فصلنامه خون
سال بیستم شماره 3 (پیاپی 81، پاییز 1402)

Discovery of antibiotics has been one of the important achievements of mankind in the field of infectious diseases, although after a short time, the phenomenon of antibiotic resistance was created. Nowadays, there is a need for an innovation in the control of microbial infections such as the use of antimicrobial peptides. These peptides are abundantly found in neutrophils and since leukoreduction filters are a valuable source of these cells, it has been studied as an available option

In this experimental study, leukoreduction filters was selected by easy non-probability sampling method. First, leukocytes were extracted from leukoreduction filters and then neutrophils were isolated. Defensin peptide was extracted after sonication of neutrophils and was purified by HPLC. Staphylococcus aureus bacteria was cultured and the amount of bacterial inoculation was determined and the minimum inhibitory concentration was measured by macrodilution method. Microbial inhibition halo diameter size of defensin was determined for the intended bacteria.

Using defensin standard, purified defensin peak was collected and the minimum inhibitory concentration was determined as 2.5 μg/mL on Staphylococcus aureus by macrodilution method. Microbial inhibition halo diameter size was calculated as 9 mm

The treatment of infectious diseases has faced a challenge with the widespread emergence of drug resistance, and the use of new innovations is inevitable. Defensin as an antimicrobial peptide is a suitable option that is abundantly found in neutrophils obtained from leukoreduction filters and is suggested for research on new antimicrobial drugs

Sickle Cell Disease is the second most common hemoglobinopathy after thalassemia and is characterized by vascular occlusion and hemolytic anemia. Blood transfusion is considered as a supportive treatment for patients with sickle cell disease. The alloimmunization of red blood cells is a major challenge in these patients. Accordingly, supplying the appropriate antigennegative blood units is a major problem in blood transfusion. The aim of this study was to= evaluate the alloimmunization rates among individuals with Sickle Cell Disease in Khuzestan province.

In this descriptive cross-sectional study, a total of 184 patients with sickle cell anemia and sickle-thalassemia were referred to the Shahid Beqaei hospital in Ahvaz. 5-10 mL of peripheral blood containing the anticoagulant EDTA was collected by non-random sampling procedure. The prevalence of phenotypes and the rate of alloimmunization were determined by the hemagglutination technique.

The prevalence of alloimmunization in this population was 13.0%. In 24 patients, twelve types of alloantibodies were detected. The most common alloantibodies were Anti-E (33.3%, n = 8), Anti-c (20.8%, n = 5), Anti-D (16.6%, n = 4), and Anti- Kell (16.6%, n 4).

Antibody against Rh blood group system and anti-Kell were the most prevalent alloantibodies among sickle cell anemia patients in the province of Khuzestan. Therefore, it is highly recommended to transfuse these individuals with blood units compatible with the Rh (D, C, c, and E) and Kell antigens.

Many of hip fracture patients need transfusion. We examined the frequency of blood transfusion, the relative factors, and the threshold of hemoglobin in hip fracture patients receiving blood transfusion before and during pelvic surgeries.

This retrospective cross-sectional study was conducted on all patients with proximal femur fractures who underwent hip surgery at Shahid Chamran Hospital in Shiraz in 2020. The frequency of blood transfusion, hemoglobin threshold, and the related factors was investigated.

Out of 218 patients, 65 (29.8%) had received blood out of whom 23 patients (35.4%) had received blood before surgery. The hemoglobin threshold before transfusion was 10.99. The average hemoglobin in patients who received blood was less than the patients who did not receive blood (p< 0.001) 10.55 ± 1.61 versus 12.45 ± 1.61. The average number of units used in patients who received blood was 2.30 ± 0.72 (1 to 4 blood units). The frequency of blood transfusion was related to hemoglobin before surgery, gender, type of anesthesia, type of surgery, history of anemia, duration of surgery, and surgeon. The amount of blood consumption did not depend on the patient age .

The average hemoglobin before transfusion was higher than previous studies. It seems that the blood transfusion threshold was higher than in previous studies. Considering the risks and costs of blood transfusion, it seems that physicians' education and emphasis on the use of restrictive transfusion strategy can lead to reduction of blood consumption, reduction of complications, and better blood management.

Blood indices have variation in Covid-19 that could affect diagnosis. Blood index changes in Covid-19 inpatiens were evaluated.

In a descriptive/cross-sectional study, 167 Covid-19 inpatients in Besat Hospital in Hamedan were selected and in terms of changes on the first and seventh days of the blood indices were investigated. Data analysis was done with SPSS software version 26. In order to compare the blood indices on the first and seventh days of hospitalization, Wilcoxon and Monte Carlo tests were used.

The average blood indices on the first and seventh day were 4.64 ± 0.59 and 4.39 ± 0.62 million in microliter (p< 0.001) for RBCs, 6.20 ± 3.84 and 7.55± 4.13 thousand in microliter (p< 0.001) for white blood cells, 179.54 ± 90.14 and 269.76 ± 109.03 thousand in microliter (p< 0.001) for platelets, 13.20 ± 1.71 and 12.27 ± 1.77 g/dL (p< 0.001) for hemoglobin, 40.45 ± 4.67 and 38.16 ± 5.02 % (p< 0.001) for hematocrit, 12.5 ± 0.55 and 13.1 ± 0.66 % (p< 0.001) for RDW, 87.18 ± 5.43 and 87.15 ± 5.62 femtoliters for MCV, 28.47 ± 2.16 and 28.18 ± 2.03 picograms (p= 0.002) for MCH and 32.56 ± 1.63 and 32.35 ± 1.64 g/dL for MCHC.

Blood indices in Covid-19 inpatients undergo changes from the time of admission to the seventh day. White blood cell, platelet and RDW were increased and red blood cell, hematocrit, hemoglobin, MCV, MCH and MCHC decreased compared to the first day of hospitalization.

Blood transfusion in thalassemia patients has side effects such as endocrine iron overload. It is necessary to use iron chelators. The aim is to investigate the prevalence of hypothyroidism and its relationship with the level of iron overload and the results of the heart and liver MRI as a new method for diagnosing iron deposition, and iron removal treatment. Determining the factors affecting this complication can help prevent or improve it.

This cross-sectional study was conducted on 232 beta-thalassemia major and intermedia patients of Tehran adult thalassemia clinic in the year 1400 who were selected by convenient sampling method. The comparison of the level of thyroid hormones and ferritin was done with Chi-squared, independent t, Mann-Whitney and Kruskal-Wallis tests by SPSS 26.

The prevalence of hypothyroidism in patients with an average age of 40.79 ± 9.02 year was 27.6% There was no significant relationship between hypothyroidism with ferritin levels or heart and liver iron deposition. TSH level was significantly (p= 0.01) higher in men than women. Most of patients used combined iron chelators, but the type of drug was not significantly different.

It seems that iron overload may be effective in hypothyroidism, but it does not necessarily lead to it. Despite the treatment of iron deficiency, this complication is still one of the main problems. It is suggested to consider the amount of iron load and iron removal treatment before and after the onset of hypothyroidism in future studies.

Exercise may play a role in regulating hematopoietic function as an activator and stimulator of hematopoietic stem cells. The purpose of this study was to investigate the effect of one week of regular aerobic exercise on the mobilization of CD34+ stem cells and the amount of new platelet production and the duration of hospitalization in leukemia patients.

In this clinical trial study, 39 patients with an average age of 46.93 ± 14.76 including 22 men (56%) and 17 women (44%) who were candidates for stem cell transplantation were randomly divided into two experimental (18 patients) and control groups (21 patients). Both groups received G-CSF. Patients in the experimental group did one week of treadmill training, but the control group did not receive any intervention. Blood samples were taken from patients immediately after training, during hospitalization and at discharge. In order to analyze the data, t-tests and SPSS 22 were used

CD34+ cells increased after training in two groups (p< 0.0001), but there was no significant difference between the two groups. The average amounts of platelets at the time of discharge in the experimental and control groups were 88687 ± 75077 and 42714.29 ± 32023 per microliter of blood, respectively, and it showed a significant difference between the two groups (p= 0.01).

Combination of G-CSF treatment and one week aerobic exercise have a positive effect on the amount of blood platelets in patients undergoing autologous peripheral blood stem cell transplantation.

There are different ways to prepare platelets. Every one of these methods can have advantages and limitations for blood transfusion centers, donors, and patients. Knowledge of them is necessary for choosing the proper technique in blood transfusion centers. This article reviewed the methods of preparing platelets and compared them.

Studies related to the preparation of platelet components, the texts of articles, and review references were extracted. PubMed, Web of Science, Scopus, Magiran, SID, Google, and Google Scholar search engines were used for keywords such as blood component, platelet-rich plasma, platelet concentrate, buffy-coat method, platelet storage, buffy-coat pooled platelet, plateletpheresis, pathogen inactivation, Overnight storage, preparation concentrate, Leukofiltered platelets from May to June 2022.

Studies comparing platelet preparation methods have had different results. One of the advantages of Buffy–coat method may be less activation, as platelets are centrifuged against a cushion of RBCs rather than the plastic container during PRP-PC production. Some recent findings have shown that the quality and clinical effectiveness of the buffy-Coat technique is better than Platelets Rich plasma (PRP) and is equivalent to the apheresis method. However, sufficient evidence is not yet available. The limitations of platelet preparation by the apheresis method, including the cost, declining apheresis donor base, and the time-consuming process, have led to the tendency towards other techniques. However, in cases such as platelet refractoriness, it is necessary to prepare matched platelets using the apheresis method.

To improve the quality of platelets and optimize the treatment of thrombocytopenic patients, it seems that the preparation of leuko-reduced pooled platelets is a suitable option considering the challenges of the apheresis method. With the advancement of techniques such as pathogen reduction and platelete additive solutions it is attempted for longer life span and safety.

Today, the issue of microbial resistance is considered as one of the most important challenges in the field of public health and the use of new biocompatible, safe and effective antimicrobial compounds is very important to solve this problem. Therefore, according to the antimicrobial properties of platelets, treatments based on platelet products can be used as complementary approaches along with antibiotics to treat microbial infections. In this review article, the properties and mechanism of the antimicrobial effect of platelets and platelet products along with some of the available evidence in this field have been briefly described.

The search process was done in Google scholar and PubMed databases using keywords “Platelets”, “Platelet-rich plasma” and “Anti-Infective Agents” without time restrictions. 107 relevant articles were selected and their findings regarding the properties and mechanism of the antimicrobial effect of platelets and platelet products were used.

Antimicrobial activities of platelet products are due to the presence of a large number of platelets and various types of bioactive molecules, high amounts of platelet microbicidal proteins, and using multiple mechanisms. On the other hand, biocompatibility, safety, high clinical efficacy and limited side effects are some of the advantages of using platelet products. However, standardization and optimization of their preparation protocols are also important challenges.

The use of platelet products together with antibiotics is a suitable option to treat various microbial infections.