FILTERABILITY OF MIXTURES OF SICKLE AND NORMAL ERYTHROCYTES FOR TRANSFUSION

用于输血的镰状红细胞和正常红细胞混合物的过滤性

• 批准号: 3776209
• 负责人: S HASEGAWA
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3776209
• 关键词: blood filtration; erythrocytes; reticulocytes; sickle cell anemia

RBC transfusion has long been and currently remains an integral part of the management of sickle cell disease (SCD). The judicious use of blood can be both life-saving and life-prolonging in a variety of clinical settings. There are two broad indications for blood transfusion in SCD, maintenance of the oxygen-carrying capacity of the blood and dilution of the circulating, HbS containing cells. The latter may be accomplished both by the direct dilutional effect of transfused blood but also secondarily by suppression of the bone marrow and decreased production of cells capable of sickling. Erythrocyte exchange offers numerous potential advantages over simple transfusion for the management of certain complications of SCD, especially if there is concern of causing circulatory overload or inducing a hyperviscosity state, which may actually exacerbate the propensity to sickle by retarding capillary transit. Guidelines for exchange transfusion therapy should be derived from an understanding of the rheological behavior of sickle cells. Microvascular occlusion by poorly deformable erythrocytes is believed to be the key pathophysiologic event in SCD. We, therefore, investigated the deformability of sickle(SS) cells and their mixture with normal(AA) cells in terms of filterability through nickel mesh. We also examined the role of dense SS cells and dense SS reticulocytes in overall deformability. In this study, we found that the filtration of mixtures of SS and AA erythrocytes was affected in almost linear fashion by both the %SS erythrocytes and %dense cells, and that dense cells impaired the filtration of these mixtures about 25 times as much as that of SS erythrocytes with no dense cells did. Filtration of mixtures of SS cells with no dense cells and AA cells of more than 60% was almost the same as that of normal erythrocytes. These results suggest that exchange transfusion therapy should aim at decreasing dense cells as much as possible, as well as at keeping the level of SS cells to the total cells below 40%. Our results also indicate the possibility that dense SS reticulocytes involved in reduced deformability. Our data, using an automated reticulocyte analyzer, showed that the proportion of high fluorescence-reticulocytes was elevated in the patients with SCD, which indicated the increased regeneration of immature reticulocytes. The benefit of exchange transfusion, therefore, can be not only due to direct dilution effect, but also due to suppression of SS reticulocytes. These studies can provide the practical guideline for exchange transfusion program based on the rheological behavior of sickle cells.

红细胞输注长期以来一直是，目前仍然是一个组成部分， 镰状细胞病（SCD）的管理。 明智地使用血液 可以在各种临床上挽救生命和延长生命， 设置. 在SCD中输血有两种广泛的适应症， 维持血液的携氧能力和稀释 循环的含HbS的细胞。 后者可以实现 这不仅是由于输血的直接稀释作用， 其次是抑制骨髓和减少生产 能够镰刀形的细胞。 红细胞交换提供了许多潜在的优势， 输血用于SCD的某些并发症的管理， 特别是如果担心造成循环过载， 引起高粘滞状态，这实际上可能加剧 通过阻碍毛细血管通过而倾向于镰刀状。 准则 换血疗法应源于对以下内容的理解： 镰状细胞的流变学行为 微血管闭塞， 变形性差的红细胞被认为是 事件在SCD。 因此，我们研究了 镰状（SS）细胞及其与正常（AA）细胞的混合物， 通过镍网的过滤性。 我们还研究了密集的 SS细胞和致密SS网织红细胞的整体变形能力。 在这 研究中，我们发现SS和AA红细胞混合物的过滤 几乎以线性方式受%SS红细胞和 %的致密细胞，并且致密细胞损害这些细胞的过滤， 混合物约为SS红细胞的25倍， 是细胞干的 过滤无致密细胞的SS细胞和 AA细胞占60%以上，与正常细胞基本相同 红细胞 这些结果表明，换血疗法 应尽可能减少密集的细胞，以及 保持SS细胞占总细胞的水平低于40%。 我们的结果 也表明密集的SS网织红细胞参与 变形能力降低。 我们的数据，使用自动网织红细胞 分析仪，显示高荧光网织红细胞的比例， SCD患者中， 未成熟网织红细胞的再生。交换的好处 因此，输血不仅是由于直接稀释效应， 而且还由于SS网织红细胞的抑制。 这些研究可以 为输血计划提供实用指南， 镰状细胞的流变学行为。