Eritrosit Transfüzyonunun Anemik Hastalarda Tiyol/Disülfit Homeostazı Üzerine Etkisi

Yıl 2024, Cilt: 7 Sayı: 2, 63 - 66, 29.06.2024

Selçuk Coşkun , Ferhat İçme , Yücel Yüzbaşıoğlu , Fatih Tanrıverdi , Gül Pamukçu Günaydın , Cagri Serdar Elgormus , Özcan Erel , Salim Neşelioğlu

https://doi.org/10.54996/anatolianjem.1468418

Öz

Amaç: Anemi, dokulara oksijen taşınmasını kısıtlar, bu da potansiyel olarak artmış oksidatif stres ile sonuçlanabilir. Bu çalışmada, anemik hastalarda eritrosit transfüzyonunun oksidatif stresin bir göstergesi olan tiyol/disülfit homeostazı üzerindeki etkisinin incelenmesi amaçlandı.

Gereç ve Yöntemler: Çalışmaya acil serviste transfüzyon alan altmış anemik hasta dahil edildi. Eritrosit transfüzyonu öncesi ve sonrası toplanan kan örneklerinde toplam tiyol, nativ tiyol ve disülfid seviyeleri ölçüldü. Aneminin etkilerini izole etmek için, akut/subakut kanama veya aplastik anemi olan hastalar hariç tutularak alt grup analizi de yapıldı.

Bulgular: Total tiyol (374.24±94.84'ten 344.6±88.5'e) ve nativ tiyol (338.91±90.51'den 304.91±90.95'e) konsantrasyonları, eritrosit süspansiyonu transfüzyonu sonrası başlangıca göre anlamlı olarak azaldı (P<0.0001). Ancak, disülfid seviyesi arttı (17.75±6.63'ten 20.97±7.25'e; p = 0.009). Bulgularımız hastalarda oksidatif stresin transfüzyon sonrası arttığını göstermektedir.

Sonuç: Anemik hastalara eritrosit transfüzyonu yapıldığında oksidatif stresin azalacağı düşünülebilir çünkü transfüzyonla oksijen taşıma kapasitesi artar, ancak sonuçlarımız bunun aksini göstermektedir. Sonuçlarımız, transfüzyon alan hastalarda işlemden hemen sonra oksidatif stresin arttığını göstermektedir. Bu durum muhtemelen depolanan eritrosit süspansiyonlarında artan oksidatif stresle ilgili olabilir.

Anahtar Kelimeler

Anemi, disulfide, eritrosit transfüzyonu, sulfhidrid bileşikleri, oksidatif stres

Impact of Erythrocyte Transfusion on Thiol/Disulfide Homeostasis in Anemic Patients

Öz

Aim: Anemia limits oxygen delivery to tissues, potentially leading to increased oxidative stress. This study examined the impact of erythrocyte transfusion on thiol/disulfide homeostasis, a marker of oxidative stress, in anemic patients.

Material and Methods: Sixty anemic patients receiving transfusions in emergency department were included in this study. We measured total thiol, native thiol, and disulfide levels in blood samples collected before and after red blood cell transfusion. To isolate the effects of anemia, a subgroup analysis that excluded patients with acute/subacute hemorrhage or aplastic anemia was also done.

Results: The concentrations of total thiol (374.24±94.84 to 344.6±88.5) and native thiol (338.91±90.51 to 304.91±90.95) significantly decreased after erythrocyte suspension treatment compared to baseline (P<0.0001). However, the disulfide level increased (17.75±6.63 to 20.97±7.25; p = 0.009). Our findings suggest a potential increase in overall oxidative stress.

Conclusion: By giving transfusions to anemic patients one may think that oxidative stress will be reduced due to increased oxygen carrying capacity but our results show the contrary. Our results support that oxidative stress increases in vivo in patients who receive transfusion right after the procedure and this is probably due to increased oxidative stressin stored erythrocyte suspensions.

Anahtar Kelimeler

Anemia, disulfides, erythrocyte transfusion, sulfhydryl compounds, oxidative stress

Etik Beyan

We obey all of ethical procedures

Destekleyen Kurum

No supporting İnstution

Teşekkür

We all thanks for all your help

Kaynakça

• Liang R, Ghaffari S. Advances in understanding the mechanisms of erythropoiesis in homeostasis and disease. Br J Haematol. 2016 ;174:661-73.
• Kurtoglu E, Ugur A, Baltaci AK, Undar L. Effect of iron supplementation on oxidative stress and antioxidant status in irondeficiency anemia. Biol. Trace Elem. Res. 2003;96: 117–23.
• Erel O, Neselioglu S. A novel and automated assay for thiol/disulfide homeostasis. Clin Biochem 2014;47:326-32
• Akarsu S, Demir H, Selek S, Oguzoncul F. Iron deficiency anemia and levels of oxidative stress induced by treatment modality. Pediatr Int. 2013;55:289-95.
• Yanpanitch OU, Hatairaktham S, Charoensakdi R, et al. Treatment of βThalassemia/Hemoglobin E with Antioxidant Cocktails Results in Decreased Oxidative Stress, Increased Hemoglobin Concentration, and Improvement of the Hypercoagulable State. Oxid Med Cell Longev. 2015;2015:537954.
• Ozdemir ZC, Koc A, Aycicek A, Kocyigit A. N-Acetylcysteine supplementation reduces oxidative stress and DNA damage in children with β-thalassemia. Hemoglobin. 2014;38:359-64.
• Grau M, Mozar A, Charlot K, et al.High red blood cell nitric oxide synthase activation is not associated with improved vascular function and red blood cell deformability in sickle cell anaemia. Br J Haematol.2015;168:728-36.
• Hsu SP, Chiang CK, Yang SY, Chien CT. N-acetylcysteine for the management of anemia and oxidative stress in hemodialysis patients. Nephron Clin Pract. 2010;116:207-16.
• Aguilar R, Marrocco T, Skorokhod OA, et al. Blood oxidative stress markers and Plasmodium falciparum malaria in non-immune African children. Br J Haematol. 2014;164:438-50.
• M. Doctor A, Spinella P. Effect of processing and storage on red blood cell function in vivo. Semin Perinatol. 2012;36(4):248-59.
• Ogunro PS, Ogungbamigbe TO, Muhibi MA. The influence of storage period on the antioxidants level of red blood cells and the plasma before transfusion. Afr J Med Med Sci. 2010 Jun;39(2):99-104.
• Yılmaz R, Koç B, Yorulmaz A, Akyürek F. Effect of Erythrocyte Suspension Transfusion on Thiol-Disulfide Homeostasis in Critically Ill Children. J Contemp Med. May 2024;14(3):109-116.
• Amen F, Machin A, Touriño C, Rodríguez I, Denicola A, Thomson L. Nacetylcysteine improves the quality of red blood cells stored for transfusion. Arch Biochem Biophys. 2017 May 1;621:31-37. doi: 10.1016/j.abb.2017.02.012. Epub 2017 Apr 6.
• Bayer SB, Hampton MB, Winterbourn CC. Accumulation of oxidized peroxiredoxin 2 in red blood cells and its prevention. Transfusion. 2015 Aug;55(8):1909-18. doi: 10.1111/trf.13039. Epub 2015 Feb 26.
• Grinberg L, Fibach E, Amer J, Atlas D. N-acetylcysteine amide, a novel cell-permeating thiol, restores cellular glutathione and protects human red blood cells from oxidative stress. Free Radic Biol Med. 2005 Jan 1;38(1):136-45