- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT01226498
Effects of Blood Transfusion in Healthy Volunteers
Effects of Duration of Stored Red Blood Cell Transfusion on Physiological Parameters and Inflammatory Mediators in Healthy Adult Volunteers
Tutkimuksen yleiskatsaus
Tila
Ehdot
Interventio / Hoito
Yksityiskohtainen kuvaus
The objective of this study is to assess effects of the storage of PRBC on endothelial function, inflammation and platelet activation in healthy volunteers.
The present study consists of two parts. During one phase of the study, 10 healthy human volunteers will donate a unit of blood, which will be leukoreduced and stored in Additive Solutions-1 (AS-1), and then transfused back to the subjects after 2 days of storage at 4º C in the MGH Blood Bank. The other part of the study consists in the collection of a unit of blood from the same volunteers, but which will be transfused back to the same subject after 40 days of storage. There will be a break of 2 week period in between these 2 study phases. The order of these 2 study parts will be randomized.
We hypothesize that old red blood cells stored under conventional conditions may trigger a complex, pro-inflammatory, pro-thrombotic and vasoconstriction response. We will compare the response to PRBC stored for 2 days with the response to PRBC stored for 40 days in the same healthy volunteers. We will monitor/measure the following markers/parameters:
- Endothelium-mediated changes in vascular (arterial) tone
- Tissue oxygen saturation will be continuously assessed during and after blood transfusion
- Hemolysis as quantified by changes in plasma haptoglobin level, plasma free hemoglobin, LDH level, bilirubin level, iron level, ferritin, and transferrin
- Changes of plasma and red blood cell levels of circulating nitrate, nitrite, RXNO, RNNO, NO-heme
- Concentration of cytokines, such as IL-6, IL-8, IL-10, IL-12, TNF, IFN-γ
- Activation of platelets through circulating P-selectin expression on platelets
- Activation of inflammatory lipid mediators
- Changes in gene expression profiling analyzing RNA microarray of circulating leukocytes
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
-
-
Massachusetts
-
Boston, Massachusetts, Yhdysvallat, 02114
- Massachusetts General Hospital (MGH)
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Have a photo ID
- Body mass index (BMI) <25 kg/m2 and >18 kg/m2
- Fasting for 8 hours prior to enrollment in the study (a sip of water or brushing teeth in the morning are allowed)
- Feel well the day of blood donation
- Normal physical exam and normal blood test as indicated:
- WBC 4.5-11.0 th/cmm
- HGB 12.5-17.5 gm/dl
- PLT 150-400 th/cumm
- Plasma Sodium 135-145 mmol/L
- Plasma Potassium 3.4-4.8 mmol/L
- Plasma Chloride 98-108 mmol/L
- Plasma Carbon Dioxide 23.0-31.9 mmol/L
- Plasma Urea Nitrogen 8-25 mg/dl
- Plasma Creatinine 0.60-1.50 mg/dl
- Plasma Glucose 70-110 mg/dl
- Transaminase-SGPT 10-55 U/L
- Transaminase-SGOT 10-40 U/L
Exclusion Criteria:
- Psychiatric disturbances such as anxiety, depression, schizophrenia requiring pharmacological treatment or hospitalization in the last year
- Systemic disease with or without any functional limitation
- controlled hypertension
- controlled diabetes without systemic effects
- Pregnancy determined by urine pregnancy test, detecting presence of human chorionic gonadotropin (hCG), or less than six weeks postpartum
- Active smoking. Volunteers may be enrolled if they quit smoking for more than 1 year
- Excess alcohol use: more than ½ L/day of wine consumption or equivalent
- Any current use of a medication other than: Over-the-counter oral medications, herbal remedies, nutritional supplements, and oral contraceptives
- Antibiotic use within 48 hours of blood donation
- Use of NSAIDS, corticosteroids, aspirin during the past 7 days
- Dental work within 24 hours prior to the donation
- Received or donated blood in the last 4 months
- Have had any forms of cancer with the exceptions of basal cell skin cancer or treatment for in situ cervical cancer
- Currently enrolled in another research study
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Perustiede
- Jako: Satunnaistettu
- Inventiomalli: Crossover-tehtävä
- Naamiointi: Yksittäinen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
---|---|
Kokeellinen: Fresh blood auto-transfusion
|
Withdrawal from 10 Healthy volunteers of one unit of red blood cells and auto-transfusion after 3 days for one arm of the study, after 40 days for the other.
Participants are enrolled in both arms of the study.
|
Kokeellinen: Old blood auto-transfusion
|
Withdrawal from 10 Healthy volunteers of one unit of red blood cells and auto-transfusion after 3 days for one arm of the study, after 40 days for the other.
Participants are enrolled in both arms of the study.
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
---|---|
Endothelial function
Aikaikkuna: Baseline
|
Baseline
|
Endothelial function
Aikaikkuna: 10 min after transfusion
|
10 min after transfusion
|
Endothelial function
Aikaikkuna: 1h after transfusion
|
1h after transfusion
|
Endothelial function
Aikaikkuna: 4h after transfusion
|
4h after transfusion
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
---|---|
Hemolysis
Aikaikkuna: Baseline
|
Baseline
|
NO metabolites
Aikaikkuna: Baseline
|
Baseline
|
Concentration of cytokines
Aikaikkuna: Baseline
|
Baseline
|
Activation of platelets
Aikaikkuna: Baseline
|
Baseline
|
Activation of inflammatory lipid mediators
Aikaikkuna: Baseline
|
Baseline
|
Changes in gene expression
Aikaikkuna: Baseline
|
Baseline
|
Hemolysis
Aikaikkuna: 10 min after transfusion
|
10 min after transfusion
|
NO metabolites
Aikaikkuna: 10 min after transfusion
|
10 min after transfusion
|
Concentration of cytokines
Aikaikkuna: 10 min after transfusion
|
10 min after transfusion
|
Activation of platelets
Aikaikkuna: 10 min after transfusion
|
10 min after transfusion
|
Activation of inflammatory lipid mediators
Aikaikkuna: 10 min after transfusion
|
10 min after transfusion
|
Changes in gene expression
Aikaikkuna: 10 min after transfusion
|
10 min after transfusion
|
Hemolysis
Aikaikkuna: 1h after transfusion
|
1h after transfusion
|
NO metabolites
Aikaikkuna: 1h after transfusion
|
1h after transfusion
|
Concentration of cytokines
Aikaikkuna: 1h after transfusion
|
1h after transfusion
|
Activation of platelets
Aikaikkuna: 1h after transfusion
|
1h after transfusion
|
Activation of inflammatory lipid mediators
Aikaikkuna: 1h after transfusion
|
1h after transfusion
|
Changes in gene expression
Aikaikkuna: 1h after transfusion
|
1h after transfusion
|
Hemolysis
Aikaikkuna: 2h after transfusion
|
2h after transfusion
|
NO metabolites
Aikaikkuna: 2h after transfusion
|
2h after transfusion
|
Concentration of cytokines
Aikaikkuna: 2h after transfusion
|
2h after transfusion
|
Activation of platelets
Aikaikkuna: 2h after transfusion
|
2h after transfusion
|
Activation of inflammatory lipid mediators
Aikaikkuna: 2h after transfusion
|
2h after transfusion
|
Changes in gene expression
Aikaikkuna: 2h after transfusion
|
2h after transfusion
|
Hemolysis
Aikaikkuna: 4h after transfusion
|
4h after transfusion
|
NO metabolites
Aikaikkuna: 4h after transfusion
|
4h after transfusion
|
Concentration of cytokines
Aikaikkuna: 4h after transfusion
|
4h after transfusion
|
Activation of platelets
Aikaikkuna: 4h after transfusion
|
4h after transfusion
|
Activation of inflammatory lipid mediators
Aikaikkuna: 4h after transfusion
|
4h after transfusion
|
Changes in gene expression
Aikaikkuna: 4h after transfusion
|
4h after transfusion
|
Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Päätutkija: Warren M Zapol, MD, Massachusetts General Hospital, DACCPM
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Koch CG, Li L, Sessler DI, Figueroa P, Hoeltge GA, Mihaljevic T, Blackstone EH. Duration of red-cell storage and complications after cardiac surgery. N Engl J Med. 2008 Mar 20;358(12):1229-39. doi: 10.1056/NEJMoa070403.
- Gladwin MT, Lancaster JR Jr, Freeman BA, Schechter AN. Nitric oxide's reactions with hemoglobin: a view through the SNO-storm. Nat Med. 2003 May;9(5):496-500. doi: 10.1038/nm0503-496. No abstract available.
- Panza JA, Casino PR, Kilcoyne CM, Quyyumi AA. Role of endothelium-derived nitric oxide in the abnormal endothelium-dependent vascular relaxation of patients with essential hypertension. Circulation. 1993 May;87(5):1468-74. doi: 10.1161/01.cir.87.5.1468.
- Hendrickson JE, Hillyer CD. Noninfectious serious hazards of transfusion. Anesth Analg. 2009 Mar;108(3):759-69. doi: 10.1213/ane.0b013e3181930a6e.
- Bennett-Guerrero E, Veldman TH, Doctor A, Telen MJ, Ortel TL, Reid TS, Mulherin MA, Zhu H, Buck RD, Califf RM, McMahon TJ. Evolution of adverse changes in stored RBCs. Proc Natl Acad Sci U S A. 2007 Oct 23;104(43):17063-8. doi: 10.1073/pnas.0708160104. Epub 2007 Oct 11.
- Cardillo C, Kilcoyne CM, Cannon RO 3rd, Panza JA. Interactions between nitric oxide and endothelin in the regulation of vascular tone of human resistance vessels in vivo. Hypertension. 2000 Jun;35(6):1237-41. doi: 10.1161/01.hyp.35.6.1237.
- Nagasaka Y, Fernandez BO, Garcia-Saura MF, Petersen B, Ichinose F, Bloch KD, Feelisch M, Zapol WM. Brief periods of nitric oxide inhalation protect against myocardial ischemia-reperfusion injury. Anesthesiology. 2008 Oct;109(4):675-82. doi: 10.1097/ALN.0b013e318186316e.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Arvio)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muut tutkimustunnusnumerot
- 2010P000961
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