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Platelet Lipidome Characteristics of Adverse Reactions Associated with Irradiated Aphaeresis Platelets Transfusion in
Insights
Specific platelet lipids like PE and TG can predict allergic transfusion reactions in children. Modifying platelet lipid composition may reduce adverse reactions and improve transfusion efficacy.
Area of Science:
- Hematology
- Biochemistry
- Immunology
Background:
- Platelet transfusions, especially in children, are linked to adverse reactions.
- Lipid components in platelets may significantly influence transfusion reactions.
- Identifying key lipids causing allergic rash is crucial for improving platelet safety.
Purpose of the Study:
- To identify bioactive lipids causing transfusion-related allergic rash in children.
- To explore methods for reducing adverse reactions in irradiated apheresis platelets.
Main Methods:
- Compared lipid profiles of platelets from children with and without transfusion reactions using mass spectrometry.
- Analyzed differential lipid composition and performed KEGG pathway enrichment analysis.
- Determined platelet antibodies in pediatric patients.
Main Results:
- Platelet antibodies were negative in the allergic transfusion reaction group.
- Specific phospholipids (PE) and triglycerides (TG) were elevated, while sphingolipids (SM) were decreased in children without adverse reactions.
- Cholesterol metabolism showed the most significant pathway diversity.
Conclusions:
- Platelet lipid profiles, including PE, TG, and SM, can predict transfusion-related allergic reactions in children.
- Altering platelet lipid composition offers a potential strategy to enhance platelet transfusion efficiency and safety.
Background:
In clinical practice, we have observed that compared with red blood cells and plasma, platelet trans-fusion is more likely to cause transfusion adverse reactions, especially in children. Platelets may suffer different degrees of structural and biochemical damage during processing and preservation, and the lipid components contained in platelets may have a significant impact on the generation of transfusion adverse reactions. Therefore, the objective of this study is to identify the key bioactive lipid components that cause adverse blood transfusion reactions especially allergic rash and to explore ways to reduce the adverse transfusion reactions caused by irradiated aphaeresis platelets.
Methods:
Platelet antibodies were determined in 15 children with rash after transfusion and 15 children with no adverse transfusion reactions, then lipid composition was analyzed by mass spectrometry. The Thermo UHPLC-Q Exactive HF-X Vanquish Horizon system compared differential lipid composition using GraphPad version 8.3.0 for statistical analysis and Pearson's correlation coefficient analysis.
Results:
Platelet antibodies were negative in the allergic transfusion reaction (ATR) group. Among the platelet lipid components, PE (18:3/18:2) and TG (18:1/18:2/24:1) were up-regulated, whereas SM (d17:1/18:1), SM (d17:1/ 18:3) were significantly down-regulated in the no-AR group. Furthermore, the enrichment analysis of the KEGG pathway of differential lipids indicated that cholesterol metabolism has the most significant diversity.
Conclusions:
The data suggests that the content of PE (18:3/18:2), TG (18:1/18:2/24:1), SM (d17:1/18:1), SM (d17:1/18:3) in platelets can prospectively predict transfusion-related allergic reactions in children. It is possible to improve platelet products by changing the lipid component of platelets to improve platelet transfusion efficiency.
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