a Department of Clinical Chemistry , Region Östergötland , Linköping , Sweden.
b Department of Clinical and Experimental Medicine , University of Linköping , Linköping , Sweden.
Platelets. 2018 Mar;29(2):140-147. doi: 10.1080/09537104.2017.1293806. Epub 2017 Mar 29.
A wide variety of clinical conditions, associated with low circulating platelet counts, require platelet transfusion in order to normalize hemostatic function. Although single-donor apheresis platelets bear the lowest risk of transfusion-transmitted infections, pathogen reduction technologies (PRT) are being implemented worldwide to reduce this risk further through inactivation of known, emergent and as yet to be discovered nucleic acid-based pathogens. Human blood platelets are now known to harbor a diverse transcriptome, important to their function and comprised of >5000 protein-coding messenger RNAs and different classes of non-coding RNAs, including microRNAs. Our appreciation of the nucleic acid-dependent functions of platelets is likely to increase. On the other hand, the side effects of PRT on platelet function are underappreciated. Recent evidences suggest that PRT may compromise platelets' responsiveness to agonists, and induce platelet activation. For instance, platelets have the propensity to release proinflammatory microparticles (MPs) upon activation, and the possibility that PRT may enhance the production of platelet MPs in platelet concentrates (PCs) appears likely. With this in mind, it would be timely and appropriate to investigate other means to inactivate pathogens more specifically, or to modify the currently available PRT so to better preserve the platelet function and improve the safety of PCs; platelets' perspective to PRT deserves to be considered.
多种临床病症会导致循环血小板计数降低，需要通过输注血小板来使止血功能正常化。虽然单采血小板的输血传播感染风险最低，但世界各地都在实施病原体减少技术（PRT），通过灭活已知的、新出现的和尚未发现的基于核酸的病原体来进一步降低这种风险。现在已知人类血小板携带有多样化的转录组，这对其功能很重要，包含 >5000 种蛋白编码信使 RNA 和不同类别的非编码 RNA，包括 microRNAs。我们对血小板中核酸依赖性功能的认识可能会增加。另一方面，PRT 对血小板功能的副作用还没有得到充分的认识。最近的证据表明，PRT 可能会损害血小板对激动剂的反应性，并诱导血小板激活。例如，血小板在激活时容易释放促炎的微小颗粒（MPs），因此 PRT 似乎可能增加血小板浓缩物（PC）中血小板 MPs 的产生。考虑到这一点，及时探索其他更具体地灭活病原体的方法，或者修改目前可用的 PRT，以更好地保持血小板功能并提高 PC 的安全性是合适的；从血小板的角度考虑 PRT 是值得的。
