中国输血杂志2025，Vol.38Issue(8)：1016-1022,1029,8.DOI:10.13303/j.cjbt.issn.1004-549x.2025.08.003
不同贮存时间悬浮红细胞外泌体对颅脑损伤的预后影响
Influence of exosomes derived from RBC suspension in different storage durations on the prognosis of traumatic brain injury
摘要
Abstract
Objective Traumatic brain injury(TBI)patients often experience massive bleeding and require blood trans-fusion.However,the storage duration of the transfused blood may affect the prognosis of these patients.This study explored the influence of exosomes derived from fresh and aged blood on the prognosis of rats with TBI,so as to provide theoretical support for the blood transfusion management of TBI patients.Methods Exosomes were isolated from red blood cell(RBC)suspensions stored for 1 week and 5 weeks using ultracentrifugation method.The size,morphology and surface markers of the exosomes were identified by nanoparticle flow cytometry,transmission electron microscopy and Western blotting,respec-tively.A rat model of TBI was constructed using a mechanical impactor for brain injury.After the successful establishment of the model,exosomes from RBC suspensions stored for 1 week and 5 weeks were injected into the extracellular space of rat brain cells using a stereotactic syringe.Cerebral edema at day 1,3,7 and 14 were recorded through cranial magnetic reso-nance imaging(MRI)scans.Magnetic tracing technology(the tracer was Gd-DTPA solution)was used to evaluate the drug metabolism level in the extracellular space of brain cells of TBI rats.The cranial magnetic resonance imaging was scanned every 15 or 30 minutes,and the recording lasted for a total of 240 minutes.The magnetic images were imported into the 3D-Slicer software in Dicom data format for analysis.Mass spectrometry technology was used to analyze the differential proteins of exosomes from RBC suspensions stored for 1 week and 5 weeks,and functional prediction was carried out to explore the possible mechanisms by which exosomes affect the prognosis of TBI.Results After injection of exosomes into TBI rats,the areas of cerebral edema on the day 1,3,7,and 14 were all significantly higher in the rats treated with exosomes from 5-week-stored RBC suspensions,with peak cerebral edema occurring at day 3.The diffusion volume of the tracer was signifi-cantly higher in TBI rats than in normal rats,which implied there was a disorder in the structure of the traumatic brain tissue in TBI rats.Compared with the rats injected with exosomes from 1-week-stored RBC suspensions,those treated with exo-somes from 5-week-stored RBC suspensions showed increased tracer diffusion volume within 120 minutes.Mass spectrometry analysis identified 81 differentially expressed proteins between exosomes from RBC suspensions stored for 5 weeks vs 1 week.Among them,93.83%(76/81)proteins had increased expression levels.The neurodegeneration-related pathways were among the most enriched pathways for upregulated proteins.Conclusion The exosomes from aged RBC suspensions can lead to exacerbated cerebral edema,disrupted extracellular space,and suppressed metabolic rate in TBI rats,sugges-ting that transfusion of aged RBC suspensions may have adverse effects on TBI patients.关键词
悬浮红细胞/外泌体/颅脑损伤/细胞外间隙/预后影响Key words
red blood cell(RBC)suspension/exosome/traumatic brain injury(TBI)/extracellular space(ECS)/prognosis influence分类
医药卫生引用本文复制引用
李通,连靖阁,赵明明,孔玉洁,尹丰..不同贮存时间悬浮红细胞外泌体对颅脑损伤的预后影响[J].中国输血杂志,2025,38(8):1016-1022,1029,8.基金项目
航天医科项目(2021YK11) （2021YK11）
成都医学院临床科学研究基金项目(24LHSJ1-02) （24LHSJ1-02）
