Shanwell A, Falker C, Gulliksson H
Department of Transfusion Medicine, Huddinge University Hospital, Stockholm, Sweden.
Vox Sang. 2003 Oct;85(3):206-12. doi: 10.1046/j.1423-0410.2003.00359.x.
Several studies have suggested that the accumulation of cytokines during storage of platelet concentrates may mediate non-haemolytic transfusion reactions. Prestorage leucodepletion can prevent the release of cytokines from white blood cells during storage, but not the release of platelet-derived cytokines. Therefore, we investigated whether the addition of magnesium and potassium to platelets stored in a platelet additive solution (PAS) would affect the generation of cytokines during platelet storage.
Platelets were prepared from buffy coats using different suspension media: plasma; 70% PAS-III + 30% plasma; 70% PAS-III supplemented with magnesium and potassium +30% plasma; and 80% PAS-III supplemented with magnesium and potassium +20% plasma. The levels of certain cytokines--regulated on activation, normal, T-cell expressed, and secreted (RANTES), beta-thromboglobulin (beta-TG), platelet factor 4 (PF4) and interleukin-7 (IL-7)--were measured by enzyme-linked immunosorbent assay (ELISA) on days 1, 5 and 7.
The concentrations of RANTES, beta-TG, PF4 and IL-7 increased, during storage, in all units. The increase was significantly greater in units stored in 70% PAS-III +30% plasma than in the other three suspension media. The storage of platelets in 70% PAS-III supplemented with magnesium and potassium +30% plasma significantly reduced the concentrations of platelet derived-cytokines during storage, as compared to platelets stored in 70% PAS-III + 30% plasma alone.
The concentrations of platelet-derived cytokines increased, to a significantly greater extent, when platelets were stored in PAS-III than in plasma. However, when magnesium and potassium were added to PAS-III, the concentrations of platelet-derived cytokines obtained during storage were about the same as those produced by platelets stored in plasma.
多项研究表明,血小板浓缩物储存期间细胞因子的蓄积可能介导非溶血性输血反应。储存前白细胞去除可防止储存期间白细胞释放细胞因子,但不能防止血小板衍生细胞因子的释放。因此,我们研究了在血小板添加剂溶液(PAS)中储存的血小板中添加镁和钾是否会影响血小板储存期间细胞因子的生成。
使用不同的悬浮介质从 Buffy 层制备血小板:血浆;70% PAS-III + 30%血浆;补充镁和钾的 70% PAS-III + 30%血浆;以及补充镁和钾的 80% PAS-III + 20%血浆。在第 1、5 和 7 天通过酶联免疫吸附测定(ELISA)测量某些细胞因子的水平——活化调节正常 T 细胞表达和分泌因子(RANTES)、β-血小板球蛋白(β-TG)、血小板因子 4(PF4)和白细胞介素-7(IL-7)。
所有单位的血小板在储存期间,RANTES、β-TG、PF4 和 IL-7 的浓度均升高。储存在 70% PAS-III + 30%血浆中的单位,其升高幅度明显大于其他三种悬浮介质。与仅储存在 70% PAS-III + 30%血浆中的血小板相比,储存在补充镁和钾的 70% PAS-III + 30%血浆中的血小板在储存期间可显著降低血小板衍生细胞因子的浓度。
血小板储存在 PAS-III 中时,血小板衍生细胞因子的浓度升高幅度明显大于储存在血浆中时。然而,当向 PAS-III 中添加镁和钾时,储存期间获得的血小板衍生细胞因子浓度与储存在血浆中的血小板产生的浓度大致相同。