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[人造血液]

[Artificial blood].

作者信息

Kobayashi Koichi

机构信息

Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 2005 Jan;106(1):31-7.

Abstract

To prepare for shortage of blood components and to avoid side effects such as blood borne infectious disease, blood substitutes such as artificial red cell (artificial oxygen carrier) and artificial platelet are being developed. As for oxygen carriers, there are several candidates such as perfluorochemicals, modified hemoglobins and liposome encapsulated hemoglobins and albuimin heme. Perfluorochemicals have limited oxygen carrying capacity and oxygen inhalation is mandatory when they are used. Modified hemoglobins such as intermolecular or intramolecular cross linked hemoglobins have side effect to cause hypertension by scavenging nitro oxide (NO) which is produced by endothelial cells, because the size of these hemoglobins are small enough to go to the adjacent place near endothelial surface. Hemoglobin vesicles (HbV) in which hemoglobins are encapsulated in liposome is most possible candidate for oxygen carrier. Usefulness and safety of the HbV is evidenced by animal shock model or exchange transfusion model and they are now being prepared for clinical trials as red blood substitutes or oxygen therapeutics. Albumin heme in which recombinant human serum albumin incorporating synthetic heme is thought an ideal resuscitation fluid as this material has colloid oncotic pressure. Short time storage and viral infection are serious concern in platelet transfusion therapy for bleeding thrombocytopenic patients. Adhesion of the platelet to the collagen surface and aggregation at the bleeding sites to plug holes in blood vessels, and to facilitate the function of the remaining platelets is a starting point in developing platelet substitutes and several platelet substitutes have been proposed on this theory.

摘要

为应对血液成分短缺并避免诸如血源性传染病等副作用,人工红细胞(人工氧载体)和人工血小板等血液替代品正在研发中。至于氧载体,有几种候选物,如全氟化合物、修饰血红蛋白、脂质体包裹血红蛋白和白蛋白血红素。全氟化合物的携氧能力有限,使用时必须进行吸氧。分子间或分子内交联血红蛋白等修饰血红蛋白会产生副作用,即通过清除内皮细胞产生的一氧化氮(NO)导致高血压,因为这些血红蛋白的尺寸足够小,能够到达内皮表面附近的相邻位置。血红蛋白包裹在脂质体中的血红蛋白囊泡(HbV)是最有可能成为氧载体的候选物。动物休克模型或换血模型证明了HbV的有效性和安全性,它们目前正准备作为红细胞替代品或氧治疗剂进行临床试验。将合成血红素整合到重组人血清白蛋白中的白蛋白血红素被认为是一种理想的复苏液,因为这种物质具有胶体渗透压。对于血小板减少性出血患者的血小板输血治疗来说,短期储存和病毒感染是严重问题。血小板与胶原蛋白表面的粘附以及在出血部位的聚集以堵塞血管中的漏洞,并促进剩余血小板的功能,是开发血小板替代品的出发点,基于这一理论已经提出了几种血小板替代品。

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