Grellier Philippe, Benach Jorge, Labaied Mehdi, Charneau Sébastien, Gil Horacio, Monsalve Gloria, Alfonso Ryan, Sawyer Lynette, Lin Lily, Steiert Matthias, Dupuis Kent
Biologie Fonctionnelle des Protozoaires, Muséum National d'Histoire Naturelle, Paris, France.
Transfusion. 2008 Aug;48(8):1676-84. doi: 10.1111/j.1537-2995.2007.01762.x. Epub 2008 May 22.
Transfusion-transmitted cases of malaria and babesiosis have been well documented. Current efforts to screen out contaminated blood products result in component wastage due to the lack of specific detection methods while donor deferral does not always guarantee safe blood products. This study evaluated the efficacy of a photochemical treatment (PCT) method with amotosalen and long-wavelength ultraviolet light (UVA) to inactivate these agents in red blood cells (RBCs) contaminating platelet (PLT) and plasma components.
Plasmodium falciparum- and Babesia microti-contaminated RBCs seeded into PLT and plasma components were treated with 150 micromol per L amotosalen and 3 J per cm2 UVA. The viability of both pathogens before and after treatment was measured with infectivity assays. Treatment with 150 micromol per L amotosalen and 1 J per cm2 UVA was used to assess the robustness of the PCT system.
No viable B. microti was detected in PLTs or plasma after treatment with 150 mol per L amotosalen and 3 J per cm2 UVA, demonstrating a mean inactivation of greater than 5.3 log in PLTs and greater than 5.3 log in plasma. After the same treatment, viable P. falciparum was either absent or below the limit of quantification in three of four replicate experiments both in PLTs and in plasma demonstrating a mean inactivation of at least 6.0 log in PLTs and at least 6.9 log in plasma. Reducing UVA dose to 1 J per cm2 did not significantly affect the level of inactivation.
P. falciparum and B. microti were highly sensitive to inactivation by PCT. Pathogen inactivation approaches could reduce the risk of transfusion-transmitted parasitic infections and avoid unnecessary donor exclusions.
输血传播疟疾和巴贝斯虫病的病例已有充分记录。由于缺乏特异性检测方法，目前筛查受污染血液制品的努力导致成分浪费，而推迟献血并不总能保证血液制品的安全。本研究评估了用氨甲环酸和长波紫外线（UVA）进行光化学处理（PCT）方法对污染血小板（PLT）和血浆成分的红细胞（RBC）中这些病原体的灭活效果。
将接种有恶性疟原虫和微小巴贝斯虫的红细胞接种到血小板和血浆成分中，用每升150微摩尔的氨甲环酸和每平方厘米3焦耳的UVA进行处理。通过感染性试验测量处理前后两种病原体的活力。用每升150微摩尔的氨甲环酸和每平方厘米1焦耳的UVA进行处理，以评估PCT系统的稳健性。
用每升150摩尔的氨甲环酸和每平方厘米3焦耳的UVA处理后，在血小板或血浆中未检测到活的微小巴贝斯虫，表明血小板中的平均灭活率大于5.3对数，血浆中的平均灭活率大于5.3对数。经过相同处理后，在四个重复实验中的三个实验中，血小板和血浆中均未检测到活的恶性疟原虫或其含量低于定量限，表明血小板中的平均灭活率至少为6.0对数，血浆中的平均灭活率至少为6.9对数。将UVA剂量降低到每平方厘米1焦耳对灭活水平没有显著影响。
恶性疟原虫和微小巴贝斯虫对PCT灭活高度敏感。病原体灭活方法可以降低输血传播寄生虫感染的风险，并避免不必要的献血者排除。
