Abonnenc M, Crettaz D, Sonego G, Escolar G, Tissot J-D, Prudent M
Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Epalinges, Switzerland.
Department of Hematopathology, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Transfus Clin Biol. 2019 Nov;26(4):209-216. doi: 10.1016/j.tracli.2019.09.001. Epub 2019 Sep 18.
Pathogen reduction technologies are implemented to increase the safety of blood products. We previously showed that the UVB alone significantly contributes to the storage lesions observed in platelets treated with riboflavin/UVB using a home-made illuminator. The present study aims at confirming these observations using the commercial Mirasol® technology.
A three-arm study (untreated, UV-, Mirasol®-treated platelets) was conducted to investigate the platelet storage lesions throughout storage (n=4). A two-arm study was then designed to compare Intersol and T-PAS+ additive solutions (n=3). Phenotype and functional platelet characteristics were assessed using flow cytometry, aggregometry, antioxidant assays and metabolic parameters.
Mirasol®-treated platelets exhibit enhanced storage lesions compared to controls (increase of activation markers and glycolysis rate, lower hypotonic shock and double-agonist activation responses, and decrease of total antioxidant capacity). Here, we also confirmed that the UV radiation alone is causing platelet lesions. Riboflavin tends to have an intracellular protective role while it decreases the extracellular antioxidant defenses. Furthermore, benefits of platelet additive solutions containing potassium and magnesium were confirmed as it reduces the extent of storage lesions.
The photosensitizer, UV illumination and composition of the platelet additive solutions are key parameters influencing the platelet storage lesion. The clinical relevance of these findings is not fully understood and recent published clinical studies could not show increase in bleeding in patients receiving Mirasol-treated platelets. New developments in storage solutions might help to improve storage conditions of PRT-treated platelets and should be prioritised as research subject in the future.
实施病原体灭活技术以提高血液制品的安全性。我们之前表明，仅使用自制照明器，紫外线B（UVB）就显著促成了用核黄素/紫外线B处理的血小板中观察到的储存损伤。本研究旨在使用商业化的Mirasol®技术证实这些观察结果。
进行了一项三臂研究（未处理、紫外线处理、Mirasol®处理的血小板），以研究整个储存过程中的血小板储存损伤（n = 4）。然后设计了一项双臂研究来比较Intersol和T - PAS +添加剂溶液（n = 3）。使用流式细胞术、凝集测定法、抗氧化剂测定法和代谢参数评估血小板的表型和功能特征。
与对照组相比，经Mirasol®处理的血小板表现出更严重的储存损伤（激活标志物和糖酵解速率增加，低渗休克和双激动剂激活反应降低，以及总抗氧化能力下降）。在此，我们还证实仅紫外线辐射就会导致血小板损伤。核黄素倾向于具有细胞内保护作用，同时它会降低细胞外抗氧化防御能力。此外，含有钾和镁的血小板添加剂溶液的益处得到证实，因为它减少了储存损伤的程度。
血小板添加剂溶液的光敏剂、紫外线照射和组成是影响血小板储存损伤的关键参数。这些发现的临床相关性尚未完全了解，最近发表的临床研究未能显示接受Mirasol处理的血小板的患者出血增加。储存溶液的新进展可能有助于改善经病原体灭活技术处理的血小板的储存条件，应将其作为未来的研究重点优先考虑。
