Developing pathogen reduction technologies for RBC suspensions

Abstract

Numerous studies have evaluated a wide variety of photosensitizers and alkylating agents as candidates for a pathogen reduction process to be used in RBC suspensions. The methodologies that produce robust inactivation of pathogens with maintenance of RBC properties during storage involve those that specifically target nucleic acids. This has been demonstrated through in vitro studies by flexible photosensitizers, which specifically target nucleic acid but do not engage in photochemistry when free in solution and nucleic acid alkylating agents in conjunction with extracellular quencher(s) to protect against RBC membrane alkylation. The flexible photosensitizer method must be scaled up to entire units, and toxicology studies would need to be performed for further development. Clinical trials will ultimately be necessary to further develop either flexible photosensitizers or nucleic acid alkylating methods with quenchers for use in Transfusion Medicine.

Whole blood treated with riboflavin and ultraviolet light: quality assessment of all blood components produced by the buffy coat method

“…Although PIs are currently licensed only for PLT and plasma products, methods for the treatment of red blood cells (RBCs) are not far from routine use . Currently, blood components are individually PI treated; however, it is desirable to carry out PI in one step before production of all three blood products.…”

The long and winding road to pathogen reduction of platelets, red blood cells and whole blood

“…Good in vitro results were later obtained with the alkylating agent PEN110 (Inactine), a chemical whose action does not depend on UV illumination. Positive in vivo autotransfusion studies with PEN110-RBC in healthy subjects led to clinical trials in sickle cell disease and cardiac surgery patients, but the studies were halted and further developments discontinued due to the detection of antibodies to PEN100 in some recipients (Benjamin, 2006;Wagner, 2011). More recent investigations led to the development of a novel, first generation, Intercept RBC-PRT by Cerus.…”

Humanes Cytomegalievirus (HCMV)

“…Neue Studienergebnisse belegen, dass frisch serokonvertierte Spender die höchsten Viruskonzentrationen im Verlauf einer HCMV-Infektion haben. Diese Spender waren klinisch asymptomatisch und wurden ohne HCMV-Diagnostik nicht erkannt [9, [152][153][154][155][156][157][158].…”