Abstract
BackgroundTransfusing blood products may induce inflammatory reactions within the vascular compartment potentially leading to a systemic inflammatory response. Experiments were designed to assess the inflammatory potential of different blood products in an endothelial cell-based in vitro model and to compare baseline levels of potentially activating substances in transfusion products.MethodsThe inflammatory response from pre-activated (endotoxin-stimulated) and non-activated endothelial cells as well as neutrophil endothelial transmigration in response to packed red blood cells (PRBC), platelet concentrates (PC) and fresh frozen plasma (FFP) was determined. Baseline inflammatory mediator and lipid concentrations in blood products were evaluated.ResultsFollowing incubation with all blood products, an increased inflammatory mediator release from endothelial cells was observed. Platelet concentrates, and to a lesser extent also FFP, caused the most pronounced response, which was accentuated in already pre-stimulated endothelial cells. Inflammatory response of endothelial cells as well as blood product-induced migration of neutrophils through the endothelium was in good agreement with the lipid content of the according blood product.ConclusionWithin the group of different blood transfusion products both PC and FFP have a high inflammatory potential with regard to activation of endothelial cells. Inflammation upon blood product exposure is strongly accentuated when endothelial cells are pre-injured. High lipid contents in the respective blood products goes along with an accentuated inflammatory reaction from endothelial cells.
Highlights
Transfusion of blood products is routinely performed in hospitals on a daily basis
Inflammatory responses have been reported to occur after transfusion of all types of blood components including whole blood, red blood cells (PRBC), platelet concentrates (PC), fresh frozen plasma (FFP); with FFP being the most implicated blood product [9]
Mimicking a state of endothelial activation in vitro using lipopolysaccharides (LPS), we investigated if the inflammatory response and migration of neutrophils through the endothelial cells layer is accentuated in pre-activated endothelial cells
Summary
Transfusion of blood products is routinely performed in hospitals on a daily basis. With an estimated frequency of approximately 1 in 5000, blood transfusion leads to an inflammatory state in recipients [1,2]. It has been previously suggested that the severe inflammatory reaction within the vascular compartment requires two triggers: one trigger being the endothelial cell activation (as seen in surgery, infection, or trauma), followed by a second triggering action represented by the transfusion of blood products containing biologic response modifiers aggravating the inflammatory status [10,11,12,13]. Transfusing blood products may induce inflammatory reactions within the vascular compartment potentially leading to a systemic inflammatory response. Experiments were designed to assess the inflammatory potential of different blood products in an endothelial cell-based in vitro model and to compare baseline levels of potentially activating substances in transfusion products
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