Discrete responses of erythrocytes, platelets, and von Willebrand factor to shear

Chris H H Chan; Michael J Simmonds; Katharine H Fraser; Kosuke Igarashi; Katrina K Ki; Tomotaka Murashige; Mary T Joseph; John F Fraser; Geoff D Tansley; Nobuo Watanabe

doi:10.1016/j.jbiomech.2021.110898

Discrete responses of erythrocytes, platelets, and von Willebrand factor to shear

J Biomech. 2022 Jan:130:110898. doi: 10.1016/j.jbiomech.2021.110898. Epub 2021 Dec 6.

Authors

Affiliations

¹ School of Engineering and Built Environment, Griffith University, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia. Electronic address: chris_houng@hotmail.com.
² Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
³ Department of Mechanical Engineering, University of Bath, Bath, United Kingdom.
⁴ School of Engineering and Built Environment, Griffith University, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; Department of Life Sciences, Systems Engineering and Science, Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan.
⁵ Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia.
⁶ School of Engineering and Built Environment, Griffith University, Queensland, Australia; School of Engineering, Tokyo Institute of Technology, Tokyo, Japan.
⁷ Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia.
⁸ Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia; School of Medicine, Griffith University, Queensland, Australia.
⁹ School of Engineering and Built Environment, Griffith University, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia.
¹⁰ Department of Life Sciences, Systems Engineering and Science, Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan.

PMID: 34896790
DOI: 10.1016/j.jbiomech.2021.110898

Abstract

Despite decades of technological advancements in blood-contacting medical devices, complications related to shear flow-induced blood trauma are still frequently observed in clinic. Blood trauma includes haemolysis, platelet activation, and degradation of High Molecular Weight von Willebrand Factor (HMW vWF) multimers, all of which are dependent on the exposure time and magnitude of shear stress. Specifically, accumulating evidence supports that when blood is exposed to shear stresses above a certain threshold, blood trauma ensues; however, it remains unclear how various constituents of blood are affected by discrete shears experimentally. The aim of this study was to expose blood to discrete shear stresses and evaluate blood trauma indices that reflect red cell, platelet, and vWF structure. Citrated human whole blood (n = 6) was collected and its haematocrit was adjusted to 30 ± 2% by adding either phosphate buffered saline (PBS) or polyvinylpyrrolidone (PVP). Viscosity of whole blood was adjusted to 3.0, 12.5, 22.5 and 37.5 mPa·s to yield stresses of 3, 6, 9, 12, 50, 90 and 150 Pa in a custom-developed shearing system. Blood samples were exposed to shear for 0, 300, 600 and 900 s. Haemolysis was measured using spectrophotometry, platelet activation using flow cytometry, and HMW vWF multimer degradation was quantified with gel electrophoresis and immunoblotting. For tolerance to 300, 600 and 900 s of exposure time, the critical threshold of haemolysis was reached after blood was exposed to 90 Pa for 600 s (P < 0.05), platelet activation and HMW vWF multimer degradation were 50 Pa for 600 s and 12 Pa for 300 s respectively (P < 0.05). Our experimental results provide simultaneous comparison of blood trauma indices and thus also the relation between shear duration and magnitude required to induce damage to red cells, platelets, and vWF. Our results also demonstrate that near-physiological shear stress (<12 Pa) is needed in order to completely avoid any form of blood trauma. Therefore, there is an urgent need to design low shear-flow medical devices in order to avoid blood trauma in this blood-contacting medical device field.

Keywords: Blood-shearing device; Exposure time; HMW vWF multimer degradation; Haemolysis; Platelet activation; Shear stress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Platelets*
Erythrocytes
Humans
Platelet Activation
Stress, Mechanical
von Willebrand Factor*

Substances

von Willebrand Factor