Spherocytic shift of red blood cells during storage provides a quantitative whole cell-based marker of the storage lesion
Spherocytic shift of red blood cells during storage provides a quantitative whole cell-based marker of the storage lesion
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DOI：
10.1111/trf.14015
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发表时间：
2017-04-01
期刊：
影响因子：
2.9
通讯作者：
Amireault, Pascal
中科院分区：
文献类型：
--
作者：
Roussel, Camille;Dussiot, Michael;Amireault, Pascal
背景：储存损伤可能解释了受者高达25%的输血红细胞(RBC)快速清除的原因。有几个变化会影响储存的红细胞，但缺乏一个基于全细胞的定量输血量预测指标。由于表面积缩小的红细胞被脾保留，我们量化了红细胞在储存过程中的尺寸变化。研究设计与方法：利用成像流式细胞术观察红细胞在储存时的尺寸和形态，以及传统的储存损伤的生化和机械标志。结果：整个红细胞群体的平均投影表面积从72.4 mm(2)减少到68.4 mm(2)，这是由于出现了界限清晰的红细胞亚群，平均投影表面减少了58 mm(2)，减少了15.2%-19.9%。在储存的第3天和第42天，这些“小红细胞”分别占所有红细胞的4.9%和23.6%。DIC显微镜证实，小红细胞在储存时已从盘状细胞转移到棘细胞III、球形棘细胞和球形细胞。结论：小红细胞表面积减少可能是导致小红细胞滞留于脾的原因之一。我们认为，在输注长期保存的血液后不久，MP引起的膜丢失所产生的小红细胞优先从循环中清除。使用成像流式细胞术对它们进行不依赖于操作者的定量，可能会提供储存损伤的标记，潜在地预测输血量。
BACKGROUND: Storage lesion may explain the rapid clearance of up to 25% of transfused red blood cells (RBCs) in recipients. Several alterations affect stored RBC but a quantitative, whole cell-based predictor of transfusion yield is lacking. Because RBCs with reduced surface area are retained by the spleen, we quantified changes in RBC dimensions during storage.STUDY DESIGN AND METHODS: Using imaging flow cytometry we observed the dimension and morphology of RBCs upon storage, along with that of conventional biochemical and mechanical markers of storage lesion. We then validated these findings using differential interference contrast (DIC) microscopy and quantified the accumulation of microparticles (MPs).RESULTS: Mean projected surface area of the whole RBC population decreased from 72.4 to 68.4 mm(2), a change resulting from the appearance of a well-demarcated subpopulation of RBCs with reduced mean projected surface (58 mm(2), 15.2%-19.9% reduction). These "small RBCs" accounted for 4.9 and 23.6% of all RBCs on Days 3 and 42 of storage, respectively. DIC microscopy confirmed that small RBCs had shifted upon storage from discocytes to echinocytes III, spheroechinocytes, and spherocytes. Glycophorin A positive MPs and small RBCs appeared after similar kinetics.CONCLUSION: The reduction in surface area of small RBCs is expected to induce their retention by the spleen. We propose that small RBCs generated by MP-induced membrane loss are preferentially cleared from the circulation shortly after transfusion of long-stored blood. Their operator-independent quantification using imaging flow cytometry may provide a marker of storage lesion potentially predictive of transfusion yield.