Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
Department of Pediatrics, Division of Pediatric Hematology/Oncology, Emory University School of Medicine, Atlanta, GA, USA.
Platelets. 2023 Dec;34(1):2185453. doi: 10.1080/09537104.2023.2185453.
Currently, point-of-care assays for human platelet function and coagulation are used to assess bleeding risks and drug testing, but they lack intact endothelium, a critical component of the human vascular system. Within these assays, the assessment of bleeding risk is typically indicated by the lack of or reduced platelet function and coagulation without true evaluation of hemostasis. Hemostasis is defined as the cessation of bleeding. Additionally, animal models of hemostasis also, by definition, lack human endothelium, which may limit their clinical relevance. This review discusses the current state-of-the-art of hemostasis-on-a-chip, specifically, human cell-based microfluidic models that incorporate endothelial cells, which function as physiologically relevant models of bleeding. These assays recapitulate the entire process of vascular injury, bleeding, and hemostasis, and provide real-time, direct observation, thereby serving as research-enabling tools that enhance our understanding of hemostasis and also as novel drug discovery platforms.
目前，用于评估出血风险和药物检测的即时检验（POCT）分析主要用于评估血小板功能和凝血，但这些检测均缺乏完整的血管内皮细胞，而内皮细胞是人类血管系统的关键组成部分。在这些检测中，通常通过血小板功能和凝血的缺乏或减少来评估出血风险，而没有真正评估止血。止血定义为出血停止。此外，由于动物模型也缺乏人类内皮细胞，因此从定义上讲，这些动物模型可能限制了其临床相关性。本综述讨论了基于芯片的止血技术的最新进展，特别是整合了内皮细胞的基于人源细胞的微流控模型，这些模型可作为生理性相关的出血模型。这些检测方法重现了血管损伤、出血和止血的整个过程，并提供实时、直接的观察，因此它们既是增强我们对止血理解的研究工具，也是新型药物发现平台。
