Jimenez-Marco Teresa, Cancino-Faure Beatriz, Girona-Llobera Enrique, Alcover M Magdalena, Riera Cristina, Fisa Roser
Fundació Banc de Sang i Teixits de las Illes Balears, Majorca.
IUNICS Institut Universitari d' Investigació en Ciències de la Salut, Universitat de les Illes Balears, Majorca.
Transfusion. 2017 Jun;57(6):1440-1447. doi: 10.1111/trf.14071. Epub 2017 Apr 16.
The parasitic Chagas disease is caused by the protozoan Trypanosoma cruzi, which is mainly transmitted by insect vectors. Other infection routes, both in endemic and in nonendemic areas, include organ and marrow transplantation, congenital transmission, and blood transfusion. Asymptomatic chronic chagasic individuals may have a low and transient parasitemia in peripheral blood and, consequently, they can unknowingly transmit the disease via blood transfusion. Riboflavin and ultraviolet (UV) light pathogen reduction is a method to reduce pathogen transfusion transmission risk based on damage to the pathogen nucleic acids.
In this study, we tested the effectiveness of this technology for the elimination of T. cruzi parasites in artificially contaminated whole blood units (WBUs) and thus for decreasing the risk of T. cruzi transfusion transmission. The contaminated WBUs were leukoreduced by filtration and treated with riboflavin and UV light. The level of pathogen reduction was quantified by a real-time polymerase chain reaction (qPCR) and a real-time reverse transcription-polymerase chain reaction (RT-qPCR) as a viability assay.
The RNA (cDNA) quantification of the parasites showed a more than 99% reduction of viable T. cruzi parasites after leukoreduction and a complete reduction (100%) after the riboflavin and UV light treatment.
Riboflavin and UV light treatment and leukoreduction used in conjunction appears to eliminate significant amounts of viable T. cruzi in whole blood. Both strategies could complement other blood bank measures already implemented to prevent the transmission of T. cruzi via blood transfusion.
寄生虫性恰加斯病由原生动物克氏锥虫引起，主要通过昆虫媒介传播。在流行区和非流行区，其他感染途径包括器官和骨髓移植、先天性传播以及输血。无症状慢性恰加斯病个体外周血中可能存在低水平且短暂的寄生虫血症，因此可能在不知情的情况下通过输血传播疾病。核黄素和紫外线病原体灭活是一种基于损伤病原体核酸来降低病原体输血传播风险的方法。
在本研究中，我们测试了该技术在消除人工污染全血单位（WBUs）中克氏锥虫寄生虫从而降低克氏锥虫输血传播风险方面的有效性。通过过滤对污染的全血单位进行白细胞去除，并使用核黄素和紫外线进行处理。通过实时聚合酶链反应（qPCR）和实时逆转录聚合酶链反应（RT-qPCR）作为生存力检测来量化病原体灭活水平。
寄生虫的RNA（cDNA）定量显示，白细胞去除后存活的克氏锥虫寄生虫减少了99%以上，核黄素和紫外线处理后完全减少（100%）。
联合使用核黄素和紫外线处理以及白细胞去除似乎可以消除全血中大量存活的克氏锥虫。这两种策略都可以补充血库已实施的其他措施，以预防克氏锥虫通过输血传播。
