Red blood cell storage and transfusion-related immunomodulation.

摘要: Red blood cell (RBC) transfusion is a life-saving treatment for patients suffering severe loss or anaemia due to trauma injury, surgery, haemorrhage, haematological disease malignancy. RBCs are stored refrigerated in preservative solution, which extends their shelf-life. Most of the solutions common use, such as saline-adenine-glucose-mannitol (SAG-M), enable storage up 42 days following collection. This expiry based on criteria set by United States America Food and Drug Administration, requires that 75 percent transfused must be recoverable peripheral circulation 24 h after transfusion1. During RBC units, undergo numerous physicochemical changes, collectively referred lesion, affects quality, function vivo survival RBCs2–4. The implications recipient these storage-related changes currently matter considerable interest debate clinical community. In addition primary transport oxygen from lungs tissues, important regulatory components haemorheology, dynamics flow5,6. In doing so, interact with other elements, including white cells (WBCs), platelets vascular cells. Many physical occur appear similar those diseased (such malaria, sickle disease, thalassemia), disturbances key morbidities7,8. These include altered membrane surface receptors cytoskeletal structures, control shape, flexibility (deformability) aggregability. Knowledge gained study may provide insight into understanding effect normal healthy how could influence interaction recipient’s own tissues. Transfusion-related immunomodulation (TRIM) has emerged concept potentially explain observations suggest associated increased proinflammatory immunosuppressive effects increase morbidity at least some patient groups9,10. predominant mechanism TRIM likely depend an interplay genetic predisposition intercurrent illnesses patient. Platelets endothelial also contribute “response” both types highly responsive inflammatory signals when activated, release significant quantities potent bioactive mediators. Thus, situations heightened inflammation breach integrity, immune thrombotic systems intricately linked complex network signalling response. article aims perspective potential relationship between lesion its broader sense along brief overview research findings support this perspective. role proteomics advancing our well biological mechanisms discussed.