Immunologic effects of trauma and transfusion

Platelet vesicles are potent inflammatory mediators in red blood cell products and washing reduces the inflammatory phenotype

“…This data agrees with our recent work where RCC‐SPs produced from fresh WBF units resulted in significantly higher IL‐8 production in a non‐LPS stimulated monocyte model . Inflammatory activities, including increased inflammatory cytokine production and neutrophil activation, have been associated with RCC transfusion . Dani et al showed an increase in proinflammatory cytokines and an increase in CAMs including ICAM‐1 and VCAM‐1 in infants who receive RCC transfusions .…”

“…Increased risks associated with transfusion of RCCs, including immune and nonimmune adverse reactions, have been an area of interest and controversy for over 20 years. Although RCCs have been reported to modulate/alter immunity, the causative fraction(s) associated with immunomodulation has not been determined. Studies have suggested that the infusion of activated cells and/or soluble mediators such as cytokines, bioactive lipids, hemoglobin, and extracellular vesicles (EVs), are potential immunomodulatory mediators .…”

Coronary artery bypass grafting is associated with immunoparalysis of monocytes and dendritic cells

“…This may translate into increased infective complications or those related to the pro‐inflammatory status associated with cardiopulmonary bypass (eg AF). In CABG patients, restoring immune homeostasis following modulated pro‐inflammatory cytokine production (eg IL‐6, IL‐8) and/or anti‐inflammatory cytokine production (eg CXCL16, IL‐10), as observed in our study, is key to reducing the risk of post‐operative complications including secondary infection; however, further investigation is required.…”

“…An imbalance in immune homeostasis can also lead to cell immunoparalysis, which renders the immune system unresponsive to a secondary insult (eg inflammation or infection) . Immunoparalysis or dysfunction of cells involved in the immune response could have detrimental implications for the patient, therefore restoring immune homeostasis is vital to prevent adverse patient outcomes . In addition, preventative measures could be employed to manage the effects of a dysfunctional immune response.…”

Characterisation of the immune profile and investigation of transfusion-related modulation of monocyte and dendritic cell function in cardiac surgery patients

“…Immunoparalysis is a form of acquired immunodeficiency rendering the immune system unresponsive to a secondary insult (e.g. infection) due to an imbalance in immune homeostasis [125,126] trauma, sepsis) and prevent secondary infection [12,135]. If balance is not restored, unresolved SIRS or CARS leads to overwhelming immunosuppression and consequently immunoparalysis ( Figure 3) [12,125,126].…”