Circulation:结合珠蛋白和血红素结合蛋白可防止输入红细胞引起的不良效应

2016-09-30 xing.T MedSci原创

由此可见,在小鼠复苏过程中输入储存红细胞引起的不良效应可被输注结合珠蛋白或血红素结合蛋白所改善,结合珠蛋白输液可防止复苏过程输入储存红细胞引起血浆中高血红蛋白浓度相关的肾损伤,给予人血浆蛋白中结合珠蛋白和血红素结合蛋白可能在长时间低血压导致的严重溶血治疗中有益处。

细胞外游离血红蛋白和血红素是红细胞溶血产生的毒性分解物,哺乳动物能够合成蛋白清除剂-结合珠蛋白和血红素结合蛋白,它们分别结合细胞外的血红蛋白和血红素。

失血性休克患者输注红细胞是挽救生命的治疗方式,由于红细胞在储存过程中会发生进展性的有害的形态和生化改变,输注存放较长时间的红细胞(储存红细胞指:人类储存35-40天,小鼠储存14天)可增加血浆游离血红蛋白和血红素。因此,对于失血性休克患者来说,灌注敏感器官如肾脏不仅要面对灌注不足的挑战,同时也要面对输注储存红细胞带来高浓度的血红蛋白和血红素的挑战。

最近,心血管领域权威杂志Circulation上发表了美国哈佛医学院Jan A. Graw医生及其研究团队的文章,旨在解决这一挑战。

研究者为了验证输注外源性人结合珠蛋白和血红素结合蛋白(而非白蛋白),能够改善失血性休克患者复苏过程中输注储存红细胞的不利影响,对小鼠输注储存红细胞输注的同时输入结合珠蛋白、血红素结合蛋白或白蛋白。

研究者发现输注外源性人结合珠蛋白和血红素结合蛋白,而非白蛋白,能够提高小鼠生存率和减轻储存红细胞诱发的炎症(p<0.05),输注结合珠蛋白可减少血浆中游离血红蛋白和防止输注储存红细胞所致的血红蛋白尿和肾损伤。而复苏小鼠给予新鲜红细胞输入,同时输入结合珠蛋白、血红素结合蛋白或白蛋白都不产生有害的影响。

由此可见,在小鼠复苏过程中输入储存红细胞引起的不良效应可被输注结合珠蛋白或血红素结合蛋白改善,结合珠蛋白输注可防止复苏过程输入储存红细胞引起血浆中高血红蛋白浓度相关的肾损伤,给予人血浆蛋白中结合珠蛋白和血红素结合蛋白可能在长时间低血压导致的严重溶血治疗中有益处。

原始出处:

Jan A. Graw, et al. Haptoglobin or Hemopexin Therapy Prevents Acute Adverse Effects of Resuscitation After Prolonged Storage of Red Cells. Circulation. 2016. 

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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138747, encodeId=2b50138e470b, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Oct 01 22:38:34 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138575, encodeId=96071385e5cd, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2016-12-01 weiz
  2. 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    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

  3. 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    2016-10-04 thlabcde

    好东西,学习了!

    0

  4. 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createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 20:27:51 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140109, encodeId=c81114010945, content=好东西,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Oct 04 19:57:56 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139676, encodeId=0a971396e687, content=要仔仔细细地去学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Oct 03 21:32:59 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281939, encodeId=1d2a1281939f6, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Sun Oct 02 14:25:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1512078, encodeId=9ad415120e890, content=<a href='/topic/show?id=29b28986491' target=_blank style='color:#2F92EE;'>#血红素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89864, encryptionId=29b28986491, topicName=血红素)], attachment=null, authenticateStatus=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138747, encodeId=2b50138e470b, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Oct 01 22:38:34 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138575, encodeId=96071385e5cd, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sat Oct 01 14:55:01 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
    2016-10-03 jyzxjiangqin

    要仔仔细细地去学习。

    0

  5. 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time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281939, encodeId=1d2a1281939f6, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Sun Oct 02 14:25:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1512078, encodeId=9ad415120e890, content=<a href='/topic/show?id=29b28986491' target=_blank style='color:#2F92EE;'>#血红素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89864, encryptionId=29b28986491, topicName=血红素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ef8a10431556, createdName=ms1692212821629096, createdTime=Sun Oct 02 14:25:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138990, encodeId=9acd138990e7, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:05 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138989, encodeId=03b71389893a, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138747, encodeId=2b50138e470b, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Oct 01 22:38:34 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138575, encodeId=96071385e5cd, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sat Oct 01 14:55:01 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
  6. 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time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281939, encodeId=1d2a1281939f6, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Sun Oct 02 14:25:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1512078, encodeId=9ad415120e890, content=<a href='/topic/show?id=29b28986491' target=_blank style='color:#2F92EE;'>#血红素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89864, encryptionId=29b28986491, topicName=血红素)], attachment=null, authenticateStatus=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138747, encodeId=2b50138e470b, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Oct 01 22:38:34 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138575, encodeId=96071385e5cd, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138747, encodeId=2b50138e470b, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Oct 01 22:38:34 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138575, encodeId=96071385e5cd, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sat Oct 01 14:55:01 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
    2016-10-02 doctorJiangchao

    继续关注

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138747, encodeId=2b50138e470b, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Oct 01 22:38:34 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138575, encodeId=96071385e5cd, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sat Oct 01 14:55:01 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
    2016-10-02 doctorJiangchao

    继续学习

    0

  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Oct 02 13:24:00 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138747, encodeId=2b50138e470b, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Oct 01 22:38:34 CST 2016, time=2016-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138575, encodeId=96071385e5cd, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sat Oct 01 14:55:01 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
    2016-10-01 忠诚向上

    好好学习

    0

  10. 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createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sat Oct 01 14:55:01 CST 2016, time=2016-10-01, status=1, ipAttribution=)]
    2016-10-01 刘煜

    学习了谢谢分享。

    0

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