Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy.
Transfusion. 2014 Apr;54(4):990-5. doi: 10.1111/trf.12369. Epub 2013 Aug 5.
The safety of red blood cells (RBCs) is of concern because of the occurrence of four transfusion-transmitted variant Creutzfeldt-Jakob disease (vCJD) cases in the United Kingdom. The absence of validated screening tests requires the use of procedures to remove prions from blood to minimize the risk of transmission. These procedures must be validated using infectious prions in a form that is as close as possible to one in blood.
Units of human whole blood (WB) and RBCs were spiked with high-speed supernatants of 263K scrapie-infected hamster brain homogenates. Spiked samples were leukoreduced and then passed through prion-removing filters (Pall Corporation). In another experiment, RBCs from 263K scrapie-infected hamsters were treated as above, and residual infectivity was measured by bioassay.
The overall removal of infectivity by the filters from prion-spiked WB and RBCs was approximately two orders of magnitude. No infectivity was detected in filtered hamster RBCs endogenously infected with scrapie.
The use of prion-removing filters may help to reduce the risk of transfusion-transmitted vCJD. To avoid overestimation of prion removal efficiency in validation studies, it may be more appropriate to use supernates from ultracentrifugation of scrapie-infected hamster brain homogenate rather than the current standard brain homogenates.
由于在英国发生了四起输血传播变异型克雅氏病(vCJD)病例,人们对红细胞(RBC)的安全性表示担忧。由于缺乏经过验证的筛选检测方法,因此需要采用从血液中去除朊病毒的程序,以最大程度地降低传播风险。这些程序必须使用与血液中尽可能接近的形式的传染性朊病毒进行验证。
用人全血(WB)和 RBC 高速上清液对 263K 感染仓鼠脑匀浆的超速沉淀物进行了接种。接种后的样本经白细胞减少处理,然后通过朊病毒去除过滤器(Pall 公司)。在另一个实验中,如上所述处理了来自 263K 感染仓鼠的 RBC,并用生物测定法测量了残留的感染性。
过滤器从朊病毒接种的 WB 和 RBC 中去除感染性的总体效率约为两个数量级。在过滤的内源性感染朊病毒的仓鼠 RBC 中未检测到感染性。
使用朊病毒去除过滤器可能有助于降低输血传播 vCJD 的风险。为了避免在验证研究中高估朊病毒去除效率,使用来自超速离心感染仓鼠脑匀浆的上清液而不是当前的标准脑匀浆可能更为合适。