供浆者多次献浆后sdLDL-C和ox-LDL水平的测定

目的探讨多次献浆后,对供浆者体内血浆小而密低密度脂蛋白胆固醇(sdLDL-C)、氧化低密度脂蛋白(ox-LDL)水平变化的影响。方法分别检测100例多次献血浆者和100例初次献血浆者的血浆sdLDL-C和ox-LDL水平,同时检测其血脂及血浆蛋白水平。结果多次献血浆者的血浆sdLDL-C、ox-LDL以及血脂水平略有下降,但与初次献浆者之间无显著性差异;多次献血浆者的血浆总蛋白(TP)、白蛋白(ALB)与初次献浆者的水平相当,两者之间也无显著性差异。结论多次献血浆是安全的,不会增加动脉粥样硬化性心血管疾病的风险。     

不同来源血浆对静注人免疫球蛋白中抗-HBs、白喉抗体效价的影响

调查分析不同来源原料血浆对静注免疫球蛋白(IVIG)制品内的抗-HBs、白喉抗体效价的影响。选择6个单采血浆站,对其提供的血浆为原料制备的IVIG所含的抗-HBs抗体、白喉抗体效价进行了测定。检测结果显示,用A、B、C、D、E、F编号的6个相应血浆站采集的血浆为原料制备成IVIG其抗-HBs抗体(IU/g)效价分别为33.77、103.95、70.94、132.45、78.84、58.28;白喉抗体平均效价分别为5.17、7.36、4.26、7.67、10.14、9.24。6个单采血浆站间的IVIG制品中白喉抗体效价无明显差异,但抗-HBs效价却存有显著差异。     

疟疾患者丙型肝炎病毒感染原因的血清学研究

本文报道了９７例疟疾患者丙型肝炎病毒（ＨＣＶ）感染的原因。发现疟疾患者抗－ＨＣＶ阳性率为７１．１３％,其中有单采血浆还输血细胞（下称单采浆）献血史者为８９．７１％,有受血史者为６４．２９％,既无单采浆史又无受血史者无一例抗－ＨＣＶ阳性。有单采浆史的疟疾患者与同村非疟疾的单采浆献血者相比,抗－ＨＣＶ阳性率无显著不同,且二者均显著高于同村既无单采浆史又无受血史的非疟疾人群。在无单采浆史和受血史人群中,疟疾病例和非病例抗－ＨＣＶ阳性率很低。说明有单采浆史的疟疾病例ＨＣＶ感染与单采浆有关,有受血史的疟疾病例ＨＣＶ感染与受血有关。对当地单采浆血站进行调查,发现在采血、分离血浆和血细胞还输过程中存在血液交叉污染,这是导致有单采浆史的疟疾病例ＨＣＶ感染的主要原因。     

Proteomic analysis of microvesicles from plasma of healthy donors reveals high individual variability

Healthy blood plasma is required for several therapeutic procedures. To maximize successful therapeutic outcomes it is critical to control the quality of blood plasma. Clearly initiatives to improve the safety of blood transfusions will have a high economical and social impact. A detailed knowledge of the composition of healthy blood plasma is essential to facilitate such improvements. Apart from free proteins, lipids and metabolites, blood plasma also contains cell-derived microvesicles, including exosomes and microparticles from several different cellular origins. In this study, we have purified microvesicles smaller than 220nm from plasma of healthy donors and performed proteomic, ultra-structural, biochemical and functional analyses. We have detected 161 microvesicle-associated proteins, including many associated with the complement and coagulation signal-transduction cascades. Several proteases and protease inhibitors associated with acute phase responses were present, indicating that these microvesicles may be involved in these processes. There was a remarkably high variability in the protein content of plasma from different donors. In addition, we report that this variability could be relevant for their interaction with cellular systems. This work provides valuable information on plasma microvesicles and a foundation to understand microvesicle biology and clinical implications.     

Can repeated plasma donation by asymptomatic HIV-infected individuals delay the onset of AIDS?

Healthy HIV-positive regular donors of plasma in a programme of passive immunotherapy for AIDS patients were studied over a period of about two years. None developed symptoms of clinical progression; most seemed to make substantial gains of CD4 cells by comparison with asymptomatic individuals who were not donating. The effects of donation did not seem to diminish with repetition, and donor CD4 counts tended towards stabilizing within normal limits. Asymptomatic HIV-positive individuals were compared immunologically with ''normals'' and people with AIDS, using a battery of 25 measurements on peripheral blood. The immunological profiles of donor and non-donor asymptomatics, indistinguishable at the start, became dissimilar: donors'' profiles resembled AIDS less, non-donors became less like ''normal'' and a few non-donor results could not be distinguished from AIDS. Improvement in the CD4 counts and amelioration of the immunological profile in donors provide prima facie evidence that plasmapheresis may be therapeutic for asymptomatic HIV-positive people. Further studies are justified.     

Haemolytic uraemic syndrome: therapeutic effect of plasma infusion.

The therapeutic effect of plasma infusion was evaluated in 10 children and seven adults with haemolytic uraemic syndrome. All but one patient responded to this treatment with rapid disappearance of haematological abnormalities. The patient who apparently failed to respond to plasma infusion obtained complete remission of the disease after plasmapheresis. Although 15 of the 17 patients were anuric or oliguric on admission, renal function recovered completely in eight children and two adults. Seven patients showed residual chronic renal failure and two required long-term maintenance haemodialysis. Treatment with plasma was also successful in patients with relapses or recurrent episodes. Plasma infusion is a promising therapeutic approach for the haemolytic uraemic syndrome and deserves further study in clinical trials.     

膳食结构对供浆员血浆蛋白及血脂含量的影响研究

目的探讨不同的膳食结构对供浆员血浆蛋白及血脂含量的影响。方法测定400例以牛、羊肉和马铃薯为主要膳食结构的供血浆者和400例以猪肉和马铃薯为主要膳食结构的供血浆者的血浆蛋白和血脂水平;同时统计食用高脂肪膳食后血浆出现乳糜的情况。结果经测定以牛、羊肉和马铃薯为主要膳食结构的供血浆者和以猪肉和马铃薯为主要饮食结构的供血浆者的血浆蛋白和血脂水平相当,两者之间无显著性差异(P>0.05);献浆前1 2 h内食用高脂肪膳食后血浆出现乳糜的概率明显增高,与食用清淡膳食相比具有显著性差异(P<0.05)。结论这两种膳食结构的差异对供浆员血浆蛋白及血脂水平没有明显影响;献浆前12 h内应当避免食用高脂肪类膳食。     

Development of blood donating in the DDR in the period 1972 to 1980

The development of the total amount of blood donations in the period from 1972-1980 was organized according to demand. With the percentage of blood from red cross donors increasing, blood donation attained a new quality which became evident in an increasing social recognition of donors coming from the red cross organization and which, above all, was characterized by its ethical-moral aspects. Further improvements could be achieved in organizing the preparation and establishment of fixed dates for blood donation. The demand for stored blood containing erythrocytes was ensured by an amount which lay below the international value of comparison. This, however, is taken as a basis for the future development of plasma demand. The increase of required plasma is effected by means of a plasmapheresis programme which still further is to be intensified.     

The economic side of blood banking and plasma fractionation.

While cellular components have a relatively short half-life, must be necessarily administered group-specifically and kept available on a round-the-clock basis, all of which add significantly to the basic cost per unit, products isolated from plasma are not handicapped by these disadvantages. Another important advantage for the production of plasma components lies in the fact that the raw material may be also collected through plasmapheresis, a process which allows the collection of significantly greater amounts of plasma from one donor as compared to conventional whole blood collection. Quite understandably, the maintenance of whole blood and cellular component supplies has been left to national and/or non-profit organizations, while commercial firms run a profitable business with the production and distribution of plasma fractions. The method for the selective isolation of plasma fractions developed in our blood transfusion service solves the high cost problems involved in conventional fractionation methods but does not solve the ethical and economical problem related to discarding precious unused raw material.     

Donor selection for the production of factor XIII preparations

For the purpose of establishing a programme of plasmapheresis for manufacturing preparations containing factor VIII, investigations were made to check the expediency of selecting donors. Factor VIII activity (Factor VIII: C) was determined in a total of 165 donors of plasmapheresis. Dependencies of factor-VIII: C on blood group, age and influence of smoking were examined. Depending on the blood group (0 less than A, B, AB) the results found by us showed significant differences in factor-VIII: C. The results are discussed and compared with data in literature. A selection of donors is considered to be reasonable. Increases in gaining factor-VIII are possible by making a pre-selection according to blood groups or better by exact testing respectively.     

Blood coagulation and fibrinolysis in blood donors after plasmapheresis]

Authors were interested in blood coagulation proteins and fibrinolysis in blood donors following several plasmaphereses. This interest was related to the occurrence of thrombo-embolic and hemorrhagic complications in these subjects. Blood morphology, serum protein, blood coagulation and fibrinolysis have been examined in 40 healthy blood donors, aged between 19 and 46 years, who gave blood plasma by plasmapheresis technique for 1-59 times. Results did not show any significant changes in blood morphology and serum protein levels prior to and after consecutive plasmaphereses. No significant decrease in blood coagulation proteins and fibrinolysis has been noted. However, a significant increase in factors VIII and IX activities was noted in several blood donors, who underwent the largest number of plasmaphereses. It may predispose these donors to thrombo-embolic complications.     

Electrophoretic control of serum proteins in donors designated for plasmapheresis. Initial evaluation of the analysis of 3500 donors

Total serum proteins were evaluated and serum protein electrophoresis performed on 3 500 blood donors after plasmapheresis. The results were standard for total serum proteins, serum albumin and immunoglobulin in 98% of the donors, whereas monoclonal immunoglobulin, immunodeficiencies or polyclonal hypergammaglobulinemia were detected in 2% of them. The frequency of monoclonal components is roughly 0.3%, corresponding to the frequency observed in normal adults of 40 to 60 years old. Donors found with monoclonal immunoglobulins or immunodeficiency should not be considered as eligible for blood donation.     

Sialyltransferase activity of human plasma and aortic intima is enhanced in atherosclerosis

Sialyltransferase activity has been determined in membrane preparations containing the Golgi apparatus that were isolated from atherosclerotic and normal human aortic intima as well as in plasma of patients with documented atherosclerosis and healthy donors by measuring the transfer of N-acetylneuraminic acid (NeuAc) from CMP-NeuAc to asialofetuin. The asialofetuin sialyltransferase activity was found to be 2 times higher in the atherosclerotic intima as compared to the normal intima and 2-fold higher in patients’ plasma than in that from healthy donors. The mean values of the apparent Michaelis constant (K_m) for the sialylating enzyme for both tissues did not differ and were close for the intima and plasma. In contrast, the maximal velocity (V_max) was 2 times higher for the atherosclerotic intima than for the normal intima and 3 times higher for patients’ plasma than for that of the donors. These results suggest that the activity of asialofetuin sialyltransferases of aortal intima is enhanced in atherosclerosis as is the secretion of their soluble forms into patients’ plasma.     

Continuous-flow plasmapheresis in management of severe rhesus disease.

Eight patients with severe rhesus disease and expected fetal loss were treated by intensive plasmapheresis using a continuous-flow cell separator. Plasmapheresis was started at 16-27 weeks'' gestation, and continued until planned intrauterine transfusion or until the infant was delivered or the rhesus disease became uncontrolled again. Altogether 24 to 2371 of plasma was exchanged over periods ranging from seven to 16 weeks. In seven of the eight patients the anti-D concentration fell during the period of plasmapheresis. Amniotic fluid spectrophotometry values remained below those recorded in the preceding pregnancy in six out of seven women. In five patients an attempt was made to control the rhesus disease by plasmapheresis alone, and two of these women delivered infants who survived. In the other three cases the infants died, one from the idiopathic respiratory distress syndrome and the other two in utero. These preliminary findings suggest that intensive plasmapheresis with a cell separator may reduce fetal haemolysis is delivered. Nevertheless, plasmapheresis may best be used to reduce haemolysis until intrauterine transfusions may be given more safely after 30 weeks'' gestation.     

Meningococcal septicaemia treated with combined plasmapheresis and leucapheresis or with blood exchange.

Mortality among patients suffering from meningococcal septicaemia has reached nearly 50% in parts of northern Norway despite intensive care. The activation of complement and blood cells by endotoxin is assumed to be the cause of most of the associated pathophysiological changes. Consequently, it would seem logical to remove such constituents either by combined plasmapheresis and leucapheresis or by blood exchange in patients with a fatal prognosis. Three patients were treated with plasmapheresis and leucapheresis and one with blood exchange. All recovered without sequelae, and no complications or serious problems caused by these procedures were observed. It is concluded that either combined leucapheresis and plasmapheresis or blood exchange is well tolerated and a valuable supplement to conventional intensive care in fulminant meningococcal septicaemia.     

Effects of selective H.E.L.P. LDL-apheresis on plasma inflammatory markers concentration in severe dyslipidemia: Implication for anti-inflammatory response

Therapeutic plasmapheresis is a recognized medical procedure in which various techniques are used to separate and remove undesirable or excessively elevated plasma elements from blood. The main purpose of the procedure is to remove the substances responsible for the disease (autoantibodies, circulating immune complexes, lipoproteins and other molecules) from the patient's blood. Low-Density-Lipoproteins-apheresis (LDL_a) is the selective removal of all apolipoprotein-B100-containing lipoproteins: LDL, very low-density lipoprotein, and lipoprotein (a). They are lowered acutely by 65-75%. There is little effect on other plasma lipidic and non-lipidic components. LDL_a was reported to increase resistance of LDL to oxidation, counteract procoagulatory state and relief disturbances of hemorheology associated with atherosclerosis. These effects are likely to be regarded as to be pleiotropic effects. In the sense that they are not necessarily related to the apolipoprotein-B100-containing lipoproteins level in plasma. There is robust evidence that LDL_a can induce the stabilization of atherosclerotic plaques through its lipid-lowering action. However, other effects unrelated to the apolipoprotein-B100-containing lipoproteins extracorporeal removal, such as the decrease of cytokines and adhesion molecules induced by LDL_a were also reported. Altogether these actions are thought to favorably influence regression of florid, nonfibrous atherosclerotic lesions through a blockade of lipid deposition in the vessel wall, plaque stabilization, and ultimately, coronary and extracoronary artery disease progression. This brief review provides some indication on existing evidence of Heparin-induced Extracorporeal Low-density-lipoprotein Precipitation LDL_a effects on plasma mediators of inflammation.     

Inhibitory neurogenic modulation of histamine-induced cutaneous plasma extravasation in the pigeon

The neurohumoral modulation of the permeability increasing effect of histamine was studied in pigeon skin. Substances were administered through plasmapheresis capillaries inserted into the dorsal wing skin and the protein contents of the perfusates were determined by a quantitative method. The vascular labelling technique was also utilized to histologically identify leaky blood vessels. In the innervated skin histamine evoked a significant, dose-dependent plasma extravasation which was markedly augmented by the coadministration of a specific galanin receptor antagonist, galanin-1-16-bradykinin-2-9-amide (M35). Chronic cutaneous denervation per se resulted in a significant elevation of the permeability-enhancing effect of histamine. In the denervated skin this response was not affected by M35 but was significantly inhibited by galanin. It is concluded that in the normally innervated skin endogenous galanin may exert a neurogenic tonic inhibitory effect on histamine-induced plasma leakage. It is suggested that sensory nerves possess not only pro-inflammatory, but also anti-inflammatory (inhibitory) sensory-efferent functions.     

Review. The status of plasmapheresis and apheresis

The paper surveys the technical and clinical development of plasmaexchange therapy. Until today there is no agreement on a unique treatment protocol, the variation ranges from 3-4 treatments in multiple sclerosis to biweekly chronic treatment in hypercholesterolaemia. An exchange volume of 1-1.5 of the plasma volume is recommended. Despite occasional complications, mostly due to replacement fluid, the method is regarded as safe. The first clinical application dates back to 1952, when Adams reported on the treatment of hyperviscosity syndrome. With rheumatoid arthritis plasmaexchange therapy of immunological mediated diseases started in 1963. In the following years a lot of enthusiastic case reports caused a general therapeutic optimism which was to be corrected by controlled trials. There is no proven benefit of plasmapheresis in rheumatoid arthritis and rapid glomerulonephritis for instance. For lymphoplasmapheresis in rheumatoid arthritis and for plasmapheresis in multiple sclerosis and renal graft rejection the results are contradictive. The paper discusses the different indications for apheresis therapy including hematologic disorders to be treated with plasmapheresis or cytapheresis.     

Immunoprophylaxis and immunotherapy of experimental Pseudomonas aeruginosa sepsis

The protective activity of pyoimmunogen II, lot 9, was studied on P. aeruginosa experimental sepsis used as a model. In experiments on rats the preparation was shown to be nontoxic according to the results of the determination of acute and chronic toxicity. The preparation under test produced a high protective effect in experiments on animals infected with various P. aeruginosa strains, irrespective of their virulence and immunotype. Anti-P. aeruginosa plasma, obtained by plasmapheresis from donors immunized with pyoimmunogen II, showed a curative effect when injected into experimental animals in a dose of 0.02 ml/g body weight at early stages of the infection.     

The multiple forms of alpha-D-mannosidase in human plasma.

The acidic alpha-D-mannosidase in human plasma closely resembles liver acidic alpha-D-mannosidase in its affinity for concanavalin A-Sepharose, molecular weight and resolution into multiple components on DEAE-cellulose. A combination of chromatography on concanavalin A-Sepharose and gel filtration on Sephadex G-200 and Sepharose 6B suggests that four forms of intermediate alpha-D-mannosidase, which differ either in their molecular weight of affinity for concanavalin A, exist in human plasma. A practical classification and nomenclature for the multiple forms of intermediate alpha-D-mannosidase in plasma based on molecular weight and affinity for concanavalin A is proposed. Multiple forms of intermediate alpha-D-mannosidase were also observed by ion-exchange chromatography on DEAE-cellulose, but there was not a simple correlation between these forms and those obtained with the other separation procedures. The form of intermediate alpha-D-mannosidase least abundant in plasma, approx. 7% of the activity, has very similar properties to the neutral alpha-D-mannosidase in human liver. In contrast, the other three forms of intermediate alpha-D-mannosidase, which account for over 90% of the activity, do not appear to be present in liver, except perhaps in trace amounts.