Tasnim Farah, Deng Rensheng, Hu Min, Liour Sean, Li Yao, Ni Ming, Ying Jackie Y, Zink Daniele
Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos, Singapore 138669, Singapore.
Fibrogenesis Tissue Repair. 2010 Aug 10;3:14. doi: 10.1186/1755-1536-3-14.
Bioartificial kidneys (BAKs) combine a conventional hemofilter in series with a bioreactor unit containing renal epithelial cells. The epithelial cells derived from the renal tubule should provide transport, metabolic, endocrinologic and immunomodulatory functions. Currently, primary human renal proximal tubule cells are most relevant for clinical applications. However, the use of human primary cells is associated with many obstacles, and the development of alternatives and an unlimited cell source is one of the most urgent challenges. BAKs have been applied in Phase I/II and Phase II clinical trials for the treatment of critically ill patients with acute renal failure. Significant effects on cytokine concentrations and long-term survival were observed. A subsequent Phase IIb clinical trial was discontinued after an interim analysis, and these results showed that further intense research on BAK-based therapies for acute renal failure was required. Development of BAK-based therapies for the treatment of patients suffering from end-stage renal disease is even more challenging, and related problems and research approaches are discussed herein, along with the development of mobile, portable, wearable and implantable devices.
生物人工肾(BAK)将传统的血液滤过器与含有肾上皮细胞的生物反应器单元串联。源自肾小管的上皮细胞应提供转运、代谢、内分泌和免疫调节功能。目前,原代人肾近端小管细胞与临床应用最为相关。然而,使用人原代细胞存在许多障碍,开发替代物和无限的细胞来源是最紧迫的挑战之一。BAK已应用于I/II期和II期临床试验,用于治疗急性肾衰竭的重症患者。观察到对细胞因子浓度和长期生存有显著影响。随后的IIb期临床试验在中期分析后停止,这些结果表明需要对基于BAK的急性肾衰竭治疗方法进行进一步深入研究。开发基于BAK的疗法来治疗终末期肾病患者更具挑战性,本文将讨论相关问题和研究方法,以及移动、便携、可穿戴和植入式设备的发展。