Impact of lipid peroxidation and antioxidants on erythrocytes during blood storage

Abstract

Background: Blood transfusion plays important role in the management of certain clinical conditions like acute blood loss, injury and anemia. The red blood cells (RBCs) for transfusion can be stored for 35 to 42 days at 2–6°C. It has been reported that some biochemical changes occur during the course of storage. During storage, progressive morphological and biochemical changes occur which are often related to the reduction of ATP, 2,3-diphosphoglycerate, and NADH in RBCs. These changes are referred to as the “storage lesions”. Oxidative damage is the most important factor causing RBC storage lesion. Free radicals can damage RBC products by lipid and protein oxidation affecting cell quality. The present study is aimed to study the impact of lipid peroxidation and potential role of enzymatic antioxidants in stored blood. Material and methods: The present study was observational study carried out in healthy blood donors at KEM hospital, Mumbai. Thirty healthy donors, who were fulfilling the inclusion and exclusion criteria, were enrolled in the study. Estimation of hemoglobin, levels of lipid peroxidation and some enzymatic antioxidants like glutathione peroxidase, catalase and superoxide dismutase activity was carried out in a properly stored blood samples at 40C. Enzyme levels estimation was carried out at every 7 days interval. Blood grouping of all the samples was also done to check if there is any change in the levels of lipid peroxidation and antioxidant levels across the groups. Results: Malondialdehyde (MDA) is an indirect marker of lipid peroxidation that can modify proteins. Increased MDA levels in the study indicate that lipid peroxidation in red cells has occurred during the preservation period. Throughout storage period, the levels of glutathione peroxidase and catalase declined. Statistically significant negative correlation existed between lipid peroxidation and glutathione peroxidase. Whereas study established positive correlation between lipid peroxidation and superoxide dismutase (SOD). On day 8, day 15 and day 22, lipid peroxidation was found to be positively correlated with SOD. But on Day 30, there was negative correlation between lipid peroxidation and SOD. Blood grouping of all samples indicate no significant susceptibility to lipid peroxidation when the different blood groups were compared. Methemoglobin levels in stored blood were increased over a period of 30 days. Conclusion: Red cell storage lesions due to oxidative injury during storage are now the reported fact, confirmed by the findings of the present study. This also indicates that antioxidant enzymatic machinery of the system comes into play adequately to circumvent the damage done. To investigate further therapeutic role of antioxidants in preventing oxidative damage to red cells during storage, large sample studies will be required.