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Kogler VJ, Miles JA, Özpolat T, Bailey SL, Byrne DA, Bawcom-Randall M, Wang Y, Larsen HJ, Reed F, Fu X, Stolla M. Platelet dysfunction reversal with cold-stored vs room temperature-stored platelet transfusions. Blood 2024; 143:2073-2088. [PMID: 38427589 PMCID: PMC11143524 DOI: 10.1182/blood.2023022593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/29/2024] [Accepted: 02/15/2024] [Indexed: 03/03/2024] Open
Abstract
ABSTRACT Platelets are stored at room temperature for 5 to 7 days (room temperature-stored platelets [RSPs]). Because of frequent and severe shortages, the US Food and Drug Administration recently approved up to 14-day cold-stored platelets (CSPs) in plasma. However, the posttransfusion function of CSPs is unknown and it is unclear which donors are best suited to provide either RSPs or CSPs. In this study, we sought to evaluate the posttransfusion platelet function and its predictors for platelets stored for the maximum approved storage times (7-day RSPs and 14-day CSPs) in healthy volunteers on acetylsalicylic acid (ASA). We conducted a randomized crossover study in 10 healthy humans. Individuals donated 1 platelet unit, stored at either 22°C or 4°C based on randomization. Before transfusion, participants ingested ASA to inhibit endogenous platelets. Transfusion recipients were tested for platelet function and lipid mediators. Platelet units were tested for lipid mediators only. A second round of transfusion with the alternative product was followed by an identical testing sequence. RSPs reversed platelet inhibition significantly better in αIIbβ3 integrin activation-dependent assays. In contrast, CSPs in recipients led to significantly more thrombin generation, which was independent of platelet microparticles. Lysophosphatidylcholine-O species levels predicted the procoagulant capacity of CSPs. In contrast, polyunsaturated fatty acid concentrations predicted the aggregation response of RSPs. In summary, we provide, to our knowledge, the first efficacy data of extended-stored CSPs in plasma. Our results suggest that identifying ideal RSP and CSP donors is possible, and pave the way for larger studies in the future. This trial is registered at www.ClinicalTrials.gov as #NCT0511102.
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Affiliation(s)
- Valery J. Kogler
- Bloodworks Northwest Research Institute, Seattle, WA
- Department of Pathology and Laboratory Medicine, University of Virginia School of Medicine, Charlottesville, VA
| | - Jeffrey A. Miles
- Bloodworks Northwest Research Institute, Seattle, WA
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Tahsin Özpolat
- Bloodworks Northwest Research Institute, Seattle, WA
- Department of Medicine, Division of Nephrology, University of Arizona, School of Medicine, Tucson, AZ
| | | | | | | | - Yi Wang
- Bloodworks Northwest Research Institute, Seattle, WA
| | | | - Franklin Reed
- Bloodworks Northwest Research Institute, Seattle, WA
| | - Xiaoyun Fu
- Bloodworks Northwest Research Institute, Seattle, WA
- Division of Hematology and Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Moritz Stolla
- Bloodworks Northwest Research Institute, Seattle, WA
- Division of Hematology and Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA
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2
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Gordy D, Swayne T, Berry GJ, Thomas TA, Hudson KE, Stone EF. Characterization of a novel mouse platelet transfusion model. Vox Sang 2024. [PMID: 38643983 DOI: 10.1111/vox.13642] [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: 01/17/2024] [Revised: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND AND OBJECTIVES Platelet transfusions are increasing with medical advances. Based on FDA criteria, platelet units are assessed by in vitro measures; however, it is not known how platelet processing and storage duration affect function in vivo. Our study's aim was to develop a novel platelet transfusion model stored in mouse plasma that meets FDA criteria adapted to mice, and transfused fresh and stored platelets are detectable in clots in vivo. STUDY DESIGN AND METHODS Platelet units stored in mouse plasma were prepared using a modified platelet-rich plasma (PRP) collection protocol. Characteristics of fresh and stored units, including pH, cell count, in vitro measures of activity, including activation and aggregation, and post-transfusion recovery (PTR), were determined. Lastly, a tail transection assay was conducted using mice transfused with fresh or stored units, and transfused platelets were identified by confocal imaging. RESULTS Platelet units had acceptable platelet and white cell counts and were negative for bacterial contamination. Fresh and 1-day stored units had acceptable pH; the platelets were activatable by thrombin and adenosine diphosphate, agreeable with thrombin, had acceptable PTR, and were present in vivo in clots of recipients after tail transection. In contrast, 2-day stored units had clinically unacceptable quality. CONCLUSION We developed mouse platelets for transfusion analogous to human platelet units using a modified PRP collection protocol with maximum storage of 1 day for an 'old' unit. This provides a powerful tool to test how process modifications and storage conditions affect transfused platelet function in vivo.
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Affiliation(s)
- Dominique Gordy
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Theresa Swayne
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Gregory J Berry
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Tiffany A Thomas
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Krystalyn E Hudson
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Elizabeth F Stone
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
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3
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Liu C, Su Y, Guo W, Ma X, Qiao R. The platelet storage lesion, what are we working for? J Clin Lab Anal 2024; 38:e24994. [PMID: 38069592 PMCID: PMC10829691 DOI: 10.1002/jcla.24994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/04/2023] [Accepted: 11/26/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Platelet concentrate (PC) transfusions are crucial in prevention and treatment of bleeding in infection, surgery, leukemia, and thrombocytopenia patients. Although the technology for platelet preparation and storage has evolved over the decades, there are still challenges in the demand for platelets in blood banks because the platelet shelf life is limited to 5 days due to bacterial contamination and platelet storage lesions (PSLs) at 20-24°C under constant horizontal agitation. In addition, the relations between some adverse effects of platelet transfusions and PSLs have also been considered. Therefore, understanding the mechanisms of PSLs is conducive to obtaining high quality platelets and facilitating safe and effective platelet transfusions. OBJECTIVE This review summarizes developments in mechanistic research of PSLs and their relationship with clinical practice, providing insights for future research. METHODS Authors conducted a search on PubMed and Web of Science using the professional terms "PSL" and "platelet transfusion." The obtained literature was then roughly categorized based on their research content. Similar studies were grouped into the same sections, and further searches were conducted based on the keywords of each section. RESULTS Different studies have explored PSLs from various perspectives, including changes in platelet morphology, surface molecules, biological response modifiers (BMRs), metabolism, and proteins and RNA, in an attempt to monitor PSLs and identify intervention targets that could alleviate PSLs. Moreover, novel platelet storage conditions, including platelet additive solutions (PAS) and reconsidered cold storage methods, are explored. There are two approaches to obtaining high-quality platelets. One approach simulates the in vivo environment to maintain platelet activity, while the other keeps platelets at a low activity level in vitro under low temperatures. CONCLUSION Understanding PSLs helps us identify good intervention targets and assess the therapeutic effects of different PSLs stages for different patients.
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Affiliation(s)
- Cheng Liu
- Peking University Third HospitalBeijingChina
| | - Yang Su
- Peking University Third HospitalBeijingChina
| | - Wanwan Guo
- Peking University Third HospitalBeijingChina
| | - Xiaolong Ma
- Peking University Third HospitalBeijingChina
| | - Rui Qiao
- Peking University Third HospitalBeijingChina
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4
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Özpolat T, Yakovenko O, Stratiievska A, Bailey SL, Miles J, Usaneerungrueng C, Byrne D, Wu X, Stolla M. Evaluating stored platelet shape change using imaging flow cytometry. Platelets 2023; 34:2136646. [PMID: 36325604 PMCID: PMC9833271 DOI: 10.1080/09537104.2022.2136646] [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: 11/06/2022]
Abstract
Platelets are routinely stored at room temperature for 5-7 days before transfusion. Stored platelet quality is traditionally assessed by Kunicki's morphology score. This method requires extensive training, experience, and is highly subjective. Moreover, the number of laboratories familiar with this technique is decreasing. Cold storage of platelets has recently regained interest because of potential advantages such as reduced bacterial growth and preserved function. However, platelets exposed to cold temperatures change uniformly from a discoid to a spherical shape, reducing the morphology score outcomes to spheroid versus discoid during cooling. We developed a simpler, unbiased screening tool to measure temperature-induced platelet shape change using imaging flow cytometry. When reduced to two dimensions, spheres appear circular, while discs are detected on a spectrum from fusiform to circular. We defined circular events as having a transverse axis of >0.8 of the longitudinal axis and fusiform events ≤0.8 of the longitudinal axis. Using this assay, mouse and human platelets show a temperature and time-dependent, two-dimensional shape change from fusiform to circular, consistent with their three-dimensional change from discs to spheres. The method we describe here is a valuable tool for detecting shape change differences in response to agonists or temperature and will help screening for therapeutic measures to mitigate the cold-induced storage lesion.
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Affiliation(s)
- Tahsin Özpolat
- Bloodworks Northwest Research Institute, Seattle, WA, USA
| | - Olga Yakovenko
- Bloodworks Northwest Research Institute, Seattle, WA, USA
| | | | | | - Jeffrey Miles
- Bloodworks Northwest Research Institute, Seattle, WA, USA
| | | | - Daire Byrne
- Bloodworks Northwest Research Institute, Seattle, WA, USA
| | - Xiaoping Wu
- Flow Core Facility, Department of Pathology, University of Washington, Seattle, WA,Bristol Myers Squibb, Analytical Development, Seattle, WA, USA
| | - Moritz Stolla
- Bloodworks Northwest Research Institute, Seattle, WA, USA,University of Washington Medical Center, Department of Medicine, Division of Hematology, Seattle, WA
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5
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Gordy D, Swayne T, Berry GJ, Thomas TA, Hudson KE, Stone EF. Characterization of a Novel Mouse Platelet Transfusion Model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.10.566577. [PMID: 38014145 PMCID: PMC10680660 DOI: 10.1101/2023.11.10.566577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Platelet transfusions are increasing with advances in medical care. Based on FDA criteria, platelet units are assessed by in vitro measures; however, it is not known how platelet processing and storage duration affect function in vivo. To address this, we developed a novel platelet transfusion model that meets FDA criteria adapted to mice, and transfused fresh and stored platelets are detected in clots in vivo. STUDY DESIGN AND METHODS Platelet units stored in mouse plasma were prepared using a modified platelet rich plasma collection protocol. Characteristics of fresh and stored units, including pH, cell count, in vitro measures of activity, including activation and aggregation, and post-transfusion recovery (PTR), were determined. Lastly, a tail transection assay was conducted using mice transfused with fresh or stored units, and transfused platelets were identified by confocal imaging. RESULTS Platelet units had acceptable platelet and white cell counts and were negative for bacterial contamination. Fresh and 1-day stored units had acceptable pH; the platelets were activatable by thrombin and ADP, aggregable with thrombin, had acceptable PTR, and were present in vivo in clots of recipients after tail transection. In contrast, 2-day stored units had clinically unacceptable quality. DISCUSSION We developed mouse platelets for transfusion analogous to human platelet units using a modified platelet rich plasma collection protocol with maximum storage of 1 day for an "old" unit. This provides a powerful tool to test how process modifications and storage conditions affect transfused platelet function in vivo.
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Affiliation(s)
- Dominique Gordy
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Theresa Swayne
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Gregory J. Berry
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Tiffany A. Thomas
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Krystalyn E. Hudson
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Elizabeth F. Stone
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
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6
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Larsen HJ, Byrne D, Özpolat T, Chauhan A, Bailey SL, Rhoads N, Reed F, Stolla MC, Adili R, Holinstat M, Fu X, Stolla M. Loss of 12-Lipoxygenase Improves the Post-Transfusion Function of Stored Platelets. Arterioscler Thromb Vasc Biol 2023; 43:1990-2007. [PMID: 37650322 PMCID: PMC10538391 DOI: 10.1161/atvbaha.123.319021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Platelets for transfusion are stored for 5 to 7 days. Previous studies have shown that HETE levels in the storage bag negatively correlate with platelet performance in vivo, suggesting that the dysregulation of bioactive lipid mediators may contribute to the storage lesion. In the current study, we sought to understand how genetic deletion and pharmacological inhibition of 12-LOX (12-lipoxygenase) affects platelets during storage and after transfusion. METHODS Platelets from 12-LOX+/+ (wild-type [WT]) and 12-LOX-/- mice were stored for 24 and 48 hours and profiled using liquid chromatography-tandem mass spectrometry-multiple reaction monitoring or transfused into thrombocytopenic hIL4R (human interleukin 4 receptor)-transgenic mice. Platelet function was assessed by flow cytometry and in vivo thrombosis and hemostasis models. To test the role of the COX-1 (cyclooxygenase-1) pathway, donor mice were treated with acetylsalicylic acid. Human platelets were treated with the 12-LOX inhibitor, VLX-1005, or vehicle, stored, and transfused to NOD/SCID (nonobese diabetic/severe combined immunodeficiency) mice. RESULTS Polyunsaturated fatty acids increased significantly in stored platelets from 12-LOX-/- mice, whereas oxylipin concentrations were significantly higher in WT platelets. After transfusion to thrombocytopenic mice, we observed significantly more baseline αIIbβ3 integrin activation in 12-LOX-/- platelets than in WT platelets. Stored platelets from 12-LOX-/- mice occluded vessels significantly faster than stored WT platelets. In hemostasis models, significantly more stored 12-LOX-/- than WT platelets accumulated at the site of venous injury leading to reduced blood loss. Inhibition of COX-1 abrogated both increased integrin activation and thromboxane generation in stored 12-LOX-/- platelets, highlighting the critical role of this pathway for improved post-transfusion function. Consistent with our mouse studies, human platelets stored with VLX-1005, showed increased integrin activation compared with vehicle-treated platelets after transfusion. CONCLUSIONS Deleting 12-LOX improves the post-transfusion function of stored murine platelets by increasing thromboxane generation through COX-1-dependent arachidonic acid metabolism. Future studies should determine the feasibility and safety of 12-LOX-inhibited platelets transfused to humans.
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Affiliation(s)
| | - Daire Byrne
- Bloodworks Northwest Research Institute, Seattle, WA
| | | | | | | | - Nicole Rhoads
- Bloodworks Northwest Research Institute, Seattle, WA
| | - Franklin Reed
- Bloodworks Northwest Research Institute, Seattle, WA
| | - Massiel C. Stolla
- University of Washington Medical Center, Department of Medicine, Division of Hematology, Seattle, WA
| | - Reheman Adili
- Bloodworks Northwest Research Institute, Seattle, WA
| | | | - Xiaoyun Fu
- Bloodworks Northwest Research Institute, Seattle, WA
- University of Washington Medical Center, Department of Medicine, Division of Hematology, Seattle, WA
| | - Moritz Stolla
- Bloodworks Northwest Research Institute, Seattle, WA
- University of Washington Medical Center, Department of Medicine, Division of Hematology, Seattle, WA
- University of Washington Medical Center, Department of Laboratory Medicine and Pathology, Seattle, WA
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7
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Xu C, Mi Z, Dong Z, Chen X, Ji G, Kang H, Li K, Zhao B, Wang F. Platelet-Derived Exosomes Alleviate Knee Osteoarthritis by Attenuating Cartilage Degeneration and Subchondral Bone Loss. Am J Sports Med 2023; 51:2975-2985. [PMID: 37551685 DOI: 10.1177/03635465231188122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is the most prevalent chronic degenerative joint disease among the aged population. However, current treatments for OA are limited to alleviating symptoms, with no therapies that prevent and regenerate cartilage deterioration. PURPOSE To assess the effects of platelet-derived exosomes (Plt-exos) on OA and then to explore the potential molecular mechanism. STUDY DESIGN Controlled laboratory study. METHODS Exosomes derived from human apheresis platelets were isolated and identified. The effects of Plt-exos in protecting chondrocytes under interleukin 1β stimulation were evaluated by analyzing the proliferation and migration in human primary chondrocytes. RNA sequencing was later performed in vitro for primary chondrocytes to reveal the underlying mechanisms of Plt-exo treatment. Anterior cruciate ligament transection was used to construct an OA mice model, and intra-articular injection of Plt-exos was given once a week for 6 weeks. Mice were sacrificed 4 weeks after the last injection. Histologic and immunohistochemistry staining and micro-computed tomography analysis were performed to assess alterations of articular cartilage and subchondral bone. RESULTS Plt-exos significantly promoted proliferation and migration of chondrocytes within a dose-dependent manner, as well as dramatically promoted cartilage regeneration and attenuated abnormal tibial subchondral bone remodeling, thus slowing the progression of OA. After being treated with Plt-exos, 1797 genes were differentially expressed in chondrocytes (923 upregulated and 874 downregulated genes). Functional enrichment results and hub genes were mainly involved in anti-inflammatory effects, mediating cell adhesion, stimulating cartilage repair, promoting anabolism, and inhibiting catabolism. CONCLUSION Our results demonstrated that Plt-exos promoted chondrocyte proliferation and migration in vitro, as well as attenuated cartilage degeneration, improved the microarchitecture of subchondral bone, and retarded OA progression in vivo. CLINICAL RELEVANCE Our study illustrated that the administered Plt-exos could alleviate knee OA by attenuating cartilage degeneration and subchondral bone loss, possibly serving as a novel promising treatment for OA in the future.
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Affiliation(s)
- Chenyue Xu
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, China
| | - Ziyue Mi
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China
| | - Zhenyue Dong
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, China
| | - Xiaobo Chen
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, China
| | - Gang Ji
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, China
| | - Huijun Kang
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, China
| | - Kehan Li
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, China
| | - Bo Zhao
- Hebei Medical University, Shijiazhuang, Hebei, China
| | - Fei Wang
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, China
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8
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Abstract
CPT2 K79 acetylation caused by NAD+ exhaustion and Sirt3 dysfunction resulted in LCAC accumulation and platelet damage. Blocking acylcarnitine generation with AMPK or CPT1 inhibitors, Sirt3 agonists, and antioxidants retarded platelet storage lesion.
The short life span of platelets is a major challenge to platelet transfusion services because of the lack of effective intervention. Here, we found that the accumulation of long-chain acylcarnitines (LCACs) is responsible for mitochondrial damage and platelet storage lesion. Further studies showed that the blockade of fatty acid oxidation and the activation of AMP-activated protein kinase (AMPK)/acetyl-CoA carboxylase/carnitine palmitoyltransferase 1 (CPT1) pathways that promote fatty acid metabolism are important reasons for the accumulation of LCACs. The excessive accumulation of LCACs can cause mitochondrial damage and a short life span of stored platelets. The mechanism study elucidated that NAD+ exhaustion and the subsequent decrease in sirtuin 3 (Sirt3) activity caused an increase in the level of CPT2 K79 acetylation, which is the primary cause of the blockade of fatty acid oxidation and the accumulation of LCACs. Blocking LCAC generation with the inhibitors of AMPK or CPT1, the agonists of Sirt3, and antioxidants tremendously retarded platelet storage lesion in vitro and prolonged the survival of stored platelets in vivo posttransfusion with single or combined use. In summary, we discovered that CPT2 acetylation attenuates fatty acid oxidation and exacerbates platelet storage lesion and may serve as a new target for improving platelet storage quality.
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9
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Meli A, McAndrew M, Frary A, Rehnstrom K, Stevens-Hernandez CJ, Flatt JF, Griffiths A, Stefanucci L, Astle W, Anand R, New HV, Bruce LJ, Cardigan R. Familial pseudohyperkalemia induces significantly higher levels of extracellular potassium in early storage of red cell concentrates without affecting other standard measures of quality: A case control and allele frequency study. Transfusion 2021; 61:2439-2449. [PMID: 33960432 DOI: 10.1111/trf.16440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/15/2021] [Accepted: 04/03/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Familial pseudohyperkalemia (FP) is characterized by an increased rate of potassium leakage in refrigerated red cells and is associated with the minor allele of the single nucleotide polymorphism rs148211042 (R723Q) in the ABCB6 gene. The study aims were to obtain the minor allele frequencies of ABCB6 variants and to measure supernatant potassium accumulation, and other red cell storage parameters, in red cell concentrates (RCC) from carriers of variant rs148211042 under standard blood bank conditions. STUDY DESIGN Whole blood units were collected from 6 FP individuals and 11 controls and processed into RCC in additive solution. RCC were sampled and tested over cold storage for full blood count, extracellular potassium, glucose, lactate, microvesicle release, deformability, hemolysis, pH, adenosine triphosphate, and 2,3-diphosphoglycerate. RESULTS Screening of genotyped cohorts identified that variant rs148211042 is present in 1 in 394 British citizens of European ancestry. FP RCC had significantly higher supernatant potassium at all time points from day 3 onwards (p < .001) and higher mean cell volume (p = .032) than controls. The initial rate of potassium release was higher in FP RCC; supernatant potassium reached 46.0 (23.8-57.6) mmol/L (mean [range]) by day 5, increasing to 68.9 (58.8-73.7) mmol/L by day 35. Other quality parameters were not significantly different between FP RCC and controls. CONCLUSION These data suggest that if a blood donor has FP, reducing the RCC shelf-life to 5 days may be insufficient to reduce the risk of hyperkalemia in clinical scenarios such as neonatal large volume transfusion.
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Affiliation(s)
- Athinoula Meli
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | - Margaret McAndrew
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | - Amy Frary
- Department of Haematology, University of Cambridge, Cambridge, UK.,National Institute for Health Research BioResource-Rare Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Karola Rehnstrom
- Department of Haematology, University of Cambridge, Cambridge, UK.,National Institute for Health Research BioResource-Rare Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Christian J Stevens-Hernandez
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK.,Bristol Institute for Transfusion Sciences, NHS Blood and Transplant, Bristol, UK.,School of Biochemistry, University of Bristol, Bristol, UK
| | - Joanna F Flatt
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant, Bristol, UK
| | | | - Luca Stefanucci
- Department of Haematology, University of Cambridge, Cambridge, UK.,British Heart Foundation Centre of Excellence, Cambridge, UK
| | - William Astle
- Medical Research Council Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, UK.,MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Rekha Anand
- Clinical Directorate, NHS Blood and Transplant, Birmingham, UK
| | - Helen V New
- Clinical Directorate, NHS Blood and Transplant, London, UK.,Centre for Haematology, Imperial College London, London, UK
| | - Lesley J Bruce
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK.,Bristol Institute for Transfusion Sciences, NHS Blood and Transplant, Bristol, UK
| | - Rebecca Cardigan
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
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10
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Current Understanding of the Relationship between Blood Donor Variability and Blood Component Quality. Int J Mol Sci 2021; 22:ijms22083943. [PMID: 33920459 PMCID: PMC8069744 DOI: 10.3390/ijms22083943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/19/2022] Open
Abstract
While differences among donors has long challenged meeting quality standards for the production of blood components for transfusion, only recently has the molecular basis for many of these differences become understood. This review article will examine our current understanding of the molecular differences that impact the quality of red blood cells (RBC), platelets, and plasma components. Factors affecting RBC quality include cytoskeletal elements and membrane proteins associated with the oxidative response as well as known enzyme polymorphisms and hemoglobin variants. Donor age and health status may also be important. Platelet quality is impacted by variables that are less well understood, but that include platelet storage sensitive metabolic parameters, responsiveness to agonists accumulating in storage containers and factors affecting the maintenance of pH. An increased understanding of these variables can be used to improve the quality of blood components for transfusion by using donor management algorithms based on a donors individual molecular and genetic profile.
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11
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Chiang JY, Lee SH, Chen YC, Wu CK, Chuang JY, Lo SC, Yeh HM, Yeh SFS, Hsu CA, Lin BB, Chang PC, Chang CH, Liang HJ, Chiang FT, Lin CY, Juang JMJ. Metabolomic Analysis of Platelets of Patients With Aspirin Non-Response. Front Pharmacol 2019; 10:1107. [PMID: 31680941 PMCID: PMC6797853 DOI: 10.3389/fphar.2019.01107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 08/28/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Aspirin is the most commonly used antiplatelet agent for the prevention of cardiovascular diseases. However, a certain proportion of patients do not respond to aspirin therapy. The mechanisms of aspirin non-response remain unknown. The unique metabolomes in platelets of patients with coronary artery disease (CAD) with aspirin non-response may be one of the causes of aspirin resistance. Materials and Methods: We enrolled 29 patients with CAD who were aspirin non-responders, defined as a study subject who were taking aspirin with a platelet aggregation time less than 193 s by PFA-100, and 31 age- and sex-matched patients with CAD who were responders. All subjects had been taking 100 mg of aspirin per day for more than 1 month. Hydrophilic metabolites from the platelet samples were extracted and analyzed by nuclear magnetic resonance (NMR). Both 1D 1H and 2D J-resolved NMR spectra were obtained followed by spectral processing and multivariate statistical analysis, such as partial least squares discriminant analysis (PLS-DA). Results: Eleven metabolites were identified. The PLS-DA model could not distinguish aspirin non-responders from responders. Those with low serum glycine level had significantly shorter platelet aggregation time (mean, 175.0 s) compared with those with high serum glycine level (259.5 s). However, this association became non-significant after correction for multiple tests. Conclusions: The hydrophilic metabolic profile of platelets was not different between aspirin non-responders and responders. An association between lower glycine levels and higher platelet activity in patients younger than 65 years suggests an important role of glycine in the pathophysiology of aspirin non-response.
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Affiliation(s)
- Jiun-Yang Chiang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sheng-Han Lee
- Institute of Environmental Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yen-Ching Chen
- College of Public Health, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Cho-Kai Wu
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jing-Yuan Chuang
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Shyh-Chyi Lo
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Huei-Ming Yeh
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shih-Fan Sherri Yeh
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Cheng-An Hsu
- Division of Haematology, Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Bin-Bin Lin
- Division of Haematology, Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pi-Chu Chang
- Division of Haematology, Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hsin Chang
- Division of Haematology, Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hao-Jan Liang
- Institute of Environmental Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Fu-Tien Chiang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Cardiovascular Center, Fu-Jen Catholic University Hospital, New Taipei, Taiwan
| | - Ching-Yu Lin
- Institute of Environmental Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jyh-Ming Jimmy Juang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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12
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International Study of the Epidemiology of Platelet Transfusions in Critically Ill Children With an Underlying Oncologic Diagnosis. Pediatr Crit Care Med 2019; 20:e342-e351. [PMID: 31107379 DOI: 10.1097/pcc.0000000000001987] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To describe the epidemiology of platelet transfusions in critically ill children with an underlying oncologic diagnosis and to examine effects of prophylactic versus therapeutic transfusions. DESIGN Subgroup analysis of a prospective, observational study. SETTING Eighty-two PICUs in 16 countries. PATIENTS All children (3 d to 16 yr old) who received a platelet transfusion during one of the six predefined screening weeks and had received chemotherapy in the previous 6 months or had undergone hematopoietic stem cell transplantation in the last year. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Of the 548 patients enrolled in the parent study, 237 (43%) had an underlying oncologic diagnosis. In this population, 71% (168/237) of transfusions were given prophylactically, and 59% (139/237) of transfusions were given at a total platelet count greater than 20 × 10/L, higher than the current recommendations. Those with an underlying oncologic diagnosis were significantly older, and received less support including less mechanical ventilation, fewer medications that affect platelet function, and less use of extracorporeal life support than those without an underlying oncologic diagnosis. In this subpopulation, there were no statistically significant differences in median (interquartile range) platelet transfusion thresholds when comparing bleeding or nonbleeding patients (50 × 10/L [10-50 × 10/L] and 30 × 10/L [10-50 × 10/L], respectively [p = 0.166]). The median (interquartile range) interval transfusion increment in children with an underlying oncologic diagnosis was 17 × 10/L (6-52 × 10/L). The presence of an underlying oncologic diagnosis was associated with a poor platelet increment response to platelet transfusion in this cohort (adjusted odds ratio, 0.46; 95% CI, 0.22-0.95; p = 0.035). CONCLUSIONS Children with an underlying oncologic diagnosis receive nearly half of platelet transfusions prescribed by pediatric intensivists. Over half of these transfusions are prescribed at total platelet count greater than current recommendations. Studies must be done to clarify appropriate indications for platelet transfusions in this vulnerable population.
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13
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Fu X, Anderson M, Wang Y, Zimring JC. LC-MS/MS-MRM-Based Targeted Metabolomics for Quantitative Analysis of Polyunsaturated Fatty Acids and Oxylipins. Methods Mol Biol 2019; 1978:107-120. [PMID: 31119659 DOI: 10.1007/978-1-4939-9236-2_7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
LC-MS/MS with multiple reaction monitoring (MRM) is a powerful tool for targeted metabolomics analysis including screening and quantification of known metabolites. Given the complexity of biological samples, the difference in ionization efficiency, and signal intensity of each metabolite, isotopically labeled internal standards are often used for accurate quantification. In this chapter, we describe a detailed protocol for the quantitative analysis of polyunsaturated fatty acids (PUFAs) and their oxidized products (oxylipins) by LC-MS/MS-MRM with isotope dilution. PUFAs are very susceptible to oxidation by both enzymatic and nonenzymatic pathways. Free PUFAs and corresponding oxylipins, known as bioactive lipids, are involved in many processes with varying biological functions depending on their chemical structure and concentration. Accurate quantification is thus becoming crucial to understanding the role of these bioactive lipids in health, disease(s), and other settings.
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Affiliation(s)
- Xiaoyun Fu
- Bloodworks Northwest Research Institute, Seattle, WA, USA.
- Division of Hematology, Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA.
| | | | - Yi Wang
- Bloodworks Northwest Research Institute, Seattle, WA, USA
| | - James C Zimring
- Bloodworks Northwest Research Institute, Seattle, WA, USA
- Division of Hematology, Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA
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14
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Bontekoe IJ, Meer PF, Verhoeven AJ, Korte D. Platelet storage properties are associated with donor age:in vitroquality of platelets from young donors and older donors with and without Type 2 diabetes. Vox Sang 2018; 114:129-136. [DOI: 10.1111/vox.12739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/08/2018] [Accepted: 11/13/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Ido J. Bontekoe
- Department of Product and Process Development Sanquin Blood Bank Amsterdam the Netherlands
| | - Pieter F. Meer
- Department of Product and Process Development Sanquin Blood Bank Amsterdam the Netherlands
- Center for Clinical Transfusion Research Sanquin Leiden the Netherlands
| | | | - Dirk Korte
- Department of Product and Process Development Sanquin Blood Bank Amsterdam the Netherlands
- Department of Blood Cell Research Sanquin Research Amsterdam the Netherlands
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15
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Abonnenc M, Tissot JD, Prudent M. General overview of blood products in vitro quality: Processing and storage lesions. Transfus Clin Biol 2018; 25:269-275. [PMID: 30241785 DOI: 10.1016/j.tracli.2018.08.162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
Blood products are issued from blood collection. Collected blood is immediately mixed with anticoagulant solutions that immediately induce chemical and/or biochemical modifications. Collected blood is then transformed into different blood products according to various steps of fabrication. All these steps induce either reversible or irreversible "preparation-related" lesions that combine with "storage-related" lesions. This short paper aims to provide an overview of the alterations that are induced by the "non-physiological" processes used to prepare blood products that are used in clinical practice.
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Affiliation(s)
- Mélanie Abonnenc
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland
| | - Jean-Daniel Tissot
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, université de Lausanne, Lausanne, Switzerland
| | - Michel Prudent
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, université de Lausanne, Lausanne, Switzerland.
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16
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Shen S, Zhang R, Zhang J, Wei Y, Guo Y, Su L, Chen F, Christiani DC. Welding fume exposure is associated with inflammation: a global metabolomics profiling study. Environ Health 2018; 17:68. [PMID: 30134906 PMCID: PMC6106842 DOI: 10.1186/s12940-018-0412-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 08/09/2018] [Indexed: 06/01/2023]
Abstract
BACKGROUND Increasing evidence suggests that welding fume exposure is associated with systemic inflammation. Although celluar metabolites may be associated with inflammation, there is limited information on metabolomic changes during welding fume exposure. Such changes may play an important role in the occurrence, development, and prevention of metal-associated diseases. We aim to investigate human metabolomics changes pre- and post-welding fume exposure. METHODS This study included 52 boilermakers totally. We collected plasma samples pre- and post-shift welding fume exposure and prepared samples using the automated MicroLab STAR® system. Metabolite concentrations were measured using ultra performance liquid chromatography - tandem mass spectrometer (UPLC-MS/MS) methods. Two-way analysis of variance was used to test the significance of metabolite changes with false discovery rate correction. RESULTS Analysis detected several metabolic changes after welding fume exposure, mainly involved in the lipid pathway [glucocorticoid class (cortisol, corticosterone, and cortisone), acylcarnitine class, and DiHOME species (9,10-DiHOME and 12,13-DiHOME)], amino acid utilization (isoleucine, proline and phenylalanine), and S-(3-hydroxypropyl) mercapturic acid (3-HPMA). These compounds are all associated with inflammation according to previous studies. Further, additive interaction effects linked smoking and 3-HPMA levels. In the metabolite set enrichment analysis for diseases, the top two disease-associated metabolite pathways were systemic inflammation-related diseases including rheumatoid arthritis and systemic lupus erythematosus. CONCLUSIONS This global metabolomics study shows evidence that metabolite changes during welding fume exposure are closely associated with systemic inflammation. The altered metabolites detected may be potential health monitoring biomarkers for boilermakers, especially for inflammation-related disease prevention.
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Affiliation(s)
- Sipeng Shen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- China International Cooperation Center for Environment and Human Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Ruyang Zhang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- China International Cooperation Center for Environment and Human Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Jinming Zhang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Yongyue Wei
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- China International Cooperation Center for Environment and Human Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yichen Guo
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Li Su
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- China International Cooperation Center for Environment and Human Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Feng Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- China International Cooperation Center for Environment and Human Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- China International Cooperation Center for Environment and Human Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- Department of Medicine, Pulmonary and Critical Care Division, Massachusetts General Hospital and Harvard Medical School, 665 Huntington Avenue, Building I Room 1401, Boston, MA, 02115, USA.
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17
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Systems analysis of metabolism in platelet concentrates during storage in platelet additive solution. Biochem J 2018; 475:2225-2240. [DOI: 10.1042/bcj20170921] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/25/2018] [Accepted: 06/18/2018] [Indexed: 02/06/2023]
Abstract
Platelets (PLTs) deteriorate over time when stored within blood banks through a biological process known as PLT storage lesion (PSL). Here, we describe the refinement of the biochemical model of PLT metabolism, iAT-PLT-636, and its application to describe and investigate changes in metabolism during PLT storage. Changes in extracellular acetate and citrate were measured in buffy coat and apheresis PLT units over 10 days of storage in the PLT additive solution T-Sol. Metabolic network analysis of these data was performed alongside our prior metabolomics data to describe the metabolism of fresh (days 1–3), intermediate (days 4–6), and expired (days 7–10) PLTs. Changes in metabolism were studied by comparing metabolic model flux predictions of iAT-PLT-636 between stages and between collection methods. Extracellular acetate and glucose contribute most to central carbon metabolism in PLTs. The anticoagulant citrate is metabolized in apheresis-stored PLTs and is converted into aconitate and, to a lesser degree, malate. The consumption of nutrients changes during storage and reflects altered PLT activation profiles following their collection. Irrespective of the collection method, a slowdown in oxidative phosphorylation takes place, consistent with mitochondrial dysfunction during PSL. Finally, the main contributors to intracellular ammonium and NADPH are highlighted. Future optimization of flux through these pathways provides opportunities to address intracellular pH changes and reactive oxygen species, which are both of importance to PSL. The metabolic models provide descriptions of PLT metabolism at steady state and represent a platform for future PLT metabolic research.
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18
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Ng MSY, Tung JP, Fraser JF. Platelet Storage Lesions: What More Do We Know Now? Transfus Med Rev 2018; 32:S0887-7963(17)30189-X. [PMID: 29751949 DOI: 10.1016/j.tmrv.2018.04.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 12/20/2022]
Abstract
Platelet concentrate (PC) transfusions are a lifesaving adjunct to control and prevent bleeding in cancer, hematologic, surgical, and trauma patients. Platelet concentrate availability and safety are limited by the development of platelet storage lesions (PSLs) and risk of bacterial contamination. Platelet storage lesions are a series of biochemical, structural, and functional changes that occur from blood collection to transfusion. Understanding of PSLs is key for devising interventions that prolong PC shelf life to improve PC access and wastage. This article will review advancements in clinical and mechanistic PSL research. In brief, exposure to artificial surfaces and high centrifugation forces during PC preparation initiate PSLs by causing platelet activation, fragmentation, and biochemical release. During room temperature storage, enhanced glycolysis and reduced mitochondrial function lead to glucose depletion, lactate accumulation, and product acidification. Impaired adenosine triphosphate generation reduces platelet capacity to perform energetically demanding processes such as hypotonic stress responses and activation/aggregation. Storage-induced alterations in platelet surface proteins such as thrombin receptors and glycoproteins decrease platelet aggregation. During storage, there is an accumulation of immunoactive proteins such as leukocyte-derive cytokines (tumor necrosis factor α, interleukin (IL) 1α, IL-6, IL-8) and soluble CD40 ligand which can participate in transfusion-related acute lung injury and nonhemolytic transfusion reactions. Storage-induced microparticles have been linked to enhanced platelet aggregation and immune system modulation. Clinically, stored PCs have been correlated with reduced corrected count increment, posttransfusion platelet recovery, and survival across multiple meta-analyses. Fresh PC transfusions have been associated with superior platelet function in vivo; however, these differences were abrogated after a period of circulation. There is currently insufficient evidence to discern the effect of PSLs on transfusion safety. Various bag and storage media changes have been proposed to reduce glycolysis and platelet activation during room temperature storage. Moreover, cryopreservation and cold storage have been proposed as potential methods to prolong PC shelf life by reducing platelet metabolism and bacterial proliferation. However, further work is required to elucidate and manage the PSLs specific to these storage protocols before its implementation in blood banks.
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Affiliation(s)
- Monica Suet Ying Ng
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland, Australia; Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia.
| | - John-Paul Tung
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland, Australia; Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia.
| | - John Francis Fraser
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland, Australia.
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19
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Wang S, Jiang T, Fan Y, Zhao S. A proteomic approach reveals the variation in human platelet protein composition after storage at different temperatures. Platelets 2018; 30:403-412. [PMID: 29595346 DOI: 10.1080/09537104.2018.1453060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cryopreservation can slow down the metabolism and decrease the risk of bacterial contamination. But, chilled platelets (PLTs) show a reduced period in circulation due to the rapid clearance by hepatic cells or spleen macrophages after transfusion. The deleterious changes that PLTs undergo are mainly considered the result of PLT protein variation. However, the basis for proteomic variation of stored PLTs remains poorly understood. Besides count, activation markers (CD62P and Annexin V), and aggregation, we used quantitative mass spectrometry to create the first comprehensive and quantitative human PLT proteome of samples stored at different temperatures (22°C, 10°C and -80°C). We found different conditions caused different platelet storage lesion (PSL). PLT count was decreased no matter at what temperature stored. PLTs viability at low temperature dropped by 21.78% and 11.21%, respectively, as compared 10.26% at room temperature, there were no significant differences between the storage methods. Membrane expression of CD62P gradually increased in all groups especially stored at 22°C up to 40% and 10°C up to 30%. However, exposure of PS on the PLT membrane was below 1% in every group. The PLT proteome showed there were 575 and 454 potential proteins identified by general iTRAQ analysis and phosphorylation iTRAQ a nalysis, respectively, among them, 33 common differentially expressed proteins caused by storage time and 44 caused by storage temperature Especially, membrane-bound proteins (such as FERMT3, STX4, MYL9 and TAGLN2) played key roles in PLT storage lesion. The pathways "Endocytosis", "Fc gamma R-mediated phagocytosis" and "Regulation of actin cytoskeleton" were affected predominantly by storage time. And the pathways "SNARE interactions in vesicular transport" and "Vasopressin-regulated water reabsorption" were affected by cold storage in our study. Proteomic results can help us to understand PLT biochemistry and physiology and thus unravel the mechanisms of PSL in time and space for more successful PLT transfusion therapy.
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Affiliation(s)
- Shichun Wang
- a Department of Blood Transfusion , Southwest Hospital, the Third Military Medical University , Chongqing , P.R. China
| | - Tianlun Jiang
- a Department of Blood Transfusion , Southwest Hospital, the Third Military Medical University , Chongqing , P.R. China
| | - Yahan Fan
- a Department of Blood Transfusion , Southwest Hospital, the Third Military Medical University , Chongqing , P.R. China
| | - Shuming Zhao
- a Department of Blood Transfusion , Southwest Hospital, the Third Military Medical University , Chongqing , P.R. China
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20
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Cushing MM, Kelley J, Klapper E, Friedman DF, Goel R, Heddle NM, Hopkins CK, Karp JK, Pagano MB, Perumbeti A, Ramsey G, Roback JD, Schwartz J, Shaz BH, Spinella PC, Cohn CS, Cohn CS, Cushing MM, Kelley J, Klapper E. Critical developments of 2017: a review of the literature from selected topics in transfusion. A committee report from the AABB Clinical Transfusion Medicine Committee. Transfusion 2018. [PMID: 29520794 DOI: 10.1111/trf.14520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The AABB compiles an annual synopsis of the published literature covering important developments in the field of Transfusion Medicine. For the first time, an abridged version of this work is being made available in TRANSFUSION, with the full-length report available as an Appendix S1 (available as supporting information in the online version of this paper). STUDY DESIGN AND METHODS Papers published in 2016 and early 2017 are included, as well as earlier papers cited for background. Although this synopsis is comprehensive, it is not exhaustive, and some papers may have been excluded or missed. RESULTS The following topics are covered: duration of red blood cell storage and clinical outcomes, blood donor characteristics and patient outcomes, reversal of bleeding in hemophilia and for patients on direct oral anticoagulants, transfusion approach to hemorrhagic shock, pathogen inactivation, pediatric transfusion medicine, therapeutic apheresis, and extracorporeal support. CONCLUSION This synopsis may be a useful educational tool.
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Affiliation(s)
| | - James Kelley
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - David F Friedman
- Blood Bank and Transfusion Medicine Department, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruchika Goel
- Department of Pathology, Weill Cornell Medicine, New York, New York
| | - Nancy M Heddle
- McMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada
| | | | - Julie Katz Karp
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Monica B Pagano
- Transfusion Medicine Division, Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Ajay Perumbeti
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Glenn Ramsey
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - John D Roback
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York-Presbyterian Hospital
| | | | - Philip C Spinella
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University School of Medicine, St Louis, Missouri
| | - Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | | | - James Kelley
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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21
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Arnone GD, Kumar P, Wonais MC, Esfahani DR, Campbell-Lee SA, Charbel FT, Amin-Hanjani S, Alaraj A, Seicean A, Mehta AI. Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy–An Analysis Based on Intracerebral Hemorrhage Score. World Neurosurg 2018; 111:e895-e904. [DOI: 10.1016/j.wneu.2018.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/29/2017] [Accepted: 01/03/2018] [Indexed: 11/16/2022]
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22
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Sut C, Tariket S, Aubron C, Aloui C, Hamzeh-Cognasse H, Berthelot P, Laradi S, Greinacher A, Garraud O, Cognasse F. The Non-Hemostatic Aspects of Transfused Platelets. Front Med (Lausanne) 2018. [PMID: 29536007 PMCID: PMC5835084 DOI: 10.3389/fmed.2018.00042] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Platelets transfusion is a safe process, but during or after the process, the recipient may experience an adverse reaction and occasionally a serious adverse reaction (SAR). In this review, we focus on the inflammatory potential of platelet components (PCs) and their involvement in SARs. Recent evidence has highlighted a central role for platelets in the host inflammatory and immune responses. Blood platelets are involved in inflammation and various other aspects of innate immunity through the release of a plethora of immunomodulatory cytokines, chemokines, and associated molecules, collectively termed biological response modifiers that behave like ligands for endothelial and leukocyte receptors and for platelets themselves. The involvement of PCs in SARs—particularly on a critically ill patient’s context—could be related, at least in part, to the inflammatory functions of platelets, acquired during storage lesions. Moreover, we focus on causal link between platelet activation and immune-mediated disorders (transfusion-associated immunomodulation, platelets, polyanions, and bacterial defense and alloimmunization). This is linked to the platelets’ propensity to be activated even in the absence of deliberate stimuli and to the occurrence of time-dependent storage lesions.
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Affiliation(s)
- Caroline Sut
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
| | - Sofiane Tariket
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
| | - Cécile Aubron
- Médecine Intensive Réanimation, Centre Hospitalier Régionale et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Chaker Aloui
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France
| | | | | | - Sandrine Laradi
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine, University of Greifswald, Greifswald, Germany
| | - Olivier Garraud
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Institut National de Transfusion Sanguine (INTS), Paris, France
| | - Fabrice Cognasse
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
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23
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Steininger PA, Strasser EF, Ziehe B, Eckstein R, Rauh M. Change of the metabolomic profile during short-term mononuclear cell storage. Vox Sang 2017; 112:163-172. [PMID: 28052337 DOI: 10.1111/vox.12482] [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: 04/21/2016] [Revised: 10/05/2016] [Accepted: 10/31/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Short-term storage of leukapheresis products used for immunotherapeutic mononuclear cell (MNC) products is a frequent event. The analysis of time-related metabolic patterns enables the characterization of storage-related effects in MNCs and the hypothesis-based optimization of the MNC medium. MATERIALS AND METHODS The MNC products from seven leukapheresis procedures were stored within a closed bag system for 48 h. Concentrations of amino acids, biogenic amines, phospho- and sphingolipids and hexoses in the medium were measured by targeted metabolomics. The viability of MNC subpopulations was assayed by Annexin V (AnV) and JC-1 staining. RESULTS Glucose depletion and a significant change of the acylcarnitine profile are early events within the first 24 h of storage. In contrast, for most amino acids, the maximum increase was observed at 48 h of storage as mirrored by an increase in the amino acid levels by a mean factor of 1·2 (1·3, 2·0) after 6 h (24 h, 48 h, respectively). This was except for the concentrations of glutamine and lysine, which did not change significantly. The taurine concentration showed a twofold increase within the first 24 h and remained constant thereafter. The steepest increase in AnV+ and 7-AAD+ CD4+ T cells was found between 24 and 48 h. CONCLUSION The time-course of apoptosis and metabolic patterns in the MNC products demonstrate that 24 h of storage is a decisive time-point, as afterwards key metabolic pathways showed nonlinear detrimental changes. Optimization of storage by supplementation of specific substrates demands therefore an early intervention.
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Affiliation(s)
- P A Steininger
- Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, Erlangen, Germany
| | - E F Strasser
- Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, Erlangen, Germany
| | - B Ziehe
- Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, Erlangen, Germany
| | - R Eckstein
- Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, Erlangen, Germany
| | - M Rauh
- Department of Paediatrics and Adolescent Medicine, University Hospital of Erlangen, Erlangen, Germany
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Acker JP, Marks DC, Sheffield WP. Quality Assessment of Established and Emerging Blood Components for Transfusion. JOURNAL OF BLOOD TRANSFUSION 2016; 2016:4860284. [PMID: 28070448 PMCID: PMC5192317 DOI: 10.1155/2016/4860284] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/02/2016] [Indexed: 12/16/2022]
Abstract
Blood is donated either as whole blood, with subsequent component processing, or through the use of apheresis devices that extract one or more components and return the rest of the donation to the donor. Blood component therapy supplanted whole blood transfusion in industrialized countries in the middle of the twentieth century and remains the standard of care for the majority of patients receiving a transfusion. Traditionally, blood has been processed into three main blood products: red blood cell concentrates; platelet concentrates; and transfusable plasma. Ensuring that these products are of high quality and that they deliver their intended benefits to patients throughout their shelf-life is a complex task. Further complexity has been added with the development of products stored under nonstandard conditions or subjected to additional manufacturing steps (e.g., cryopreserved platelets, irradiated red cells, and lyophilized plasma). Here we review established and emerging methodologies for assessing blood product quality and address controversies and uncertainties in this thriving and active field of investigation.
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Affiliation(s)
- Jason P. Acker
- Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Denese C. Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - William P. Sheffield
- Centre for Innovation, Canadian Blood Services, Hamilton, ON, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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Could Microparticles Be the Universal Quality Indicator for Platelet Viability and Function? JOURNAL OF BLOOD TRANSFUSION 2016; 2016:6140239. [PMID: 28053805 PMCID: PMC5178367 DOI: 10.1155/2016/6140239] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/27/2016] [Accepted: 11/06/2016] [Indexed: 12/22/2022]
Abstract
High quality means good fitness for the intended use. Research activity regarding quality measures for platelet transfusions has focused on platelet storage and platelet storage lesion. Thus, platelet quality is judged from the manufacturer's point of view and regulated to ensure consistency and stability of the manufacturing process. Assuming that fresh product is always superior to aged product, maintaining in vitro characteristics should preserve high quality. However, despite the highest in vitro quality standards, platelets often fail in vivo. This suggests we may need different quality measures to predict platelet performance after transfusion. Adding to this complexity, platelets are used clinically for very different purposes: platelets need to circulate when given as prophylaxis to cancer patients and to stop bleeding when given to surgery or trauma patients. In addition, the emerging application of platelet-rich plasma injections exploits the immunological functions of platelets. Requirements for quality of platelets intended to prevent bleeding, stop bleeding, or promote wound healing are potentially very different. Can a single measurable characteristic describe platelet quality for all uses? Here we present microparticle measurement in platelet samples, and its potential to become the universal quality characteristic for platelet production, storage, viability, function, and compatibility.
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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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Antonelou MH, Seghatchian J. Insights into red blood cell storage lesion: Toward a new appreciation. Transfus Apher Sci 2016; 55:292-301. [PMID: 27839967 DOI: 10.1016/j.transci.2016.10.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Red blood cell storage lesion (RSL) is a multifaceted biological phenomenon. It refers to deterioration in RBC quality that is characterized by lethal and sub-lethal, reversible and irreversible defects. RSL is influenced by prestorage variables and it might be associated with variable clinical outcomes. Optimal biopreservation conditions are expected to offer maximum levels of RBC survival and acceptable functionality and bioreactivity in-bag and in vivo; consequently, full appraisal of RSL requires understanding of how RSL changes interact with each other and with the recipient. Recent technological innovation in MS-based omics, imaging, cytometry, small particle and systems biology has offered better understanding of RSL contributing factors and effects. A number of elegant in vivo and in vitro studies have paved the way for the identification of quality control biomarkers useful to predict RSL profile and posttransfusion performance. Moreover, screening tools for the early detection of good or poor "storers" and donors have been developed. In the light of new perspectives, storage time is not the touchstone to rule on the quality of a packed RBC unit. At least by a biochemical standpoint, the metabolic aging pattern during storage may not correspond to the currently fresh/old distinction of stored RBCs. Finally, although each unit of RBCs is probably unique, a metabolic signature of RSL across storage variables might exist. Moving forward from traditional hematologic measures to integrated information on structure, composition, biochemistry and interactions collected in bag and in vivo will allow identification of points for intervention in a transfusion meaningful context.
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Affiliation(s)
- Marianna H Antonelou
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece.
| | - Jerard Seghatchian
- International Consultancy in Blood Component Quality/Safety Improvement, Audit/Inspection and DDR Strategy, London, UK.
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Hegde S, Cancelas JA. Dissecting the metabolic pathways controlling platelet survival in vivo: are our platelets what they eat? Transfusion 2016; 56:1928-31. [PMID: 27500916 DOI: 10.1111/trf.13684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 05/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Shailaja Hegde
- Hoxworth Blood Center, University of Cincinnati College of Medicine.,Division of Experimental Hematology, Cincinnati Children's Research Foundation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Jose A Cancelas
- Hoxworth Blood Center, University of Cincinnati College of Medicine.,Division of Experimental Hematology, Cincinnati Children's Research Foundation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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