Abstract

Autologous blood transfusion (ABT) has been frequently abused in endurance sport and is prohibited since the mid-1980s by the International Olympic Committee. Apart from any significant performance-enhancing effects, the ABT may pose a serious health issue due to aging erythrocyte-derived “red cell storage lesions.” The current study investigated the effect of blood storage in citrate phosphate dextrose adenine (CPDA1) on the red blood cell (RBC) membrane proteome. One unit of blood was collected in CPDA1 blood bags from 6 healthy female volunteers. RBC membrane protein samples were prepared on days 0, 14, and 35 of storage. Proteins were digested in gel and peptides separated by nanoliquid chromatography coupled to tandem mass spectrometry resulting in the confident identification of 33 proteins that quantitatively change during storage. Comparative proteomics suggested storage-induced translocation of cytoplasmic proteins to the membrane while redox proteomics analysis identified 14 proteins prone to storage-induced oxidation. The affected proteins are implicated in the RBC energy metabolism and membrane vesiculation and could contribute to the adverse posttransfusion outcomes. Spectrin alpha chain, band 3 protein, glyceraldehyde-3-phosphate dehydrogenase, and ankyrin-1 were the main proteins affected by storage. Although potential biomarkers of stored RBCs were identified, the stability and lifetime of these markers posttransfusion remain unknown. In summary, the study demonstrated the importance of studying storage-induced alterations in the erythrocyte membrane proteome and the need to understand the clearance kinetics of transfused erythrocytes and identified protein markers.

Highlights

  • Transfusion of whole blood or erythrocyte concentrates is considered blood doping and prohibited by the World Anti-Doping Agency (WADA) [1]

  • Changes in erythrocyte membrane proteome of human erythrocytes stored in CPDA1 bags were established by a comparative analysis of proteins identified in all fresh samples (n = 6) versus those identified in all stored samples, irrespective of the duration of storage (n = 12 with 6 for 14 and 6 for 35 days of storage) when analyzed for differentially expressed proteins and the redox proteome

  • Changes in the amount of membrane proteins were established by a comparative analysis of proteins identified in more than 80% (15 out of 18 samples) fresh samples (n = 6) with those identified in samples stored for 14 (n = 6) and 35 days (n = 6)

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Summary

Introduction

Transfusion of whole blood or erythrocyte concentrates is considered blood doping and prohibited by the World Anti-Doping Agency (WADA) [1]. There are performance-enhancing effects from applying the transfusion, one needs to consider the possible adverse effects such as deep venous thrombosis and transfusion-related acute lung injury which might be connected to aging erythrocyte-derived “red cell storage lesions” [7]. Other side effects such as acute and delayed hemolytic reactions, blood-borne infections, or graft-versus-host disease are related to incompatibilities with donor blood and can occur in cases of homologous blood transfusion [8]

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