Nair Alison B, Miyazawa Byron, Trivedi Alpa, Vivona Lindsay, Fields Alexander, Herrera Kimberly, Kornblith Lucy Z, Cuschieri Joseph, Pati Shibani
Department of Pediatrics, University of California, San Francisco, CA.
Department of Laboratory Medicine, University of California, San Francisco, CA.
Blood Vessel Thromb Hemost. 2025 Feb 6;2(3):100058. doi: 10.1016/j.bvth.2025.100058. eCollection 2025 Aug.
Platelet transfusion not only attenuates bleeding and promotes hemostasis but also plays a critical role in vascular stability and endothelial barrier integrity. Under amotosalen-UVA pathogen reduction of platelets, pathogen nucleic acids undergo adduction, which prevents their replication and greatly reduces the risk of transfusion-transmitted infections. Although pathogen-reduced (PR) platelets are increasing in clinical use, the physiologic effects of pathogen reduction on platelets, particularly its impact on platelet-endothelial interactions, have yet to be described. This study compared PR platelets with nonpathogen-reduced (NPR) platelets in measures of effect on endothelial permeability in vitro. We hypothesized that PR platelets would be similar to NPR platelets. However, in endothelial cell immunohistochemistry and impedance assays, PR platelets demonstrated a significantly diminished capacity to attenuate endothelial barrier permeability at early storage time points. This small but significant difference requires further mechanistic and clinical study to understand its implications, particularly in patients with bleeding with vascular fragility.
血小板输注不仅能减轻出血并促进止血，还在血管稳定性和内皮屏障完整性方面发挥关键作用。在血小板的氨甲环酸-紫外线A病原体灭活处理下，病原体核酸会发生加合作用，从而阻止其复制并大大降低输血传播感染的风险。尽管经过病原体灭活（PR）的血小板在临床应用中越来越多，但病原体灭活对血小板的生理影响，尤其是其对血小板-内皮相互作用的影响，尚未得到描述。本研究在体外对PR血小板和未经过病原体灭活（NPR）的血小板在内皮通透性影响方面进行了比较。我们假设PR血小板与NPR血小板相似。然而，在内皮细胞免疫组织化学和阻抗测定中，PR血小板在早期储存时间点显示出显著降低的减轻内皮屏障通透性的能力。这一微小但显著的差异需要进一步的机制和临床研究来了解其影响，特别是在有血管脆性出血的患者中。
