Plasma from stored packed red blood cells and MHC class I antibodies causes acute lung injury in a 2-event in vivo rat model
Plasma from stored packed red blood cells and MHC class I antibodies causes acute lung injury in a 2-event in vivo rat model
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DOI：
10.1182/blood-2008-09-177857
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发表时间：
2009-02-26
期刊：
影响因子：
20.3
通讯作者：
Silliman, Christopher C.
中科院分区：
文献类型：
--
作者：
Kelher, Marguerite R.;Masuno, Tomhiko;Silliman, Christopher C.
输血相关急性肺损伤（TRALI）是输血死亡的主要原因。我们假设TRALI需要两个事件：(1)患者的临床状况；(2)输注针对MHC I类抗原的抗体或储存血液中的血浆。建立a2事件大鼠模型，以生理盐水（NS）或内毒素（LPS）作为第一事件，以填充红细胞（prbc）血浆或抗MHC I类抗原的抗体（OX18和OX27）作为第二事件。通过Evans蓝染料从血浆中泄漏到支气管肺泡灌洗液（BALF）、BALF中蛋白和CINC-1浓度以及肺组织学检测ALI。ns处理的大鼠没有出现任何二次事件，LPS也没有引起ALI。lps处理的动物表现出ALI对储存的红细胞血浆的反应，包括储存前白细胞诱导的和未修饰的，以及对OX18和OX27的反应，均以浓度依赖性的方式进行。ALI依赖于中性粒细胞（PMN）， OX18/OX27在体内定位于PMN表面并激活大鼠PMN的氧化酶。我们得出结论，TRALI是两个事件的结果，第二个事件包括来自储存血液的血浆和启动PMNs的抗体。（《血液》，2009;113:2079-2087）
Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion death. We hypothesize that TRALI requires 2 events: (1) the clinical condition of the patient and (2) the infusion of antibodies against MHC class I antigens or the plasma from stored blood. A2-event rat model was developed with saline (NS) or endotoxin (LPS) as the first event and the infusion of plasma from packed red blood cells (PRBCs) or antibodies (OX18 and OX27) against MHC class I antigens as the second event. ALI was determined by Evans blue dye leak from the plasma to the bronchoalveolar lavage fluid (BALF), protein and CINC-1 concentrations in the BALF, and the lung histology. NS-treated rats did not evidence ALI with any second events, and LPS did not cause ALI. LPS-treated animals demonstrated ALI in response to plasma from stored PRBCs, both prestorage leukoreduced and unmodified, and to OX18 and OX27, all in a concentration-dependent fashion. ALI was neutrophil (PMN) dependent, and OX18/OX27 localized to the PMN surface in vivo and primed the oxidase of rat PMNs. We conclude that TRALI is the result of 2 events with the second events consisting of the plasma from stored blood and antibodies that prime PMNs. (Blood. 2009; 113: 2079-2087)