OBJECTIVE: To determine if the complement system, a potent mediator of inflammation, contributes to haemolysis during red blood cell (RBC) storage. BACKGROUND: RBCs in storage undergo structural and biochemical changes that may result in adverse patient outcomes post-transfusion. Complement activation on leukodepletion and during storage may contribute to the RBC storage lesion. METHODS/MATERIALS: We performed a cross-sectional analysis of aliquots of leukoreduced RBC units, stored for 1-6 weeks, for the levels of C3a, C5a, Bb, iC3b, C4d and C5b-9 [membrane attack complex (MAC)] by enzyme-linked immunosorbent assay (ELISA). RESULTS: We observed that only MAC levels significantly increased in RBC units as a function of storage time. We also observed that the level of C5b-9 bound to RBCs increased as a function of storage time. CONCLUSION: MAC levels increased over time, suggesting that MAC is the primary complement-mediated contributor to changes in stored RBCs. Inhibition of the terminal complement pathway may stabilise RBC functionality and extend shelf life.
OBJECTIVE: To determine if the complement system, a potent mediator of inflammation, contributes to haemolysis during red blood cell (RBC) storage. BACKGROUND: RBCs in storage undergo structural and biochemical changes that may result in adverse patient outcomes post-transfusion. Complement activation on leukodepletion and during storage may contribute to the RBC storage lesion. METHODS/MATERIALS: We performed a cross-sectional analysis of aliquots of leukoreduced RBC units, stored for 1-6 weeks, for the levels of C3a, C5a, Bb, iC3b, C4d and C5b-9 [membrane attack complex (MAC)] by enzyme-linked immunosorbent assay (ELISA). RESULTS: We observed that only MAC levels significantly increased in RBC units as a function of storage time. We also observed that the level of C5b-9 bound to RBCs increased as a function of storage time. CONCLUSION: MAC levels increased over time, suggesting that MAC is the primary complement-mediated contributor to changes in stored RBCs. Inhibition of the terminal complement pathway may stabilise RBC functionality and extend shelf life.
Authors: Maciej M Markiewski; Bo Nilsson; Kristina Nilsson Ekdahl; Tom Eirik Mollnes; John D Lambris Journal: Trends Immunol Date: 2007-03-01 Impact factor: 16.687
Authors: Astrid J F Thielen; Elisabeth M Meulenbroek; Inge Baas; Robin Bruggen; Sacha S Zeerleder; Diana Wouters Journal: Transfus Med Hemother Date: 2018-03-09 Impact factor: 3.747