Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 10;21(1):110.
doi: 10.1186/s12871-021-01330-9.

Effect of intraoperative blood transfusion on Treg and FOXP3 in patients with digestive tract malignancies and different ABO blood types

Yajun Liu #  1 , Junzhi Sun #  1 , Yun Xia  2 , Michael R Lyaker  2 , Jianshe Yu  3
Affiliations

Effect of intraoperative blood transfusion on Treg and FOXP3 in patients with digestive tract malignancies and different ABO blood types

Yajun Liu et al. BMC Anesthesiol. .

Abstract

Background: Blood transfusion can cause immunosuppression and lead to worse outcomes in patients with digestive tract malignancies; however, the specific mechanism behind this is not completely understood. One theory is that increased numbers of regulatory CD3+CD4+CD25+FOXP3+ T cells (Tregs) and forkhead box protein-3 mRNA (FOXP3) expression in the blood after transfusion contribute to these outcomes. The effect of blood transfusion on immune function in patients with different ABO blood types is variable. This study investigates the effect of intraoperative blood transfusion on the number of Tregs and the expression of FOXP3 in the blood of patients with different ABO blood types and digestive tract malignancies.

Methods: Patients with digestive tract malignancies who underwent radical resection and received intraoperative blood transfusion were divided into four groups according to their blood types:blood group A, blood group B, blood group O and blood group AB (n = 20 for each group). Blood was collected from all patients before surgery, immediately after transfusion, 1 day after transfusion, and 5 days after transfusion. The number of Tregs was measured by flow cytometry. The expression of FOXP3 was detected by real time reverse transcription polymerase chain reaction (RT-PCR).

Results: There was no significant difference in the number of Tregs or expression of FOXP3 mRNA among patients with different blood types before surgery. However, the number of Tregs and the expression of FOXP3 increased after blood transfusion in all blood type groups. This increase was especially evident and statistically significant on the first day after blood transfusion when compared with measures obtained before the surgery. Measures returned to the preoperative level five days after surgery. There were significant differences in the increase of Tregs and expression of FOXP3 among patients with different blood types. The greatest increase was seen in patients with blood group B and the least in blood group A.

Conclusions: Intraoperative blood transfusion can lead to an increase in blood Tregs and FOXP3 expression in patients with digestive tract malignancies. Increases were greatest on the first day after surgery and differed among patients with different blood types. Increases were greatest in blood type B and least in blood type A.

Keywords: ABO blood group; Blood transfusion; Digestive tract; FOXP3; Immunity; Malignant tumor; Treg.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of CD3+CD4+CD25+CD127low Tregs at different time points in different blood types. A, blood group A; B, blood group B; O, blood group O; AB, blood group AB. T0, before surgery; T1, immediately after transfusion; T2, 1 day after transfusion; T3, 5 days after transfusion. Compared with T0, ★P < 0.05; compared with blood group B, O, AB, ▲P < 0.05; compared with blood group A, O, AB, △P < 0.05
Fig. 2
Fig. 2
Flow cytometry image. Flow cytometric gating scheme for Treg: Starting from lymphocytes by FSC and SSC gating, cells were further gated on CD4+ and CD25+, then CD127low was used to define Treg population as CD4+CD25+CD127low T lymphocytes, gating of this marker was based on CD4+ T lymphocytes
Fig. 3
Fig. 3
Comparison of FOXP3mRNA at different time points in different blood types. A, blood group A; B, blood group B; O, blood group O; AB, blood group AB. T0, before surgery; T1, immediately after transfusion; T2, 1 day after transfusion; T3, 5 days after transfusion. Compared with T0, ★fold-change > 2; compared with blood group B, O, AB, ▲P < 0.05; compared with blood group A, O, AB, △P < 0.05
See this image and copyright information in PMC

References

    1. Calleja JL, Delgado S, del Val A, Hervás A, Larraona JL, Terán Á, et al. Ferric carboxymaltose reduces transfusions and hospital stay in patients with colon cancer and anemia. Int J Color Dis. 2016;31(3):543–551. doi: 10.1007/s00384-015-2461-x. - DOI - PMC - PubMed
    1. Hou D, Dai J, Deng Z, Yan D. Effects of hemoglobin level and perioperative blood transfusion on prognosis of patients with clon cancer. Modern Oncol. 2018;26(07):1070–1074.
    1. Ceanga AI, Ceanga M, Eveslage M, Herrmann E, Fischer D, Haferkamp A, et al. Preoperative anemia and extensive transfusion during stay-in-hospital are critical for patient's mortality: a retrospective multicenter cohort study of oncological patients undergoing radical cystectomy [J] Transf Apheresis Sci. 2018;57(6):739–745. doi: 10.1016/j.transci.2018.08.003. - DOI - PubMed
    1. Ness PM, Triulzi DJ, Carson JL. Adverse effects of red-cell transfusion [J] N Engl J Med. 2018;378(1):97–98. doi: 10.1056/NEJMc1714159. - DOI - PubMed
    1. Aquina CT, Blumberg N, Becerra AZ, Boscoe FP, Schymura MJ, Noyes K, Monson JRT, Fleming FJ. Association among blood transfusion, Sepsis, and decreased long-term survival after Colon Cancer resection [J] Ann Surg. 2017;266(2):311–317. doi: 10.1097/SLA.0000000000001990. - DOI - PubMed