Sowemimo-Coker S O, Pesci S, Andrade F, Kim A, Kascsak R B, Kascsak R J, Meeker C, Carp R
Pall Medical, Pall Corporation, Port Washington, New York 11050, USA.
Vox Sang. 2006 May;90(4):265-75. doi: 10.1111/j.1423-0410.2006.00765.x.
Three recent probable cases of transmission of a variant of human Creutzfeldt-Jakob disease (vCJD) through blood transfusion suggest that the disease can be transmitted through transfusion of blood components from presymptomatic blood donors. In this study, we investigated the performance of a new filter for reducing the levels of infectious prions (PrP(Sc)) from red cell concentrates (RCC).
Endogenous Infectivity: A pool of 500 ml of whole blood was collected from 263K-strain scrapie-infected hamsters into an anticoagulant, processed into non-leucoreduced RCC (NL-RCC), and then passed through a prion-reduction filter. Pre- and postfiltration samples were tested for PrP(Sc) by Western blot and infectivity by inoculation of healthy hamsters. Results of the endogenous infectivity study after 200 days post-inoculation are discussed. Exogenous (Spiking) Study: Scrapie-infected hamster brain homogenates containing PrP(Sc) were added to human RCC and then filtered. Levels of PrP(Sc) were determined by Western blot assay. The effect of prior leucodepletion of 'spiked' RCC on PrP(Sc) removal by the prion-removal filter was also assessed.
In the endogenous infectivity study, at 200-day observation time, the prefiltered RCC transmitted disease to six of the 187 hamsters, whereas the filtered RCC did not transmit disease to any of 413 animals, P = 0.001. The prion filter also significantly reduced the concentration of leucocytes in the RCC by about 4 logs, P < 0.05. In the exogenous (spiking) study, the level of PrP(res) was significantly reduced in RCC P < 0.05. Prior leucodepletion of the RCC with a leucoreduction filter did not significantly reduce the concentration of exogenously spiked PrP(Sc), P > 0.05.
The use of this new prion-reduction filter should reduce the risk of vCJD transmission through transfusion of RCC, the most widely transfused blood component.
近期有三例可能通过输血传播变异型克雅氏病（vCJD）的病例，这表明该疾病可通过无症状献血者的血液成分输血传播。在本研究中，我们调查了一种新型过滤器降低红细胞浓缩液（RCC）中感染性朊病毒（PrP(Sc)）水平的性能。
内源性感染性：从263K株羊瘙痒病感染的仓鼠中采集500ml全血，加入抗凝剂，处理成未进行白细胞去除的红细胞浓缩液（NL-RCC），然后通过朊病毒去除过滤器。过滤前后的样本通过蛋白质印迹法检测PrP(Sc)，并通过接种健康仓鼠检测感染性。讨论接种后200天的内源性感染性研究结果。外源性（加样）研究：将含有PrP(Sc)的羊瘙痒病感染仓鼠脑匀浆加入人红细胞浓缩液中，然后进行过滤。通过蛋白质印迹法测定PrP(Sc)水平。还评估了预先对“加样”红细胞浓缩液进行白细胞去除对朊病毒去除过滤器去除PrP(Sc)的影响。
在内源性感染性研究中，在200天观察期时，过滤前的红细胞浓缩液使187只仓鼠中的6只感染疾病，而过滤后的红细胞浓缩液未使413只动物中的任何一只感染疾病，P = 0.001。朊病毒过滤器还使红细胞浓缩液中的白细胞浓度显著降低约4个对数级，P < 0.05。在外源性（加样）研究中，红细胞浓缩液中PrP(res)水平显著降低，P < 0.05。预先用白细胞去除过滤器对红细胞浓缩液进行白细胞去除并未显著降低外源性加样的PrP(Sc)浓度，P > 0.05。
使用这种新型朊病毒去除过滤器应可降低通过输注红细胞浓缩液（最广泛输注的血液成分）传播vCJD的风险。
