The Introduction of Dendrimers as a New Approach to Improve the Performance and Quality of Various Blood Products (Platelets, Plasma and Erythrocytes): A 2010-2022 Review Study

Abstract

Objectives: Platelet-, erythrocyte- and plasma-related products are vital for some patients. The main problems with these products are storage lesions, shelf life limitations, and function and quality maintenance. Dendrimers, a well-known group of polymeric nanoparticles, may help overcome these challenges due to their special properties. Methods: This review article, for the first time, comprehensively discusses studies from 2010 to 2022 on the compatibility of positive, negative, neutral, and modified charge dendrimers with each blood product. Moreover, it provides information regarding dendrimers' applications for improving the quality and function of blood products. Results: A total of one hundred and twenty-six studies showed that dendrimers affect blood components depending on their load, size, molecular weight, functional group, concentration, and exposure time. Generally, cationic dendrimers with higher concentrations and molecular weight and larger size showed little hemocompatibility, while anionic or neutral dendrimers with lower concentrations and molecular weight, and small size were more hemocompatible. Further, some modifications of cationic dendrimers were found to improve their compatibility. For erythrocytes, they included PEGylation and thiolation of dendrimers or functionalizing them with cyclic RGD, nmaleyl chitosan, zwitterionic chitosan, prednisolone, or carbohydrates. Additionally, dendrimers functionalized with arginine-birch, lysine-Cbz, polyethylene glycol, polyethylene glycol-cyclic RGD, thiol, TiO2, maltotriose, or streptokinase decreased the platelet toxicity of dendrimers. The dendrimers modified with polyethylene glycol, glucose, and gold nanoparticles showed increased compatibility in the case of albumin products. Moreover, the PAMAM-dendrimer-antibody conjugates had no adverse effect on antibodies. Dendrimers have a wide range of applications, including virus detection kits, synthetic O2 carriers, bacterial nanofilters, drug carriers, anticoagulants, and enhanced blood product storage. Conclusion: It can be concluded that due to the outstanding properties of different types of dendrimers, particularly their manipulability, nanomaterials can be promising to enhance the quality of blood products. Thus, further research in this area is required.