Curr Opin Immunol. 2025 Jul 2;95:102603. doi: 10.1016/j.coi.2025.102603. Online ahead of print.
ABSTRACT
PURPOSE OF THE REVIEW: Recent insights into extracellular vesicles (EVs) derived from platelet (PC) and red blood cell concentrates (RBC), which form during blood product processing and storage.
RECENT FINDINGS: EVs impact transfusion outcomes by modulating immune and inflammatory responses. Acting as lipid mediators and expressing adhesion molecules, EVs contribute to immune signaling via cytokines, DAMPs, and antigen-presenting molecules. In RBC, EVs accumulate during storage and are linked to endothelial cell (EC) activation, increased thrombotic risk, and tissue inflammation – especially under existing inflammatory conditions. While their effect on circulating immune cells is limited, they strongly activate tissue-resident immune and EC. In PCs, platelet-derived EVs and other cell-specific EVs also emerge. Certain EV subtypes express CD27, CD70, CD39, and HLA antigens, altering T-cell, B-cell, and monocyte activity. These immunomodulatory effects may contribute to transfusion-related immunomodulation and alloimmunization.
SUMMARY: EVs in stored blood products influence immune responses highlighting the need for monitoring.
PMID:40609228 | DOI:10.1016/j.coi.2025.102603