Hassouna Mona Mahmoud, Mostafa Mohammed Sayed, Omar Hazem Metwally, Mohammed Esraa Azab, Abdallah Heba Mohamed
National Liver Institute, Menoufia University, Shebin El Kom, Egypt.
National Liver Institute, Menoufia University, Shebin El Kom, Egypt.
Hematol Transfus Cell Ther. 2023 Oct-Dec;45(4):461-466. doi: 10.1016/j.htct.2022.08.009. Epub 2022 Oct 18.
Immune dysfunction and thrombocytopenia are common features in liver cirrhosis. Platelet transfusion is the most widely used therapeutic approach for thrombocytopenia when indicated. The transfused platelets are prone to lesions during their storage that empower their interaction with the recipient leucocyte. These interactions modulate the host immune response. The impact of platelet transfusion on the immune system in cirrhotic patients is little understood. Therefore, this study aims to investigate the impact of platelet transfusion on neutrophil function in cirrhotic patients.
This prospective cohort study was implemented on 30 cirrhotic patients receiving platelet transfusion and 30 healthy individuals as a control group. EDTA blood samples were collected from cirrhotic patients before and after an elective platelet transfusion. Flowcytometric analysis of neutrophil functions (CD11b expression and PCN formation) was performed.
There was a significant increase in expression of CD11b on neutrophils and Frequency of platelet-complexed neutrophils (PCN) in patients with cirrhosis compared with controls. Platelet transfusion increased level of CD11b and the frequency of PCN even more. There was a significant positive correlation between change in PCN Frequency pefore and after transfusion and the change in expression of CD11b among cirrhotic patients.
Elective platelet transfusion appears to increase level of PCN in cirrhotic patients, moreover, exacerbate the expression of activation marker CD11b on both neutrophils and PCN. More research and studies are needed to corroborate our preliminary findings.
免疫功能障碍和血小板减少是肝硬化的常见特征。血小板输注是血小板减少症指征明确时最广泛使用的治疗方法。输注的血小板在储存过程中容易发生病变,从而增强其与受者白细胞的相互作用。这些相互作用调节宿主免疫反应。血小板输注对肝硬化患者免疫系统的影响了解甚少。因此,本研究旨在探讨血小板输注对肝硬化患者中性粒细胞功能的影响。
本前瞻性队列研究纳入30例接受血小板输注的肝硬化患者,并以30名健康个体作为对照组。在择期血小板输注前后采集肝硬化患者的乙二胺四乙酸(EDTA)抗凝血样本。对中性粒细胞功能(CD11b表达和血小板复合中性粒细胞[PCN]形成)进行流式细胞术分析。
与对照组相比,肝硬化患者中性粒细胞上CD11b的表达以及血小板复合中性粒细胞(PCN)的频率显著增加。血小板输注使CD11b水平和PCN频率进一步升高。肝硬化患者输注前后PCN频率的变化与CD11b表达的变化之间存在显著正相关。
择期血小板输注似乎会增加肝硬化患者的PCN水平,此外,还会加剧中性粒细胞和PCN上活化标志物CD11b的表达。需要更多的研究来证实我们的初步发现。