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Horan A, Warreth S, Hervig T, Waters A. The expanding role of blood and tissue establishments in the development of advanced therapy medicinal products. Cytotherapy 2024; 26:524-530. [PMID: 38441513 DOI: 10.1016/j.jcyt.2024.02.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND AIMS The relationship between blood establishments and advanced cellular therapies is evident in several European countries, with some involved in research and development and/or in manufacturing. The aim of the present study was to understand the advanced therapy medicinal product (ATMP) infrastructural, regulatory and logistic requirements needed for the Irish Blood Transfusion Service to support advanced therapeutics in Ireland. METHODS An online survey consisting of 13 questions was distributed in a targeted manner to the identified ATMP stakeholders in Ireland, namely those working in industry, health care, regulatory agencies or education. Subject matter experts in the field were approached and interviewed to gain further insight into the relationship between blood and tissue establishments (BTEs) and ATMPs, to explore the advantages these institutions have in development and to highlight potential challenges for implementation. RESULTS In total, 84.9% of survey respondents stated that BTEs have a role in the development of advanced therapeutics. Key BTE services identified as applicable to the ATMP sector from both surveys and interviews include the provision of starting materials for research and manufacturing, donor management, use of existing quality and traceability frameworks, product logistic strategies and Good Manufacturing Practice. Challenges for BTE expansion into the sector currently include high costs associated with ATMPs, lack of expertise in these therapies, limited therapeutic populations and no national ATMP strategic plan for Ireland. CONCLUSIONS Blood establishments have services and expertise that can be extended into the advanced therapy sector. The existing knowledge and skill base of BTEs in Ireland should be leveraged to accelerate the development of ATMP strategies for industry and healthcare.
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Affiliation(s)
- Aisling Horan
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Shada Warreth
- School of Chemical and Pharmaceutical Sciences, Technological University Dublin, Dublin, Ireland; National Institute for Bioprocessing Research and Training (NIBRT), Co., Dublin, Ireland
| | - Tor Hervig
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland; School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Allison Waters
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland; UCD School of Public Health, Physiotherapy and Social Science, University College Dublin, Dublin, Ireland.
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2
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Lewin A, Goldman M, Busch MP, Davison K, van de Laar T, Tiberghien P, Shinar E, O'Brien SF, Lambert G, Field S, Hervig T, Tan DHS, Custer B, Drews SJ, Lanteri MC, Klochkov D, Widmer E, Domingue MP, Renaud C, Germain M. End of selection criteria based on sexual orientation: An international symposium on alternatives to donation deferral. Vox Sang 2024; 119:388-401. [PMID: 38270352 DOI: 10.1111/vox.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVES Until recently, gay, bisexual and other men who have sex with men (MSM) were deferred from donating blood for 3-12 months since the last male-to-male sexual contact. This MSM deferral has been discontinued by several high-income countries (HIC) that now perform gender-neutral donor selection. MATERIALS AND METHODS An international symposium (held on 20-04-2023) gathered experts from seven HICs to (1) discuss how this paradigm shift might affect the mitigation strategies for transfusion-transmitted infections and (2) address the challenges related to gender-neutral donor selection. RESULTS Most countries employed a similar approach for implementing a gender-neutral donor selection policy: key stakeholders were consulted; the transition was bridged by time-limited deferrals; donor compliance was monitored; and questions or remarks on anal sex and the number and/or type of sexual partners were often added. Many countries have now adopted a gender-neutral approach in which questions on pre- and post-exposure prophylaxis for human immunodeficiency virus (HIV) have been added (or retained, when already in place). Other countries used mitigation strategies, such as plasma quarantine or pathogen reduction technologies for plasma and/or platelets. CONCLUSION The experience with gender-neutral donor selection has been largely positive among the countries covered herein and seems to be acceptable to stakeholders, donors and staff. The post-implementation surveillance data collected so far appear reassuring with regards to safety, although longer observation periods are necessary. The putative risks associated with HIV antiretrovirals should be further investigated.
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Affiliation(s)
- Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
| | - Mindy Goldman
- Donation Policy and Studies, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California in San Francisco, San Francisco, California, USA
| | - Katy Davison
- NHS Blood and Transplant/UK Health Security Agency (UKHSA) Epidemiology Unit, UKHSA, London, UK
| | - Thijs van de Laar
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Laboratory of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Pierre Tiberghien
- Établissement Français du Sang, La Plaine Saint Denis, France
- UMR 1098, Inserm, Établissement Français du Sang, Université de Franche-Comté, Besançon, France
| | - Eilat Shinar
- National Blood Services, Magen David Adom, Tel Aviv, Israel
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Gilles Lambert
- Direction régionale de santé publique - Montréal, Montréal, Québec, Canada
- Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Stephen Field
- Irish Blood Transfusion Service, Dublin, County Dublin, Ireland
| | - Tor Hervig
- Irish Blood Transfusion Service, Dublin, County Dublin, Ireland
| | - Darrell H S Tan
- Division of Infectious Diseases, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California in San Francisco, San Francisco, California, USA
| | - Steven J Drews
- Donation Policy and Studies, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Marion C Lanteri
- Department of Laboratory Medicine, University of California in San Francisco, San Francisco, California, USA
- Scientific Affairs, Creative Testing Solutions, Tempe, Arizona, USA
| | - Denis Klochkov
- Research and Development, CSL Behring, Bern, Switzerland
| | | | - Marie-Pier Domingue
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
- Faculté des Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
| | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
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Fogarty H, McSweeney E, Hervig T. Their health is our wealth: lay perceptions on the health impacts of blood donation. Blood Transfus 2024; 22:1-3. [PMID: 37847206 PMCID: PMC10812896 DOI: 10.2450/bloodtransfus.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Helen Fogarty
- Irish Blood Transfusion Service, National Blood Centre, Dublin 8, Ireland
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ellen McSweeney
- Irish Blood Transfusion Service, National Blood Centre, Dublin 8, Ireland
| | - Tor Hervig
- Irish Blood Transfusion Service, National Blood Centre, Dublin 8, Ireland
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Moore CM, Lorusso A, Morgan L, Brazil S, Croxon H, Waters A, Farrelly A, Hervig T, Curley A. Safety and feasibility of platelet transfusion through long catheters in the neonatal intensive care unit: an in vitro study. Arch Dis Child Fetal Neonatal Ed 2023; 109:70-73. [PMID: 37433587 PMCID: PMC10803993 DOI: 10.1136/archdischild-2023-325632] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE To assess the safety and feasibility of platelet transfusion through small-bore long lines used in the neonatal intensive care unit (NICU), including double-lumen umbilical venous catheters (UVCs) and 24 G and 28 G peripherally inserted central catheters (PICCs). DESIGN Prospective in vitro controlled study. SETTING Blood transfusion service laboratory. METHODS In vitro platelet transfusions were set up as per NICU practice. Transfusion line pressure was monitored. Post-transfusion swirling, presence of aggregates, pH analysis and automated cell count in vitro activation response by flow cytometry assessing CD62P expression were assessed. MAIN OUTCOME MEASURES All transfusions completed successfully. The rate of infusion was reduced in 5 of 16 transfusions through 28 G lines due to 'pressure high' alarms. There was no difference in swirling values or transfusion aggregate formation, CD62P expression levels, platelet count, platelet distribution width, mean platelet volume, plateletcrit or platelet to large cell ratio across transfusions post-transfusion. CONCLUSIONS This study showed that in vitro platelet transfusion performed through 24 G and 28 G neonatal PICC lines and double-lumen UVCs is non-inferior to 24 G short cannulas, using outcome measures of platelet clumping, platelet activation and line occlusion. This suggests that where available these lines can be used if necessary for platelet transfusion.
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Affiliation(s)
- Carmel Maria Moore
- School of Medicine, University College Dublin, Dublin, Ireland
- Neonatology, National Maternity Hospital, Dublin, Ireland
| | - Alice Lorusso
- National Blood Centre, Irish Blood Transfusion Service, Dublin, Ireland
| | - Liam Morgan
- National Blood Centre, Irish Blood Transfusion Service, Dublin, Ireland
| | - Sinead Brazil
- National Blood Centre, Irish Blood Transfusion Service, Dublin, Ireland
| | - Harry Croxon
- National Blood Centre, Irish Blood Transfusion Service, Dublin, Ireland
| | - Allison Waters
- National Blood Centre, Irish Blood Transfusion Service, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Aileen Farrelly
- National Blood Centre, Irish Blood Transfusion Service, Dublin, Ireland
| | - Tor Hervig
- National Blood Centre, Irish Blood Transfusion Service, Dublin, Ireland
| | - Anna Curley
- School of Medicine, University College Dublin, Dublin, Ireland
- Neonatology, National Maternity Hospital, Dublin, Ireland
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Coyne D, Butler D, Meehan A, Keogh E, Williams P, Carterson A, Hervig T, O'Flaherty N, Waters A. The changing profile of SARS-CoV-2 serology in Irish blood donors. Glob Epidemiol 2023; 5:100108. [PMID: 37122774 PMCID: PMC10121150 DOI: 10.1016/j.gloepi.2023.100108] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/02/2023] Open
Abstract
Background The present study aimed to investigate the progression of the SARS-CoV-2 pandemic in Ireland over the first three waves of infection. Method A selection of blood donor serum samples collected between February 2020 and December 2021 were analysed by various commercially available serological assays for antibodies to SARS-CoV-2 (n = 15,066). Results An increase in seropositivity was observed between wave 1 (February to September 2020) and wave 2 (November and December 2020) of 2.20% to 3.55%. A large increase in estimated seroprevalence to 11.89% was observed in samples collected in February and March 2021 (wave 3 of infection).The rate of seropositivity varied by age group, with the highest rate observed in the youngest donors (18-29 years) peaking at 18.79% in wave 3. The results of spike antibody (anti-S) testing indicated that 44/1009 (4.36%) of seroreactive donors in wave 3 had a serological profile consistent with vaccination. By November 2021, we detected an overall seropositivity of 97.04%. Conclusions The present study provides a comprehensive estimation of the level of circulating SARS-CoV-2 antibodies in Irish blood donors, enabling differentiation between vaccination and natural infection, as well as real-time monitoring of the progression of the COVID-19 pandemic in Ireland. Seroepidemiology has a role in determining reliable estimates of transmission, infection fatality rates and vaccine uptake. The continued screening of blood donors for this purpose has the potential to generate important data to assist with the management of future waves of SARS-CoV-2.
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Affiliation(s)
- Dermot Coyne
- Irish Blood Transfusion Service, National Blood Centre, James's Street, Dublin D08 NH5R, Ireland
| | - Dearbhla Butler
- Irish Blood Transfusion Service, National Blood Centre, James's Street, Dublin D08 NH5R, Ireland
| | - Adrienne Meehan
- Irish Blood Transfusion Service, National Blood Centre, James's Street, Dublin D08 NH5R, Ireland
| | - Evan Keogh
- Centre for Laboratory Medicine and Molecular Pathology, St James's Hospital, James's Street, Dublin D08 NHY1, Ireland
| | - Pádraig Williams
- Irish Blood Transfusion Service, National Blood Centre, James's Street, Dublin D08 NH5R, Ireland
| | - Alex Carterson
- Abbott Laboratories, 100 Abbott Park Road, Abbott Park, IL 60064, USA
| | - Tor Hervig
- Irish Blood Transfusion Service, National Blood Centre, James's Street, Dublin D08 NH5R, Ireland
| | - Niamh O'Flaherty
- Irish Blood Transfusion Service, National Blood Centre, James's Street, Dublin D08 NH5R, Ireland
- UCD National Virus Reference Laboratory, University College Dublin, Dublin 4, Ireland
| | - Allison Waters
- Irish Blood Transfusion Service, National Blood Centre, James's Street, Dublin D08 NH5R, Ireland
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
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6
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Lorusso A, Croxon H, Faherty-O'Donnell S, Field S, Fitzpatrick Á, Farrelly A, Hervig T, Waters A. The impact of donor biological variation on the quality and function of cold-stored platelets. Vox Sang 2023; 118:730-737. [PMID: 37439150 DOI: 10.1111/vox.13495] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/09/2023] [Accepted: 06/18/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Room temperature-stored platelets (RTPs) maximize platelet viability but limit shelf life. The aims of this study were to investigate the impact of donor variability on cold-stored platelets (CSPs) and RTP, to determine whether RTP quality markers are appropriate for CSP. MATERIALS AND METHODS Double platelet donations (n = 10) were collected from consented regular male donors stored in 100% plasma. A full blood count, donor age, weight, height and body mass index (BMI) were collected at the time of donation. Platelet donations were split equally into two bags, and assigned to non-agitated CSP or agitated RTP. The quality and function of platelets were assessed throughout the standard 7 days of storage and at expiry (day 8). Non-parametric statistical analyses were used to analyse results given the small sample size. RESULTS As expected, there were significant differences between CSP and RTP throughout storage including a reduction in CSP concentration as well as a loss of swirling. Furthermore, a significant increase in CSP exhibiting activation and apoptotic markers was observed. Platelet concentrations were further impacted by donor BMI, and donors with the highest BMI (>29) had the lowest platelet concentration and activation response at the end of CSP storage. CONCLUSION Platelet quality and functionality play a vital role in transfusion outcomes; however, blood components are inherently variable. This study demonstrated, for the first time, the specific impact of donor BMI on CSP quality and function and highlights the requirement for novel quality markers for assessing CSPs.
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Affiliation(s)
- Alice Lorusso
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Harry Croxon
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | | | - Stephen Field
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Áine Fitzpatrick
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Aileen Farrelly
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Tor Hervig
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Allison Waters
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
- UCD School of Public Health, Population Science and Physiotherapy, University College Dublin, Dublin, Ireland
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7
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Espinosa A, Aandahl A, Arsenovic MG, Sundic T, Hervig T, Jacobsen B, Kristoffersen G, Holtan A, Detlie TE. Evidensbasert transfusjonspraksis ved jernmangelanemi. Tidsskr Nor Laegeforen 2023; 143:22-0443. [PMID: 37254973 DOI: 10.4045/tidsskr.22.0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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8
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Apelseth TO, Kristoffersen EK, Strandenes G, Hervig T. Training of medical students in the use of emergency whole blood collection and transfusion in the framework of a civilian walking blood. Transfusion 2023; 63 Suppl 3:S60-S66. [PMID: 37057630 DOI: 10.1111/trf.17343] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 04/15/2023]
Abstract
INTRODUCTION In this report, we describe a training program in emergency whole blood collection and transfusion for medical students at the University of Bergen. The overall aim of the program is to improve the availability of early balanced blood transfusion for the treatment of patients with life-threatening bleeding in rural health care services. STUDY DESIGN AND METHODS The voluntary training program provides the knowledge needed to practice emergency whole blood transfusions and understand the system for emergency whole blood collection in the framework of a civilian walking blood bank (WBB). It includes theoretical and practical sessions. In-person teaching and web-based learning resources are provided. An anonymous survey of the students attending the training course in the autumn of 2022 and spring 2023 was performed. RESULTS 128 of 178 students participated in the practical training. 88 of 128 (69%) responded to the survey. 82 (93%) performed blood typing, 71 (81%) performed donor interviews, 61 (69%) partially performed whole blood collection (up to blood in bag) and 27 (30%) participated in complete whole blood collection and performed autologous reinfusion. No complications occurred during training. The students reported that the training course increased their understanding of how to ensure access to emergency blood transfusion by the use of a WBB. DISCUSSION Structured theoretical and practical training in emergency whole blood collection and emergency transfusion is feasible and of interest to medical students. A multidisciplinary approach to student training in emergency whole blood collection and transfusion should be considered.
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Affiliation(s)
- Torunn O Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Norwegian Armed Forces Joint Medical Services, Sessvollmoen, Norway
- Institute of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Einar K Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Institute of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Irish Blood Transfusion Service, Dublin, Ireland
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Abstract
INTRODUCTION Cancer-related drug expenses are rising with the increasing cancer incidence and cost may represent a severe challenge for drug access for patients with cancer. Consequently, strategies for increasing therapeutic efficacy of already available drugs may be essential for the future health-care system. AREAS COVERED In this review, we have investigated the potential for the use of platelets as drug-delivery systems. We searched PubMed and Google Scholar to identify relevant papers written in English and published up to January 2023. Papers were included at the authors' discretion to reflect an overview of state of the art. EXPERT OPINION It is known that cancer cells interact with platelets to gain functional advantages including immune evasion and metastasis development. This platelet-cancer interaction has been the inspiration for numerous platelet-based drug delivery systems using either drug-loaded or drug-bound platelets, or platelet membrane-containing hybrid vesicles combining platelet membranes with synthetic nanocarriers. Compared to treatment with free drug or synthetic drug vectors, these strategies may improve pharmacokinetics and selective cancer cell targeting. There are multiple studies showing improved therapeutic efficacy using animal models, however, no platelet-based drug delivery systems have been tested in humans, meaning the clinical relevance of this technology remains uncertain.
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Affiliation(s)
- Daniel Cacic
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Tor Hervig
- Irish Blood Transfusion Service, Dublin, Ireland
| | - Håkon Reikvam
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
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10
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Piccin A, Magzoub I, Hervig T. The 'scintilla' starting vaso-occlusion in sickle cell disease. Br J Haematol 2023; 201:379-380. [PMID: 36647924 DOI: 10.1111/bjh.18648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023]
Affiliation(s)
- Andrea Piccin
- Northern Ireland Blood Transfusion Service (NIBTS), Belfast, UK.,Department of Haematology (V), University of Medicine, Innsbruck, Austria.,Department of Industrial Engineering, University of Trento, Trento, Italy
| | | | - Tor Hervig
- Irish Blood Transfusion Service, Dublin, Ireland
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Binder V, Chruścicka-Smaga B, Bergum B, Jaisson S, Gillery P, Sivertsen J, Hervig T, Kaminska M, Tilvawala R, Nemmara VV, Thompson PR, Potempa J, Marti HP, Mydel P. Carbamylation of Integrin α IIb β 3: The Mechanistic Link to Platelet Dysfunction in ESKD. J Am Soc Nephrol 2022; 33:1841-1856. [PMID: 36038265 PMCID: PMC9528322 DOI: 10.1681/asn.2022010013] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/05/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Bleeding diatheses, common among patients with ESKD, can lead to serious complications, particularly during invasive procedures. Chronic urea overload significantly increases cyanate concentrations in patients with ESKD, leading to carbamylation, an irreversible modification of proteins and peptides. METHODS To investigate carbamylation as a potential mechanistic link between uremia and platelet dysfunction in ESKD, we used liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) to quantify total homocitrulline, and biotin-conjugated phenylglyoxal labeling and Western blot to detect carbamylated integrin α IIb β 3 (a receptor required for platelet aggregation). Flow cytometry was used to study activation of isolated platelets and platelet-rich plasma. In a transient transfection system, we tested activity and fibrinogen binding of different mutated forms of the receptor. We assessed platelet adhesion and aggregation in microplate assays. RESULTS Carbamylation inhibited platelet activation, adhesion, and aggregation. Patients on hemodialysis exhibited significantly reduced activation of α IIb β 3 compared with healthy controls. We found significant carbamylation of both subunits of α IIb β 3 on platelets from patients receiving hemodialysis versus only minor modification in controls. In the transient transfection system, modification of lysine 185 in the β 3 subunit was associated with loss of receptor activity and fibrinogen binding. Supplementation of free amino acids, which was shown to protect plasma proteins from carbamylation-induced damage in patients on hemodialysis, prevented loss of α IIb β 3 activity in vitro. CONCLUSIONS Carbamylation of α IIb β 3-specifically modification of the K185 residue-might represent a mechanistic link between uremia and dysfunctional primary hemostasis in patients on hemodialysis. The observation that free amino acids prevented the carbamylation-induced loss of α IIb β 3 activity suggests amino acid administration during dialysis may help to normalize platelet function.
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Affiliation(s)
- Veronika Binder
- Broegelmann Research Laboratory, University of Bergen, Bergen, Norway
| | | | - Brith Bergum
- Broegelmann Research Laboratory, University of Bergen, Bergen, Norway
| | - Stéphane Jaisson
- Laboratory of Biochemistry and Molecular Biology, Unité Mixte de Recherche (UMR) Centre National de la Recherche Scientifique (CNRS) 7369, University of Reims Champagne-Ardenne, Reims, France
| | - Philippe Gillery
- Laboratory of Biochemistry and Molecular Biology, Unité Mixte de Recherche (UMR) Centre National de la Recherche Scientifique (CNRS) 7369, University of Reims Champagne-Ardenne, Reims, France
| | - Joar Sivertsen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Broegelmann Research Laboratory, University of Bergen, Bergen, Norway
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Marta Kaminska
- Broegelmann Research Laboratory, University of Bergen, Bergen, Norway
| | - Ronak Tilvawala
- Department of Biochemistry and Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Venkatesh V. Nemmara
- Department of Biochemistry and Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Paul R. Thompson
- Department of Biochemistry and Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Jan Potempa
- Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky
| | - Hans-Peter Marti
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Piotr Mydel
- Broegelmann Research Laboratory, University of Bergen, Bergen, Norway
- Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
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Vo AK, Hervig T, Reikvam H. Pure red cell aplasia after hematopoietic stem cell transplantation - experimental therapeutic approaches. Expert Opin Investig Drugs 2022; 31:881-884. [PMID: 35975626 DOI: 10.1080/13543784.2022.2113055] [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: 11/04/2022]
Abstract
Not relevant.
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Affiliation(s)
- Anh Khoi Vo
- Section Hematology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Irish Blood Transfusion Service, Dublin, Ireland
| | - Håkon Reikvam
- Section Hematology, Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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13
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Sivertsen J, Hervig T, Strandenes G, Kristoffersen EK, Braathen H, Apelseth TO. In vitro quality and hemostatic function of cold-stored CPDA-1 whole blood after repeated transient exposure to 28°C storage temperature. Transfusion 2022; 62 Suppl 1:S105-S113. [PMID: 35748681 PMCID: PMC9541954 DOI: 10.1111/trf.16970] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 12/03/2022]
Abstract
Background Blood products are frequently exposed to room temperature or higher for longer periods than permitted by policy. We aimed to investigate if this resulted in a measurable effect on common quality parameters and viscoelastic hemostatic function of cold stored CPDA‐1 whole blood. Study Design and Methods 450 ml of whole blood from 16 O Rh(D) positive donors was collected in 63 ml of CPDA‐1 and stored cold. Eights bags were exposed to five weekly 4‐h long transient temperature changes to 28°C. Eight bags were stored continuously at 4°C as a control. Samples were collected at baseline on day 1, after the first cycle on day 1 and weekly before each subsequent cycle (day 7, 14, 21, 28 and 35). Hemolysis, hematological parameters, pH, glucose, lactate, potassium, thromboelastography, INR, APTT, fibrinogen, and factor VIII were measured. Results CPDA‐1 whole blood repeatedly exposed to 28°C did not show reduced quality compared to the control group on day 35. Two units in the test group had hemolysis of 1.1% and 1.2%, and two in the control group hemolysis of 0.8%. Remaining thromboelastography clot strength (MA) on day 35 was 51.7 mm (44.8, 58.6) in the test group and 46.1 (41.6, 50.6) in the control group (p = .023). Platelet count was better preserved in the test group (166.7 [137.8, 195.6] vs. 117.8 [90.3, 145.2], p = .018). One sample in the test group was positive for Cutibacterium acnes on day 35 + 6. Conclusion Hemolysis findings warrant further investigation. Other indicators of quality were not negatively affected.
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Affiliation(s)
- Joar Sivertsen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Einar K Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Hanne Braathen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Torunn O Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of War Surgery and Emergency Medicine, Norwegian Armed Forces Joint Medical Services, Oslo, Norway
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14
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Nissen-Meyer LSH, Hervig T, Fevang B, Norheim G, Kran AMB, Vaage JT, Flesland Ø. COVID-19 convalescent plasma from Norwegian blood donors. Tidsskriftet 2022; 142:22-0057. [DOI: 10.4045/tidsskr.22.0057] [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] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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15
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Ohanian M, Cancelas JA, Davenport R, Pullarkat V, Hervig T, Broome C, Marek K, Kelly M, Gul Z, Rugg N, Nestheide S, Kinne B, Szczepiorkowski Z, Kantarjian H, Pehta J, Biehl R, Yu A, Aung F, Antebi B, Fitzpatrick GM. Freeze-dried platelets are a promising alternative in bleeding thrombocytopenic patients with hematological malignancies. Am J Hematol 2022; 97:256-266. [PMID: 34748664 DOI: 10.1002/ajh.26403] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 02/02/2023]
Abstract
Thrombosomes are trehalose-stabilized, freeze-dried group O platelets with a 3-year shelf life. They can be stockpiled, rapidly reconstituted, and infused regardless of the recipient's blood type. Thrombosomes thus represent a potential alternative platelet transfusion strategy. The present study assessed the safety and potential early signals of efficacy of Thrombosomes in bleeding thrombocytopenic patients. We performed an open-label, phase 1 study of single doses of allogeneic Thrombosomes at three dose levels in three cohorts, each consisting of eight patients who had hematologic malignancies, thrombocytopenia, and bleeding. Adverse events, dose-limiting toxicities (DLTs), World Health Organization (WHO) bleeding scores, and hematology values were assessed. No DLTs were reported. The median age was 59 years (24-71). Most patients had AML (58%) or ALL (29%), followed by MDS (8%) and myeloproliferative neoplasm (4%). The WHO scores of 22 patients who were actively bleeding at a total of 27 sites at baseline either improved (n = 17 [63%]) or stabilized (n = 10 [37%]) through day 6. Twenty-four hours after infusion, 12 patients (50%) had a clinically significant platelet count increase. Of eight patients who received no platelet transfusions for 6 days after Thrombosomes infusion, 5 had a clinically significant increase in platelet count of ≥5000 platelets/μL and 2 had platelet count normalization. Thrombosomes doses up to 3.78 × 108 particles/kg demonstrated safety in 24 bleeding, thrombocytopenic patients with hematological malignancies. Thrombosomes may represent an alternative to conventional platelets to treat bleeding. A phase 2 clinical trial in a similar patient population is underway.
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Affiliation(s)
- Maro Ohanian
- Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA
| | | | | | - Vinod Pullarkat
- City of Hope Comprehensive Cancer Center Duarte California USA
| | - Tor Hervig
- Haukeland Universitetssjukehus Bergen Norway
| | - Catherine Broome
- MedStar Georgetown University Hospital Washington District of Columbia USA
| | - Kelly Marek
- Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Mary Kelly
- Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Zartash Gul
- Division of Hematology/Oncology, Department of Internal Medicine University of Cincinnati College of Medicine Cincinnati Ohio USA
| | - Neeta Rugg
- Hoxworth Blood Center Cincinnati Ohio USA
| | | | - Bridget Kinne
- Division of Hematology/Oncology, Department of Internal Medicine University of Cincinnati College of Medicine Cincinnati Ohio USA
| | | | - Hagop Kantarjian
- Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Joan Pehta
- The Alpha Bio Group New Canaan Connecticut USA
| | - Ruth Biehl
- Cellphire Therapeutics Rockville Maryland USA
| | - Anna Yu
- Cellphire Therapeutics Rockville Maryland USA
| | - Fleur Aung
- Department of Transfusion Medicine The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Ben Antebi
- Cellphire Therapeutics Rockville Maryland USA
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16
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Bjerkvig CK, Strandenes G, Hervig T, Sunde GA, Apelseth TO. Prehospital Whole Blood Transfusion Programs in Norway. Transfus Med Hemother 2021; 48:324-331. [PMID: 35082563 PMCID: PMC8739851 DOI: 10.1159/000519676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/15/2021] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Prehospital management of severe hemorrhage has evolved significantly in Norwegian medical emergency services in the last 10 years. Treatment algorithms for severe bleeding were previously focused on restoration of the blood volume by administration of crystalloids and colloids, but now the national trauma system guidelines recommend early balanced transfusion therapy according to remote damage control resuscitation principles. MATERIALS AND METHODS This survey describes the implementation, utilization, and experience of the use of low titer group O whole blood (LTOWB) and blood components in air ambulance services in Norway. Medical directors from all air ambulance bases in Norway as well as the blood banks that support LTOWB were invited to participate. RESULTS Medical directors from all 13 helicopter emergency medical services (HEMS) bases, the 7 search and rescue (SAR) helicopter bases, and the 4 blood banks that support HEMS with LTOWB responded to the survey. All HEMS and SAR helicopter services carry LTOWB or blood components. Four of 20 (20%) HEMS bases have implemented LTOWB. A majority of services (18/20, 90%) have a preference for LTOWB, primarily because LTOWB enables early balanced transfusion and has logistical benefits in time-critical emergencies and during prolonged evacuations. CONCLUSION HEMS services and blood banks report favorable experiences in the implementation and utilization of LTOWB. Prehospital balanced blood transfusion using whole blood is feasible in Norway.
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Affiliation(s)
- Christopher Kalhagen Bjerkvig
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
- Norwegian Naval Special Operations Commando, Norwegian Armed Forces, Bergen, Norway
- Institute of Clinical Science, University of Bergen, Bergen, Norway
- Helicopter Emergency Medical Services, HEMS-Bergen, Bergen, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Department of War Surgery and Emergency Medicine, Norwegian Armed Forces, Medical Services, Oslo, Norway
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Laboratory of Immunology and Transfusion Medicine, Haugesund Hospital, Haugesund, Norway
| | - Geir Arne Sunde
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
- Helicopter Emergency Medical Services, HEMS-Bergen, Bergen, Norway
| | - Torunn Oveland Apelseth
- Institute of Clinical Science, University of Bergen, Bergen, Norway
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Department of War Surgery and Emergency Medicine, Norwegian Armed Forces, Medical Services, Oslo, Norway
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17
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Hervig T, Tvedt THA, Knoop T, Sandnes M, Reikvam H. A young woman with dyspnoea and proteinuria. Tidsskr Nor Laegeforen 2021; 141:21-0171. [PMID: 34758596 DOI: 10.4045/tidsskr.21.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Systemic lupus erythematosus and anti-phospholipid syndrome may cause severe haematological complications despite few other symptoms of disease. CASE PRESENTATION A previously healthy woman in her late twenties was admitted to hospital with chest pain and dyspnoea. CT of the thorax revealed bilateral pulmonary embolism and urine sampling showed haematuria and proteinuria. A few days after hospital admission, she developed transfusion-requiring anaemia. The investigation revealed a positive direct antiglobulin test, presence of anti-nuclear antibodies, lupus anticoagulant, anti-cardiolipin and anti-glycoprotein antibodies. INTERPRETATION Pulmonary embolism in a young, previously healthy woman may be caused by different predisposing conditions. Systemic lupus erythematosus with accompanying anti-phospholipid syndrome was the diagnosis in this case. Severe autoimmune haemolytic disease may occur as a secondary phenomenon to systemic lupus erythematosus, and the condition must not be overlooked.
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18
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Hagen KG, Strandenes G, Kristoffersen EK, Braathen H, Sivertsen J, Bjerkvig CK, Sommerfelt-Pettersen N, Aasheim IB, Lunde THF, Hervig T, Apelseth TO. A whole blood based resuscitation strategy in civilian medical services: Experience from a Norwegian hospital in the period 2017-2020. Transfusion 2021; 61 Suppl 1:S22-S31. [PMID: 34269432 DOI: 10.1111/trf.16490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 01/05/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Civilian and military guidelines recommend early balanced transfusion to patients with life-threatening bleeding. Low titer group O whole blood was introduced as the primary blood product for resuscitation of massive hemorrhage at Haukeland University Hospital, Bergen, Norway, in December 2017. In this report, we describe the whole blood program and present results from the first years of routine use. STUDY DESIGN AND METHODS Patients who received whole blood from December 2017 to April 2020 were included in our quality registry for massive transfusions. Post-transfusion blood samples were collected to analyze isohemagglutinin (anti-A/-B) and hemolysis markers. Administration of other blood products, transfusion reactions, and patient survival (days 1 and 30) were recorded. User experiences were surveyed for both clinical and laboratory staff. RESULTS Two hundred and five patients (64% male and 36% female) received 836 units in 226 transfusion episodes. Patients received a mean of 3.7 units (range 1-35) in each transfusion episode. The main indications for transfusion were trauma (26%), gastrointestinal (22%), cardiothoracic/vascular (18%), surgical (18%), obstetric (11%), and medical (5%) bleeding. There was no difference in survival between patients with blood type O when compared with non-group O. Haptoglobin level was lower in the transfusion episodes for non-O group patients, however no clinical hemolysis was reported. No patients had conclusive transfusion-associated adverse events. Both clinical and laboratory staff preferred whole blood to component therapy for massive transfusion. DISCUSSION The experience from Haukeland University Hospital indicates that whole blood is feasible, safe, and effective for in-hospital treatment of bleeding.
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Affiliation(s)
- Kristin Gjerde Hagen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of War Surgery and Emergency Medicine, Norwegian Armed Forces Medical Services, Sessvollmoen, Norway
| | - Einar Klaeboe Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Institute of Clinical Science, University of Bergen, Bergen, Norway
| | - Hanne Braathen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Joar Sivertsen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Christopher Kalhagen Bjerkvig
- Institute of Clinical Science, University of Bergen, Bergen, Norway.,Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | | | - Irmelin Beathe Aasheim
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Turid Helen Felli Lunde
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Institute of Clinical Science, University of Bergen, Bergen, Norway.,Laboratory of Immunology and Transfusion Medicine, Haugesund Hospital, Haugesund, Norway
| | - Torunn Oveland Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of War Surgery and Emergency Medicine, Norwegian Armed Forces Medical Services, Sessvollmoen, Norway
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19
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Cacic D, Nordgård O, Meyer P, Hervig T. Platelet Microparticles Decrease Daunorubicin-Induced DNA Damage and Modulate Intrinsic Apoptosis in THP-1 Cells. Int J Mol Sci 2021; 22:ijms22147264. [PMID: 34298882 PMCID: PMC8304976 DOI: 10.3390/ijms22147264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/26/2021] [Accepted: 07/02/2021] [Indexed: 02/07/2023] Open
Abstract
Platelets can modulate cancer through budding of platelet microparticles (PMPs) that can transfer a plethora of bioactive molecules to cancer cells upon internalization. In acute myelogenous leukemia (AML) this can induce chemoresistance, partially through a decrease in cell activity. Here we investigated if the internalization of PMPs protected the monocytic AML cell line, THP-1, from apoptosis by decreasing the initial cellular damage inflicted by treatment with daunorubicin, or via direct modulation of the apoptotic response. We examined whether PMPs could protect against apoptosis after treatment with a selection of inducers, primarily associated with either the intrinsic or the extrinsic apoptotic pathway, and protection was restricted to the agents targeting intrinsic apoptosis. Furthermore, levels of daunorubicin-induced DNA damage, assessed by measuring gH2AX, were reduced in both 2N and 4N cells after PMP co-incubation. Measuring different BCL2-family proteins before and after treatment with daunorubicin revealed that PMPs downregulated the pro-apoptotic PUMA protein. Thus, our findings indicated that PMPs may protect AML cells against apoptosis by reducing DNA damage both dependent and independent of cell cycle phase, and via direct modulation of the intrinsic apoptotic pathway by downregulating PUMA. These findings further support the clinical relevance of platelets and PMPs in AML.
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Affiliation(s)
- Daniel Cacic
- Department of Hematology and Oncology, Stavanger University Hospital, 4068 Stavanger, Norway; (O.N.); (P.M.)
- Correspondence:
| | - Oddmund Nordgård
- Department of Hematology and Oncology, Stavanger University Hospital, 4068 Stavanger, Norway; (O.N.); (P.M.)
| | - Peter Meyer
- Department of Hematology and Oncology, Stavanger University Hospital, 4068 Stavanger, Norway; (O.N.); (P.M.)
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway;
- Laboratory of Immunology and Transfusion Medicine, Haugesund Hospital, 5528 Haugesund, Norway
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20
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Cacic D, Reikvam H, Nordgård O, Meyer P, Hervig T. Platelet Microparticles Protect Acute Myelogenous Leukemia Cells against Daunorubicin-Induced Apoptosis. Cancers (Basel) 2021; 13:cancers13081870. [PMID: 33919720 PMCID: PMC8070730 DOI: 10.3390/cancers13081870] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 02/28/2021] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 12/21/2022] Open
Abstract
The role of platelets in cancer development and progression is increasingly evident, and several platelet-cancer interactions have been discovered, including the uptake of platelet microparticles (PMPs) by cancer cells. PMPs inherit a myriad of proteins and small RNAs from the parental platelets, which in turn can be transferred to cancer cells following internalization. However, the exact effect this may have in acute myelogenous leukemia (AML) is unknown. In this study, we sought to investigate whether PMPs could transfer their contents to the THP-1 cell line and if this could change the biological behavior of the recipient cells. Using acridine orange stained PMPs, we demonstrated that PMPs were internalized by THP-1 cells, which resulted in increased levels of miR-125a, miR-125b, and miR-199. In addition, co-incubation with PMPs protected THP-1 and primary AML cells against daunorubicin-induced cell death. We also showed that PMPs impaired cell growth, partially inhibited cell cycle progression, decreased mitochondrial membrane potential, and induced differentiation toward macrophages in THP-1 cells. Our results suggest that this altering of cell phenotype, in combination with decrease in cell activity may offer resistance to daunorubicin-induced apoptosis, as serum starvation also yielded a lower frequency of dead and apoptotic cells when treated with daunorubicin.
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Affiliation(s)
- Daniel Cacic
- Department of Hematology and Oncology, Stavanger University Hospital, 4068 Stavanger, Norway; (O.N.); (P.M.)
- Correspondence:
| | - Håkon Reikvam
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (H.R.); (T.H.)
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Oddmund Nordgård
- Department of Hematology and Oncology, Stavanger University Hospital, 4068 Stavanger, Norway; (O.N.); (P.M.)
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, 4036 Stavanger, Norway
| | - Peter Meyer
- Department of Hematology and Oncology, Stavanger University Hospital, 4068 Stavanger, Norway; (O.N.); (P.M.)
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (H.R.); (T.H.)
- Laboratory of Immunology and Transfusion Medicine, Haugesund Hospital, 5528 Haugesund, Norway
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21
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Shanbhag S, Mohamed-Ahmed S, Lunde THF, Suliman S, Bolstad AI, Hervig T, Mustafa K. Influence of platelet storage time on human platelet lysates and platelet lysate-expanded mesenchymal stromal cells for bone tissue engineering. Stem Cell Res Ther 2020; 11:351. [PMID: 32962723 PMCID: PMC7510290 DOI: 10.1186/s13287-020-01863-9] [Citation(s) in RCA: 20] [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: 03/03/2020] [Revised: 06/25/2020] [Accepted: 07/29/2020] [Indexed: 12/20/2022] Open
Abstract
Background Human platelet lysate (HPL) is emerging as the preferred xeno-free supplement for the expansion of mesenchymal stromal cells (MSCs) for bone tissue engineering (BTE) applications. Due to a growing demand, the need for standardization and scaling-up of HPL has been highlighted. However, the optimal storage time of the source material, i.e., outdated platelet concentrates (PCs), remains to be determined. The present study aimed to determine the optimal storage time of PCs in terms of the cytokine content and biological efficacy of HPL. Methods Donor-matched bone marrow (BMSCs) and adipose-derived MSCs (ASCs) expanded in HPL or fetal bovine serum (FBS) were characterized based on in vitro proliferation, immunophenotype, and multi-lineage differentiation. Osteogenic differentiation was assessed at early (gene expression), intermediate [alkaline phosphatase (ALP) activity], and terminal stages (mineralization). Using a multiplex immunoassay, the cytokine contents of HPLs produced from PCs stored for 1–9 months were screened and a preliminary threshold of 4 months was identified. Next, HPLs were produced from PCs stored for controlled durations of 0, 1, 2, 3, and 4 months, and their efficacy was compared in terms of cytokine content and BMSCs’ proliferation and osteogenic differentiation. Results BMSCs and ASCs in both HPL and FBS demonstrated a characteristic immunophenotype and multi-lineage differentiation; osteogenic differentiation of BMSCs and ASCs was significantly enhanced in HPL vs. FBS. Multiplex network analysis of HPL revealed several interacting growth factors, chemokines, and inflammatory cytokines. Notably, stem cell growth factor (SCGF) was detected in high concentrations. A majority of cytokines were elevated in HPLs produced from PCs stored for ≤ 4 months vs. > 4 months. However, no further differences in PC storage times between 0 and 4 months were identified in terms of HPLs’ cytokine content or their effects on the proliferation, ALP activity, and mineralization of BMSCs from multiple donors. Conclusions MSCs expanded in HPL demonstrate enhanced osteogenic differentiation, albeit with considerable donor variation. HPLs produced from outdated PCs stored for up to 4 months efficiently supported the proliferation and osteogenic differentiation of MSCs. These findings may facilitate the standardization and scaling-up of HPL from outdated PCs for BTE applications.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5008, Bergen, Norway
| | - Samih Mohamed-Ahmed
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5008, Bergen, Norway
| | - Turid Helen Felli Lunde
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Salwa Suliman
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5008, Bergen, Norway
| | - Anne Isine Bolstad
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5008, Bergen, Norway
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Laboratory of Immunology and Transfusion Medicine, Haugesund Hospital, Fonna Health Trust, Haugesund, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5008, Bergen, Norway.
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22
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Apelseth TO, Strandenes G, Kristoffersen EK, Hagen KG, Braathen H, Hervig T. How do I implement a whole blood–based blood preparedness program in a small rural hospital? Transfusion 2020; 60:2793-2800. [DOI: 10.1111/trf.16057] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/27/2020] [Accepted: 06/27/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Torunn O. Apelseth
- Department of Immunology and Transfusion Medicine Haukeland University Hospital Bergen Norway
- Department of War Surgery and Emergency Medicine Norwegian Armed Forces Medical Services Oslo Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine Haukeland University Hospital Bergen Norway
- Department of War Surgery and Emergency Medicine Norwegian Armed Forces Medical Services Oslo Norway
| | - Einar K. Kristoffersen
- Department of Immunology and Transfusion Medicine Haukeland University Hospital Bergen Norway
- Institute of Clinical Science University of Bergen Bergen Norway
| | - Kristin G. Hagen
- Department of Immunology and Transfusion Medicine Haukeland University Hospital Bergen Norway
| | - Hanne Braathen
- Department of Immunology and Transfusion Medicine Haukeland University Hospital Bergen Norway
- Institute of Clinical Science University of Bergen Bergen Norway
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine Haukeland University Hospital Bergen Norway
- Institute of Clinical Science University of Bergen Bergen Norway
- Haugesund Hospital Haugesund Norway
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23
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Bjerkvig C, Sivertsen J, Braathen H, Lunde THF, Strandenes G, Assmus J, Hervig T, Cap A, Kristoffersen EK, Fosse T, Apelseth TO. Cold-stored whole blood in a Norwegian emergency helicopter service: an observational study on storage conditions and product quality. Transfusion 2020; 60:1544-1551. [PMID: 32319702 DOI: 10.1111/trf.15802] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/16/2020] [Accepted: 02/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Increasing numbers of emergency medical service agencies and hospitals are developing the capability to administer blood products to patients with hemorrhagic shock. Cold-stored whole blood (WB) is the only single product available to prehospital providers who aim to deliver a balanced resuscitation strategy. However, there are no data on the safety and in vitro characteristics of prehospital stored WB. This study aimed to describe the effects on in vitro quality of storing WB at remote helicopter bases in thermal insulating containers. STUDY DESIGN AND METHODS We conducted a two-armed single-center study. Twenty units (test) were stored in airtight thermal insulating containers, and 20 units (controls) were stored according to routine procedures in the Haukeland University Hospital Blood Bank. Storage conditions were continuously monitored during emergency medical services missions and throughout remote and blood bank storage. Hematologic and metabolic variables, viscoelastic properties, and platelet (PLT) aggregation were measured on Days 1, 8, 14, and 21. RESULTS Storage conditions complied with the EU guidelines throughout remote and in-hospital storage for 21 days. There were no significant differences in PLT aggregation, viscoelastic properties, and hematology variables between the two groups. Minor significantly lower pH, glucose, and base excess and higher lactate were observed after storage in airtight containers. CONCLUSION Forward cold storage of WB is safe and complies with EU standards. No difference is observed in hemostatic properties. Minor differences in metabolic variables may be related to the anaerobic conditions within the thermal box.
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Affiliation(s)
- Christopher Bjerkvig
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.,Norwegian Naval Special Operations Commando, Norwegian Armed Forces, Bergen, Norway.,Institute of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Joar Sivertsen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Hanne Braathen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Turid Helen Felli Lunde
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of War Surgery and Emergency Medicine, Norwegian Armed Forces Medical Services, Oslo, Norway
| | - Jörg Assmus
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Institute of Clinical Sciences, University of Bergen, Bergen, Norway.,Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Andrew Cap
- U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Einar K Kristoffersen
- Institute of Clinical Sciences, University of Bergen, Bergen, Norway.,Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Theodor Fosse
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.,Norwegian Naval Special Operations Commando, Norwegian Armed Forces, Bergen, Norway.,Institute of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Torunn Oveland Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
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24
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Sivertsen J, Braathen H, Lunde THF, Kristoffersen EK, Hervig T, Strandenes G, Apelseth TO. Cold-stored leukoreduced CPDA-1 whole blood: in vitro quality and hemostatic properties. Transfusion 2020; 60:1042-1049. [PMID: 32187700 DOI: 10.1111/trf.15748] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Some jurisdictions require leukoreduction of cellular blood components. The only whole blood collection set with a platelet-saving filter uses citrate-phosphate-dextrose (CPD) as storage solution. Substituting CPD with citrate-phosphate-dextrose-adenine (CPDA-1) increases shelf life from 21 to 35 days. This would simplify prehospital and rural resupply and reduce wastage. We investigated in vitro quality and hemostatic properties of CPDA-1 whole blood leukoreduced with a platelet-saving filter. STUDY DESIGN AND METHODS CPDA-1 whole blood was leukoreduced using a platelet-saving filter and stored 35 days. EDQM requirements, hematology, metabolic parameters, thromboelastography, light transmission aggregometry, fibrinogen, factor VIII, and interleukin-6 were measured on Days 0, 1, 14, 21, and 35 and compared to non-leukoreduced blood. RESULTS All units met EDQM requirements. Leukoreduction yielded residual white blood cell count <1 × 106 and 87% platelet recovery on Day 1. It caused reduction in thromboelastography parameters, but not aggregometry response. No hemolysis >0.8% was observed. Factor VIII was higher on Day 35 in the leukoreduced group, 37.9 (95% CI: 26.0, 49.8) versus 13.8 (9.4, 18.2) IU/dL. In both groups, aggregation was significantly reduced by Day 14. Thromboelastography showed remaining platelet activity on Day 35, MA 46.9 (42.1, 51.7) in the leukoreduced and 44.3 (39.6, 49.0) mm in the non-leukoreduced group. Fibrinogen was within reference ranges at Day 35 (>2 g/dL). Interleukin-6 was not detectable. CONCLUSION Leukoreducing CPDA-1 whole blood with a platelet-saving filter did not compromise hemostatic properties. We encourage development of a single bag CPDA-1 whole blood collection set with in-line platelet-saving filter.
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Affiliation(s)
- Joar Sivertsen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Hanne Braathen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Turid Helen Felli Lunde
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Einar K Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Norwegian Armed Forces Joint Medical Services, Sessvollmoen, Norway
| | - Torunn O Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
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25
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Averina M, Hervig T, Huber S, Kjær M, Kristoffersen EK, Bolann B. Environmental pollutants in blood donors: The multicentre Norwegian donor study. Transfus Med 2020; 30:201-209. [DOI: 10.1111/tme.12662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Maria Averina
- Department of Laboratory MedicineUniversity Hospital of North Norway Tromsø Norway
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of Norway Tromsø Norway
| | - Tor Hervig
- Department of Clinical ScienceUniversity of Bergen, Norway
- Laboratory of Immunology and Transfusion MedicineHaugesund Hospital Haugesund Norway
| | - Sandra Huber
- Department of Laboratory MedicineUniversity Hospital of North Norway Tromsø Norway
| | | | - Einar K. Kristoffersen
- Department of Clinical ScienceUniversity of Bergen, Norway
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
| | - Bjørn Bolann
- Department of Clinical ScienceUniversity of Bergen, Norway
- Department of Medical Biochemistry and PharmacologyHaukeland University Hospital Bergen Norway
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26
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Opheim EN, Apelseth TO, Stanworth SJ, Eide GE, Hervig T. Multiple electrode aggregometry and thromboelastography in thrombocytopenic patients with haematological malignancies. Blood Transfus 2019; 17:181-190. [PMID: 30747706 PMCID: PMC6596372 DOI: 10.2450/2018.0140-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/07/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND In thrombocytopenic patients better assessment of bleeding risk than that provided by platelet count alone is required. Multiplate® aggregometry and thromboelastography (TEG) could be used, but information on their role in such patients is limited. The primary aim of this study was to investigate the feasibility of Multiplate® analyses in patients with haematological malignancies. A secondary aim was to explore whether a multiple logistic regression model combining Multiplate®, TEG, clinical and laboratory variables was associated with risk of bleeding. MATERIALS AND METHODS This was an exploratory, prospective observational study of thrombocytopenic patients with haematological malignancies. Total platelet count (TPC), white blood cell count, C-reactive protein (CRP) level, temperature and bleeding status were recorded daily. TEG and Multiplate® analyses with four agonists were performed on weekdays. RESULTS Ten patients were enrolled into the study. The median number of days in a study period was 21. Bleeding was observed on 64 of 298 study days. TPC <20×109/L and <10×109/L occurred on 119 and 25 days, respectively. When TPC was <33×109/L, many samples showed no aggregation, regardless of bleeding status. Despite this, the odds of World Health Organization (WHO) grade 2 bleeding decreased significantly as aggregation increased and Multiplate® had a negative predictive value (NPV) of 96% and a positive predictive value (PPV) of 19% for significant bleeding. In the multiple logistic regression model collagen-activated Multiplate® aggregation, TEG angle, TEG reaction time and CRP significantly affected the odds of WHO grade 2 bleeding. The combined model had a NPV of 99% and a PPV of 19%. DISCUSSION Our findings suggest that the markers of platelet function and haemostasis provided by Multiplate® aggregometry and TEG may add information to support prediction of bleeding, although platelet count still remains the most accessible analysis for routine testing.
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Affiliation(s)
- Elin N. Opheim
- Department of Clinical Science, University of Bergen, Norway
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Torunn O. Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Simon J. Stanworth
- NHS Blood and Transplant/Oxford University Hospitals NHS Trust, “John Radcliffe” Hospital, Oxford, United Kingdom
| | - Geir E. Eide
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, Norway
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
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27
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Kaada SH, Apelseth TO, Hagen KG, Kristoffersen EK, Gjerde S, Sønstabø K, Halvorsen H, Hervig T, Sunde GA, Dahle GO, Johnsen MC, Strandenes G. How do I get an emergency civilian walking blood bank running? Transfusion 2019; 59:1446-1452. [DOI: 10.1111/trf.15184] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Silje Helland Kaada
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
| | - Torunn Oveland Apelseth
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
- Department of Medical Biochemistry and PharmacologyHaukeland University Hospital Bergen Norway
| | - Kristin Gjerde Hagen
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
| | - Einar Klæboe Kristoffersen
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
- University of Bergen, Institute of Clinical SciencesFaculty of Medicine and Dentistry Bergen Norway
| | - Stig Gjerde
- Department of Anaesthesia and Intensive CareHaukeland University Hospital Bergen Norway
| | - Kristian Sønstabø
- Department of Anaesthesia and Intensive CareHaukeland University Hospital Bergen Norway
| | - Henrik Halvorsen
- Department of SurgeryHaukeland University Hospital Bergen Norway
| | - Tor Hervig
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
- University of Bergen, Institute of Clinical SciencesFaculty of Medicine and Dentistry Bergen Norway
| | - Geir Arne Sunde
- Department of Anaesthesia and Intensive CareHaukeland University Hospital Bergen Norway
| | - Geir Olav Dahle
- Department of Anaesthesia and Intensive CareHaukeland University Hospital Bergen Norway
| | | | - Geir Strandenes
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
- Department of War Surgery and Emergency Medicine, Norwegian Armed ForcesMedical Services Oslo Norway
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28
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Wendelbo Ø, Opheim EN, Hervig T, Felli Lunde TH, Bruserud Ø, Mollnes TE, Reikvam H. Cytokine profiling and post-transfusion haemoglobin increment in patients with haematological diseases. Vox Sang 2018; 113:657-668. [PMID: 30159896 DOI: 10.1111/vox.12703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES In a previous pilot study, we demonstrated significantly lower haemoglobin (Hb) increment after red-blood-cell (RBC) transfusions in febrile patients compared to patients without fever. The aim of this study was to examine associations between inflammatory mediators and post-transfusion haemoglobin increment in patients with haematological diseases. MATERIALS AND METHODS Twenty-seven patients (eight women, 19 men), median age 56 years receiving RBC transfusion, were included in the study. Hb increment per unit transfused was corrected for estimated patient blood volume and the amount of Hb transfused. A wide spectrum of inflammatory mediators was determined by multiplex technology. Association between post-transfusion haemoglobin increment, plasma inflammatory mediators and patient characteristics was analysed using a mixed linear regression model. RESULTS Febrile patients had significantly lower corrected Hb increment, significantly increased values of IL-6, IL-8, IL-10 and G-CSF, significantly reduced levels of CCL5 and CXCL10, and significantly higher pretransfusion levels of CRP. There was a significant association between pretransfusion CRP levels and corrected Hb increment for the whole patient cohort, but not within each of the two groups. Results demonstrated an association between haemoglobin increment, fever and inflammatory mediators. Febrile patients had a significantly lower corrected Hb increment compared to nonfebrile patients, when adjusting for mediators. When fever was kept constant, a significant negative association between haemoglobin increment and the proinflammatory mediators IL-6 and IL-8 was observed. CONCLUSION Both fever and the inflammatory mediators IL-6 and IL-8 were negatively associated with post-transfusion haemoglobin increment.
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Affiliation(s)
- Øystein Wendelbo
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Elin Netland Opheim
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Turid Helen Felli Lunde
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Øystein Bruserud
- Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,K.G. Jebsen IRC, University of Oslo, Oslo, Norway.,Research Laboratory, Nordland Hospital, Bodø, Norway.,Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway.,Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Håkon Reikvam
- Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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29
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Doughty H, Apelseth TO, Sivertsen J, Annaniasen K, Hervig T. Massive transfusion: changing practice in a single Norwegian centre 2002-2015. Transfus Med 2018; 28:357-362. [DOI: 10.1111/tme.12529] [Citation(s) in RCA: 5] [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: 01/04/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - T. O. Apelseth
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
- Laboratory of Clinical Biochemistry; Haukeland University Hospital; Bergen Norway
| | - J. Sivertsen
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - K. Annaniasen
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - T. Hervig
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
- Institute of Clinical Science; University of Bergen; Bergen Norway
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30
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Erikstein BS, Hagen KG, Hervig T. RBC alloantibody prevalence and specificity in a Western Norwegian tertiary hospital. Transfus Med 2018; 29:169-178. [PMID: 29377396 DOI: 10.1111/tme.12511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 09/14/2017] [Revised: 12/02/2017] [Accepted: 12/31/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Although several studies focus on red blood cell (RBC) alloantibody distribution in selected patient populations, few address the specificity and frequency in all relevant groups. This study reports alloantibody frequency, distribution and the relationship to age and gender in blood donors, pregnant women and potential recipients of blood products. METHODS This historical cohort study included 55 462 consecutive antibody screening tests from a tertiary Western Norwegian Hospital. Descriptive statistics were performed, and the results were compared with the literature. RESULTS The detection and immunisation frequency for the whole cohort were 0·39 and 0·51%, respectively, whereas the RBC alloantibody prevalence was 0·73%. The most frequent RBC alloantibodies were anti-E (20·1%), anti-M (18·7%), anti-K (9·8%), anti-D (8·9%) and anti-Fy(a) (7·0%). In pregnant women, the most frequent RBC alloantibodies were anti-M, anti-D and anti-Le(a) (20·8, 18·9 and 18·9%, respectively), whereas there was no anti-K detected. Anti-E and anti-M were the dominating RBC alloantibodies in the pre-transfusion testing of in-hospital patients (24·1 and 17·1%, respectively). Eighteen (9·2%) persons in the total cohort had two RBC alloantibodies, six persons had three alloantibodies, and two persons had four alloantibodies. Rh and K typing to prevent future immunisations was only performed in 21·0% of the individuals who presented with a new alloantibody; despite that, 50·5% of the detected alloantibodies had such specificities. CONCLUSIONS The immunisation frequency and the level of anti-K are low compared to national and international studies. Rh and K phenotype-matched blood transfusions might be a feasible future strategy to further decrease RBC alloantibodies.
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Affiliation(s)
- B S Erikstein
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - K G Hagen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - T Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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Abstract
Early identification of sepsis followed by diagnostic blood cultures and prompt administration of appropriate intravenous antibiotics covering all likely pathogen remains the corner stone in the initial management of sepsis. Source control, obtained by harvesting microbiological cultures and removal or drainage of the infected foci, is mandatory. However, optimization of hemodynamically unstable patients including volume support supplemented with vasopressor, inotropic and transfusion of red blood cells (RBCs) in case of persistent hypoperfusion have the potential to reduce morbidity and mortality. Given the imbalance between the ability of the cardiovascular system to deliver enough oxygen to meet the oxygen demand, transfusion of RBCs should theoretically provide the ideal solution to the challenge. However, both changes in the septic patients' RBCs induced by endogenous factors as well as the storage lesion affecting transfused RBCs have negative effects on the microcirculation. RBC morphology, distribution of fatty acids on the membrane surface, RBC deformability needed for capillary circulation and the nitrogen oxide (NO) signaling systems are involved. Although these deteriorating effects develop during storage, transfusion of fresh RBCs has not proven to be beneficial, possibly due to limitations of the studies performed. Until better evidence exists, transfusion guidelines recommend a restrictive strategy of RBC transfusion i.e. transfuse when hemoglobin (Hb)<7g/dL in septic patients.
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Affiliation(s)
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of immunology and Transfusion Medicine, Haukeland University Hospital, Norway
| | - Oddbjørn Haugen
- Department of Clinical Medicine, University of Bergen, Norway; Department of Anesthesiology, Haukeland University Hospital, Norway
| | - Jerard Seghatchian
- International Consultancy in Blood Components Quality/Safety Improvement and DDR Strategies, London, United Kingdom.
| | - Håkon Reikvam
- Department of Medicine, Haukeland University Hospital, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
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32
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Affiliation(s)
- T. O. Apelseth
- Laboratory of Clinical Biochemistry; Haukeland University Hospital; Bergen Norway
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - A. P. Cap
- U.S. Army Institute of Surgical Research; FT Sam Houston; San Antonio TX USA
| | - P. C. Spinella
- Division of Critical Care; Department of Pediatrics; Washington University in St. Louis; St. Louis MO USA
| | - T. Hervig
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
- Institute of Clinical Science; School of Medicine and Dentistry; University of Bergen; Bergen Norway
- Norwegian Armed Forces Medical Services; Oslo Norway
| | - G. Strandenes
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
- Norwegian Armed Forces Medical Services; Oslo Norway
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33
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Shanbhag S, Stavropoulos A, Suliman S, Hervig T, Mustafa K. Efficacy of Humanized Mesenchymal Stem Cell Cultures for Bone Tissue Engineering: A Systematic Review with a Focus on Platelet Derivatives. Tissue Eng Part B Rev 2017; 23:552-569. [PMID: 28610481 DOI: 10.1089/ten.teb.2017.0093] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Fetal bovine serum (FBS) is the most commonly used supplement for ex vivo expansion of human mesenchymal stem cells (hMSCs) for bone tissue engineering applications. However, from a clinical standpoint, it is important to substitute animal-derived products according to current good manufacturing practice (cGMP) guidelines. Humanized alternatives to FBS include three categories of products: human serum (HS), human platelet derivatives (HPDs)-including platelet lysate (PL) or platelet releasate (PR), produced by freeze/thawing or chemical activation of platelet concentrates, respectively, and chemically defined media (serum-free) (CDM). In this systematic literature review, the in vitro and in vivo osteogenic potential of hMSCs expanded in humanized (HS-, HPD-, or CDM-supplemented) media versus hMSCs expanded in FBS-supplemented media, was compared. In addition, PL and PR were compared in terms of their growth factor (GF)/cytokine-content and cell-culture efficacy. When using either 10-20% autologous or pooled HS, 3-10% pooled HPDs or CDM supplemented with GFs, in comparison with 10-20% FBS, a majority of studies reported similar or superior in vitro proliferation and osteogenic differentiation, and in vivo bone formation in ectopic or orthotopic rodent models. Moreover, a trend for higher GF content was observed in PL versus PR, although evidence for cell culture efficacy is limited. In summary, humanized supplements seem at least equally effective as FBS for hMSC expansion and osteogenic differentiation. Although pooled HPDs appear to be the most favorable supplement for large-scale hMSC expansion, further efforts are needed to standardize the preparation and composition of these products in compliance with cGMP standards.
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Affiliation(s)
- Siddharth Shanbhag
- 1 Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Andreas Stavropoulos
- 2 Department of Periodontology, Faculty of Odontology, Malmö University , Malmö, Sweden
| | - Salwa Suliman
- 1 Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Tor Hervig
- 3 Department of Immunology and Transfusion Medicine, Haukeland University Hospital , Bergen, Norway
| | - Kamal Mustafa
- 1 Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen , Bergen, Norway
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34
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Opheim EN, Apelseth TO, Stanworth SJ, Eide GE, Hervig T. Thromboelastography may predict risk of grade 2 bleeding in thrombocytopenic patients. Vox Sang 2017. [DOI: 10.1111/vox.12544] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E. N. Opheim
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - T. O. Apelseth
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
- Laboratory of Clinical Biochemistry; Haukeland University Hospital; Bergen Norway
| | - S. J. Stanworth
- NHS Blood and Transplant/Oxford University Hospitals NHS Trust; John Radcliffe Hospital; Oxford UK
| | - G. E. Eide
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Centre for Clinical Research; Haukeland University Hospital; Bergen Norway
| | - T. Hervig
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
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35
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Spinella PC, Pidcoke HF, Strandenes G, Hervig T, Fisher A, Jenkins D, Yazer M, Stubbs J, Murdock A, Sailliol A, Ness PM, Cap AP. Whole blood for hemostatic resuscitation of major bleeding. Transfusion 2017; 56 Suppl 2:S190-202. [PMID: 27100756 DOI: 10.1111/trf.13491] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 12/02/2015] [Accepted: 12/17/2015] [Indexed: 01/15/2023]
Abstract
Recent combat experience reignited interest in transfusing whole blood (WB) for patients with life-threatening bleeding. US Army data indicate that WB transfusion is associated with improved or comparable survival compared to resuscitation with blood components. These data complement randomized controlled trials that indicate that platelet (PLT)-containing blood products stored at 4°C have superior hemostatic function, based on reduced bleeding and improved functional measures of hemostasis, compared to PLT-containing blood products at 22°C. WB is rarely available in civilian hospitals and as a result is rarely transfused for patients with hemorrhagic shock. Recent developments suggest that impediments to WB availability can be overcome, specifically the misconceptions that WB must be ABO specific, that WB cannot be leukoreduced and maintain PLTs, and finally that cold storage causes loss of PLT function. Data indicate that the use of low anti-A and anti-B titer group O WB is safe as a universal donor, WB can be leukoreduced with PLT-sparing filters, and WB stored at 4°C retains PLT function during 15 days of storage. The understanding that these perceived barriers are not insurmountable will improve the availability of WB and facilitate its use. In addition, there are logistic and economic advantages of WB-based resuscitation compared to component therapy for hemorrhagic shock. The use of low-titer group O WB stored for up to 15 days at 4°C merits further study to compare its efficacy and safety with current resuscitation approaches for all patients with life-threatening bleeding.
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Affiliation(s)
- Philip C Spinella
- Division of Critical Care, Department of Pediatrics, Washington University in St Louis, St Louis, Missouri.,U.S. Army Institute of Surgical Research, JBSA-Fort Sam Houston, Texas
| | - Heather F Pidcoke
- U.S. Army Institute of Surgical Research, JBSA-Fort Sam Houston, Texas
| | - Geir Strandenes
- Norwegian Naval Special Operations Commando, Bergen, Norway.,Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Donald Jenkins
- Department of Surgery, College of Medicine, Medical Director, Trauma Center, Mayo Clinic, Rochester, Minnesota
| | - Mark Yazer
- Department of Pathology, University of Pittsburgh and the Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | - James Stubbs
- Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota
| | - Alan Murdock
- Department of Surgery, University of Pittsburgh, and Division of Trauma, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - Anne Sailliol
- French Military Blood Transfusion Center, Clamart, France
| | - Paul M Ness
- Transfusion Medicine Division, Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Andrew P Cap
- U.S. Army Institute of Surgical Research, JBSA-Fort Sam Houston, Texas
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Hervig T, Seghatchian J. The blood donor with hemochromatosis: To be or not to be! Transfus Apher Sci 2017; 56:484. [PMID: 28579370 DOI: 10.1016/j.transci.2017.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Norway.
| | - Jerard Seghatchian
- International Consultancy in Blood Components Quality/Safety Improvement, Audit/Inspection and DDR Strategies, London, UK.
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Braseth TA, Hervig T, Rosvik AS. Hemochromatosis and blood donation. Transfus Apher Sci 2017; 56:485-489. [PMID: 28610845 DOI: 10.1016/j.transci.2017.05.012] [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: 11/30/2022]
Abstract
The voluntary, unpaid, altruistic blood donor is a cornerstone of current transfusion medicine. The complexity of medical and ethical issues related to blood donation and hemochromatosis has led to a large number of studies related to the safety of the hemochromatosis donor and the quality of the blood components produced from these donations. The issue of accepting persons with HC as blood donors is diverting, both in Europe and worldwide and without joint guidelines. A questionnaire-based study was performed and mailed to all 25 blood bank leaders in Norway. Descriptive analysis was used to evaluate the data. Eight of 22 blood banks strictly followed national guidelines concerning persons with hemochromatosis. Other blood banks make local adjustments. 16 of 22 responding blood banks accept hemochromatosis donors and five do not, and one answered partly yes. The reasons the blood bank leaders supported the acceptance of hemochromatosis donors differ. Based on published papers and the present questionnaire, we believe that a clear definition of the "hemochromatosis donor" and guidelines with more detailed information on an acceptable donation regime would be important to overcome the weak points in blood donor eligibility criteria.
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Affiliation(s)
- Turid Aarhus Braseth
- Faculty of Engineering and Business Administration, Department of Biomedical Laboratory Sciences and Chemical Engineering, Bergen University College, pb 7030, 5020 Bergen, Norway; Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway
| | - Tor Hervig
- Institute of Clinical Sciences, University of Bergen, 5021 Bergen, Norway; Department of Immunology and transfusion medicine, Haukeland University Hospital, 5021 Bergen, Norway.
| | - Anne Synnove Rosvik
- Department of Biological Sciences Aalesund, Faculty of Natural Sciences and Technology, The Norwegian University of Science and Technology (NTNU) in Aalesund, PB1517, N-6025 Aalesund, Norway
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Wendelbo Ø, Netland Opheim E, Felli Lunde TH, Bruserud Ø, Hervig T, Reikvam H. A prospective observational study on effects of fever on red cell transfusion outcome. Vox Sang 2017; 112:484-486. [DOI: 10.1111/vox.12526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/30/2017] [Accepted: 03/30/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Ø. Wendelbo
- Department of Medicine; Haukeland University Hospital; Bergen Norway
| | | | - T. H. Felli Lunde
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - Ø. Bruserud
- Department of Medicine; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - T. Hervig
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - H. Reikvam
- Department of Medicine; Haukeland University Hospital; Bergen Norway
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van der Meer PF, Couture C, Hervig T, Kruit G, Devine DV, de Korte D, Kerkhoffs JL. Experiences with semi-routine production of riboflavin and UV-B pathogen-inactivated platelet concentrates in three blood centres. Vox Sang 2016; 112:9-17. [DOI: 10.1111/vox.12465] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/15/2016] [Accepted: 09/17/2016] [Indexed: 11/28/2022]
Affiliation(s)
- P. F. van der Meer
- Department of Product and Process Development; Sanquin Blood Bank; Amsterdam The Netherlands
- Department of Clinical Transfusion Research; Sanquin Research; Leiden The Netherlands
| | - C. Couture
- Canadian Blood Services; Ottawa ON Canada
| | - T. Hervig
- Department of Immunology and Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - G. Kruit
- Department of Production; Sanquin Blood Bank; Amsterdam The Netherlands
| | | | - D. de Korte
- Department of Product and Process Development; Sanquin Blood Bank; Amsterdam The Netherlands
| | - J.-L. Kerkhoffs
- Department of Clinical Transfusion Research; Sanquin Research; Leiden The Netherlands
- Department of Hematology; Haga Teaching Hospital; The Hague The Netherlands
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Mallick S, Li H, Lipson M, Mathieson I, Gymrek M, Racimo F, Zhao M, Chennagiri N, Nordenfelt S, Tandon A, Skoglund P, Lazaridis I, Sankararaman S, Fu Q, Rohland N, Renaud G, Erlich Y, Willems T, Gallo C, Spence JP, Song YS, Poletti G, Balloux F, van Driem G, de Knijff P, Romero IG, Jha AR, Behar DM, Bravi CM, Capelli C, Hervig T, Moreno-Estrada A, Posukh OL, Balanovska E, Balanovsky O, Karachanak-Yankova S, Sahakyan H, Toncheva D, Yepiskoposyan L, Tyler-Smith C, Xue Y, Abdullah MS, Ruiz-Linares A, Beall CM, Di Rienzo A, Jeong C, Starikovskaya EB, Metspalu E, Parik J, Villems R, Henn BM, Hodoglugil U, Mahley R, Sajantila A, Stamatoyannopoulos G, Wee JTS, Khusainova R, Khusnutdinova E, Litvinov S, Ayodo G, Comas D, Hammer MF, Kivisild T, Klitz W, Winkler CA, Labuda D, Bamshad M, Jorde LB, Tishkoff SA, Watkins WS, Metspalu M, Dryomov S, Sukernik R, Singh L, Thangaraj K, Pääbo S, Kelso J, Patterson N, Reich D. The Simons Genome Diversity Project: 300 genomes from 142 diverse populations. Nature 2016; 538:201-206. [PMID: 27654912 PMCID: PMC5161557 DOI: 10.1038/nature18964] [Citation(s) in RCA: 791] [Impact Index Per Article: 98.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 06/23/2016] [Indexed: 02/06/2023]
Abstract
Here we report the Simons Genome Diversity Project data set: high quality genomes from 300 individuals from 142 diverse populations. These genomes include at least 5.8 million base pairs that are not present in the human reference genome. Our analysis reveals key features of the landscape of human genome variation, including that the rate of accumulation of mutations has accelerated by about 5% in non-Africans compared to Africans since divergence. We show that the ancestors of some pairs of present-day human populations were substantially separated by 100,000 years ago, well before the archaeologically attested onset of behavioural modernity. We also demonstrate that indigenous Australians, New Guineans and Andamanese do not derive substantial ancestry from an early dispersal of modern humans; instead, their modern human ancestry is consistent with coming from the same source as that of other non-Africans.
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Affiliation(s)
- Swapan Mallick
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Heng Li
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
| | - Mark Lipson
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Iain Mathieson
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Melissa Gymrek
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
- Whitehead Institute for Biomedical Research, Cambridge, Massachusetts 02142, USA
- Harvard-MIT Division of Health Sciences and Technology, MIT, Cambridge, Massachusetts 02139, USA
- New York Genome Center, New York, New York 10013, USA
| | - Fernando Racimo
- Department of Integrative Biology, University of California, Berkeley, California 94720-3140, USA
| | - Mengyao Zhao
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Niru Chennagiri
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Susanne Nordenfelt
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Arti Tandon
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
| | - Pontus Skoglund
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
| | - Iosif Lazaridis
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
| | - Sriram Sankararaman
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
| | - Qiaomei Fu
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
- Key Laboratory of Vertebrate Evolution and Human Origins of Chinese Academy of Sciences, IVPP, CAS, Beijing 100044, China
| | - Nadin Rohland
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
| | - Gabriel Renaud
- Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, D-04103 Leipzig, Germany
| | - Yaniv Erlich
- New York Genome Center, New York, New York 10013, USA
- Department of Computer Science, Columbia University, New York, New York 10027, USA
- Center for Computational Biology and Bioinformatics, Columbia University, New York, New York 10032, USA
| | - Thomas Willems
- New York Genome Center, New York, New York 10013, USA
- Computational and Systems Biology Program, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Carla Gallo
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima 15102, Perú
| | - Jeffrey P Spence
- Computational Biology Graduate Group, University of California, Berkeley, California 94720, USA
| | - Yun S Song
- Computer Science Division, University of California, Berkeley, California 94720, USA
- Department of Statistics, University of California, Berkeley, California 94720, USA
- Department of Mathematics and Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Giovanni Poletti
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima 15102, Perú
| | - Francois Balloux
- Genetics Institute, University College London, Gower Street, London WC1E 6BT, UK
| | - George van Driem
- Institute of Linguistics, University of Bern, Bern CH-3012, Switzerland
| | - Peter de Knijff
- Department of Human and Clinical Genetics, Postzone S5-P, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - Irene Gallego Romero
- School of Biological Sciences, Nanyang Technological University, 637551 Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921 Singapore
| | - Aashish R Jha
- Department of Human Genetics, University of Chicago, Chicago, Illinois 60637, USA
| | - Doron M Behar
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
| | - Claudio M Bravi
- Laboratorio de Genética Molecular Poblacional, Instituto Multidisciplinario de Biología Celular (IMBICE), CCT-CONICET La Plata/CIC Buenos Aires/Universidad Nacional de La Plata, La Plata B1906APO, Argentina
| | | | - Tor Hervig
- Department of Clinical Science, University of Bergen, Bergen 5021, Norway
| | - Andres Moreno-Estrada
- National Laboratory of Genomics for Biodiversity (LANGEBIO), CINVESTAV, Irapuato, Guanajuato 36821, Mexico
| | - Olga L Posukh
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
- Novosibirsk State University, Novosibirsk 630090, Russia
| | | | - Oleg Balanovsky
- Research Centre for Medical Genetics, Moscow 115478, Russia
- Vavilov Institute for General Genetics, Moscow 119991, Russia
- Moscow Institute for Physics and Technology, Dolgoprudniy 141700, Russia
| | - Sena Karachanak-Yankova
- Department of Medical Genetics, National Human Genome Center, Medical University Sofia, Sofia 1431, Bulgaria
| | - Hovhannes Sahakyan
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
- Laboratory of Ethnogenomics, Institute of Molecular Biology, National Academy of Sciences of Armenia, Yerevan 0014, Armenia
| | - Draga Toncheva
- Department of Medical Genetics, National Human Genome Center, Medical University Sofia, Sofia 1431, Bulgaria
| | - Levon Yepiskoposyan
- Laboratory of Ethnogenomics, Institute of Molecular Biology, National Academy of Sciences of Armenia, Yerevan 0014, Armenia
| | - Chris Tyler-Smith
- The Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Yali Xue
- The Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | | | - Andres Ruiz-Linares
- Department of Genetics, Evolution and Environment, University College London WC1E 6BT, UK
| | - Cynthia M Beall
- Department of Anthropology, Case Western Reserve University, Cleveland, Ohio 44106-7125, USA
| | - Anna Di Rienzo
- Department of Human Genetics, University of Chicago, Chicago, Illinois 60637, USA
| | - Choongwon Jeong
- Department of Human Genetics, University of Chicago, Chicago, Illinois 60637, USA
| | - Elena B Starikovskaya
- Laboratory of Human Molecular Genetics, Institute of Molecular and Cellular Biology, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Ene Metspalu
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
- Department of Evolutionary Biology, University of Tartu, Tartu 51010, Estonia
| | - Jüri Parik
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
| | - Richard Villems
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
- Department of Evolutionary Biology, University of Tartu, Tartu 51010, Estonia
- Estonian Academy of Sciences, Tallinn 10130, Estonia
| | - Brenna M Henn
- Department of Ecology and Evolution, Stony Brook University, Stony Brook, New York 11794, USA
| | | | - Robert Mahley
- Gladstone Institutes, San Francisco, California 94158, USA
| | - Antti Sajantila
- Department of Forensic Medicine, University of Helsinki, Helsinki 00014, Finland
| | - George Stamatoyannopoulos
- Department of Medicine, Division of Medical Genetics, University of Washington, Seattle, Washington 98195, USA
| | | | - Rita Khusainova
- Institute of Biochemistry and Genetics, Ufa Research Centre, Russian Academy of Sciences, Ufa 450054, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa 450074, Russia
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Research Centre, Russian Academy of Sciences, Ufa 450054, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa 450074, Russia
| | - Sergey Litvinov
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
- Institute of Biochemistry and Genetics, Ufa Research Centre, Russian Academy of Sciences, Ufa 450054, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa 450074, Russia
| | - George Ayodo
- Jaramogi Oginga Odinga University of Science and Technology, Bondo 40601, Kenya
| | - David Comas
- Institut de Biologia Evolutiva (CSIC-UPF), Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona 08003, Spain
| | - Michael F Hammer
- ARL Division of Biotechnology, University of Arizona, Tucson, Arizona 85721, USA
| | - Toomas Kivisild
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
- Division of Biological Anthropology, University of Cambridge, Fitzwilliam Street, Cambridge CB2 1QH, UK
| | - William Klitz
- New York Genome Center, New York, New York 10013, USA
| | - Cheryl A Winkler
- Basic Research Laboratory, Center for Cancer Research, NCI, Leidos Biomedical Research, Inc., Frederick National Laboratory, Frederick, Maryland 21702, USA
| | - Damian Labuda
- CHU Sainte-Justine, Pediatrics Departement, Université de Montréal, Québec H3T 1C5, Canada
| | - Michael Bamshad
- Department of Pediatrics, University of Washington, Seattle, Washington 98119, USA
| | - Lynn B Jorde
- Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, Utah 84112, USA
| | - Sarah A Tishkoff
- Departments of Genetics and Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - W Scott Watkins
- Department of Human Genetics, Eccles Institute of Human Genetics, University of Utah, Salt Lake City, Utah 84112, USA
| | - Mait Metspalu
- Estonian Biocentre, Evolutionary Biology group, Tartu 51010, Estonia
| | - Stanislav Dryomov
- Laboratory of Human Molecular Genetics, Institute of Molecular and Cellular Biology, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
- Department of Paleolithic Archaeology, Institute of Archaeology and Ethnography, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Rem Sukernik
- Laboratory of Human Molecular Genetics, Institute of Molecular and Cellular Biology, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
- Altai State University, Barnaul 656000, Russia
| | - Lalji Singh
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad 500 007, India
| | | | - Svante Pääbo
- Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, D-04103 Leipzig, Germany
| | - Janet Kelso
- Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, D-04103 Leipzig, Germany
| | - Nick Patterson
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
| | - David Reich
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, Massachusetts 02115, USA
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Abstract
BACKGROUND Many patients with genetic haemochromatosis complain about fatigue and reduced physical capacity. Exercise capacity, however, has not been evaluated in larger series of haemochromatosis patients treated with repeated phlebotomy. DESIGN AND METHODS We performed exercise echocardiography in 152 treated haemochromatosis patients (48+/-13 years, 26% women) and 50 healthy blood donors (49+/-13 years, 30% women), who served as controls. Echocardiography was performed at rest and during exercise in a semiupright position on a chair bicycle, starting from 20 W, increasing by 20 W/min. Transmitral early and atrial velocity and isovolumic relaxation time were measured at each step. Ventilatory gas exchange was measured by the breath-to-breath-technique. RESULTS Compared with healthy controls, haemochromatosis patients were more obese and less trained. More of them smoked, and 17% had a history of cardiovascular or pulmonary disease. Adjusted for training, the left ventricular function and dimensions at rest did not differ between the groups. During exercise the haemochromatosis patients obtained a significantly lower peak oxygen (O2) uptake (28.1 vs. 34.4 ml/kg per min, P<0.001). In a multiple regression analysis haemochromatosis predicted lower peak O2 uptake independently of significant contributions of sex, age, and height, as well as of systolic blood pressure and log-transformed isovolumic relaxation time at peak exercise, whereas no independent association was found with weight or physical activity (multiple R=0.74, P<0.001). Adding genotype, s-ferritin, prevalence of smoking, or history of cardiopulmonary disease among the covariates in subsequent models did not change the results. CONCLUSION Genetic haemochromatosis, even when treated with regular phlebotomy, is associated with lower exercise capacity independently of other covariates of exercise capacity.
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Melve GK, Ersvaer E, Akkök ÇA, Ahmed AB, Kristoffersen EK, Hervig T, Bruserud Ø. Immunomodulation Induced by Stem Cell Mobilization and Harvesting in Healthy Donors: Increased Systemic Osteopontin Levels after Treatment with Granulocyte Colony-Stimulating Factor. Int J Mol Sci 2016; 17:ijms17071158. [PMID: 27447610 PMCID: PMC4964530 DOI: 10.3390/ijms17071158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/25/2016] [Accepted: 07/11/2016] [Indexed: 12/13/2022] Open
Abstract
Peripheral blood stem cells from healthy donors mobilized by granulocyte colony-stimulating factor (G-CSF) and harvested by leukapheresis are commonly used for allogeneic stem cell transplantation. The frequency of severe graft versus host disease is similar for patients receiving peripheral blood and bone marrow allografts, even though the blood grafts contain more T cells, indicating mobilization-related immunoregulatory effects. The regulatory phosphoprotein osteopontin was quantified in plasma samples from healthy donors before G-CSF treatment, after four days of treatment immediately before and after leukapheresis, and 18–24 h after apheresis. Myeloma patients received chemotherapy, combined with G-CSF, for stem cell mobilization and plasma samples were prepared immediately before, immediately after, and 18–24 h after leukapheresis. G-CSF treatment of healthy stem cell donors increased plasma osteopontin levels, and a further increase was seen immediately after leukapheresis. The pre-apheresis levels were also increased in myeloma patients compared to healthy individuals. Finally, in vivo G-CSF exposure did not alter T cell expression of osteopontin ligand CD44, and in vitro osteopontin exposure induced only small increases in anti-CD3- and anti-CD28-stimulated T cell proliferation. G-CSF treatment, followed by leukapheresis, can increase systemic osteopontin levels, and this effect may contribute to the immunomodulatory effects of G-CSF treatment.
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Affiliation(s)
- Guro Kristin Melve
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
- Department of Clinical Science, University of Bergen, N-5020 Bergen, Norway.
| | - Elisabeth Ersvaer
- Department of Biomedical Laboratory Sciences and Chemical Engineering, Faculty of Engineering and Business Administration, Bergen University College, N-5020 Bergen, Norway.
| | - Çiğdem Akalın Akkök
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevål, N-0424 Oslo, Norway.
| | - Aymen Bushra Ahmed
- Division for Hematology, Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
| | - Einar K Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
- Department of Clinical Science, University of Bergen, N-5020 Bergen, Norway.
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
- Department of Clinical Science, University of Bergen, N-5020 Bergen, Norway.
| | - Øystein Bruserud
- Department of Clinical Science, University of Bergen, N-5020 Bergen, Norway.
- Division for Hematology, Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
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Frostad S, Bjerknes R, Hervig T, Nesthus I, Olweus J, Bruserud Ø. Insulin-like Growth Factor-1 (IGF-1) is a Costimulator of the Expansion of Lineage Committed Cells Derived from Peripheral Blood Mobilized CD34+Cells in Multiple Myeloma Patients. Hematology 2016; 4:217-29. [DOI: 10.1080/10245332.1999.11746445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Stein Frostad
- Division for Endocrinology, University of Bergen, Haukeland Hospital, Norway
| | - Robert Bjerknes
- Pediatric Department, University of Bergen, Haukeland Hospital, Norway
| | - Tor Hervig
- The Blood Bank, University of Bergen, Haukeland Hospital, Norway
| | - Ingerid Nesthus
- Division for Hematology, Medical Department B, University of Bergen, Haukeland Hospital, Norway
| | - Johanna Olweus
- Becton Dickinson Immunocytometry Systems, San Jose, CA, USA
| | - Øystein Bruserud
- Division for Hematology, Medical Department B, University of Bergen, Haukeland Hospital, Norway
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Espinosa A, Arsenovic M, Hervig T, Sundic T, Aandahl A, Kronborg J, Seghatchian J. Implementing a patient blood management program in Norway: Where to start? Transfus Apher Sci 2016; 54:422-7. [PMID: 27216542 DOI: 10.1016/j.transci.2016.05.015] [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: 11/26/2022]
Abstract
Norway has recently established a working group to implement a national patient blood management (PBM) program. Although benchmarking regarding blood usage is challenging in Norway due to legal barriers, a survey was sent to different hospitals to identify possible areas to be prioritized in the first phase of the PBM program. Among them, optimizing the patient's hemoglobin level before elective surgery and implementing electronic check-lists for the indication of transfusion when ordering blood products are two measures that may have a considerable impact on blood usage. The results of the survey also showed that patients may receive a red blood cell transfusion at hemoglobin levels that are higher than those internationally recommended. Since there are no national guidelines for the use of blood products, agreement regarding hemoglobin thresholds is essential to reduce variation in transfusion practice. To achieve these goals, the transfusion specialist plays a key role in promoting the principles behind the PBM concept at the local hospital.
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Affiliation(s)
- A Espinosa
- Department of Immunology and Transfusion Medicine, St. Olav's Hospital, Trondheim, Norway.
| | - M Arsenovic
- Division of Immunology and Transfusion Medicine, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway
| | - T Hervig
- Blood Bank, Haukeland University Hospital, Bergen, Norway
| | - T Sundic
- Department of Immunology and Transfusion Medicine, Haugesund Hospital, Haugesund, Norway
| | - A Aandahl
- Department of Immunology and Transfusion Medicine, Akershus University Hospital, Lørenskog, Norway
| | - J Kronborg
- Department of Immunology and Transfusion Medicine, Innlandet Hospital Trust, Norway
| | - J Seghatchian
- International Consultancy in Blood Components Quality/Safety Improvement, Audit/Inspection & DDR Strategies, London, UK.
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Ypma PF, van der Meer PF, Heddle NM, van Hilten JA, Stijnen T, Middelburg RA, Hervig T, van der Bom JG, Brand A, Kerkhoffs JLH. A study protocol for a randomised controlled trial evaluating clinical effects of platelet transfusion products: the Pathogen Reduction Evaluation and Predictive Analytical Rating Score (PREPAReS) trial. BMJ Open 2016; 6:e010156. [PMID: 26817642 PMCID: PMC4735127 DOI: 10.1136/bmjopen-2015-010156] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 12/23/2015] [Accepted: 01/05/2016] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Patients with chemotherapy-induced thrombocytopaenia frequently experience minor and sometimes severe bleeding complications. Unrestrictive availability of safe and effective blood products is presumed by treating physicians as well as patients. Pathogen reduction technology potentially offers the opportunity to enhance safety by reducing bacterial and viral contamination of platelet products along with a potential reduction of alloimmunisation in patients receiving multiple platelet transfusions. METHODS AND ANALYSIS To test efficacy, a randomised, single-blinded, multicentre controlled trial was designed to evaluate clinical non-inferiority of pathogen-reduced platelet concentrates treated by the Mirasol system, compared with standard plasma-stored platelet concentrates using the percentage of patients with WHO grade ≥ 2 bleeding complications as the primary endpoint. The upper limit of the 95% CI of the non-inferiority margin was chosen to be a ≤ 12.5% increase in this percentage. Bleeding symptoms are actively monitored on a daily basis. The adjudication of the bleeding grade is performed by 3 adjudicators, blinded to the platelet product randomisation as well as by an automated computer algorithm. Interim analyses evaluating bleeding complications as well as serious adverse events are performed after each batch of 60 patients. The study started in 2010 and patients will be enrolled up to a maximum of 618 patients, depending on the results of consecutive interim analyses. A flexible stopping rule was designed allowing stopping for non-inferiority or futility. Besides analysing effects of pathogen reduction on clinical efficacy, the Pathogen Reduction Evaluation and Predictive Analytical Rating Score (PREPAReS) is designed to answer several other pending questions and translational issues related to bleeding and alloimmunisation, formulated as secondary and tertiary endpoints. ETHICS AND DISSEMINATION Ethics approval was obtained in all 3 participating countries. Results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NTR2106; Pre-results.
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Affiliation(s)
- Paula F Ypma
- Department of Hematology, HAGA Teaching Hospital Den Haag, The Netherlands
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | | | - Nancy M Heddle
- Faculty of Health Sciences, Department of Medicine, Canadian Blood Services, McMaster University, and Centre for Innovation, Hamilton, Ontario, Canada
| | - Joost A van Hilten
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Theo Stijnen
- Leiden University Medical Centre, Leiden, The Netherlands
| | - Rutger A Middelburg
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tor Hervig
- Department of Immunology and Transfusion Medicine, and Department of Clinical Science, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Johanna G van der Bom
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anneke Brand
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Jean-Louis H Kerkhoffs
- Department of Hematology, HAGA Teaching Hospital Den Haag, The Netherlands
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
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Busby GB, Hellenthal G, Montinaro F, Tofanelli S, Bulayeva K, Rudan I, Zemunik T, Hayward C, Toncheva D, Karachanak-Yankova S, Nesheva D, Anagnostou P, Cali F, Brisighelli F, Romano V, Lefranc G, Buresi C, Ben Chibani J, Haj-Khelil A, Denden S, Ploski R, Krajewski P, Hervig T, Moen T, Herrera RJ, Wilson JF, Myers S, Capelli C. The Role of Recent Admixture in Forming the Contemporary West Eurasian Genomic Landscape. Curr Biol 2015; 25:2878. [PMID: 28843288 PMCID: PMC5628165 DOI: 10.1016/j.cub.2015.10.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Knutson F, Osselaer J, Pierelli L, Lozano M, Cid J, Tardivel R, Garraud O, Hervig T, Domanovic D, Cukjati M, Gudmundson S, Hjalmarsdottir IB, Castrillo A, Gonzalez R, Brihante D, Santos M, Schlenke P, Elliott A, Lin JS, Tappe D, Stassinopoulos A, Green J, Corash L. A prospective, active haemovigilance study with combined cohort analysis of 19,175 transfusions of platelet components prepared with amotosalen-UVA photochemical treatment. Vox Sang 2015; 109:343-52. [PMID: 25981525 PMCID: PMC4690512 DOI: 10.1111/vox.12287] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 03/24/2015] [Accepted: 03/27/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES A photochemical treatment process (PCT) utilizing amotosalen and UVA light (INTERCEPT(™) Blood System) has been developed for inactivation of viruses, bacteria, parasites and leucocytes that can contaminate blood components intended for transfusion. The objective of this study was to further characterize the safety profile of INTERCEPT-treated platelet components (PCT-PLT) administered across a broad patient population. MATERIALS AND METHODS This open-label, observational haemovigilance programme of PCT-PLT transfusions was conducted in 21 centres in 11 countries. All transfusions were monitored for adverse events within 24 h post-transfusion and for serious adverse events (SAEs) up to 7 days post-transfusion. All adverse events were assessed for severity (Grade 0-4), and causal relationship to PCT-PLT transfusion. RESULTS Over the course of 7 years in the study centres, 4067 patients received 19,175 PCT-PLT transfusions. Adverse events were infrequent, and most were of Grade 1 severity. On a per-transfusion basis, 123 (0.6%) were classified an acute transfusion reaction (ATR) defined as an adverse event related to the transfusion. Among these ATRs, the most common were chills (77, 0.4%) and urticaria (41, 0.2%). Fourteen SAEs were reported, of which 2 were attributed to platelet transfusion (<0.1%). No case of transfusion-related acute lung injury, transfusion-associated graft-versus-host disease, transfusion-transmitted infection or death was attributed to the transfusion of PCT-PLT. CONCLUSION This longitudinal haemovigilance safety programme to monitor PCT-PLT transfusions demonstrated a low rate of ATRs, and a safety profile consistent with that previously reported for conventional platelet components.
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Affiliation(s)
- F Knutson
- Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - J Osselaer
- Cliniques Universitaires de Mont Godinne, Universite Catholique de Louvain, Yvoir, Belgium
| | - L Pierelli
- Department of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - M Lozano
- Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - J Cid
- Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | | | - O Garraud
- EFS Auvergne Loire, St. Etienne, France
| | - T Hervig
- Department of Immunology and Transfusion Medicine, University of Bergen, Bergen, Norway
| | - D Domanovic
- Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - M Cukjati
- Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - S Gudmundson
- Blood Bank, National University Hospital, Reykjavik, Iceland
| | | | - A Castrillo
- Transfusion Centre of Galicia, Santiago de Compostela, Spain
| | - R Gonzalez
- Transfusion Centre of Galicia, Santiago de Compostela, Spain
| | - D Brihante
- Servico de Imuno-Hemoterapia, Instituto Portugues de Oncologia de Lisboa, Lisbon, Portugal
| | - M Santos
- Servico de Imuno-Hemoterapia, Instituto Portugues de Oncologia de Lisboa, Lisbon, Portugal
| | - P Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | | | - J-S Lin
- Cerus Corporation, Concord, CA, USA
| | - D Tappe
- Cerus Corporation, Concord, CA, USA
| | | | - J Green
- Cerus Corporation, Concord, CA, USA
| | - L Corash
- Cerus Corporation, Concord, CA, USA
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48
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Dzik WS, Ziman A, Cohen C, Pai M, Lozano M, Kaufman RM, Delaney M, Selleng K, Murphy MF, Hervig T, Yazer M. Survival after ultramassive transfusion: a review of 1360 cases. Transfusion 2015; 56:558-63. [DOI: 10.1111/trf.13370] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 08/31/2015] [Accepted: 08/31/2015] [Indexed: 11/27/2022]
Affiliation(s)
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, Division of Transfusion Medicine; UCLA Medical Center; Los Angeles California
| | - Claudia Cohen
- Lab Medicine and Pathology; University of Minnesota Medical Center; Minneapolis Minnesota
| | - Menaka Pai
- Medicine and Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
| | - Miguel Lozano
- Hemotherapy and Hemostasis; University Clinic Hospital; Barcelona Spain
| | | | - Meghan Delaney
- Laboratory Medicine; University of Washington, and Puget Sound Blood Center; Seattle Washington
| | - Kathleen Selleng
- Institut for Immunology and Transfusion Medicine; Ernst-Moritz-Arndt-University; Greifswald Germany
| | | | - Tor Hervig
- Transfusion Medicine; Haukeland University Hospital; Bergen Norway
| | - Mark Yazer
- Institute for Transfusion Medicine; Pittsburgh Pennsylvania
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49
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Busby GBJ, Hellenthal G, Montinaro F, Tofanelli S, Bulayeva K, Rudan I, Zemunik T, Hayward C, Toncheva D, Karachanak-Yankova S, Nesheva D, Anagnostou P, Cali F, Brisighelli F, Romano V, Lefranc G, Buresi C, Ben Chibani J, Haj-Khelil A, Denden S, Ploski R, Krajewski P, Hervig T, Moen T, Herrera RJ, Wilson JF, Myers S, Capelli C. The Role of Recent Admixture in Forming the Contemporary West Eurasian Genomic Landscape. Curr Biol 2015; 25:2518-26. [PMID: 26387712 PMCID: PMC4714572 DOI: 10.1016/j.cub.2015.08.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/29/2015] [Accepted: 08/05/2015] [Indexed: 11/19/2022]
Abstract
Over the past few years, studies of DNA isolated from human fossils and archaeological remains have generated considerable novel insight into the history of our species. Several landmark papers have described the genomes of ancient humans across West Eurasia, demonstrating the presence of large-scale, dynamic population movements over the last 10,000 years, such that ancestry across present-day populations is likely to be a mixture of several ancient groups [1, 2, 3, 4, 5, 6, 7]. While these efforts are bringing the details of West Eurasian prehistory into increasing focus, studies aimed at understanding the processes behind the generation of the current West Eurasian genetic landscape have been limited by the number of populations sampled or have been either too regional or global in their outlook [8, 9, 10, 11]. Here, using recently described haplotype-based techniques [11], we present the results of a systematic survey of recent admixture history across Western Eurasia and show that admixture is a universal property across almost all groups. Admixture in all regions except North Western Europe involved the influx of genetic material from outside of West Eurasia, which we date to specific time periods. Within Northern, Western, and Central Europe, admixture tended to occur between local groups during the period 300 to 1200 CE. Comparisons of the genetic profiles of West Eurasians before and after admixture show that population movements within the last 1,500 years are likely to have maintained differentiation among groups. Our analysis provides a timeline of the gene flow events that have generated the contemporary genetic landscape of West Eurasia. Recent admixture events involved outside groups at the edges of West Eurasia Admixture within Europe tended to fall within the European Migration Period West Eurasian genetic structure today is likely to have been maintained by admixture
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Affiliation(s)
- George B J Busby
- Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK; Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK.
| | - Garrett Hellenthal
- UCL Genetics Institute, University College London, Gower Street, London WC1E 6BT, UK
| | - Francesco Montinaro
- Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK
| | - Sergio Tofanelli
- Department of Biology, Università di Pisa, Via Ghini 13, 56126 Pisa, Italy
| | - Kazima Bulayeva
- N.I.Vavilov Institute of General Genetics, 3 Gubkin Street, Moscow 119991, Russia
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Heath Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - Tatijana Zemunik
- Department of Medical Biology, School of Medicine Split, Soltanska 2, Split 21000, Croatia
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine (IGMM), University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK
| | - Draga Toncheva
- Department of Medical Genetics, National Human Genome Center, Medical University Sofia, Sofia 1431, Bulgaria
| | - Sena Karachanak-Yankova
- Department of Medical Genetics, National Human Genome Center, Medical University Sofia, Sofia 1431, Bulgaria
| | - Desislava Nesheva
- Department of Medical Genetics, National Human Genome Center, Medical University Sofia, Sofia 1431, Bulgaria
| | - Paolo Anagnostou
- Department of Environmental Biology, Università La Sapienza, Roma 00185, Italy; Istituto Italiano di Antropologia, Roma 00185, Italy
| | - Francesco Cali
- Laboratorio di Genetica Molecolare, IRCCS Associazione Oasi Maria SS, Troina 94018, Italy
| | - Francesca Brisighelli
- Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK; Forensic Genetics Laboratory, Institute of Legal Medicine, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Valentino Romano
- Dipartimento di Fisica e Chimica, Università di Palermo, Palermo 90128, Italy
| | - Gerard Lefranc
- Institute of Human Genetics, CNRS UPR 1142, and Montpellier University, Place Eugene Bataillon, 34095 Montpellier Cedex 5, France
| | - Catherine Buresi
- Institute of Human Genetics, CNRS UPR 1142, and Montpellier University, Place Eugene Bataillon, 34095 Montpellier Cedex 5, France
| | - Jemni Ben Chibani
- Laboratory of Biochemistry and Molecular Biology, Faculty of Pharmacy, 1 Avenue Avicenne, 5019 Monastir, Tunisia
| | - Amel Haj-Khelil
- Laboratory of Biochemistry and Molecular Biology, Faculty of Pharmacy, 1 Avenue Avicenne, 5019 Monastir, Tunisia
| | - Sabri Denden
- Laboratory of Biochemistry and Molecular Biology, Faculty of Pharmacy, 1 Avenue Avicenne, 5019 Monastir, Tunisia
| | - Rafal Ploski
- Department of Medical Genetics, Warsaw Medical University, 3c Pawinskiego Street, Warsaw 02-106, Poland
| | - Pawel Krajewski
- Department of Forensic Medicine, Warsaw Medical University, 1 Oczki Street, Warsaw 02-007, Poland
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, Bergen 5021, Norway
| | | | - Rene J Herrera
- Department of Human and Molecular Genetics, Florida International University, University Park, Miami, FL 33174, USA
| | - James F Wilson
- Centre for Global Health Research, Usher Institute of Population Heath Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK; MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine (IGMM), University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK
| | - Simon Myers
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK; Department of Statistics, University of Oxford, South Parks Road, Oxford OX1 3TG, UK
| | - Cristian Capelli
- Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK.
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50
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Sudmant PH, Mallick S, Nelson BJ, Hormozdiari F, Krumm N, Huddleston J, Coe BP, Baker C, Nordenfelt S, Bamshad M, Jorde LB, Posukh OL, Sahakyan H, Watkins WS, Yepiskoposyan L, Abdullah MS, Bravi CM, Capelli C, Hervig T, Wee JTS, Tyler-Smith C, van Driem G, Romero IG, Jha AR, Karachanak-Yankova S, Toncheva D, Comas D, Henn B, Kivisild T, Ruiz-Linares A, Sajantila A, Metspalu E, Parik J, Villems R, Starikovskaya EB, Ayodo G, Beall CM, Di Rienzo A, Hammer MF, Khusainova R, Khusnutdinova E, Klitz W, Winkler C, Labuda D, Metspalu M, Tishkoff SA, Dryomov S, Sukernik R, Patterson N, Reich D, Eichler EE. Global diversity, population stratification, and selection of human copy-number variation. Science 2015; 349:aab3761. [PMID: 26249230 DOI: 10.1126/science.aab3761] [Citation(s) in RCA: 255] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 07/29/2015] [Indexed: 12/14/2022]
Abstract
In order to explore the diversity and selective signatures of duplication and deletion human copy-number variants (CNVs), we sequenced 236 individuals from 125 distinct human populations. We observed that duplications exhibit fundamentally different population genetic and selective signatures than deletions and are more likely to be stratified between human populations. Through reconstruction of the ancestral human genome, we identify megabases of DNA lost in different human lineages and pinpoint large duplications that introgressed from the extinct Denisova lineage now found at high frequency exclusively in Oceanic populations. We find that the proportion of CNV base pairs to single-nucleotide-variant base pairs is greater among non-Africans than it is among African populations, but we conclude that this difference is likely due to unique aspects of non-African population history as opposed to differences in CNV load.
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Affiliation(s)
- Peter H Sudmant
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Swapan Mallick
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA 02142, USA. Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Bradley J Nelson
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | | | - Niklas Krumm
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - John Huddleston
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA. Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Bradley P Coe
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Carl Baker
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Susanne Nordenfelt
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA 02142, USA. Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Michael Bamshad
- Department of Pediatrics, University of Washington, Seattle, WA 98119, USA
| | - Lynn B Jorde
- Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Olga L Posukh
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia. Novosibirsk State University, Novosibirsk 630090, Russia
| | - Hovhannes Sahakyan
- Estonian Biocentre, Evolutionary Biology Group, Tartu 51010, Estonia. Laboratory of Ethnogenomics, Institute of Molecular Biology, National Academy of Sciences of Armenia, Yerevan 0014, Armenia
| | - W Scott Watkins
- Department of Human Genetics, Eccles Institute of Human Genetics, University of Utah, Salt Lake City, UT 84112, USA
| | - Levon Yepiskoposyan
- Laboratory of Ethnogenomics, Institute of Molecular Biology, National Academy of Sciences of Armenia, Yerevan 0014, Armenia
| | - M Syafiq Abdullah
- Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, Brunei Darussalam
| | - Claudio M Bravi
- Laboratorio de Genética Molecular Poblacional, Instituto Multidisciplinario de Biología Celular (IMBICE), Centro Científico y Tecnológico-Consejo Nacional de Investigaciones Científicas y Técnicas (CCT-CONICET) and Comisión de Investigaciones Científicas de la Provincia de Buenos Aires (CICPBA), La Plata B1906APO, Argentina
| | | | - Tor Hervig
- Department of Clinical Science, University of Bergen, Bergen 5021, Norway
| | | | - Chris Tyler-Smith
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | - George van Driem
- Institute of Linguistics, University of Bern, Bern CH-3012, Switzerland
| | | | - Aashish R Jha
- Department of Human Genetics, University of Chicago, Chicago, IL 60637, USA
| | - Sena Karachanak-Yankova
- Department of Medical Genetics, National Human Genome Center, Medical University Sofia, Sofia 1431, Bulgaria
| | - Draga Toncheva
- Department of Medical Genetics, National Human Genome Center, Medical University Sofia, Sofia 1431, Bulgaria
| | - David Comas
- Institut de Biologia Evolutiva [Consejo Superior de Investigaciones Científicas-Universitat Pompeu Fabra (CSIC-UPF)], Departament de Ciències Experimentals i de la Salut, UPF, Barcelona 08003, Spain
| | - Brenna Henn
- Department of Ecology and Evolution, Stony Brook University, Stony Brook, NY 11794, USA
| | - Toomas Kivisild
- Division of Biological Anthropology, University of Cambridge, Fitzwilliam Street, Cambridge CB2 1QH, UK
| | - Andres Ruiz-Linares
- Department of Genetics, Evolution and Environment, University College London, WC1E 6BT, UK
| | - Antti Sajantila
- University of Helsinki, Department of Forensic Medicine, Helsinki 00014, Finland
| | - Ene Metspalu
- Estonian Biocentre, Evolutionary Biology Group, Tartu 51010, Estonia. University of Tartu, Department of Evolutionary Biology, Tartu 5101, Estonia
| | - Jüri Parik
- Estonian Biocentre, Evolutionary Biology Group, Tartu 51010, Estonia
| | - Richard Villems
- Estonian Biocentre, Evolutionary Biology Group, Tartu 51010, Estonia
| | - Elena B Starikovskaya
- Laboratory of Human Molecular Genetics, Institute of Molecular and Cellular Biology, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - George Ayodo
- Center for Global Health and Child Development, Kisumu 40100, Kenya
| | - Cynthia M Beall
- Department of Anthropology, Case Western Reserve University, Cleveland, OH 44106-7125, USA
| | - Anna Di Rienzo
- Department of Human Genetics, University of Chicago, Chicago, IL 60637, USA
| | - Michael F Hammer
- Arizona Research Laboratories Division of Biotechnology, University of Arizona, Tucson, AZ 85721, USA
| | - Rita Khusainova
- Institute of Biochemistry and Genetics, Ufa Research Centre, Russian Academy of Sciences, Ufa 450054, Russia. Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa 450074, Russia
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Research Centre, Russian Academy of Sciences, Ufa 450054, Russia. Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa 450074, Russia
| | - William Klitz
- Integrative Biology, University of California, Berkeley, CA 94720-3140, USA
| | - Cheryl Winkler
- Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Leidos Biomedical Research, Incorporated, Frederick National Laboratory, Frederick, MD 21702, USA
| | - Damian Labuda
- Centre Hospitalier Universitaire (CHU) Sainte-Justine, Département de Pédiatrie, Université de Montréal, QC H3T 1C5, Canada
| | - Mait Metspalu
- Estonian Biocentre, Evolutionary Biology Group, Tartu 51010, Estonia
| | - Sarah A Tishkoff
- Departments of Biology and Genetics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Stanislav Dryomov
- Laboratory of Human Molecular Genetics, Institute of Molecular and Cellular Biology, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia. Department of Paleolithic Archaeology, Institute of Archaeology and Ethnography, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Rem Sukernik
- Laboratory of Human Molecular Genetics, Institute of Molecular and Cellular Biology, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia. Altai State University, Barnaul 656000, Russia
| | - Nick Patterson
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA 02142, USA. Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - David Reich
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA 02142, USA. Department of Genetics, Harvard Medical School, Boston, MA 02115, USA. Howard Hughes Medical Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Evan E Eichler
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA. Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA.
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