Infusion of routinely stored blood may limit reperfusion injury to acutely ischemic myocardial cells

Emergency thrombolysis and restoration of blood supply to acutely ischemic myocardium kills many reversibly injured muscle cells by free radicals generation and calcium influx. Such reversibly injured cells form the major bulk during the initial 10–20 min of ischaemia and in an era where emergency r...

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Bibliographic Details
Published in:	Medical hypotheses Vol. 64; no. 3; pp. 455 - 457
Main Authors:	Bagla, Nipin, Singh, Sarvpreet, Mangal, Ritika
Format:	Journal Article
Language:	English
Published:	United States Elsevier Ltd 2005
Subjects:	Antioxidants - therapeutic use Blood Transfusion, Autologous Complement Inactivator Proteins - therapeutic use Humans Myocardial Ischemia - metabolism Myocardial Ischemia - physiopathology Myocardial Ischemia - therapy Myocardial Reperfusion Injury - drug therapy Myocardial Reperfusion Injury - therapy Myocytes, Cardiac - pathology Thrombolytic Therapy
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Summary:	Emergency thrombolysis and restoration of blood supply to acutely ischemic myocardium kills many reversibly injured muscle cells by free radicals generation and calcium influx. Such reversibly injured cells form the major bulk during the initial 10–20 min of ischaemia and in an era where emergency recanalization of arteries is possible, reperfusion injury becomes significant. Therefore, researchers have been trying to find out ways to limit the reperfusion injury by using antioxidants, complement inhibitors or by reperfusion of leucodepleted autologous blood. Red cell concentrates routinely available in blood banks are already depleted of plasma and hence calcium (chelated to the anticoagulant), leukocytes and most viable plasma proteins including complement. They have reduced oxygen content by virtue of storage; hence there might be less free radical generation. So infusion of such a blood through an intracoronary catheter might limit reperfusion injury. Addition of antioxidants or controlling the oxygen content while infusing this blood might give additional benefits. This hypothesis might be tested in animals by inducing controlled ischaemia with reperfusion of homologous cross-matched and group tested blood followed by cardiac radioactive scans. If the experimental results permit, clinical trials might be carried out eventually.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0306-9877 1532-2777
DOI:	10.1016/j.mehy.2004.09.014