Eckstein M, Zimmermann R, Roth T, Hauck-Dlimi B, Strasser E F, Xiang W
Department of Transfusion Medicine and Haemostaseology, University Hospital Erlangen, Erlangen, Germany.
Vox Sang. 2015 May;108(4):359-67. doi: 10.1111/vox.12235. Epub 2015 Mar 6.
Some effects of the red blood cell (RBC) storage lesion are well documented whereas others are not. Whether a period of room temperature hold (RTH) during RBC production enhances the RBC storage lesion has remained controversial. In this study, we compared whole blood (WB)-derived RBCs produced after 24-h RTH with rapidly cooled (RC) RBCs and tested them for classical metabolic markers and signs of oxidative damage.
SAGM-RBCs were prepared from mixed and split pairs (n = 12) of WB units. RBCs prepared after a 24-h period of RTH on day+1 after collection (RTH-RBCs) were compared with RC-RBCs. All RBCs were stored at 4°C for 42 days with assay of in vitro variables on days+1, +15, +22, +29 and +42. The study examined standard quality parameters, glutathione, catalase and superoxide dismutase (SOD) activities, and indicative markers of oxidative cell damage including post-translational haemoglobin modification, malondialdehyde (MDA), and phosphatidylserine expression.
RTH-RBCs exhibited decreased levels of potassium (1·98 ± 0·26 vs. 5·23 ± 0·65 mmol/l) and of 2,3-diphosphoglycerate (2,3-DPG) on day+1 compared with RC-RBCs. Haemolysis rate on day+42 was higher in RTH-RBCs than in RC-RBCs (0·52 ± 0·13 vs. 0·37 ± 0·12%). The phosphatidylserine expression amounted to 0·25 ± 0·20% in RTH-RBCs and 0·07 ± 0·12% in RC-RBCs. Haemoglobin modification was not different between both RBC groups. RTH-RBCs showed slightly higher MDA concentration on days +29 and +42.
RC-RBCs and RTH-RBCs show only small differences of classical in vitro parameters and no relevant differences in antioxidative metabolism and oxidative haemoglobin modification. These findings do not explain the loss observed in in vivo survival studies with RBCs.
红细胞(RBC)储存损伤的一些影响已有充分记录,而其他影响则不然。在红细胞生成过程中进行一段时间的室温保存(RTH)是否会加剧红细胞储存损伤仍存在争议。在本研究中,我们将经过24小时室温保存后产生的全血(WB)来源的红细胞与快速冷却(RC)的红细胞进行比较,并对它们进行经典代谢标志物和氧化损伤迹象的检测。
从WB单位的混合和分割对(n = 12)中制备SAGM-RBC。将采集后第1天经过24小时室温保存后制备的红细胞(RTH-RBC)与RC-RBC进行比较。所有红细胞均在4°C下储存42天,并在第1、15、22、29和42天检测体外变量。该研究检查了标准质量参数、谷胱甘肽、过氧化氢酶和超氧化物歧化酶(SOD)活性,以及氧化细胞损伤的指示标志物,包括翻译后血红蛋白修饰、丙二醛(MDA)和磷脂酰丝氨酸表达。
与RC-RBC相比,RTH-RBC在第1天的钾水平(1.98±0.26 vs. 5.23±0.65 mmol/l)和2,3-二磷酸甘油酸(2,3-DPG)水平降低。RTH-RBC在第42天的溶血率高于RC-RBC(0.52±0.13 vs. 0.37±0.12%)。RTH-RBC中的磷脂酰丝氨酸表达量为0.25±0.20%,RC-RBC中为0.07±0.12%。两组红细胞之间的血红蛋白修饰没有差异。RTH-RBC在第29天和第42天的MDA浓度略高。
RC-RBC和RTH-RBC在经典体外参数上仅显示出微小差异,在抗氧化代谢和氧化血红蛋白修饰方面没有相关差异。这些发现无法解释在红细胞体内存活研究中观察到的损失。