Toxic masculinity in red blood cell units? Testosterone therapy in blood donors revisited.
Toxic masculinity in red blood cell units? Testosterone therapy in blood donors revisited.
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DOI：
10.1111/trf.16658
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发表时间：
2021-11
期刊：
影响因子：
2.9
通讯作者：
Kanias T
中科院分区：
文献类型：
--
作者：
Hazegh K;Anawalt BD;Dumont LJ;Kanias T
FDA的指导方针限制接受睾酮替代疗法(TRT)的献血者的血液只能用于浓缩红细胞(RBC)，而血浆和血小板则被丢弃。这项研究的目的是让人们意识到来自TRT捐赠者的红细胞单位中游离睾酮浓度高于平均水平。我们定量测定了17名TRT男性供者和17名匹配对照组(无TRT)42天保存的去白细胞RBC单位血浆(冷冻24小时内)和上清液中游离(生物可利用度；pg/ml)和总(蛋白结合和游离；ng/dl)睾酮的浓度。采用LC-MS/MS法测定血清总睾酮浓度。用平衡透析/LC-MS/MS法对同一样本中的游离睾酮浓度进行定量，TRT供者的血浆游离和总睾酮浓度分别是对照组的2.9倍和1.8倍。红细胞上清液中的总睾酮浓度约为血浆的30%。RBC上清液中游离睾酮浓度为血浆的80%-100%，与对照组(252.3±245.3)pg/ml和(103.4±88.2pg/ml)相比，差异有统计学意义(p=0.005)。观察了5名TRT供者和2名对照供者红细胞培养上清液中游离睾酮浓度(>；244pg/ml)。来自TRT捐献者的红细胞单位可能含有超生理浓度的游离睾酮。这可以通过避免在服用睾丸素后不久采血和加强对TRT捐赠者的筛查来解决。这些数据为新的研究和重新检查关于TRT献血者血液成分利用的现行指南奠定了基础。
FDA guidelines limit the use of blood from donors taking testosterone replacement therapy (TRT) to red blood cell (RBC) concentrates, whereas plasma and platelets are discarded. The purpose of this study is to bring awareness to above-average free testosterone concentrations in RBC units from TRT donors. We quantified the concentrations of free (bioavailable; pg/ml) and total (protein bound and free; ng/dl) testosterone in plasma (frozen within 24 h) and supernatants from 42-day stored leukocyte-reduced RBC units from 17 TRT male donors and 17 matched controls (no TRT). Total testosterone concentrations were determined by liquid chromatography with tandem mass spectrometry (LC–MS/MS). Free testosterone concentrations were quantified in the same samples using equilibrium dialysis/LC–MS/MS. Plasma free and total testosterone concentrations in TRT donors were 2.9 and 1.8 times higher than that of controls. Total testosterone concentrations in RBC supernatants were about 30% of that of plasma. In contrast, free testosterone concentrations in RBC supernatants were 80%–100% of that of plasma and were significantly (p = .005) higher in TRT compared with controls (252.3 ± 245.3 vs. 103.4 ± 88.2 pg/ml). Supraphysiological free testosterone concentrations (>244 pg/ml) in RBC supernatants were observed in five TRT donors and two control donors. RBC units from TRT donors may contain supraphysiological concentrations of free testosterone. This may be resolved by avoiding blood collections soon after testosterone dosing and by enhanced screening of TRT donors. These data establish a rationale for new studies and reexamination of the current guidelines concerning the utilization of blood components from TRT donors.
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影响因子：
2.8
作者：
Yabluchanskiy A;Tsitouras PD
通讯作者：
Tsitouras PD
影响因子：
16.1
作者：
Villa CH;Anselmo AC;Mitragotri S;Muzykantov V
通讯作者：
Muzykantov V
影响因子：
8
作者：
Nemkov, Travis;Stefanoni, Davide;D'Alessandro, Angelo
通讯作者：
D'Alessandro, Angelo
影响因子：
2.9
作者：
Kanias, Tamir;Sinchar, Derek;Gladwin, Mark T.
通讯作者：
Gladwin, Mark T.
影响因子：
2.2
作者：
Jordan, Andrew;Acker, Jason P.
通讯作者：
Acker, Jason P.