Folléa G, Hervé P, Andreu G, Bidet J M, Boudard D, Dazey B, Noël L, Piquet Y
Groupe Atténuation virale des produits sanguins labiles, Société Française de Transfusion Sanguine.
Transfus Clin Biol. 1996;3(2):113-23. doi: 10.1016/s1246-7820(96)80027-9.
Viral inactivation is one of the possibilities to reduce the residual risk of blood products. It is now applied to all plasma derived products (PDP). Application of such techniques to labile blood products (LBP) is difficult for two main reasons: any method should inactivate cell-associated viruses and should avoid any injury of the cells constituting the active ingredient. Physical techniques may reduce the viral content of cellular BPL (leucodepletion, washing, gamma irradiation), but none of them is active enough to comply with the present requirements for efficacy. An important work has been dedicated to the development of virus photoinactivation techniques. They consist of the addition of a photoreagent followed by illumination at an appropriate wavelength which results in a photochemical reaction responsible for the viral inactivation. Treatment of platelet concentrates by psoralen derivatives and UV-A illumination significantly inactivate in vitro enveloped and naked viruses, free and cell-associated viruses and also sequences integrated in the viral genome. Recent progresses have led to these results without detectable functional alteration of platelets and mutagenicity. Viral inactivation of red blood cells yet did not reach the same level because hemoglobin does not allow the use of the photoreagent compounds applicable to platelet concentrates. Viral decontamination of fresh frozen plasma by solvent and detergent, active on enveloped viruses, has been used in France since 1992. Other techniques of comparable efficacy, have received an agreement in other countries. The research on viral inactivation of LBP could prove to be of great importance in the near future in bringing additional safety to patients not only for the residual viral risk but maybe also for the residual bacterial risk of LBP.
病毒灭活是降低血液制品残留风险的方法之一。目前该方法已应用于所有血浆衍生产品（PDP）。由于两个主要原因，将此类技术应用于不稳定血液制品（LBP）存在困难：任何方法都应能灭活与细胞相关的病毒，且应避免对构成活性成分的细胞造成任何损伤。物理技术可能会降低细胞性血液制品（如白细胞去除、洗涤、伽马射线照射）中的病毒含量，但没有一种技术的活性足以满足目前对疗效的要求。一项重要工作致力于病毒光灭活技术的开发。这些技术包括添加一种光试剂，然后在适当波长下进行光照，这会引发一种负责病毒灭活的光化学反应。用补骨脂素衍生物和紫外线A照射处理血小板浓缩物，可在体外显著灭活包膜病毒和裸露病毒、游离病毒和与细胞相关的病毒，以及整合在病毒基因组中的序列。最近的进展在未检测到血小板功能改变和致突变性的情况下取得了这些成果。红细胞的病毒灭活尚未达到相同水平，因为血红蛋白不允许使用适用于血小板浓缩物的光试剂化合物。自1992年以来，法国已使用溶剂和去污剂对新鲜冰冻血浆进行病毒去污，该方法对包膜病毒有效。其他具有可比疗效的技术已在其他国家获得批准。对不稳定血液制品进行病毒灭活的研究在不久的将来可能会变得非常重要，这不仅能为患者带来额外的安全性，降低不稳定血液制品的残留病毒风险，还可能降低其残留细菌风险。
