Interleukin‐6 and C‐reactive protein load in pre‐storage and post‐storage white blood cell‐filtered red blood cell transfusions in premature infants

B, Say; Sarı, Fatma Nur; Oguz, SS; Değirmencioğlu, Halil; Arayıcı, Sema; Şimşek, Gülsüm Kadıoğlu; Ibrişim, Ece Gül; Dilmen, U

doi:10.1111/tme.12207

Cited by 4 publications

(4 citation statements)

References 14 publications

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Section: Discussionmentioning

confidence: 99%

“…For example, researches have demonstrated that changes in mesenteric blood flow velocity, reoxygenation, and reperfusion after transfusion could incite intestinal oxidative stress injury 20 – 22 . Furthermore, multiple immune factors such as IL-1β, IL-6, IFN-γ, and ICAM-1 have been shown to increase in circulation following RBC transfusion 23 , 24 . Studies have described a murine model of NEC instigated by transfusions after anemia, illustrating typical NEC-like gut injuries in the anemia-transfusion group within 48 h post transfusion due to Toll-like receptor-4-mediated injury and intestinal epithelial barrier dysfunction 25 , 26 .…”

Section: Discussionmentioning

confidence: 99%

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RBC transfusion and necrotizing enterocolitis in very preterm infants: a multicenter observational study

Dang,

Gu,

Jiang

et al. 2024

Sci Rep

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The causal relationship between Packed red blood cell (RBC) transfusion and necrotizing enterocolitis (NEC) remains uncertain. This study aims to provide an exploration of transfusion and NEC in very preterm infants. Using data from the Chinese Neonatal Network cohort study between 2019 and 2021, the analysis focused on very preterm infants (with a birth weight of < 1500 g or a gestational age of < 32 weeks) who developed NEC after receiving transfusions. The time interval between the prior transfusion and NEC was analyzed. An uneven distribution of the time interval implies an association of transfusion and NEC. Additionally, multivariable logistic analysis was conducted to detect the prognosis of defined transfusion-associated NEC(TANEC). Of the 16,494 infants received RBC transfusions, NEC was noted in 1281 (7.7%) cases, including 409 occurred after transfusion. Notably, 36.4% (149/409) of post-transfusion NEC occurred within 2 days after transfusion. The time interval distribution showed a non-normal pattern (Shapiro–Wilk test, W = 0.513, P < 0.001), indicating a possible link between transfusion and NEC. TANEC was defined as NEC occurred within 2 days after transfusion. Infants with TANEC had a higher incidence of death (adjusted OR 1.69; 95% CI 1.08 to 2.64), severe bronchopulmonary dysplasia (adjusted OR 2.03; 95% CI 1.41 to 2.91) and late-onset sepsis (adjusted OR 2.06; 95% CI 1.37 to 3.09) compared with infants without NEC after transfusion. Unevenly high number of NEC cases after RBC transfusions implies transfusion is associated with NEC. TANEC is associated with a poor prognosis. Further research is warranted to enhance our understanding of TANEC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

RBC transfusion and necrotizing enterocolitis in very preterm infants: a multicenter observational study

Dang,

Gu,

Jiang

et al. 2024

Sci Rep

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“…A total of 796 records were excluded from screening titles and abstracts because of the pertinence of the study for review. The remaining 26 reports were read in full to con rm their relevance for the review, and 17 were excluded for failing to meet the inclusion criteria 24,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] ; thus, nine studies [19][20][21]25,[43][44][45][46][47] were included in this review.…”

Section: Study Inclusion Criteriamentioning

confidence: 99%

Effect of post-storage filters vs. pre-storage filters for leukoreduction of blood components on clinical outcomes: A systematic review

Silva,

Nukui,

Takahashi

et al. 2024

Preprint

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Background: Leukoreduction has been used to limit the risk of adverse events. The most commonly used methodology is filtration (pre or post-storage). However, whether pre-storage filtration is better than post-storage filtration needs to be clearly defined, particularly for countries that still use post-storage filtration. This study aimed to synthesize the best available evidence on the effectiveness of pre-storage filters compared with post-storage filters for transfusion reactions, for the occurrence of infections, for the length of hospital stay, and for the death of patients undergoing leukoreduced transfusion. Methods: Eight databases and gray literature were searched, and GRADE was used to determine the certainty of the evidence. Results: The meta-analysis showed that pre-storage filtration was a protective factor against febrile non-hemolytic transfusion reactions in red blood cells and platelet concentrate transfusions. The same did not occur for post-surgical infection after platelet concentrate transfusions. Only one study analyzed the length of hospital stay and showed no significant difference between patients who received leukoreduced transfusions according to the type of filter used. According to the GRADE criteria, the certainty of the evidence for febrile non-hemolytic transfusion reactions was low for red blood cells and very low for platelet concentrate due to the high risk of bias. For infection was low risk due to imprecision. Conclusions: The results of this review showed that the certainty of recommending the best type of filter (pre or post-storage) for the benefit of the outcomes analyzed is still fragile; therefore, more robust evidence is needed. Systematic review registration number: PROSPERO CRD42020192202

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“…Until now, studies on TANEC have focused mainly on the following aspects: (1) mesenteric blood flow velocity altered after transfusion, and more fluctuant oxygenation was observed in patients with NEC 6 ; (2) re‐oxygenation and reperfusion accompanied by transfusion after anemia, which may cause oxidative stress injury in the intestine 7 ; (3) multiple immune factors (such as IL‐1β, IL‐6, IFN‐γ, and ICAM‐1) increased in circulation after RBC transfusion 8,9 ; and (4) recently, a study revealed that macrophages infiltrated the intestinal mucosa and subsequent RBC transfusion activated these macrophages via a TLR4‐mediated inflammatory response to cause bowel injury 10 . However, these studies cannot be applied to strategies for TANEC prevention or treatment clinically.…”

Section: Introductionmentioning

confidence: 99%

Heme induces intestinal epithelial cell ferroptosis via mitochondrial dysfunction in transfusion‐associated necrotizing enterocolitis

et al. 2022

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Transfusion-associated necrotising enterocolitis (TANEC) is a life-threatening disease with a poor prognosis in preterm infants. This study explored whether and how heme induces ferroptosis in TANEC gut injury. A TANEC mouse model and a cell culture system for heme and Caco-2 cells were established. Ferroptosis was assessed by measuring iron and malondialdehyde (MDA) levels and mitochondrial morphology in intestinal tissues and Caco-2 cells. Mitochondrial dysfunction was evaluated by measuring mitochondrial reactive oxygen species (ROS) production and membrane potential using JC-1. The intestinal injury grade was higher in the anemia-transfusion group than in the control group (p < .0001). Higher intestinal iron concentration (p < .0001), elevated levels of lipid peroxidation MDA (p = .0021), and ferroptotic mitochondrial morphological changes were found in mice of the anemia-transfusion group; specific ferroptosis inhibitor could alleviate anemia-transfusion gut injury, suggesting that ferroptosis play a role in the TANEC gut injury. Next, we explored whether heme released by hemolysis of erythrocytes induces ferroptosis in intestinal epithelial cells in vitro. The viability of Caco-2 cells significantly decreased after heme treatment (p < .0001). Iron accumulation, MDA elevated levels, and mitochondrial dysfunction also existed in the co-culture system, which ferroptosis inhibitors could reduce. In summary, ferroptosis was discovered in TANEC, and heme could induce ferroptosis in intestinal epithelial cells via mitochondrial dysfunction. Heme-inducing ferroptosis may be a possible mechanism and therapeutic target for TANEC.

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Interleukin‐6 and C‐reactive protein load in pre‐storage and post‐storage white blood cell‐filtered red blood cell transfusions in premature infants

Cited by 4 publications

References 14 publications

RBC transfusion and necrotizing enterocolitis in very preterm infants: a multicenter observational study

RBC transfusion and necrotizing enterocolitis in very preterm infants: a multicenter observational study

Effect of post-storage filters vs. pre-storage filters for leukoreduction of blood components on clinical outcomes: A systematic review

Heme induces intestinal epithelial cell ferroptosis via mitochondrial dysfunction in transfusion‐associated necrotizing enterocolitis

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