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以脐带血来源的血小板浓缩物为起始材料,在公共脐带血库中制备新型治疗性血液成分:从产品开发到临床应用。

Cord blood-derived platelet concentrates as starting material for new therapeutic blood components prepared in a public cord blood bank: from product development to clinical application.

机构信息

"Banc de Sang i Teixits", Barcelona, Spain.

Transfusional Medicine Research Group, "Vall d'Hebron" Research Institute (VHIR), Barcelona, Spain.

出版信息

Blood Transfus. 2020 May;18(3):208-216. doi: 10.2450/2020.0305-19. Epub 2020 Apr 3.

Abstract

BACKGROUND

There are many advantages to using cord blood (CB) as a source of therapeutic platelet and plasma derivatives for regenerative medicine. These include availability, universal use, young donor source, and virally safe biological material, rich in tissue regenerative factors.

MATERIALS AND METHODS

We aimed to validate a bioprocess design for the production of cord blood-derived platelet concentrates (CBPC) in a public Cord Blood Bank (CBB). CBPC was defined as a product of 10±5 mL, 1,000±200×10/L total platelets, free of erythrocytes and leukocytes. A total of 300 CB units were centrifuged in two steps to enrich for platelets, in compliance with Good Manufacturing Practice. The samples were tested for the degree of platelet activation present, and the levels of growth factor were analysed to evaluate their potential function. CBPC were then activated after thawing with 10% calcium gluconate to generate platelet gels (CBPG) to treat patients with diabetic foot ulcers.

RESULTS

After processing, 84% of the products fulfilled the acceptance criteria. Final products contained 1,017±149×10 platelets/mL in 10±3mL of plasma. Platelet recovery was 50±9%. The methods described here ensure depletion of white and red blood cells down to a residual concentration of 0.2±0.1×10/mL and 0.03±0.02×10/mL, respectively. Platelets showed low levels of activation during processing, but were significantly activated after thawing, as indicated by an increase in CD62p expression. The growth factors EGF, VEGF, bFGF, PDGF AB/BB and TGF-β1 were at concentrations of 1,706±123 pg/mL; 1,602±227 pg/mL; 314±26 pg/mL; 30±1.5 ng/mL; 24±2 ng/mL (mean±standard error of mean), respectively. For clinical evaluation, a total of 21 CBPG were applied in 3 patients, with no reported adverse events and improvement of ulcers in all of them.

DISCUSSION

We designed and validated a highly reproducible, closed system method to manufacture high quality CBPC suitable for clinical applications using CB units not suitable for transplantation in a public CBB.

摘要

背景

使用脐带血(CB)作为治疗性血小板和血浆衍生物的来源,用于再生医学,具有许多优势。这些优势包括可用性、普遍适用性、年轻供体来源和病毒安全的生物材料,富含组织再生因子。

材料和方法

我们旨在验证公共脐带血库(CBB)中生产脐带血衍生血小板浓缩物(CBPC)的生物工艺设计。CBPC 被定义为 10±5mL、1,000±200×10/L 总血小板、无红细胞和白细胞的产品。总共 300 个 CB 单位在两个步骤中离心以富集血小板,符合良好生产规范。对存在的血小板活化程度进行测试,并分析生长因子水平以评估其潜在功能。解冻后用 10%葡萄糖酸钙激活 CBPC 生成血小板凝胶(CBPG),以治疗糖尿病足溃疡患者。

结果

处理后,84%的产品符合验收标准。最终产品中含有 1,017±149×10 个血小板/mL,在 10±3mL 血浆中。血小板回收率为 50±9%。这里描述的方法可确保白细胞和红细胞的消耗分别降至 0.2±0.1×10/mL 和 0.03±0.02×10/mL 的残留浓度。血小板在处理过程中显示出低水平的活化,但解冻后明显活化,表现为 CD62p 表达增加。EGF、VEGF、bFGF、PDGF AB/BB 和 TGF-β1 生长因子的浓度分别为 1,706±123pg/mL、1,602±227pg/mL、314±26pg/mL、30±1.5ng/mL、24±2ng/mL(平均值±标准误差)。在临床评估中,总共 21 个 CBPG 应用于 3 名患者,没有报告不良事件,所有患者的溃疡均得到改善。

讨论

我们设计并验证了一种高度可重复、封闭系统的方法,用于在公共 CBB 中使用不适合移植的 CB 单位生产高质量的 CBPC,适用于临床应用。

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