Abstract: Objective Red blood cells (RBCs) storage lesion has been an important concern on RBCs storage in vitro, involving a series of physiological, biochemical, morphological, and omics changes during RBCs storage. These changes interact with each other and affect stored RBCs. In order to further elucidate the mechanism of RBCs storage lesion, the mechanism of RBCs lesion during storage was conducted by multi-omics. Methods A total of 10 bags of RBCs were collected using disposable plastic blood bags (abnormal ALT test results). The prepared RBCs was stored at 4 ℃ for 0, 1, 3 and 5 weeks, respectively, and tested according to RBC quality standards (HCT, HGB and hemolysis rate during storage). The biochemical indexes (K⁺、Na⁺、Cl^-、Ca²⁺、Glu and LDH) were detected in different storage periods. Proteomic and metabolomic tests were performed, and bioinformatics analysis was used to evaluate the changes and correlation of biological functions during RBCs storage. Results In line with the national quality standard for RBCs, its biochemical indexes K⁺ and LDH increased with the preservation time, Na⁺ and Glu decreased. At 5 weeks, the difference was significant (P<0.01), and other indexes Cl^- and Ca²⁺ had no significant changes (P>0.05). We performed proteomics and metabolomics based on the screened proteins and their downstream differential metabolite changes. By different levels of biomolecules, we found that RBCs storage had more effects on RBCs metabolism etc., especially on metabolic pathways such as nucleotide metabolism, purine metabolism, and protein digestion and absorption, but had less effects on RBC metabolism-related proteins. Conclusion By metabolomics and proteomics, we promote the study of RBCs structure, function, etc., which lays a good foundation for further research on the mechanism of RBCs storage lesion.

Key words: Red blood cells, Metabolomics, Proteomics, Integrative approach