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Open AccessArticle

Attenuation of Red Blood Cell Storage Lesions with Vitamin C

Department of Pathology, Director, Transfusion Services, Virginia Commonwealth University, Richmond, VA 23298, USA
Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
Author to whom correspondence should be addressed.
Antioxidants 2017, 6(3), 55;
Received: 6 June 2017 / Revised: 6 July 2017 / Accepted: 8 July 2017 / Published: 12 July 2017
(This article belongs to the Special Issue Vitamin C: Current Concepts in Human Physiology)
PDF [4566 KB, uploaded 12 July 2017]


Stored red blood cells (RBCs) undergo oxidative stress that induces deleterious metabolic, structural, biochemical, and molecular changes collectively referred to as “storage lesions”. We hypothesized that vitamin C (VitC, reduced or oxidized) would reduce red cell storage lesions, thus prolonging their storage duration. Whole-blood-derived, leuko-reduced, SAGM (saline-adenine-glucose-mannitol)-preserved RBC concentrates were equally divided into four pediatric storage bags and the following additions made: (1) saline (saline); (2) 0.3 mmol/L reduced VitC (Lo VitC); (3) 3 mmol/L reduced VitC (Hi VitC); or (4) 0.3 mmol/L oxidized VitC (dehydroascorbic acid, DHA) as final concentrations. Biochemical and rheological parameters were serially assessed at baseline (prior to supplementation) and Days 7, 21, 42, and 56 for RBC VitC concentration, pH, osmotic fragility by mechanical fragility index, and percent hemolysis, LDH release, glutathione depletion, RBC membrane integrity by scanning electron microscopy, and Western blot for β-spectrin. VitC exposure (reduced and oxidized) significantly increased RBC antioxidant status with varying dynamics and produced trends in reduction in osmotic fragility and increases in membrane integrity. Conclusion: VitC partially protects RBC from oxidative changes during storage. Combining VitC with other antioxidants has the potential to improve long-term storage of RBC. View Full-Text
Keywords: vitamin C; RBC storage lesions; mean fragility index; β-spectrin; scanning electron microscopy vitamin C; RBC storage lesions; mean fragility index; β-spectrin; scanning electron microscopy

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Sanford, K.; Fisher, B.J.; Fowler, E.; Fowler, A.A.; Natarajan, R. Attenuation of Red Blood Cell Storage Lesions with Vitamin C. Antioxidants 2017, 6, 55.

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