Impact of alloantigens and storage-associated factors on stimulated cytokine response in an in vitro model of blood Transfusion

Transfusion of blood may contribute to immunosuppression in major surgery. The authors assessed the impact of alloantigens and storage on function of peripheral blood mononuclear cells cultured in their physiologic environment. Blood units (whole blood, packed erythrocytes) were prepared with or wit...

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Bibliographic Details
Published in:	Anesthesiology (Philadelphia) Vol. 97; no. 5; pp. 1102 - 1109
Main Authors:	BIEDLER, Andreas E, SCHNEIDER, Sven O, SEYFERT, Ullrich, RENSING, Hauke, GRENNER, Sasha, GIRNDT, Matthias, BAUER, Inge, BAUER, Michael
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott 01-11-2002
Subjects:	Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Preservation Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Coculture Techniques Cytokines - biosynthesis Humans Immune Tolerance Interleukin-10 - biosynthesis Isoantigens - immunology Leukocytes - immunology Lipopolysaccharides - pharmacology Medical sciences Transfusion Reaction Transfusions. Complications. Transfusion reactions. Cell and gene therapy Tumor Necrosis Factor-alpha - biosynthesis Human Cell culture Transfusion Conservation Cytokine Leukocyte poor blood Red blood cell In vitro Blood Whole blood Immunosuppression Alloantigen Mononuclear cell Interleukin 10 Complication Tumor necrosis factor α
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Summary:	Transfusion of blood may contribute to immunosuppression in major surgery. The authors assessed the impact of alloantigens and storage on function of peripheral blood mononuclear cells cultured in their physiologic environment. Blood units (whole blood, packed erythrocytes) were prepared with or without prestorage leukodepletion and stored for 24-26 days. Blood samples were coincubated with allogeneic fresh blood, autologous, or allogeneic stored blood. Endotoxin-stimulated release of tumor necrosis factor-alpha (TNF-alpha) and interleukin 10 (IL-10) was measured after 24 h of culture by enzyme-linked immunosorbent assay. Coincubation with equal amounts of allogeneic fresh blood showed almost no influence on TNF-alpha (-12%, not significant) and IL-10 (+11%, not significant) release. Stored allogeneic whole blood resulted in a significant TNF-alpha depression (-61%) and IL-10 induction (+221%). These effects were diminished but not prevented by prestorage leukodepletion (TNF-alpha -42%, IL-10 +110%) and required the presence of soluble factors (TNF-alpha suppression) and cellular components (IL-10 induction). TNF-alpha decrease and IL-10 increase were in the same order of magnitude (-40%, +134% with, -65%, +314% without leukodepletion) after coincubation with autologous blood. In contrast, allogeneic erythrocytes had only little effects (TNF-alpha -6%, IL-10 +36%) even at this high transfusion equivalent. These data suggest that banked whole blood has an immunosuppressive effect that is largely attributable to storage-dependent factors. These factors are partially removed by prestorage leukodepletion, while the contribution of alloantigens is of minor significance. Immunosuppressive effects are least apparent with leukodepleted erythrocytes, suggesting that the presence of plasma during storage is required for the immunosuppressive effect to develop.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-3022 1528-1175
DOI:	10.1097/00000542-200211000-00011