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Gary
E. Stack, MD, PhD
Associate
Professor of Laboratory Medicine
Chief, Pathology and Laboratory Medicine,
VA
Connecticut Healthcare System
1-3-M, Bldg. 1 West Haven Campus
203-937-3415 (VA)
gary.stack@yale.edu
B.S.,
1971, University of Maryland (College Park)
Ph.D., 1983, University of Wisconsin (Madison)
M.D., 1984, Johns Hopkins University
Research Fellowship: Molecular Endocrinology, Institut de Chimie
Biologique (Strasbourg, France)
Clinical Fellowship: Transfusion Medicine, Yale University School
of Medicine
Research
Interests
Our research has focused on the role of inflammatory cytokines in
mediating adverse effects of blood transfusion. We have shown that
leukocyte-derived cytokines such as interleukins-1$, -6, - 8, as
well as MIP-1", GRO-", and TNF-" are present in the
plasma portion of stored platelet concentrates and are generated
in vitro during blood bank storage. Some cytokines were also detected
in the supernatant portion of red blood cell units. These cytokines
are generated in direct proportion to the leukocyte content of the
component, the storage temperature, and the storage time. Bacterial
contamination of blood components, as might occur in the setting
of a septic transfusion reaction, further stimulates cytokine generation.
Pre-storage leukoreduction of blood components prevents the generation
of these cytokines.
We
also have tested for two platelet-derived cytokines, TGF-$1 and
RANTES, in the plasma portion of platelet concentrates. TFG-$1 has
diverse effects on immunoinflammatory responses and in excess amounts
can produce immunosuppression. RANTES chemoattracts and activates
eosinophils and basophils. TGF-$1 and RANTES are present at the
highest levels of any cytokines measured to date in platelet concentrates.
These cytokines are already present early in storage and their accumulation
is not prevented by pre-storage leukoreduction. Studies are in progress
to determine the stimulus and regulation of cytokine generation
in the transfusion setting, the cell(s) of origin, and methods to
prevent cytokine generation, and their possible role in transfusion-related
adverse effects.
- Stack
G. Cytokine Accumulation in Stored Platelet Concentrates: Detection,
Prevention and Potential Significance. Biol Clin Hematol 17:58-64,
1995.
- Stack
G, Baril L, Napychank P and Snyder EL. Cytokine Generation in
Stored, Leukor- educed and Bacterially-contaminated Units of Red
Blood Cells. Transfusion 35:199-203, 1995.
- Stack
G and Snyder EL. Cytokine Generation in Stored Platelet Concentrates.
Transfu- sion 34:20-5, 1994.
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