Biscola Natalia Perussi, Cartarozzi Luciana Politti, Ulian-Benitez Suzana, Barbizan Roberta, Castro Mateus Vidigal, Spejo Aline Barroso, Ferreira Rui Seabra, Barraviera Benedito, Oliveira Alexandre Leite Rodrigues
Graduate Program in Tropical Diseases, Botucatu Medical School, Univ Estadual Paulista (UNESP), Botucatu, SP Brazil.
Center for the Study of Venoms and Venomous Animals (CEVAP), Univ Estadual Paulista (UNESP), Botucatu, SP Brazil.
J Venom Anim Toxins Incl Trop Dis. 2017 Mar 14;23:13. doi: 10.1186/s40409-017-0103-1. eCollection 2017.
Lesions to the nervous system often produce hemorrhage and tissue loss that are difficult, if not impossible, to repair. Therefore, scar formation, inflammation and cavitation take place, expanding the lesion epicenter. This significantly worsens the patient conditions and impairment, increasing neuronal loss and glial reaction, which in turn further decreases the chances of a positive outcome. The possibility of using hemostatic substances that also function as a scaffold, such as the fibrin sealant, reduces surgical time and improve postoperative recovery. To date, several studies have demonstrated that human blood derived fibrin sealant produces positive effects in different interventions, becoming an efficient alternative to suturing. To provide an alternative to homologous fibrin sealants, the Center for the Study of Venoms and Venomous Animals (CEVAP, Brazil) has proposed a new bioproduct composed of certified animal components, including a thrombin-like enzyme obtained from snake venom and bubaline fibrinogen. Thus, the present review brings up to date literature assessment on the use of fibrin sealant for nervous system repair and positions the new heterologous bioproduct from CEVAP as an alternative to the commercial counterparts. In this way, clinical and pre-clinical data are discussed in different topics, ranging from central nervous system to peripheral nervous system applications, specifying positive results as well as future enhancements that are necessary for improving the use of fibrin sealant therapy.
神经系统损伤常常会导致出血和组织损失，即便并非完全无法修复，修复起来也十分困难。因此，会形成瘢痕、炎症和空洞，从而扩大损伤中心。这会显著恶化患者的病情和损伤状况，增加神经元损失和神经胶质反应，进而进一步降低获得良好预后的几率。使用兼具支架功能的止血物质（如纤维蛋白密封剂）的可能性，能够缩短手术时间并促进术后恢复。迄今为止，多项研究表明，人血源性纤维蛋白密封剂在不同干预措施中都能产生积极效果，成为缝合的一种有效替代方法。为了提供同源纤维蛋白密封剂的替代物，巴西毒液与有毒动物研究中心（CEVAP）提出了一种由经过认证的动物成分组成的新型生物制品，其中包括从蛇毒中提取的一种类凝血酶和水牛纤维蛋白原。因此，本综述对纤维蛋白密封剂用于神经系统修复的文献评估进行了更新，并将CEVAP的新型异源生物制品定位为商业同类产品的替代物。通过这种方式，在从中枢神经系统到外周神经系统应用的不同主题中讨论了临床和临床前数据，明确了积极成果以及改进纤维蛋白密封剂治疗应用所需的未来改进方向。
