Hod E A, Spitalnik S L
Laboratory of Transfusion Biology, Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY 10032, USA.
Transfus Clin Biol. 2012 Jun;19(3):84-9. doi: 10.1016/j.tracli.2012.04.001. Epub 2012 Jun 7.
The potential adverse effects of transfusion of red blood cells after prolonged storage have been hotly debated. During refrigerated storage, red blood cells are damaged, a process known as the red blood cell "storage lesion." We hypothesized that the delivery of a bolus of iron derived from these rapidly cleared, damaged, red blood cells is responsible for some of the adverse effects of transfusion. Iron may play a role in producing a pro-inflammatory response to transfused red blood cells, potentially through the effects of reactive oxygen species on stress pathways and inflammasome activation. Furthermore, the excess iron may impair the host's ability to combat infection by its innate iron-withholding pathways. This symposium paper summarizes the background for the "iron hypothesis" as it relates to transfusion of red blood cells after prolonged refrigerated storage. It also includes a summary of the data from recent murine and human studies, and concludes with a discussion of several unresolved questions arising from these published studies.
长期储存后输注红细胞的潜在不良影响一直备受热议。在冷藏储存期间，红细胞会受到损伤，这一过程被称为红细胞“储存损伤”。我们推测，这些迅速清除的受损红细胞释放的大量铁会导致输血的一些不良影响。铁可能通过活性氧对应激途径和炎性小体激活的作用，在对输注红细胞产生促炎反应中发挥作用。此外，过量的铁可能会通过宿主固有的铁扣留途径损害其抗感染能力。本专题论文总结了与长期冷藏储存后红细胞输注相关的“铁假说”的背景。它还包括最近小鼠和人体研究数据的总结，并以讨论这些已发表研究中出现的几个未解决问题作为结尾。
