国内外原料血浆综合利用水平的比较

随着近年来血液制品的快速发展,加快了对原料血浆的需求,血液制品行业普遍出现原料血浆供应不足的紧张局面。同时,血液制品安全事件在各国的相继发生,各国政府加强了监管力度,企业的兼并重组行动升级,目前全球仅剩不到52家血液制品企业(含中国32家),国内的投浆量不及国外血液制品企业一家的投浆量,且国内生产企业规模小、产品单一、质量及安全性不及国外的产品。本文就其目前国内外现状、研发能力、政策引导等方面,对国内外原料血浆生产人血浆蛋白制品综合利用水平作一比较,并就其中的问题进行如何改进提出可能的建议。     

血液制品的现状与展望

血液制品特指血浆蛋白制品和相应的重组制品。根据临床应用的效能,血液制品可以分为白蛋白类、免疫球蛋白类、凝血因子类和微量蛋白制品等不同种类。血浆白蛋白制品是最早应用于战伤救治的血液制品,高纯白蛋白、重组白蛋白以及重组白蛋白融合药物的研发和上市开创了血液制品的新局面。肌肉注射用免疫球蛋白因其制备工艺相对简单,使用方便,价格低廉且不良反应可以接受而一直在临床实践中应用;静脉注射用免疫球蛋白随着新的适应症不断发现,其应用范围越来越广;皮下注射用免疫球蛋白的出现使免疫球蛋白的使用更加方便,已经成为静脉注射用免疫球蛋白安全有效的替代品;针对特定病原体的特异性免疫球蛋白在临床上更具有不可替代的作用。凝血因子和重组凝血因子类制品主要用于相应的先天性遗传性缺陷患者,纤维蛋白原、因子Ⅶ、因子Ⅷ、von Willebrand因子复合物、因子Ⅸ和凝血酶原复合物、因子Ⅺ、因子ⅩⅢ等制品的应用取得了良好的治疗效果。因子Ⅶa和活化凝血酶原复合物对于治疗产生凝血因子抑制物的血友病病人具有十分明显的效果。纤维蛋白原类制品和凝血酶在外科止血方面发挥着重要的作用。多种微量血浆蛋白制品已经上市,如蛋白C、抗凝血酶、α1-抗胰蛋白酶和组织纤溶酶原激活剂等。部分微量血浆蛋白制品也在研发和临床试验过程中,如C1-抑制剂、补体系统Ⅰ因子、α2-巨球蛋白、血清胆碱酯酶、铜蓝蛋白以及纤维结合蛋白等。尽管多种重组血浆蛋白制品已经上市,血浆来源的制品仍将具有其不可替代的特殊地位,血浆蛋白新品种的研发仍是热点。目前,我国血液制品的研发与国外存在着较大的差距,我国血液制品企业面临着机遇与挑战。     

血液制品的科研策略分析

血液制品以健康人血液为原料,通过采用生物工程技术或分离纯化技术制备的具有生物活性的一类特殊制品,是宝贵的人源性生物类药品。在医疗急救（如创伤失血、烧伤等）、战伤抢救以及某些特定疾病（如血友病等）的预防和治疗上,有着不可替代的作用。血液制品主要包括人血白蛋白、各类免疫球蛋白、凝血因子、特殊蛋白及因子、纤维蛋白黏合剂等五大类。血液制品产业知识密集,技术含量高,工艺及质量标准高,多学科高度综合和相互交叉渗透,所需投入高,具有高风险的特性。     

层析技术在血液制品分离纯化中应用的探讨

随着市场需求的多元化发展,原采用低温乙醇法生产的血液制品在品种及质量上均已不能满足人们的需要。国外血浆分离过程中应用层析技术,显著地提高了血浆利用率及产品质量,并丰富了产品的种类,节约了经济成本。在我国分离技术起步较晚,血液制品的规模化生产仍以低温乙醇法为主。在分析国内外现有层析技术的应用现状的基础上,并对其主流层析工艺进行了简要综述,为我国改进现有血液制品的工艺提供参考依据。     

应用PCR方法检测部分血液制品中HCV-RNA

应用市售丙型肝炎ＰＣＲ检测试剂盒,对１９９４ １９９６年用不同病毒灭活工艺生产的人凝血因子类制品、人静注丙球和人血白蛋白进行ＨＣＶ ＲＮＡ检测。结果表明,检测六种血液制品共２１批,１批阳性,占４８％。     

E.国家检定要求

<正>1.总则 按修订的第1号生物制品规程B部分有关检定实验室的基本要求执行。(生产单应和检定实验室的基本要求) 国家质控当局应为人血和血液制品的质量检定的需要提供标准品和参考制品。在适宜情况下,这些标准应与相应的国际标准进行标校。     

关于血液制品灭活试验的指示病毒及灭活指标问题的商榷

<正>一、血液制品灭活的重要性和必要性 由于血液制品在急救、治疗和防病中具有良好的效用,在临床上已受到十分广泛的大量应用。对于皿液制品的高质量要求,特别是保证使用安全已成为当前大家所关注的首要问题。 制备血液制品的原料是人的血浆,因而通过血液传播的病原体特别是某些病毒是导致不安全的主要因素。自七十年代以后,人们先后发现大批量制备的未经病毒灭活的凝血因子Ⅷ制剂,使甲型血友病患者大多数感染了乙型肝炎、丙型肝炎或AIDS病。     

我国婴幼儿配方乳粉行业变化新特征与新趋势

从生产、消费、贸易三个方面对我国婴幼儿配方乳粉行业变化新特征进行研究,探讨促进行业变化的主因,在此基础上对我国婴幼儿配方乳粉行业发展新趋势进行研判,厘清行业变化的新特征、新趋势,为推动我国婴幼儿配方乳粉行业健康发展提供参考。     

S／D法处理凝血因子浓缩物类制品的病毒灭活验证

以水泡性口炎病毒 (VSV)为指示病毒 ,验证应用有机溶剂 /去污剂 (简称S/D)法灭活血液制品中病毒的生产工艺 ,并对不同厂家不同批号的四种凝血因子浓缩物类制品 (中间品 )的病毒灭活效果进行了分析总结。结果表明当制品中TNBP和Tween80终浓度为 0 3%和 1 0 % ,在 2 5± 1℃处理 6小时后对于包膜病毒确有显著的灭活效果。     

血液制品病毒灭活及去除工艺进展

随着医学科学的进步和大众生活水平的提高,血液制品的安全性愈来愈受到关注。为了提高血液制品的安全性,国家食品药品监督管理局发布的相关指导原则要求生产工艺要具有一定的去除/灭活部分病毒能力,生产过程中应有特定的去除/灭活病毒方法。我们对几种适用于血液制品的病毒灭活方法及病毒去除工艺进行综述,以期对生产及科研提供参考。     

WHO Expert Committee on Biological Standardization: highlights of the 50th meeting, October 1999.

Biological medicines, which include vaccines, blood products and biological therapeutics, have historically played a dominant role in improving world health and are expected to make an increasingly important contribution to public health in the 21st century. Recent scientific and biotechnological developments have opened the way to novel products, new production methods and to highly sensitive assay procedures. However, the nature of biologicals, and especially new vaccines, blood products and therapeutics, raises particular questions regarding their standardization and quality control. These relate both to efficacy and to safety not only for the individual recipient but also for the population at large. Such advances highlight the complex issues surrounding standardization and control of biologicals, issues that need to be addressed on an international level.     

The clearance of viruses and transmissible spongiform encephalopathy agents from biologicals

The viral and transmissible spongiform encephalopathy (TSE) safety of therapeutics of biological origin (biologicals) is greatly influenced by the nature and degree of variability of the source material and by the mode of purification. Plasma-derived and recombinant DNA products currently have good viral safety records, but challenges remain. In general, large enveloped viruses are easier to remove from biologicals than small 'naked' viruses. Monoclonal antibodies and recombinant DNA biopharmaceuticals are derived from relatively homogeneous source materials and purified by multistep schemes that are robust and amenable to scientific analysis and engineering improvement. Viral clearance is more challenging for blood and cell products, as they are complex and labile. Source selection (e.g. country of origin, deferral for CJD risk factors) currently occupies the front line for ensuring that biologicals are free of TSE agents, but robust methods for their clearance from products are under development.     

Activating hydroxyl groups of polymeric carriers using 4-fluorobenzenesulfonyl chloride.

4-Fluorobenzenesulfonyl chloride (fosyl chloride), due to the strong electron-withdrawing property of its fluoride atom, is found to be an excellent activating agent for the covalent attachment of biologicals to a variety of solid supports (e.g. functionalized polystyrene microspheres, Sepharose beads, or cellulose rods and hollow fibers). This reagent reacts rapidly with primary or secondary hydroxyl groups, at ambient temperature and pressure, to form 4-fluorobenzenesulfonate leaving groups. The activated solid support can be used immediately or preserved for several months without loss of activity by freeze-drying or by storage at 4 degrees C in aqueous solution at pH 5. Enzymes, antibodies, avidin, and other biologicals can be covalently attached to the activated solid phase with excellent retention of biological function. Potential therapeutic applications of the fosyl chloride chemistry for bioselective separation of human lymphocyte subsets from whole blood and tumor cells from bone marrow are presented.     

Biosimilars--global issues, national solutions

Biotechnology derived medicinal products are presently the best characterized biologicals with considerable production and clinical experience, and have revolutionized the treatment of some of the most difficult-to-treat diseases, prolonging and improving the quality of life and patient care. They are also currently one of the fastest growing segments of the pharmaceutical industry market. The critical challenge that the biopharmaceutical industry is facing is the expiry of patents for the first generation of biopharmaceuticals, mainly recombinant DNA derived products, such as interferons, growth hormone and erythropoetin. The question that immediately arose was how should such copies of the originator products be licensed, bearing in mind that they are highly complex biological molecules produced by equally complex biological production processes with their inherent problem of biological variability. Copying biologicals is much more complex than copying small molecules and the critical issue was how to handle the licensing of products if relying in part on data from an innovator product. Since 2004 there has been considerable international consultation on how to deal with biosimilars and biological copy products. This has led to a better understanding of the challenges in the regulatory evaluation of the quality, safety and efficacy of "biosimilars", to the exchange of information between regulators, as well as to the identification of key issues. The aim of this article is to provide a brief overview of the scientific and regulatory challenges faced in developing and evaluating similar biotherapeutic products for global use. It is intended as an introduction to the series of articles in this special issue of Biologicals devoted to similar biotherapeutic products.     

Where is biological therapy going?

The substantial progress in our understanding of molecular and cellular biology has allowed us to design biological therapeutics ('biologicals') with defined targets and effector functions. These biologicals have greatly contributed to our current knowledge of pathogenetic mechanisms in autoimmune diseases. However, although some of the biologicals have been extremely successful in treating the symptoms of chronic inflammation, biological therapy has not yet met the expectations of permanently silencing the chronic immune response. In this commentary we discuss current concepts and future directions of biological therapy, and the potential usefulness of biologicals as a treatment of human autoimmune diseases in appropriate critical applications with the use of suitably designed agents.     

Application of 2-D DIGE to survey the quality of biological medicines

2-D DIGE was used to investigate 'fingerprint proteins' in biological medicines. A presumably non-originator human albumin was analysed, and the 2-D DIGE patterns of the non-genuine and the authentic product were compared. The products could be clearly distinguished based on the pattern of minor components, which represent plasma proteins and degradation products remaining in the final products after fractionation and purification. The approach demonstrated that 2-D DIGE is an excellent tool for the analysis of biologicals of different sources and for ensuring the identity and quality of blood products.     

Advances in Targeted Therapies III, Nassau, Bahamas, 27 April-1 May 2001

This conference was the third in a series focusing on developments in the therapy of rheumatoid arthritis (RA) and other rheumatic conditions with biologicals; in many ways, it was perhaps the best one so far. One strength of the meeting was the mix of scientists from academia and from industry, and of workers in basic science as well as clinical investigators. The risks of inhibition of tumor necrosis factor (TNF) were covered in depth for the first time. A number of putative and actual new targets were presented. An updated consensus document on the use of TNF inhibitors will appear in the near future in the Annals of Rheumatic Diseases, authored by Dan Furst et al.     

A prion primer

By biological and medical criteria, prions are infectious agents; however, many of their properties differ profoundly from those of conventional microbes. Prions are "encoded" by alterations in protein conformation rather than in nucleic acid or amino acid sequence. New epidemic prion diseases (bovine spongiform encephalopathy and new variant Creutzfeldt-Jakob disease) have recently emerged under the active surveillance of the modern world. The risk of contracting prion disease from blood products or other biologicals is now a focus of worldwide concern. Much has been discovered about prions and prion diseases, but much remains to be done.     

实验动物与兽用生物制品检验和研发

在兽用生物制品的质量检验和研发中,实验动物的应用极其普遍.其应用的历史悠久、使用面广,涉及的动物种类多、数量大.本文对应用动物进行兽用生物制品检验和研发中存在的问题进行了分析,并提出了建立大动物基地、保证供应,完善标准、保证质量,更新观念、完善法规、减少动物用量,加强管理、确保生物安全等方面的建议.     

黄芩苷作为一种抗生物制剂的过敏反应的研究

通过黄芩苷抗生物制剂过敏反应的研究,在不影响疫苗免疫效果的前提下,解决注射生物制剂引起的过敏反应问题,为生物制品与天然药物相结合开辟了一条新路。采用生物制品过敏试验常规检测方法。黄芩苷使用安全,抗过敏作用明显,具有抑制肥大细胞脱颗粒和降低毛细血管通透性作用。黄芩苷与生物制品相结合,初步试验结果表明有抗动物过敏反应的效果。