Thrombin generation in vivo and ex vivo in sickle cell disease patients.

Activation of coagulation is an important hallmark of sickle cell disease (SCD) and it is believed that hypercoagulability plays a role to the disease pathophysiology. Studies have sought to identify how hemostatic biomarkers are expressed in SCD, however, the results are inconclusive. In this context, our objective was to evaluate the thrombin generation in vivo and ex vivo in SCD patients and the association between these biomarkers and the use of HU. This cross-sectional study was carried out with patients diagnosed with SCD, users or not of Hydroxyurea (HU), and healthy individuals as controls. D dimer (D-Di) was evaluated by ELISA and (TGT) thrombin generation test by CAT method. D-Di plasma levels were significantly higher in SCD patients when compared to the controls. TGT parameters such as peak, ETP and normalized ETP at low TF concentration and time-to-peak, peak, ETP and normalized ETP values at high TF concentration were lower in SCD patients than in controls. In contrast, the normalized activated protein C sensitivity ratio (nAPCsr) was higher in patients compared to controls, indicating resistance to the action of this natural anticoagulant. Regarding the use of HU, comparing users and non-users of this drug, no difference was observed in D-Di levels and in most TGT parameters. Our data analyzed together allow us to conclude that patients with SCD present a state of hypercoagulability in vivo due to the higher levels of D-Di and resistance to APC assessed ex vivo which is consistent with the coagulation imbalance described in SCD patients.

The effect of gamma radiation on the lipid profile of irradiated red blood cells.

An investigation into the effects of irradiation and of the storage time on aging and quality are a relevant issue to ensure the safety and the efficiency of irradiation in the prevention of transfusion-associated graft-versus-host disease (TA-GVHD). In this work, the biochemical properties and alterations presented by erythrocyte membranes, up to 28-days post-irradiation, with a dose of 25 Gy, were studied as a function of storage and post-irradiation time. There was a considerable variation in the total of phospholipid content, when comparing the control and irradiated samples, mostly from the third day onwards; and at the same time, the effect occurred as a function on the storage time of blood bags. The levels of total cholesterol decreased 3-9 days after irradiation. TBARS levels were increased after irradiation and 7 days of storage, but no increment of catalase activity was observed after the irradiation. Furthermore, the protein profile was maintained throughout the irradiation and storage time, until the 21st day, with the presence of a protein fragmentation band of around 28 kDa on the 28th day. In conclusion, although gamma irradiation is the main agent for the prevention of TA-GVHD, a better understanding of the physical and biochemical properties of erythrocytes are necessary to better assess their viability, and to be able to issue more secure recommendations on the shelf life of blood bags, and the safe use of the irradiated red cells therein.