Storing red blood cells with vitamin C and N-acetylcysteine prevents oxidative stress-related lesions: a metabolomics overview

Blood Transfus. 2014 Jul;12(3):376-87. doi: 10.2450/2014.0266-13. Epub 2014 Jun 5.


Background: Recent advances in red blood cell metabolomics have paved the way for further improvements of storage solutions.

Materials and methods: In the present study, we exploited a validated high performance liquid chromatography-mass spectrometry analytical workflow to determine the effects of vitamin C and N-acetylcysteine supplementation (anti-oxidants) on the metabolome of erythrocytes stored in citrate-phosphate-dextrose saline-adenine-glucose-mannitol medium under blood bank conditions.

Results: We observed decreased energy metabolism fluxes (glycolysis and pentose phosphate pathway). A tentative explanation of this phenomenon could be related to the observed depression of the uptake of glucose, since glucose and ascorbate are known to compete for the same transporter. Anti-oxidant supplementation was effective in modulating the redox poise, through the promotion of glutathione homeostasis, which resulted in decreased haemolysis and less accumulation of malondialdehyde and oxidation by-products (including oxidized glutathione and prostaglandins).

Discussion: Anti-oxidants improved storage quality by coping with oxidative stress at the expense of glycolytic metabolism, although reservoirs of high energy phosphate compounds were preserved by reduced cyclic AMP-mediated release of ATP.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcysteine / pharmacology*
  • Adult
  • Ascorbic Acid / pharmacology*
  • Blood Preservation / methods*
  • Erythrocytes / metabolism*
  • Free Radical Scavengers / pharmacology*
  • Humans
  • Male
  • Metabolome / drug effects*
  • Metabolomics / methods
  • Middle Aged
  • Oxidative Stress / drug effects*


  • Free Radical Scavengers
  • Ascorbic Acid
  • Acetylcysteine