Effects of red cell storage and lysis on in vitro cytokine release

Mynster, Tommie

doi:10.1016/s1473-0502(01)00081-7

Cited by 17 publications

(17 citation statements)

References 38 publications

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“…It is possible that transfusion of a higher number of units could have induced a detectable secretion of cytokines. However, it has previously been shown in in vitro studies that only one erythrocyte unit could cause a reduction in stimulated TNF-α release with a concomitantly increased IL-10 secretion from whole blood-derived recipient cells [14]. The reason for not finding this effect in the present study may have been an insufficient stimulation of immune cells.…”

Section: Discussioncontrasting

confidence: 70%

No Early Effect of Storage Time of Transfused Red Blood Cells on Fatigue and Plasma Cytokines in Patients with Anaemia from Non-Acute Gastrointestinal Bleeding

Mynster¹,

Dziegiel²,

Kofoed³

2007

Transfus Med Hemother

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Background: Fatigue in anaemia is empirically reduced by blood transfusion. Long storage time of red cells may be associated with immunomodulatory effects, and blood stored for a long time may cause tissue hypoxia upon transfusion. Patients and Methods: 22 patients admitted with haemoglobin < 6.0 mmol/l, complaints of fatigue and no active bleeding were included. Eleven patients received two red cells units (SAGM) stored less than 1 week (short storage time, S), and 11 patients received two units stored more than 3 weeks (long storage time, L). Fatigue was self-estimated on a visual analogue scale. Clinical observations and blood samples were obtained before transfusion was started, and were repeated 2-8 h after transfusion of the 2nd unit. Measured plasma parameters included IL- 1ß, IL-6, IL-8, IL-10, IL-12 and TNF-a. Results: There were no significant differences between group S and L (nsSL) in demographic data, observational data and blood plasma values. Haemoglobin increased from mean (± SD) 5.2 ± 0.6 to 6.4 ± 0.7 mmol/l after transfusion (nsSL). Fatigue score significantly decreased from a pre-transfusion median 6.6 (range 0.1-9.9) to post-transfusion 4.7 (0.6-10.0) (p = 0.02) for all patients (nsSL). Beside increase in haemoglobin the only significant change in blood parameters after transfusion was a decrease in thrombocyte count (nsSL). No significant differences were seen in concentrations of cytokines before and after transfusion. Conclusion: Transfusion of two units of red cells relieved self-estimated fatigue, independent of blood storage time. Thrombocyte count decreased after transfusion, probably due to dilution by transfused blood. Aged red cells may not, or only sparsely, directly trigger the interleukin cascade.

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Section: Discussioncontrasting

confidence: 70%

No Early Effect of Storage Time of Transfused Red Blood Cells on Fatigue and Plasma Cytokines in Patients with Anaemia from Non-Acute Gastrointestinal Bleeding

Mynster¹,

Dziegiel²,

Kofoed³

2007

Transfus Med Hemother

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“…Moreover, in a mice study, allogeneic blood transfusion led to a 5-fold increase in IL-10 production, which did not return to control levels before day 30 after transfusion [39]. Finally, Mynster presented in vitro evidence of reduced responsiveness of innate immune cells along with an increase in IL-10 production after incubation of freshly donated blood with allogeneic stored red blood cells [40]. …”

Section: Discussionmentioning

confidence: 99%

The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

Theodoraki

Markatou

Rizos

et al. 2014

Journal of Immunology Research

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Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively). In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82 ± 29.07 vs. 15.83 ± 13.22 pg mL−1, P < 0.05). Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r 2 = 0.38, P = 0.032, r 2 = 0.52, P = 0.007, and r 2 = 0.68, P<0.001, respectively). IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525.

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“…While the underlying mechanisms are still under investigation, it is interesting to note that, in both instances (naïve gut and post-antibiotic gut such as in CDI), there is dramatic flux in the intestinal microbiota, which may have implications for the gut’s normal role in modulating immune cell differentiation [23]. With respect to immunomodulatory effects, RBCs have been shown to suppress monocyte function which is exacerbated by the length of storage and modified by the type of preservative solution [24], [25]. Packed red blood cells also depress peripheral T-cell proliferation in a dose-response manner [26].…”

Section: Discussionmentioning

confidence: 99%

Storage Duration of Red Blood Cell Transfusion and Clostridium difficile Infection: A Within Person Comparison

et al. 2014

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ObjectiveRandomized controlled trials demonstrated that red blood cell (RBC) transfusion elevates the risk of infection, and trials are underway to evaluate whether RBC storage affects outcomes. We previously reported that transfusion predicts Clostridium difficile infection (CDI) and, therefore, planned an investigation to examine this further using a more robust design.DesignWithin-person case-crossover study. Hospitalizations in which CDI developed (n = 406) were compared to hospitalizations for the same individuals in which CDI did not occur (n = 949). Transfusion volume and storage duration were assessed prior to the onset of CDI.SettingUniversity of Michigan Health System.PatientsParticipants were individuals with a diagnosis of CDI from July 2009 through June 2012.Measurements and Main ResultsDuring the hospitalizations when CDI occurred, 34.7% of the patients received allogeneic RBC transfusions (mean volume, 688 ml) compared to 19.0% of patients in hospitalizations without CDI (mean volume, 180 ml). The odds of healthcare-associated CDI increased by 76% (95% CI 1.39–2.23) for every liter of RBCs transfused and was elevated in both nonsurgical (OR = 1.90) and surgical (OR = 1.86) hospitalizations. In patients who received RBC transfusions, the odds of developing CDI increased by 6% for every additional day of RBC stored and by 53% for every week of additional storage (P = 0.002).ConclusionsHospitalizations in which a patient received a greater volume of RBC transfusions were more likely to be associated with the development of CDI. RBC units stored for a longer duration were associated with the development of healthcare-associated CDI after adjustment for RBC volume.

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Effects of red cell storage and lysis on in vitro cytokine release

Cited by 17 publications

References 38 publications

No Early Effect of Storage Time of Transfused Red Blood Cells on Fatigue and Plasma Cytokines in Patients with Anaemia from Non-Acute Gastrointestinal Bleeding

No Early Effect of Storage Time of Transfused Red Blood Cells on Fatigue and Plasma Cytokines in Patients with Anaemia from Non-Acute Gastrointestinal Bleeding

The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

Storage Duration of Red Blood Cell Transfusion and Clostridium difficile Infection: A Within Person Comparison

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