Department of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway.
Transfusion. 2013 Jan;53(1):147-55. doi: 10.1111/j.1537-2995.2012.03681.x. Epub 2012 May 7.
Lipids and other biologically active substances accumulate in platelet concentrates (PCs) during storage. Some of these substances have been suggested to modulate immune responses and to play a pathogenic role in the development of transfusion-related acute lung injury. This study compared the content and impact of some biological response modifiers in PCs treated with pathogen reduction (PR) technology and nontreated PCs.
Apheresis PCs (n = 12) were split in two: one split was subjected to PR treatment (INTERCEPT, Cerus Corp.) and the other split was left untreated. Basic characterization and content of vascular endothelial growth factor (VEGF) and sCD154 were measured. Lipopolysaccharide (LPS)-induced secretion of interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) was measured after incubation of heparinized whole blood with platelet (PLT) supernatants. The supernatants' neutrophil (PMN)-priming capacity, and thereby activation of the NADPH oxidase, was measured as the rate of superoxide anion production after formyl-Met-Leu-Phe activation. Lipids were extracted from the supernatants on Day 6 and tested for PMN-priming activity.
Supernatants from PR-treated PCs demonstrated significantly higher mean PLT volume (MPV) and O(2) , lower pH, CO(2) , and HCO(3-) , and significantly less LPS-induced TNF-α secretion compared to untreated PCs. No differences in swirling, PLT count, potassium levels, glucose consumption, lactate production, IL-10, VEGF, sCD154, or PMN-priming activity were found between the groups over time.
INTERCEPT PR treatment caused no substantial differences in PCs, except for minor changes in MPV and metabolic variables. Further studies are needed to explain the differences in the LPS-induced TNF-α secretion.
在储存过程中,血小板浓缩物 (PC) 中会积累脂质和其他具有生物活性的物质。其中一些物质被认为可以调节免疫反应,并在输血相关急性肺损伤的发展中发挥致病作用。本研究比较了经病原体减少 (PR) 技术处理和未经处理的 PC 中一些生物反应调节剂的含量和作用。
将 12 份采集的 PC 等分两份:一份进行 PR 处理(INTERCEPT,Cerus 公司),另一份不做处理。测量基本特征和血管内皮生长因子 (VEGF) 和 sCD154 的含量。孵育肝素化全血与血小板 (PLT) 上清液后,测量白细胞介素-10 (IL-10) 和肿瘤坏死因子-α (TNF-α) 的 LPS 诱导分泌。测量上清液的中性粒细胞 (PMN) 引发能力,即通过甲酰基-Met-Leu-Phe 激活后超氧化物阴离子的产生速率来测量 NADPH 氧化酶的激活。第 6 天从上清液中提取脂质,并测试 PMN 引发活性。
与未处理的 PC 相比,经 PR 处理的 PC 上清液中平均血小板体积 (MPV) 和 O2 更高,pH、CO2 和 HCO3-更低,LPS 诱导的 TNF-α 分泌也显著降低。两组在旋动、PLT 计数、钾水平、葡萄糖消耗、乳酸产生、IL-10、VEGF、sCD154 或 PMN 引发活性方面均无随时间变化的差异。
INTERCEPT PR 处理对 PC 几乎没有产生实质性的影响,只是 MPV 和代谢变量略有变化。需要进一步的研究来解释 LPS 诱导的 TNF-α 分泌的差异。