Red blood cell derived extracellular vesicles during the process of autologous blood doping

The purpose of this pilot study was to investigate the effects of the transfusion of one erythrocyte concentrate on the number of circulating red blood cell extracellular vesicles (RBC-EVs) and their clearance time. Six, healthy volunteers donated their blood and were transfused with their RBC concentrate after 35-36 days of storage. One K₂ EDTA and one serum sample were collected before donation, at four timepoints after donation and at another six timepoints after transfusion. RBC-EVs were analyzed on a Cytek Aurora flow cytometer. A highly significant increase (p < 0.001) of RBC-EVs from an average of 60.1 ± 19.8 (10³ /μL) at baseline to 179.3 ± 84.7 (10³ /μL) in the first 1-3 h after transfusion could be observed. Individual differences in the response to transfusion became apparent with one volunteer showing no increase and another an increased concentration at one timepoint after donation due to an influenza infection. We concluded that in an individualized passport approach, increased RBC-EVs might be considered as additional evidence when interpreting suspicious Athletes Biological Passport (ABPs) but for this additional research related to sample collection and transport processes as well as method development and harmonization would be necessary.

The impact of COVID-19 pandemic on blood supplies and transfusion services in Eastern Mediterranean Region

Background

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spurred a global health crisis. The safety and supply of blood during this pandemic has been a concern of blood banks and transfusion services as it is expected to adversely affect blood system activities. We aim to assess the situation in the Eastern Mediterranean Region (EMR) during the first months of the pandemic.

Materials and methods

A survey was designed to address blood supply, transfusion demand, and donor management during the coronavirus disease-19 (COVID-19) pandemic. Medical directors of different blood banks were invited to participate.

Results

A total of 16 centers participated with representation from 15/19 countries in the region. In total, 75% were from national blood banks. Most centres had a decrease in the blood supply, ranging from 26–50%. Representatives from 14 countries (93.3%) believed that public fear has contributed to a decrease in donations. Most centres (n = 12, 75%) had a reduction in transfusion demand, while those who did not, reported heavy involvement in treating patients with underlying haemoglobinopathies and haematological malignancies. Half of the centres activated their contingency plans. Four centres had to alter the blood donor eligibility criteria to meet demands. All centres implemented donor deferral criteria in relation to SARS-CoV-2, but were variable in measures to mitigate the risk of donor and staff exposure.

Conclusion

Blood services in the region faced variable degrees of blood shortages. We summarize lessons learnt during this pandemic for the blood banks to consider to plan, assess, and respond proportionately to future similar pandemics.

Antral nodularity, gastric lymphoid hyperplasia, and Helicobacter pylori in adults

Our objective is to evaluate endoscopically-diagnosed antral nodularity in adults and its relationship to lymphoid hyperplasia (LH) and Helicobacter pylori (HP). Antral biopsy specimens were studied for inflammation, presence of HP, and lymphoid follicles. Patients with marked functional dyspepsia or recurrent duodenal ulcers were given triple therapy (bismuth subcitrate, tetracycline, and metronidazole in the recommended doses for 2 weeks) to eradicate HP. Follow-up endoscopy and biopsies, at least 4 weeks after finishing treatment, were performed to assess eradication of HP and its effect on nodularity and LH. In all 25 patients (age range, 20-42 years) with antral nodularity, biopsy specimens were positive for HP. Twenty (80%) of subjects had lymphoid follicles; 13 of these 20 were given triple therapy. Eradication of HP was achieved in five cases (38%). Patients in whom HP was successfully eradicated showed improvement of their symptoms; antral nodularity subsided and there was marked regression of the lymphoid follicles. Antral nodularity with LH, reported to be unique to children, is not uncommon in adults and is induced by HP, eradication of which leads to regression of nodularity and LH in most cases. Low eradication rates achieved with metronidazole-based triply therapy is due, possibly, to primary resistance to metronidazole. Long-term follow-up of such patients is required to assess the evolution of these findings.