REMOVAL OF ANAPHYLATOXINS C3A AND C5A AND CHEMOKINES INTERLEUKIN-8 AND RANTES BY POLYESTER WHITE CELL-REDUCTION AND PLASMA FILTERS

BACKGROUND: A few bedside polyester white cell (WBC)-reduction filters have been shown to scavenge C3a anaphylatoxin from stored blood compo nents. One has been shown to remove the chemokines interleukin (IL)-8 and RANTES, but not the proinflammatory cytokines IL-1, IL-6, and tumo r necrosis factor alpha. Removal by any filter of the anaphylatoxin C5 a or the soluble membrane attack complex (SC5b-9) has not been studied . Further, the ability of other filters to scavenge these biologic res ponse modifiers (BRM) is not known. Four WBC-reduction filters and one plasma filter were studied for their ability to remove IL-8, RANTES, IL-1 beta, C3a, C5a, and SC5b-9. STUDY DESIGN AND METHODS: Plasma was obtained either as freshly thawed fresh-frozen plasma, fresh-frozen pl asma thawed and stored for 5 days, or platelet-poor supernatant. Cell- poor plasma was obtained and samples were taken before and after filtr ation through the various filters. Levels of IL-1 beta, IL-8, RANTES, C3a, and SC5b9 were quantitated by enzyme immunoassay. To evaluate fil ter scavenging of C5a, an in vitro model was developed to generate hig h levels of C5a in plasma by activating plasma with zymosan. RESULTS: Levels of C3a, C5a, IL-8, and RANTES were reduced by filtration throug h two bedside platelet WBC-reduction filters, a plasma filter, and a p restorage red cell WBC-reduction filter, but not following filtration through a prestorage platelet WBC-reduction filter. For some BRMs and filters, however, evidence of filter saturation was seen. IL-1 beta wa s not removed by any of the filters tested. CONCLUSION: Some, but not all, bedside polyester filters and prestorage polyester filters can re move IL-8, RANTES, C3a, and C5a from units of plasma or platelets. Imp roved biomaterial engineering of these and other filters could maximiz e scavenging of BRMs and potentially diminish the adverse reactions as sociated with their infusion during transfusion.