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使用超高剂量率辐射对临床单采血液制品进行快速灭菌

Rapid Sterilization of Clinical Apheresis Blood Products using Ultra-High Dose Rate Radiation.

作者信息

Melemenidis Stavros, Nguyen Khoa D, Baraceros-Pineda Rosella, Barclay Cherie K, Bautista Joanne, Lau Hubert, Ashraf M Ramish, Manjappa Rakesh, Dutt Suparna, Soto Luis Armando, Katila Nikita, Lau Brianna, Visvanathan Vignesh, Yu Amy S, Surucu Murat, Skinner Lawrie B, Engleman Edgar G, Loo Billy W, Pham Tho D

机构信息

Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California, USA.

Stanford Blood Center, Stanford Health Care, Stanford, California, USA.

出版信息

bioRxiv. 2024 Dec 14:2024.12.14.628469. doi: 10.1101/2024.12.14.628469.

Abstract

BACKGROUND AND OBJECTIVES

Apheresis platelets products and plasma are essential for medical interventions, but both still have inherent risks associated with contamination and viral transmission. Platelet products are vulnerable to bacterial contamination due to storage conditions, while plasma requires extensive screening to minimize virus transmission risks. Here we investigate rapid irradiation to sterilizing doses for bacteria and viruses as an innovative pathogen reduction technology.

MATERIALS AND METHODS

We configured a clinical linear accelerator to deliver ultra-high dose rate (6 kGy/min) irradiation to platelet and plasma blood components. Platelet aliquots spiked with 10 CFU of were irradiated with 0.1-20 kGy, followed by growth and platelet count assays. COVID Convalescent Plasma (CCP) aliquots were irradiated at a virus-sterilizing dose of 25 kGy and subsequently, RBD-specific antibody binding was assessed.

RESULTS

1 kGy irradiation of bacteria-spiked platelets reduced growth by 2.7-log without significant change of platelet count, and 5 kGy or higher produced complete growth suppression. The estimated sterilization (6-log bacterial reduction) dose was 2.3 kGy, corresponding to 31% platelet count reduction. A 25 kGy virus sterilizing dose to CCP produced a 9.2% average drop of RBD-specific IgG binding.

CONCLUSION

This study shows proof-of-concept of a novel rapid blood sterilization technique using a clinical linear accelerator. Promising platelet counts and CCP antibody binding were maintained at bacteria and virus sterilizing doses, respectively. This represents a potential point-of-care blood product sterilization solution. If additional studies corroborate these findings, this may be a practical method for ensuring blood products safety.

摘要

背景与目的

单采血小板制品和血浆对于医疗干预至关重要,但两者仍存在与污染和病毒传播相关的固有风险。由于储存条件,血小板制品易受细菌污染,而血浆则需要广泛筛查以将病毒传播风险降至最低。在此,我们研究将快速辐照至杀菌剂量用于细菌和病毒,作为一种创新的病原体灭活技术。

材料与方法

我们配置了一台临床直线加速器,以向血小板和血浆血液成分提供超高剂量率(6 kGy/分钟)的辐照。对添加了10 CFU 的血小板等分试样进行0.1 - 20 kGy 的辐照,随后进行生长和血小板计数测定。对新冠康复者血浆(CCP)等分试样以25 kGy 的病毒灭活剂量进行辐照,随后评估RBD 特异性抗体结合情况。

结果

对添加细菌的血小板进行1 kGy 辐照可使细菌生长减少2.7 个对数级,血小板计数无显著变化,5 kGy 及以上剂量可产生完全生长抑制。估计的杀菌剂量(6 个对数级的细菌减少)为2.3 kGy,对应血小板计数减少31%。对CCP 进行25 kGy 的病毒灭活剂量导致RBD 特异性IgG 结合平均下降9.2%。

结论

本研究展示了使用临床直线加速器的新型快速血液杀菌技术的概念验证。在细菌和病毒杀菌剂量下,分别保持了有前景的血小板计数和CCP 抗体结合。这代表了一种潜在的即时护理血液制品杀菌解决方案。如果进一步的研究证实这些发现,这可能是确保血液制品安全的一种实用方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5063/11661200/c0fb21da4789/nihpp-2024.12.14.628469v1-f0001.jpg

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