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. 2017 Jun;81(6):905-910.
doi: 10.1038/pr.2017.14. Epub 2017 Jan 18.

Estimation of adult and neonatal RBC lifespans in anemic neonates using RBCs labeled at several discrete biotin densities

Denison J Kuruvilla  1 , John A Widness  2 , Demet Nalbant  2 , Robert L Schmidt  2 , Donald M Mock  3   4 , Guohua An  1 , Peter Veng-Pedersen  1
Affiliations

Estimation of adult and neonatal RBC lifespans in anemic neonates using RBCs labeled at several discrete biotin densities

Denison J Kuruvilla et al. Pediatr Res. 2017 Jun.

Abstract

Background: Prior conclusions that autologous neonatal red blood cells (RBC) have substantially shorter lifespans than allogeneic adult RBCs were not based on direct comparison of autologous neonatal vs. allogeneic adult RBCs performed concurrently in the same infant. Biotin labeling of autologous neonatal RBCs and allogeneic adult donor RBCs permits concurrent direct comparison of autologous vs. allogeneic RBC lifespan.

Methods: RBCs from 15 allogeneic adult donors and from 15 very-low-birth-weight (VLBW) neonates were labeled at separate biotin densities and transfused simultaneously into the 15 neonates. Two mathematical models that account for the RBC differences were employed to estimate lifespans for the two RBC populations.

Results: Mean ± SD lifespan for adult allogeneic RBC was 70.1 ± 19.1 d, which is substantially shorter than the 120 d lifespan of both autologous and adult allogeneic RBC in healthy adults. Mean ± SD lifespan for neonatal RBC was 54.2 ± 11.3 d, which is only about 30% shorter than that of the adult allogeneic RBCs.

Conclusion: This study provides evidence that extrinsic environmental factors primarily determine RBC survival (e.g., small bore of the capillaries of neonates, rate of oxygenation/deoxygenation cycles) rather than factors intrinsic to RBC.

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Conflict of interest statement

Conflict of Interest Disclosures: The authors have the following potential conflicts of interest items to disclose:

  1. ■

    Dr. John A. Widness is a paid consultant for HemoGenix (http://hemogenix.com) and holds a loan agreement with Sysmex Corporation, Kobe, Japan (http://www.sysmex.co.jp/en/index.html) for use of the XE-2100 hematology analyzer in his research lab.

  2. ■

    Donald M. Mock is a consultant for MedDay Pharmaceutical.

Figures

Figure 1
Figure 1
Model fit to Hb amount vs. time data. Panel A and B depict the fit (solid line) of the non-SS neonatal RBC survival model (Equation 4) to the empirical Hb amount circulating in autologous neonatal BioRBCs (open squares) for two representative study subjects. Panels C and D depict the fit (solid line) of the steady-state adult RBC survival model (Equation 1) to the empirical Hb in circulating allogeneic adult donor BioRBCs (open squares) for the same two subjects. Agreement is good between the model fits and the Hb amounts in circulation for each population of RBC (adult and infant) for both subjects.
Figure 2
Figure 2
The mean (± SD) RBC lifespan of neonatal autologous and adult allogeneic RBCs in VLBW anemic infants. The lifespan of neonatal RBCs was significantly less than the estimated lifespan of adult transfused RBCs (P<0.05, two tailed paired t-test).
Figure 3
Figure 3
Influence of infant body weight on allogeneic adult RBC lifespan. The individual data points represent the estimated adult RBC lifespan plotted against the infant body weight for the 15 VLBW anemic preterm infants. The mean adult RBC lifespan increased with infant body weight (P<0.05).
Figure 4
Figure 4
Study protocol diagram of RBC biotinylation and population enumeration by flow cytometry. Allogeneic adult donor RBCs and autologous neonatal RBCs were labeled at discreet biotin density levels and and transfused to VLBW anemic study subjects at the end of the first (unlabeled) RBC transfusion given to treat anemia. Post-transfusion blood samples leftover from laboratory testing were analyzed by flow cytometry to determine the fraction of biotin-labeled adult and neonatal RBCs that remained in circulation.
See this image and copyright information in PMC

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