A perspective on exogenous redox regulation mediated by transfused RBCs subject to the storage lesion

• Published in: Transfusion and apheresis science Vol. 63; no. 3; p. 103929
• Main Authors: William, Nishaka, Acker, Jason P.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2024
• Subjects: Adverse transfusion reactions; Blood Preservation - methods; Erythrocyte Transfusion - methods; Erythrocytes - metabolism; Hematology, Oncology, and Palliative Medicine; Hemoglobin oxidation; Humans; Nitric oxide; Oxidation-Reduction; Oxidative Stress; Peroxynitrite; Reactive Oxygen Species - metabolism; Red blood cells; Redox regulation; Redox signalling; Storage lesion; Superoxide; Peroxynitrite; Storage lesion; RONS; Redox regulation; MV; Superoxide; GPx; Adverse transfusion reactions; RBC; RCC; Red blood cells; Hemoglobin oxidation; Nitric oxide; XO; metHb; Hb; Prx2; Redox signalling; oxyHb; red blood cells; peroxiredoxin 2; oxyhemoglobin; hemoglobin; red cell concentrates; xanthine oxidase; methemoglobin; microvesicles; reactive oxygen and nitrogen species; glutathione peroxidase
• ISSN: 1473-0502; 1878-1683
• DOI: 10.1016/j.transci.2024.103929

Granted with a potent ability to interact with and tolerate oxidative stressors, RBCs scavenge most reactive oxygen and nitrogen species (RONS) generated in circulation. This essential non-canonical function, however, renders RBCs susceptible to damage when vascular RONS are generated in excess, making vascular redox imbalance a common etiology of anemia, and thus a common indication for transfusion. This accentuates the relevance of impairments in redox metabolism during hypothermic storage, as the exposure to chronic oxidative stressors upon transfusion could be exceedingly deleterious to stored RBCs. Herein, we review the prominent mechanisms of the hypothermic storage lesion that alter the ability of RBCs to scavenge exogenous RONS as well as the associated clinical relevance.