Red blood cell transfusion-induced inflammation: myth or reality.
Red blood cell transfusion-induced inflammation: myth or reality.
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DOI：
10.1111/voxs.12108
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Hod EA
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文献类型：
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作者：
Hod EA
输血前，用于输血的红细胞（RBC）可在冰箱中储存长达42天。我们在小鼠和狗中的研究表明，输注较旧的储存红细胞，而不是新鲜红细胞，会导致循环促炎细胞因子水平急性升高。尽管我们在健康成年人志愿者中的研究未能证明输注储存40-42天的RBC后的促炎细胞因子反应，但最近在早产儿中的一项研究表明，RBC输注与促炎反应相关。因此，红细胞输注，特别是较老的储存红细胞输注，是否会导致促炎细胞因子反应，仍然是一个悬而未决的问题。动物研究表明这是真的，但人类研究尚未明确证明这种炎症反应的发生。对此的可能解释包括人类和动物生物学之间的差异，输注的RBC剂量以及炎症水平的基线差异。本综述将总结目前可用的证据和方法，以解决是否输注较旧的储存红细胞与受者的炎症相关。
Red blood cells (RBCs) destined for transfusion can be refrigerator stored for up to 42 days prior to transfusion. Our studies in mice and dogs suggest that transfusion of older, stored RBCs, but not fresh RBCs, produce acute elevations in circulating pro-inflammatory cytokine levels. Although our study in healthy adult human volunteers failed to demonstrate a pro-inflammatory cytokine response following transfusion of RBCs stored for 40–42 days, a recent study in preterm infants suggests that RBC transfusions are associated with a pro-inflammatory response. Thus, whether RBC transfusions, particularly of older, stored RBCs, result in a pro-inflammatory cytokine response, is still an unresolved issue. Animal studies suggest this to be true, yet human studies have yet to demonstrate definitively that such an inflammatory response occurs. Potential explanations for this include differences between human and animal biology, the dose of RBCs transfused, and baseline differences in levels of inflammation. This review will summarize the currently available evidence and approaches to resolving whether transfusions of older, stored RBCs are associated with inflammation in recipients.