Blood, Vol. 94 No. 11 (December 1), 1999:
pp. 3922-3927
Solvent/Detergent-Treated Plasma Has Decreased Antitrypsin Activity
and Absent Antiplasmin Activity
Alan E. Mast,
Jason E. Stadanlick,
J. Marcus Lockett, and
Dennis
J. Dietzen
From the Research and Pathology Services, Department of Veterans
Affairs, and Department of Pathology, University of Tennessee, Memphis,
TN.
Solvent/detergent (S/D)-treated plasma is currently marketed by the
American Red Cross as a virally inactivated alternative to fresh-frozen
plasma (FFP). The serpin-type serine proteinase inhibitors have a
flexible reactive site loop (RSL) that can convert from the active
conformation to the inactive latent or polymerized conformations when
exposed to heat and/or detergents. We have compared the conformational
stability and inhibitory activity of 3 plasma serpins
antithrombin,
antitrypsin, and antiplasminin S/D plasma and FFP. In S/D plasma,
virtually 100% of the antiplasmin and approximately 50% of the
antitrypsin are in either the latent or polymerized conformation and
lack inhibitory activity, while in FFP only the active conformation is
present. Interestingly, antithrombin is not affected by S/D treatment
and remains fully active. These data demonstrate that S/D plasma is not
simply a virally inactivated equivalent of FFP. The lack of antiplasmin activity and decreased antitrypsin activity in S/D plasma suggest that
it may not be as effective as FFP for the treatment of bleeding in
patients with systemic activation of proteolytic cascades, such as
disseminated intravascular coagulation and sepsis, acquired fibrinolytic states, and large-volume transfusion. Although there has
been extensive use of S/D plasma in several European countries with no
reports of adverse effects, clinical studies directly comparing the
efficacy of these 2 plasma products are needed to directly evaluate the
relative therapeutic efficacy of FFP and S/D plasma for the treatment
of these diseases.
