Fresenius Kabi Lake Zurich, Illinois, United States
Background/Case Studies: Cytokine reduction in autotransfusion procedures can be beneficial to lessen adverse reactions. Pro-inflammatory cytokines (IL-1, IL-6, and TNF-α) play a role in up-regulation of inflammatory reactions and promote systemic inflammation. This study compared cytokine concentration and other key parameters pre- and post-Smart wash on the CATSmart device.
Study
Design/Methods: Whole blood collected in CPD anticoagulant was diluted with 0.9% NaCl to obtain a hematocrit 20.3 - 20.5 (n=3). Diluted blood was injected with 200 pg/mL for each IL-1α, IL-6 and TNF-α cytokines (Sigma; SRP3310, SRP3096, and SRP3177). Cytokine-rich blood (500 µL) was processed on the CATSmart device using the Smart wash procedure. Samples were collected pre- and post-wash and tested same day. Concentrations of IL-1α, IL-6 and TNF-α were determined using a commercially available method for cytokine quantitation by flow cytometry (BD Biosciences). In addition, total protein, potassium, and albumin washouts were also evaluated, as well as %Hemolysis pre/post wash.
Results/Findings: Cytokine concentrations were found to have >90% washout for all three cytokines. A reduction in potassium (mEq/L), albumin (g/dL) and total protein (g/dL) was also observed. %Hemolysis increased slightly from 0.4 to 0.5, which is consistent with prior work (Groom et al, 2017). Conclusions: The CATSmart instrument using the Smart wash procedure was able to reduce concentrations for IL-1α, IL-6, and TNF-α cytokines. Additional investigations to assess reduction in cytokine concentrations using other wash procedures (Flex, Emergency, and Low Volume wash) on the CATSmart instrument are warranted to further understand cytokine washout for different applications.
Importance of research: Cytokines can cause adverse reactions. This study shows a possible way to reduce cytokine concentrations for autotransfusion procedures.
