Divalent magnesium restores cytoskeletal storage lesions in cold-stored platelet concentrates
Abstract Cold storage of platelet concentrates (PC) has become attractive due to the reduced risk of bacterial proliferation, but in vivo circulation time of cold-stored platelets is reduced. Ca2+ release from storage organelles and higher activity of Ca2+ pumps at temperatures < 15°C triggers cytoskeleton changes. This is suppressed by Mg2+ addition, avoiding a shift in Ca2+ hemostasis and cytoskeletal alterations. We report on the impact of 2–10 mM Mg2+ addition on cytoskeleton alterations of platelets from PC stored at room temperature (RT) or 4°C in additive solution (PAS), 30% plasma. Deformation of platelets was assessed by real-time deformability cytometry (RT-DC), a method for biomechanical cell characterization. Deformation was strongly affected by storage at 4°C and preserved by Mg2+ addition ≥ 4 mM Mg2+ (mean ± SD of median deformation 4°C vs. 4°C + 10mM Mg2+ 0.073 ± 0.021 vs. 0.118 ± 0.023, p < 0.01; n = 6, day 7). These results were confirmed by immunofluorescence microscopy, showing that Mg2+ ≥ 4mM prevents 4°C storage induced cytoskeletal structure lesion. Standard in vitro platelet function tests showed minor differences between RT and cold-stored platelets. Hypotonic shock response was reduced in cold-stored platelets (45.65 ± 11.59% vs. RT stored platelets 56.38 ± 29.36; p = 0.042) but normal at 4°C + 10 mM Mg2+ (55.22 ± 11.16%, all n = 6, day 1). CD62P expression and platelet aggregation response were similar between RT and 4°C stored platelets, with minor changes in the presence of higher Mg2+ concentrations. In conclusion, increasing Mg2+ up to 10 mM in PAS counteracts 4°C storage lesions in platelets, maintains platelet cytoskeletal integrity and biomechanical properties comparable to RT stored platelets.