Hyllner M, Tylman M, Bengtson J P, Rydberg L, Bengtsson A
Department of Anaesthesiology & Intensive Care, Sahlgrenska University Hospital, Goteborg University, Goteborg, Sweden.
Transfus Med. 2004 Feb;14(1):45-52. doi: 10.1111/j.0958-7578.2004.00479.x.
Complement activation and generation of pro-inflammatory cytokines occur during storage of blood components. Prestorage leucocyte filtration of platelet concentrates and red cells diminishes the accumulation of leucocyte-derived cytokines during storage, however, transfusion reactions are not eliminated. We investigated inflammatory mediator release during storage of plasma and whole blood and the effect of prestorage leucocyte filtration of plasma. Twenty-four blood units were collected from healthy blood donors and stored for 35 days. Eight units were stored as whole blood, eight units as plasma and eight units as prestorage filtered plasma. Samples were collected weekly for analyses of potassium, leucocytes, free plasma haemoglobin, complement activation (C3a and SC5b-9) and pro-inflammatory cytokines [interleukin (IL)-6, IL-8 and tumor necrosis factor (TNF)-alpha]. Elevated levels of C3a and SC5b-9 were registered in filtered plasma, from the beginning of storage. C3a levels increased during storage. There was a higher rate of change during storage in C3a (P < 0.01) and SC5b-9 (P < 0.05) in plasma compared with filtered plasma. Interleukin (IL)-8 is released in whole blood. The cytokine levels generated in plasma and filtered plasma were low. Complement activation is present in whole blood, plasma and filtered plasma during storage. Prestorage filtration of plasma activates the complement cascade but does not influence cytokine generation.
血液成分储存期间会发生补体激活和促炎细胞因子的生成。对血小板浓缩物和红细胞进行储存前白细胞过滤可减少储存期间白细胞衍生细胞因子的积累，然而，输血反应并未消除。我们研究了血浆和全血储存期间炎症介质的释放以及血浆储存前白细胞过滤的影响。从健康献血者采集24个血液单位并储存35天。8个单位作为全血储存，8个单位作为血浆储存，8个单位作为储存前过滤血浆储存。每周采集样本分析钾、白细胞、游离血浆血红蛋白、补体激活（C3a和SC5b-9）和促炎细胞因子[白细胞介素（IL）-6、IL-8和肿瘤坏死因子（TNF）-α]。从储存开始，过滤血浆中C3a和SC5b-9水平升高。储存期间C3a水平升高。与过滤血浆相比，血浆中C3a（P<0.01）和SC5b-9（P<0.05）在储存期间的变化率更高。白细胞介素（IL）-8在全血中释放。血浆和过滤血浆中产生的细胞因子水平较低。储存期间全血、血浆和过滤血浆中均存在补体激活。血浆储存前过滤会激活补体级联反应，但不影响细胞因子的生成。
