title: Platelet derived cytokine accumulation in platelet concentrates treated for pathogen reduction.
abstract: BACKGROUND
  Pathogen reduction technologies (PRTs) prevent replication and proliferation of pathogens in platelet (PLT) concentrates (PCs) by modifying nucleic acids. Due to increased cell activation, PRT may also lead to increased cytokine release from α granules and promote adverse transfusion reactions in the recipient.
  
  
  METHODS
  Fifteen double-dose leukoreduced apheresis PCs were collected on the Trima Accel platform (vs. 5.2.) allowing for the resuspension in PLT additive solution (PAS) immediately after collection. After a 2-h resting period (1st hour without, 2nd hour with agitation), splitting was performed: one unit remained untreated to serve as control (C), while the other was riboflavin-UVB treated using the Mirasol-PRT system according to the manufacturer's instructions (M). During 8 days of storage, PCs were analyzed for contaminating white and red blood cells, bacterial growth, PLT activation, LDH and cytokine release (MIP-1 α, RANTES, PF4, and TGF-β-1). Results obtained were opposed to a former study, where triple-dose PCs underwent Mirasol-PRT prior to resuspension or the INTERCEPT BLOOD SYSTEM (psoralen-UVA) or remained untreated.
  
  
  RESULTS
  Despite similar LDH release, PRT treatment was associated with significantly higher (p<0.05) cell activation but only slightly higher cytokine accumulation during storage. Differences became significant only for PF4 and RANTES at day 8 of storage. On the other hand, in the investigation on triple-dose PCs (yielding higher cytokine levels), TGF beta-1 and RANTES remained significantly (p<0.05) lower after PRT treatment compared to untreated units.
  
  
  CONCLUSIONS
  Factors, such as collection modality, onset of resuspension and additional amounts of magnesium/potassium in the PAS used may be of equal or even greater impact for cytokine accumulation in stored PCs than PRT treatment.
authors: Transfusion Medicine, University Hospital of Cologne, Germany. marie.tauszig@uk-koeln.de
authors: Marie E
authors: ME
authors: Tauszig
authors: Susanne M
authors: SM
authors: Picker
authors: Birgit S
authors: BS
authors: Gathof
mesh_terms: D001792:Blood Platelets / Q000166:cytology / Q000378:metabolism*; D017848:Blood-Borne Pathogens; D016207:Cytokines / Q000378:metabolism*; D004203:Disinfection / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D017319:Photosensitizing Agents / Q000494:pharmacology*; D015539:Platelet Activation / Q000187:drug effects / Q000528:radiation effects; D010983:Plateletpheresis; D012256:Riboflavin / Q000494:pharmacology*; D022142:Secretory Vesicles / Q000378:metabolism; D014466:Ultraviolet Rays
chemical_list: D016207:Cytokines; D017319:Photosensitizing Agents; D012256:Riboflavin