The platelets’ perspective to pathogen reduction technologies

Abstract

A wide variety of clinical conditions, associated with low circulating platelet counts, require platelet transfusion in order to normalize hemostatic function. Although single-donor apheresis platelets bear the lowest risk of transfusion-transmitted infections, pathogen reduction technologies (PRT) are being implemented worldwide to reduce this risk further through inactivation of known, emergent and as yet to be discovered nucleic acid-based pathogens. Human blood platelets are now known to harbor a diverse transcriptome, important to their function and comprised of >5000 protein-coding messenger RNAs and different classes of non-coding RNAs, including microRNAs. Our appreciation of the nucleic acid-dependent functions of platelets is likely to increase. On the other hand, the side effects of PRT on platelet function are underappreciated. Recent evidences suggest that PRT may compromise platelets’ responsiveness to agonists, and induce platelet activation. For instance, platelets have the propensity to release proinflammatory microparticles (MPs) upon activation, and the possibility that PRT may enhance the production of platelet MPs in platelet concentrates (PCs) appears likely. With this in mind, it would be timely and appropriate to investigate other means to inactivate pathogens more specifically, or to modify the currently available PRT so to better preserve the platelet function and improve the safety of PCs; platelets’ perspective to PRT deserves to be considered.

Keywords:

• Nucleic acids
• pathogen reduction technologies
• platelet activation
• platelet concentrate
• RNA transcriptome

Declaration of interest

The authors declare no conflict of interest.

Funding

The authors’ laboratories are financially supported by Grant Nos. LIO-202231 and LIO-203061 from the County Council of Östergötland, Sweden (to A.O.), and Grant Nos. 286777 and 327364 from the Canadian Blood Services/Canadian Institutes of Health Research Blood Utilization and Conservation Initiatives via Health Canada (to P.P.), which will cover the costs to publish in open access. The views expressed herein do not necessarily represent the view of the Canadian government.

Additional information

Funding

The authors’ laboratories are financially supported by Grant Nos. LIO-202231 and LIO-203061 from the County Council of Östergötland, Sweden (to A.O.), and Grant Nos. 286777 and 327364 from the Canadian Blood Services/Canadian Institutes of Health Research Blood Utilization and Conservation Initiatives via Health Canada (to P.P.), which will cover the costs to publish in open access. The views expressed herein do not necessarily represent the view of the Canadian government.

Notes on contributors

Patrick Provost

A.O., W.E.H., and P.P. wrote the manuscript.