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在血小板生成的道路上。

On the Way to Platelet Production.

作者信息

Strassel Catherine, Gachet Christian, Lanza François

机构信息

Université de Strasbourg, INSERM, EFS Grand Est, BPPS UMR-S 1255, FMTS, Strasbourg, France.

出版信息

Front Med (Lausanne). 2018 Aug 28;5:239. doi: 10.3389/fmed.2018.00239. eCollection 2018.

Abstract

The severely decreased platelet counts (10-30. 10 platelets/μL) frequently observed in patients undergoing chemotherapy, radiation treatment, or organ transplantation are associated with life-threatening increased bleeding risks. To circumvent these risks, platelet transfusion remains the treatment of choice, despite some limitations which include a limited shelf-life, storage-related deterioration, the development of alloantibodies in recipients and the transmission of infectious diseases. A sustained demand has evolved in recent years for controlled blood products, free of infectious, inflammatory, and immune risks. As a consequence, the challenge for blood centers in the near future will be to ensure an adequate supply of blood platelets, which calls for a reassessment of our transfusion models. To meet this challenge, many laboratories are now turning their research efforts toward the and customized production of blood platelets. In recent years, there has been a major enthusiasm for the cultured platelet production, as illustrated by the number of reviews that have appeared in recent years. The focus of the present review is to critically asses the arguments put forward in support of the culture of platelets for transfusion purposes. In light of this, we will recapitulate the main advances in this quickly evolving field, while noting the technical limitations to overcome to make cultured platelet a transfusional alternative.

摘要

在接受化疗、放疗或器官移植的患者中,经常观察到血小板计数严重下降(10 - 30×10⁹血小板/μL),这与危及生命的出血风险增加有关。为规避这些风险,尽管存在一些局限性,包括保质期有限、储存相关的变质、受者体内同种抗体的产生以及传染病的传播,但血小板输注仍然是首选治疗方法。近年来,对无感染、炎症和免疫风险的可控血液制品的需求持续增长。因此,血液中心在不久的将来面临的挑战将是确保血小板的充足供应,这需要重新评估我们的输血模式。为应对这一挑战,许多实验室现在正将研究精力转向血小板的体外生成和定制生产。近年来,人们对培养血小板生产表现出极大的热情,近年来出现的综述数量就说明了这一点。本综述的重点是批判性地评估支持培养血小板用于输血目的的论据。有鉴于此,我们将概述这一快速发展领域的主要进展,同时指出要使培养血小板成为输血替代品需克服的技术限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35eb/6120994/d1ccb615b1a6/fmed-05-00239-g0001.jpg

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