Impact of Leukoreduction Timing on Plasma Citrullinated Histone H3 (H3cit) Dynamics and Red Blood Cell Storage Lesions

September 10, 2026 updated by: Mayar Medhat Hamed Thabet, Assiut University
Impact of Leukoreduction Timing on Plasma Citrullinated Histone H3 (H3cit) Dynamics and Red Blood Cell Storage Lesions To measure H3cit levels immediately after filtration on Days 0, 1, 3, and 5. To measure H3cit levels during storage at mid-storage and shelf-life end To correlate H3cit levels with standard blood storage markers

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Packed red blood cells (PRBCs) are the most commonly transfused blood component and play a critical role in treating anemia, trauma, and surgical patients. However, during refrigerated storage, PRBCs undergo a sequence of biochemical, metabolic, and structural changes collectively referred to as the "storage lesion." These changes include depletion of adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG), glucose utilization, lactate production, pH changes, potassium loss, oxidative stress, increased free hemoglobin release, and morphological alterations such as decreased deformability and microparticle formation. Such changes can impair erythrocyte function and survival following transfusion, particularly in critically ill patients and those requiring massive transfusion Studies have demonstrated that markers of NETs increase during RBC storage and are significantly higher in non-leukoreduced units compared to leukoreduced units(5) Specifically, in canine models, day 42 non-leukoreduced units contained approximately 1000-fold more cell-free DNA than leukoreduced units, with significantly higher Cit-H3 levels Leukoreduction, the removal of white blood cells from blood products, is performed to reduce transfusion reactions and immunomodulation. Pre-storage leukoreduction has been shown to prevent cytokine accumulation during storage and reduce the risk of febrile nonhemolytic transfusion reactions and TRALI The timing of leukoreduction is critical, as pre-storage filtration prevents the accumulation of leukocyte-derived bioactive substances that occur during storage, whereas post-storage filtration does not Importantly, universal leukoreduction has been associated with an 83% decrease in TRALI rates, highlighting the clinical significance of leukocyte removal Neutrophil extracellular traps (NETs) are web-like structures composed of DNA, histones, and neutrophil granular proteins extruded from activated neutrophils. NETs have been implicated in cytotoxicity, thrombosis, and autoimmunity, and they play a role in the pathogenesis of transfusion-related acute lung injury (TRALI) Citrullinated histone H3 (Cit-H3) is a specific marker of NETosis, as NET formation requires histone citrullination by peptidylarginine deiminase 4 (PAD4) Given the established role of NETs in transfusion-related complications and the potential for Cit-H3 to serve as a quality marker, this study aims to evaluate Cit-H3 levels in stored RBC units and assess its correlation with storage duration and leukoreduction timing. The findings could provide insights into optimizing storage conditions and improving transfusion outcomes through better identification and mitigation of storage lesions

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Egypt
      • Asyut, Egypt
        • Mayar Medhat
        • Contact:
          • Thabet
          • Phone Number: +201028494332

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • • Standard whole blood units collected from healthy voluntary donors who meet the national blood transfusion service fitness criteria (age 18-60 years, body weight ≥50 kg).

    • Collection Volume & Container: Standard unit volume (450 ± 45 mL) collected into closed bag systems with additive/anticoagulant solution (CPDA-1).
    • Thermal Storage Chain: Blood units maintained continuously within standard blood bank temperature limits (2 C to 6C )from collection until the end of the storage period.

Baseline Hematological Parameters: Normal baseline hematological profile immediately post-collection (Hemoglobin ≥12.5g dl)

Exclusion Criteria:

  • Donor Clinical Factors: Donors with a history of acute or chronic inflammatory conditions, active infections, autoimmune diseases, or those who ingested anti-inflammatory/antiplatelet medications (e.g., NSAIDs, aspirin) within 14 days prior to donation.
  • Technical Collection Complications: Phlebotomy draw time exceeding 12 minutes, difficult venipuncture, or units displaying macro-clots or excessive lipemia post-collection.
  • Storage Excursions & Bag Damage: Any blood unit subjected to cold-chain temperature violations outside 2-6C, physical damage, or system breaches/leaks.

Transfusion-Transmitted Infections (TTI): Units testing reactive for screening markers, including HBsAg, Anti-HCV, Anti-HIV-1/2, or Syphilis

  • Donor Clinical Factors: Donors with a history of acute or chronic inflammatory conditions, active infections, autoimmune diseases, or those who ingested anti-inflammatory/antiplatelet medications (e.g., NSAIDs, aspirin) within 14 days prior to donation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Leukoreduction Timing on H3Cit
Other: H3Cit
To measure H3cit levels during storage at mid-storage and shelf-life end

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
To measure H3cit levels immediately after filtration
Time Frame: on Days 0, 1, 3, and 5.
on Days 0, 1, 3, and 5.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Assiut University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Mariam Ezzat Abdallah, Assistant professor, Assiut University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 1, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 10, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 10, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 16, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 16, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 10, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • Leukoreduction Timing on H3cit

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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