Testosterone supplementation increases red blood cell susceptibility to oxidative stress, decreases membrane deformability, and decreases survival after cold storage and transfusion.

Autor: Tran J; Vitalant Research Institute, San Francisco, California, USA.; Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA., Jackman RP; Vitalant Research Institute, San Francisco, California, USA.; Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA., Muench MO; Vitalant Research Institute, San Francisco, California, USA.; Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA., Hazegh K; Vitalant Research Institute, Denver, Colorado, USA., Bean SW; Vitalant Research Institute, Denver, Colorado, USA., Thomas KA; Vitalant Research Institute, Denver, Colorado, USA.; Department of Pathology, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA., Fang F; Genomics and Translational Research Center, RTI International, North Carolina, USA., Page G; Genomics and Translational Research Center, RTI International, North Carolina, USA.; Fellow Program, RTI International, Atlanta, Georgia, USA., O'Connor K; Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA., Roubinian NH; Vitalant Research Institute, San Francisco, California, USA.; Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.; Kaiser Permanente Northern California Division of Research, Oakland, California, USA., Anawalt BD; Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA., Kanias T; Vitalant Research Institute, Denver, Colorado, USA.; Department of Pathology, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2024 Aug; Vol. 64 (8), pp. 1469-1480. Date of Electronic Publication: 2024 Jun 17.
DOI: 10.1111/trf.17922
Abstrakt: Background: Blood collection from donors on testosterone therapy (TT) is restricted to red blood cell (RBC) concentrates to avoid patient exposure to supraphysiological testosterone (T). The objective of this study was to identify TT-related changes in RBC characteristics relevant to transfusion effectiveness in patients.
Study Design: This was a two-part study with cohorts of patients and blood donors on TT. In part 1, we conducted longitudinal evaluation of RBCs collected before and at three time points after initiation of T. RBC assays included storage and oxidative hemolysis, membrane deformability (elongation index), and oximetry. In part 2, we evaluated the fate of transfused RBCs from TT donors in immunodeficient mice and by retrospective analyses of NIH's vein-to-vein databases.
Results: TT increased oxidative hemolysis (1.45-fold change) and decreased RBC membrane deformability. Plasma free testosterone was positively correlated with oxidative hemolysis (r = .552) and negatively correlated with the elongation index (r = -.472). Stored and gamma-irradiated RBCs from TT donors had lower posttransfusion recovery in mice compared to controls (41.6 ± 12 vs. 55.3 ± 20.5%). Recipients of RBCs from male donors taking T had 25% lower hemoglobin increments compared to recipients of RBCs from non-TT male donors, and had increased incidence (OR, 1.80) of requiring additional RBC transfusions within 48 h of the index transfusion event.
Conclusions: TT is associated with altered RBC characteristics and transfusion effectiveness. These results suggest that clinical utilization of TT RBCs may be less effective in recipients who benefit from longer RBC survival, such as chronically transfused patients.
(© 2024 AABB.)
Databáze: MEDLINE
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