Glucose 6-phosphate dehydrogenase deficient subjects may be better "storers" than donors of red blood cells.
Storage of packed red blood cells (RBCs) is associated with progressive accumulation of lesions, mostly triggered by energy and oxidative stresses, which potentially compromise the effectiveness of the transfusion therapy. Concerns arise as to whether glucose 6-phosphate dehydrogenase deficient subjects (G6PD(-)), ~5% of the population in the Mediterranean area, should be accepted as routine donors in the light of the increased oxidative stress their RBCs suffer from. To address this question, we first performed morphology (scanning electron microscopy), physiology and omics (proteomics and metabolomics) analyses on stored RBCs from healthy or G6PD(-) donors. We then used an in vitro model of transfusion to simulate transfusion outcomes involving G6PD(-) donors or recipients, by reconstituting G6PD(-) stored or fresh blood with fresh or stored blood from healthy volunteers, respectively, at body temperature. We found that G6PD(-) cells store well in relation to energy, calcium and morphology related parameters, though at the expenses of a compromised anti-oxidant system. Additional stimuli, mimicking post-transfusion conditions (37°C, reconstitution with fresh healthy blood, incubation with oxidants) promoted hemolysis and oxidative lesions in stored G6PD(-) cells in comparison to controls. On the other hand, stored healthy RBC units showed better oxidative parameters and lower removal signaling when reconstituted with G6PD(-) fresh blood compared to control. Although the measured parameters of stored RBCs from the G6PD deficient donors appeared to be acceptable, the results from the in vitro model of transfusion suggest that G6PD(-) RBCs could be more susceptible to hemolysis and oxidative stresses post-transfusion. On the other hand, their chronic exposure to oxidative stress might make them good recipients, as they better tolerate exposure to oxidatively damaged long stored healthy RBCs.
Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece.
Vassilis L
VL
Tzounakas
Laboratory of Hematology and Transfusion Medicine, Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological and Educational Institute of Athens, Athens 12210, Greece.
Anastasios G
AG
Kriebardis
Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece.
Hara T
HT
Georgatzakou
Regional Blood Transfusion Center, "Agios Panteleimon" General Hospital of Nikea, Piraeus 18454, Greece.
Leontini E
LE
Foudoulaki-Paparizos
Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA.
Monika
M
Dzieciatkowska
Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA.
Matthew J
MJ
Wither
Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA.
Travis
T
Nemkov
Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA.
Kirk C
KC
Hansen
Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece.
Issidora S
IS
Papassideri
Department of Biochemistry and Molecular Genetics, University of Colorado, School of Medicine-Anschutz Medical Campus, Aurora, 80045 CO, USA. Electronic address: angelo.dalessandro@ucdenver.edu.
Angelo
A
D'Alessandro
Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens 15784, Greece. Electronic address: manton@biol.uoa.gr.
Marianna H
MH
Antonelou
D000328:Adult; D001782:Blood Donors; D001803:Blood Transfusion / Q000592:standards; D004912:Erythrocytes / Q000378:metabolism* / Q000648:ultrastructure; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000097:blood* / Q000235:genetics; D006461:Hemolysis; D006801:Humans; D008297:Male; D055432:Metabolomics; D008855:Microscopy, Electron, Scanning; D018384:Oxidative Stress; D040901:Proteomics
G6PD deficiency; Omics analyses; Oxidative stress; Red blood cell storage lesion