Damage to red blood cells occurring during freezing can also develop with transfusion. An increase in the concentration of free iron in the blood during the destruction of red blood cells results in an acceleration of the reactive oxygen species production, peroxide damage to cells and stimulation of inflammation. With multiple transfusions of red blood cells, the function of internal organs may be impaired as a result of iron overload. The cryoprotective properties of glycerol include its collegiate ability to reduce the concentration of NaCl at temperatures below 0°C. However, it was found out that the cryoprotective efficacy of glycerol was far less than it was expected from its colligative properties. Damage to red blood cells during their rapid thawing is the result of osmotic shock due to the inability of an excess of intracellular glycerol to exit the cells quickly enough to prevent their swelling and hemolysis. These data indicate the need to reduce the glycerol concentration in the cryoconservant. However, maintaining the protective effectiveness of the cryoprotectant requires a decrease in the NaCl concentration. This study investigates the effect of the composition of the cryoconservant on erythrocyte hemolysis during freezing and hypothermic storage. We used 2 types of cryoconservants: a) 38% (w / v) glycerin, 2.9% sorbitol, 0.63% NaCl (standard composition); b) 28% (w / v) glycerol, 6.8% sorbitol, 0.25% NaCl (modified composition). It was found out that a decrease in the concentration of glycerol and an increase in the concentration of sorbitol leads to a decrease in the erythrocyte hemolysis. The results obtained suggest that a change in the composition of the cryoconservant will reduce osmotic stress during thawing of red blood cells, which, in turn, will reduce their destruction upon transfusion and the likelihood of inflammation.
When hypothermic storage of red blood cellsб there is a decrease in the level of glutathione and an increase in the concentration of homocysteine, at the same time, inclusion in the medium of substrate amino-acids of the synthesis of glutathione activates the utilization of this cytotoxin. Moreover, stimulation of the synthesis of glutathione reduces the loss of membrane proteins and lowers the intensity of hemoglobin oxidation that ensures the preservation of the osmotic stability of erythrocytes. Red blood cells as a component of the body redox homeostasis absorb and neutralize reactive oxygen and nitrogen species, which normally determine a certain antioxidant potential and are not enough to maintain the structural and functional state of red blood cells after isolation from donor blood and storage. Oxidative stress in cells, including red blood cells, in various pathologies usually causes a decrease in the level of glutathione and an impairment of its synthesis that leads to an increase in the production of homocysteine and its entry into the blood plasma. Homocysteine is a cytotoxic amino acid that enhances the production of superoxide, limits the bioavailability of nitric oxide and causes the development of vascular pathology. The data presented in the review indicate that stimulation of the antioxidant potential of erythrocytes during the storage may prevent the development of oxidative stress and inflammation during subsequent transfusion. In addition, the preservation of the viability indicators of various cells during cryopreservation in a medium with substrate amino-acids shows that stimulation of the antioxidant potential contributes to an increase in the cell resistance to the damaging factors of freeze-thawing.
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