Developing pathogen reduction technologies for RBC suspensions

Numerous studies have evaluated a wide variety of photosensitizers and alkylating agents as candidates for a pathogen reduction process to be used in RBC suspensions. The methodologies that produce robust inactivation of pathogens with maintenance of RBC properties during storage involve those that specifically target nucleic acids. This has been demonstrated through in vitro studies by flexible photosensitizers, which specifically target nucleic acid but do not engage in photochemistry when free in solution and nucleic acid alkylating agents in conjunction with extracellular quencher(s) to protect against RBC membrane alkylation. The flexible photosensitizer method must be scaled up to entire units, and toxicology studies would need to be performed for further development. Clinical trials will ultimately be necessary to further develop either flexible photosensitizers or nucleic acid alkylating methods with quenchers for use in Transfusion Medicine.