold-exposed PLTs are rapidly cleared from circulation by the hepatic Ashwell-Morell (AM) receptor, which recognizes PLT surface carbohydrates terminated by β-galactose. We cycled storage temperature between 4 and 37°C to preserve PLT function and reduce bacterial growth. STUDY DESIGN AND METHODS Temperature-cycled (TC) human PLTs were stored at 4°C for 12 hours and then incubated at 37°C for 30 minutes before returning back to cold storage. PLTs stored at RT or at 4°C (COLD) or TC for 2, 5, and 7 days were infused into SCID mice and the in vivo recovery was determined at 5, 20, and 60 minutes after transfusion. RESULTS PLTs stored for 2 days in COLD had significantly lower in vivo recoveries than RT PLTs. TC PLTs had improved recoveries over COLD and comparable to RT PLTs. After 5- and 7-day storage, TC PLTs had better recoveries than RT and COLD PLTs. PLT surface β-galactose was increased significantly for both COLD and TC PLTs compared to RT. Blocking of the AM receptor by asialofetuin increased COLD but not TC PLT recovery. CONCLUSION TC cold storage may be an effective method to store PLTs without loss of in vivo recovery. The increased β-galactose exposure in TC PLTs suggests that mechanisms in addition to AM receptors may mediate clearance of cold-stored PLTs.
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Affiliation(s)
- Fei Xu
- Laboratory of Cellular Hematology, Center for Biologics Evaluation and Research, FDA, Bethesda, Maryland 20852-1448, USA
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Abstract
The use of pathogen reduction technologies (PRTs) for labile blood components is slowly but steadily increasing. While pathogen-reduced plasma is already used routinely, efficacy and safety concerns impede the widespread use of pathogen-reduced platelets. The supportive and often prophylactic nature of blood component therapy in a variety of clinical situations complicates the clinical evaluation of these novel blood products. However, an increasing body of evidence on the clinical efficacy, safety, cost-benefit ratio and development of novel technologies suggests that pathogen reduction has entered a stage of maturity that could further increase the safety margin in haemotherapy. This review summarizes the clinical evidence on PRTs for plasma and platelet products that are currently licensed or under development.
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Affiliation(s)
- Axel Seltsam
- Institute Springe, German Red Cross Blood Service NSTOB, Springe, Germany.
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Chi X, Zhi L, Vostal JG. Human platelets pathogen reduced with riboflavin and ultraviolet light do not cause acute lung injury in a two-event SCID mouse model. Transfusion 2013; 54:74-85. [DOI: 10.1111/trf.12242] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 04/02/2013] [Indexed: 01/27/2023]
Affiliation(s)
- Xuan Chi
- Laboratory of Cellular Hematology; Division of Hematology; OBRR; Center for Biologics Evaluation and Research; Food and Drug Administration; Rockville Maryland
| | - Li Zhi
- Laboratory of Cellular Hematology; Division of Hematology; OBRR; Center for Biologics Evaluation and Research; Food and Drug Administration; Rockville Maryland
| | - Jaroslav G. Vostal
- Laboratory of Cellular Hematology; Division of Hematology; OBRR; Center for Biologics Evaluation and Research; Food and Drug Administration; Rockville Maryland
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Berger K, Bauer M, Schopohl D, Henschler R, Ostermann H. Model Calculations to Quantify Clinical and Economic Effects of Pathogen Inactivation in Platelet Concentrates. ACTA ACUST UNITED AC 2013; 36:53-9. [DOI: 10.1159/000346309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Chi X, Zhi L, Gelderman MP, Vostal JG. Host platelets and, in part, neutrophils mediate lung accumulation of transfused UVB-irradiated human platelets in a mouse model of acute lung injury. PLoS One 2012; 7:e44829. [PMID: 23028636 PMCID: PMC3446987 DOI: 10.1371/journal.pone.0044829] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 08/07/2012] [Indexed: 11/26/2022] Open
Abstract
We previously reported that ultraviolet light B (UVB)-treated human platelets (hPLTs) can cause acute lung injury (ALI) in a two-event SCID mouse model in which the predisposing event was Lipopolysaccharide (LPS) injection and the second event was infusion of UVB-treated hPLTs. To delineate contributions of host mouse platelets (mPLTs) and neutrophils in the pathogenesis of ALI in this mouse model, we depleted mPLTs or neutrophils and measured hPLT accumulation in the lung. We also assessed lung injury by protein content in bronchoalveolar lavage fluid (BALF). LPS injection followed by infusion of UVB-treated hPLTs resulted in sequestration of both mPLTs and hPLTs in the lungs of SCID mice, although the numbers of neutrophils in the lung were not significantly different from the control group. Depletion of mouse neutrophils caused only a mild reduction in UVB-hPLTs accumulation in the lungs and a mild reduction in protein content in BALF. In comparison, depletion of mPLTs almost completely abolished hPLTs accumulation in the lung and significantly reduced protein content in BALF. UVB-treated hPLTs bound to host mPLTs, but did not bind to neutrophils in the lung. Aspirin treatment of hPLTs in vitro abolished hPLT accumulation in the lung and protected mice from lung injury. Our data indicate that host mPLTs accumulated in the lungs in response to an inflammatory challenge and subsequently mediated the attachment of transfused UVB-hPLTs. Neutrophils also recruited a small percentage of platelets to the lung. These findings may help develop therapeutic strategies for ALI which could potentially result from transfusion of UV illuminated platelets.
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Affiliation(s)
| | | | | | - Jaroslav G. Vostal
- Laboratory of Cellular Hematology, Division of Hematology, OBRR, Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, Maryland, United States of America
- * E-mail:
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Zhi L, Chi X, Gelderman MP, Vostal JG. Activation of platelet protein kinase C by ultraviolet light B mediates platelet transfusion-related acute lung injury in a two-event animal model. Transfusion 2012; 53:722-31. [DOI: 10.1111/j.1537-2995.2012.03811.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Menis M, Izurieta HS, Anderson SA, Kropp G, Holness L, Gibbs J, Erten T, Worrall CM, MaCurdy TE, Kelman JA, Ball R. Outpatient transfusions and occurrence of serious noninfectious transfusion-related complications among US elderly, 2007-2008: utility of large administrative databases in blood safety research. Transfusion 2012; 52:1968-76. [DOI: 10.1111/j.1537-2995.2011.03535.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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