Inactivation of leukocytes in platelet concentrates by photochemical treatment with psoralen plus UVA.

A photochemical treatment (PCT) process using a novel psoralen and long wavelength ultraviolet light (UVA, 320-400 nm) has been developed to inactivate bacteria and viruses in platelet concentrates. This study evaluated the efficacy of PCT for inactivation of leukocytes that contaminate platelet preparations. Three psoralens, 8-methoxypsoralen (8-MOP), 4'-aminomethyl 4,5', 8-trimethylpsoralen (AMT), and the novel psoralen S-59, were compared using the following four independent but complementary biological and molecular assays. (1) T-cell viability: Treatment with 150 mumol/L S-59 and 1.0 to 3.0 Joules/cm2 UVA inactivated >5.4 +/- 0.3 log10 of T cells in full-sized single-donor plateletpheresis units. Using 1.0 Joule/cm2 UVA, the lowest dose of S-59, AMT and 8-MOP required to reduce the number of T cells to the limit of detection was 0.05 micromol/L, 1.0 micromol/L, and 10.0 micromol/L, respectively. (2) Cytokine synthesis: Treatment with 1.9 Joules/cm2 UVA and 150 micromol/L S-59 or AMT completely inhibited synthesis of the cytokine IL-8 by contaminating leukocytes during 5 days of platelet storage. After treatment with 75 micromol/L 8-MOP and 1.9 Joules/cm2 UVA, only low levels of IL-8 were detected. (3) Psoralen-DNA adduct formation: The combination of 1.9 Joules/cm2 UVA and 150 micromol/L S-59, AMT, or 8-MOP induced 12.0 +/- 3.0, 6.0 +/- 0. 9, and 0.7 psoralen adducts per 1,000 bp DNA, respectively. (4) Replication competence: Polymerase chain reaction (PCR) amplification of small genomic DNA sequences (242-439 bp) after PCT was inhibited. The degree of PCR amplification inhibition correlated with the level of adduct formation (S-59 > AMT > 8-MOP). In contrast, 2,500 cGy gamma radiation, a dose that inactivates >5 log10 of T cells in blood products, had minimal effect on cytokine synthesis and did not induce sufficient DNA strand breaks to inhibit PCR amplification of the same small DNA sequences. These results demonstrate that leukocytes are sensitive to PCT with psoralens and among the psoralens tested S-59 is the most effective. Therefore, PCT has the potential to reduce the incidence of leukocyte-mediated adverse immune reactions associated with platelet transfusion.

Removal of cytokines from HAS-containing solutions by adsorption onto silica.

Septic shock syndrome is a potentially fatal medical condition that is associated with elevated blood levels of low molecular weight proteins known as cytokines. Adsorption was investigated as a potential method for removing cytokines from blood. Saline with 50 mg/mL human serum albumin (HAS) spiked with pathological concentrations (ng-pg/mL) of radiolabeled cytokine was used to study cytokine adsorption. Adsorption isotherms were linear in the pathological concentration range, with adsorption constants ranging from 33.0 mL/g to 173 mL/g for tumor necrosis factor (TNF-alpha), interleukin-8 (IL-8),interleukin-6 (IL-6), and C3a. Adsorption constants were also determined for interleukin-1alpha (IL-1alpha), IL-1beta, and interferon-gamma (IFN-gamma). The adsorption of cytokines by several different silica adsorbents was investigated. Increased concentrations of NaCl reduced cytokine adsorption, but did not completely eliminate adsorption even at high concentrations, suggesting that adsorption wads not entirely electrostatic in nature. Possible mechanisms of cytokine adsorption are discussed. Data for batch adsorption for TNF-alpha was used to estimate the minimum amount of silica required to treat septic shock. It was concluded that a silica adsorbent has a sufficiently high capacity to be used for hemoperfusion. Adsorption of myoglobin and cytochrome c was also investigated as possible marker proteins for future dynamic adsorption studies in hemoperfusion devices.