Role of blood transfusion in trichosanthin-induced anaphylaxis

Trichosanthin (TCS) is a type 1 ribosome inactivating protein extracted from Chinese medicinal herb. It possesses various biological functions such as abortifacient, anti-tumor and anti-viral activities. Clinical trial of this compound against human immunodeficiency virus (HIV) had been conducted. However, its use is limited by its high immunogenicity that elicits hypersensitivity reaction. This may lead to fatal anaphylactic response. The study described an approach of using blood transfusion to reduce TCS induced anaphylaxis in rats using a cross-circulation model. A TCS-sensitized Sprague Dawley rat was connected to a normal rat via the femoral vessels in a cross-circulation circuit before antigenic challenge. The donor rat served as a blood exchange basin to lower the level of the blood-borne components responsible for the anaphylactic reaction in the sensitized rat. Our results showed that cross-circulation shortened the duration of circulatory hypotension and reduced mortality of TCS induced anaphylaxis. The control group not undergoing cross-circulation had a mortality of 50% at 2h post-TCS challenge and there was no mortality in the cross-circulation group. This demonstrated that prior blood transfusion can be one of the alternatives to reduce anaphylactic response of TCS.