Treatment of Buffy Coat Platelets in Platelet Additive Solution with the Mirasol^® Pathogen Reduction Technology System

Abstract

Background: The Mirasol pathogen reduction technology (PRT) system uses riboflavin and ultraviolet light and is currently approved and used in Europe for the treatment of platelets and plasma. Mirasol treatment is intended to reduce the infectious pathogen load and to inactivate leukocytes in blood products. Our objective was to evaluate buffy coat platelet concentrates (BCPCs) prepared with platelet additive solution (PAS) and treated with the Mirasol system and to examine the effects on platelet cell quality during storage. Methods: 26 BCPCs were prepared and split, creating 13 paired control and test units. The test units were treated with the Mirasol system and the platelet quality was assessed in all units over 7 days of storage. Results: All products met the incoming specifications for Mirasol treatment, and the pH of all Mirasol-treated BCPCs in PAS met the requirements of the Council of Europe guidelines throughout storage. Analysis of lactate production and glucose consumption rates, CD62p expression and cytokines indicates enhanced cellular metabolism in treated platelets, but the levels were within previously published ranges. Conclusion: While Mirasol-treated BCPCs in PAS had increased metabolism and activation compared to controls, the results indicate that these units can be stored for 7 days with acceptable cell quality.

In vitro study of platelet function confirms the contribution of the ultraviolet B (UVB) radiation in the lesions observed in riboflavin/UVB‐treated platelet concentrates

“…A change of ATP consumption rate is another hypothesis for the increased glycolytic flux in riboflavin/UVB‐treated PLTs. Increased expression of P‐selectin and lower ATP content were reported in riboflavin/UVB‐treated PLTs . We also found an increased expression of CD62P, active GPIIbIIIa at the surface of the PLTs, and an increased adhesion to fibrinogen indicating that the riboflavin/UVB‐treated PLTs were somehow activated upon treatment.…”

“…The results from this study reveal that the riboflavin/UVB treatment significantly impacts the metabolism of PLTs as evidenced by higher glucose consumption and lactate production rates. This phenomenon has been observed by other groups in Mirasol‐treated PLTs . It has been hypothesized that the increased anaerobic glycolysis rate in riboflavin/UVB‐treated PLTs was either due 1) to an impaired mitochondrial functionality leading to a decrease of oxidative phosphorylation, 2) to an alteration of the PLT storage medium characteristics (pH, oxygen content, plasma protein content), or 3) to changes in ATP consumption rate …”

“…In vitro studies reported metabolic changes, impaired mitochondrial function, accelerated passive activation, and altered agonist‐induced PLT aggregation in INTERCEPT‐treated compared to untreated PLTs . Mirasol‐treated PLTs exhibit an increased expression of P‐selectin (CD62P), higher lactate production, and increased glucose and oxygen consumption, as well as lower ATP over storage time . The Mirasol PIT leads to hyperactive PLTs resulting in a reduced degranulation capacity upon acute stimulation …”

Treatment of Platelet Concentrates with the Mirasol Pathogen Inactivation System Modulates Platelet Oxidative Stress and NF-κB Activation

“…A number of studies have concluded that Mirasol treatment exacerbates the effects of the platelet storage lesion, resulting in increased glucose consumption, lactate production, and increased markers of platelet activation [2,3,4,5,6]. Further, we and others have previously demonstrated that Mirasol treatment affects platelet signal transduction and apoptotic protein expression [7,8,9,10].…”

Platelet MicroRNAs: An Overview

“…Several different techniques are available to reduce the bacterial burden in stored platelets. The 2 most common methods used for pathogen reduction are Mirasol Pathogen Reduction Technology (riboflavin + ultraviolet B light) [42] and Intercept Blood System (amotosalen + ultraviolet A light) [43]. …”