Seltsam Axel, Müller Thomas H
German Red Cross Blood Service NSTOB, Institute Springe, Germany.
Transfus Med Hemother. 2011;38(1):43-54. doi: 10.1159/000323845. Epub 2011 Jan 22.
Besides the current efforts devoted to microbial risk reduction, pathogen inactivation technologies promise reduction of the residual risk of known and emerging infectious agents. A novel pathogen reduction process for platelets, the THERAFLEX UV-Platelets system, has been developed and is under clinical evaluation for its efficacy and safety. In addition, proof of principle has been shown for UVC treatment of plasma units. The pathogen reduction process is based on application of UVC light of a specific wavelength (254 nm) combined with intense agitation of the blood units to ensure a uniform treatment of all blood compartments. Due to the different absorption characteristics of nucleic acids and proteins, UVC irradiation mainly affects the nucleic acid of pathogens and leukocytes while proteins are largely preserved. UVC treatment significantly reduces the infectivity of platelet units contaminated by disease-causing viruses and bacteria. In addition, it inactivates residual white blood cells in the blood components while preserving platelet function and coagulation factors. Since no photoactive compound needs to be added to the blood units, photoreagent-related adverse events are excluded. Because of its simple and rapid procedure without the need to change the established blood component preparation procedures, UVC-based pathogen inactivation could easily be implemented in existing blood banking procedures.
除了目前致力于降低微生物风险的努力之外,病原体灭活技术有望降低已知和新出现的传染源的残余风险。一种用于血小板的新型病原体灭活工艺——THERAFLEX UV-血小板系统已经开发出来,并且正在对其有效性和安全性进行临床评估。此外,紫外线C(UVC)处理血浆单位的原理验证已经得到证实。病原体灭活工艺基于特定波长(254纳米)的UVC光的应用,并结合对血液单位的剧烈搅拌,以确保对所有血液成分进行均匀处理。由于核酸和蛋白质具有不同的吸收特性,UVC照射主要影响病原体和白细胞的核酸,而蛋白质基本得以保留。UVC处理可显著降低被致病病毒和细菌污染的血小板单位的感染性。此外,它可灭活血液成分中的残余白细胞,同时保留血小板功能和凝血因子。由于无需向血液单位中添加光活性化合物,因此排除了与光试剂相关的不良事件。由于其操作简单、快速,且无需改变既定的血液成分制备程序,基于UVC的病原体灭活可以很容易地应用于现有的血库程序中。