Institute of Biochemistry and Clinical Biochemistry, Catholic University of Rome, Rome, Italy.
Blood Transfus. 2013 Jan;11(1):61-70. doi: 10.2450/2012.0145-11. Epub 2012 Apr 13.
It is essential that the quality of platelet metabolism and function remains high during storage in order to ensure the clinical effectiveness of a platelet transfusion. New storage conditions and additives are constantly evaluated in order to achieve this. Using glucose as a substrate is controversial because of its potential connection with increased lactate production and decreased pH, both parameters triggering the platelet lesion during storage.
In this study, we analysed the morphological status and metabolic profile of platelets stored for various periods in autologous plasma enriched with increasing glucose concentrations (13.75, 27.5 and 55 mM). After 0, 2, 4, 6 and 8 days, high energy phosphates (ATP, GTP, ADP, AMP), oxypurines (hypoxanthine, xanthine, uric acid), lactate, pH, mitochondrial function, cell lysis and morphology, were evaluated.
The data showed a significant dose-dependent improvement of the different parameters in platelets stored with increasing glucose, compared to what detected in controls. Interestingly, this phenomenon was more marked at the highest level of glucose tested and in the period of time generally used for platelet transfusion (0-6 days).
These results indicate that the addition of glucose during platelet storage ameliorates, in a dose-dependent manner, the biochemical parameters related to energy metabolism and mitochondrial function. Since there was no correspondence between glucose addition, lactate increase and pH decrease in our experiments, it is conceivable that platelet derangement during storage is not directly caused by glucose through an increase of anaerobic glycolysis, but rather to a loss of mitochondrial functions caused by reduced substrate availability.
为确保血小板输注的临床效果，在储存过程中保持血小板代谢和功能的高质量至关重要。因此，人们不断评估新的储存条件和添加剂。由于葡萄糖可能与乳酸生成增加和 pH 值降低有关，而这两个参数都会在储存过程中触发血小板损伤，所以使用葡萄糖作为底物存在争议。
在这项研究中，我们分析了在含有不同浓度葡萄糖（13.75、27.5 和 55mM）的自体血浆中储存不同时间的血小板的形态状态和代谢谱。在 0、2、4、6 和 8 天后，评估了高能磷酸化合物（ATP、GTP、ADP、AMP）、氧化嘌呤（次黄嘌呤、黄嘌呤、尿酸）、乳酸、pH 值、线粒体功能、细胞溶解和形态。
数据显示，与对照组相比，在储存过程中添加葡萄糖可显著改善不同参数的剂量依赖性，与对照组相比，储存过程中添加葡萄糖可显著改善不同参数的剂量依赖性。有趣的是，这种现象在测试的最高葡萄糖水平和血小板输注的一般时间段（0-6 天）更为明显。
这些结果表明，在血小板储存过程中添加葡萄糖可以改善与能量代谢和线粒体功能相关的生化参数，呈剂量依赖性。由于在我们的实验中，葡萄糖的添加、乳酸的增加和 pH 值的降低之间没有对应关系，因此可以想象，储存过程中血小板的紊乱不是由葡萄糖通过增加无氧糖酵解直接引起的，而是由于底物可用性降低导致线粒体功能丧失所致。
