Pei Siya, Wang Yanjie, Yao Run, Zhang Zhimin, Yin Wenyu, Li Ning
Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, China.
Clinical Transfusion Research Centre, Xiangya Hospital, Central South University, Changsha, China.
FASEB J. 2025 Jan 31;39(2):e70358. doi: 10.1096/fj.202401748RR.
Hemolytic anemia (HA) is characterized by massive destruction of red blood cells (RBCs) and insufficient oxygen supply, which can lead to shock, organ failure, even death. Recent studies have preliminarily demonstrated the therapeutic effectiveness of whole blood exchange (WBE) in the management of acute hemolytic anemia and exhibited potential for reducing the duration of corticosteroid treatment, while the underlying mechanism of WBE therapy was not investigated in preclinical study. Hence, we investigate the therapeutic mechanisms of WBE in HA through established continued WBE therapy in rats creatively. This study aims to examine the mechanism of WBE on phenylhydrazine hydrochloride-induced hemolytic anemia in SD rats to aid the development of therapeutics for drug-induced hemolytic anemia (DIHA). Research results demonstrated the efficacy of WBE therapy in reducing mortality and ameliorating anemia in DIHA, as evidenced by significant improvements in representative hematological parameters such as RBCs, hemoglobin, and lactate dehydrogenase levels. Additionally, WBE indicated the ability to suppress oxidative stress and inflammation, and it mitigated organ damage and biochemical function by stabilizing hepatic ferroportin levels and decreasing organ iron content. These results highlighted the effectiveness of WBE as an innovative treatment for HA, furnishing evidence to prioritize it over traditional blood transfusion for severe anemias.
溶血性贫血（HA）的特征是红细胞（RBC）大量破坏以及氧气供应不足，这可能导致休克、器官衰竭，甚至死亡。最近的研究初步证明了全血置换（WBE）在急性溶血性贫血治疗中的有效性，并显示出缩短皮质类固醇治疗疗程的潜力，而在临床前研究中尚未对WBE治疗的潜在机制进行研究。因此，我们创新性地通过在大鼠中建立持续WBE疗法来研究WBE在HA中的治疗机制。本研究旨在探讨WBE对盐酸苯肼诱导的SD大鼠溶血性贫血的作用机制，以辅助药物性溶血性贫血（DIHA）治疗方法的开发。研究结果证明了WBE疗法在降低DIHA死亡率和改善贫血方面的疗效，红细胞、血红蛋白和乳酸脱氢酶水平等代表性血液学参数的显著改善证明了这一点。此外，WBE显示出抑制氧化应激和炎症的能力，并通过稳定肝脏铁转运蛋白水平和降低器官铁含量减轻了器官损伤和生化功能。这些结果突出了WBE作为HA创新治疗方法的有效性，为在严重贫血中优先于传统输血使用WBE提供了证据。
