Red blood cell transfusion-induced non-transferrin-bound iron promotes Pseudomonas aeruginosa biofilms in human sera and mortality in catheterized mice

Br J Haematol. 2022 Feb;196(4):1105-1110. doi: 10.1111/bjh.17934. Epub 2021 Nov 2.

Abstract

Transfusion of storage-damaged red blood cells (RBCs) increases non-transferrin-bound iron (NTBI) levels in humans. This can potentially enhance virulence of microorganisms. In this study, Pseudomonas aeruginosa replication and biofilm production in vitro correlated with NTBI levels of transfused subjects (R2 = 0·80; P < 0·0001). Transfusion of stored RBCs into catheterized mice enhanced P. aeruginosa virulence and mortality in vivo, while pre-administration of apotransferrin reduced NTBI levels improving survival (69% vs 27% mortality; P < 0·05). These results suggest that longer RBC storage, by modulating the bioavailability of iron, may increase the risk of P. aeruginosa biofilm-related infections in transfused patients.

Keywords: biofilm; blood transfusion; infection; iron; non-transferrin bound iron.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Biofilms
  • Erythrocyte Transfusion / methods*
  • Erythrocyte Transfusion / mortality
  • Erythrocytes / metabolism*
  • Healthy Volunteers
  • Humans
  • Iron / blood*
  • Male
  • Mice
  • Pseudomonas aeruginosa
  • Survival Analysis

Substances

  • Iron