康复者恢复期血浆在病毒性疾病治疗中的研究进展

doi:10.3969/j.issn.1671-2587.2020.04.001

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (4): 337-342.DOI: 10.3969/j.issn.1671-2587.2020.04.001

• 新型冠状病毒肺炎专题（二） • 下一篇

康复者恢复期血浆在病毒性疾病治疗中的研究进展

朱鑫方, 王苑, 杜丹心, 夏荣

200040 上海, 复旦大学附属华山医院输血科

收稿日期:2020-04-20 出版日期:2020-08-20 发布日期:2020-08-12
通讯作者: 夏荣, 男, 博士, 教授, 主任医师, 主要从事输血相关免疫调节及输血治疗方面研究, （Tel）021-52888331（E-mail）xiarongcn@126.com。
作者简介:朱鑫方（1983-）, 女, 河北人, 硕士, 主治医师, 主要从事输血相关免疫及治疗方面研究, （E-mail）279676540@qq.com。
基金资助:
*本课题受国家自然科学基金（No.81670173）资助

Research Progress in the Convalescent Plasma Therapy of Virus Infection

ZHU Xin-fang, WANG Yuan, DU Dan-xin, et al.

Department of Blood Transfusion, Huashan Hospital, Fudan University, Shanghai 200040

Received:2020-04-20 Online:2020-08-20 Published:2020-08-12

摘要/Abstract

摘要： 康复者恢复期血浆可治疗多种病毒性感染疾病。本文通过总结既往康复者恢复期血浆在治疗病毒性传播疾病中的研究进展, 分析其在新型冠状病毒肺炎治疗中的潜在价值。总结了康复者恢复期血浆在募集、血浆处理、抗体效价检测中的技术进展及其在禽流感病毒、MERS-CoV、SARS-CoV、EBOV、SARS-CoV-2等病毒性感染的临床治疗效果以及血浆输注相关不良反应等。康复者恢复期血浆在多数病例报道及回顾性分析结果提示其可以降低疾病死亡率, 可作为新型冠状病毒肺炎感染潜在的治疗方法。

关键词: 新型冠状病毒肺炎, 康复者恢复期血浆, 临床随机对照试验

Abstract: Convalescent plasma (CP) has been applied to the treatment of many virus infectious diseases. This paper summarized the previous researches in contagious viral diseases treated with CP, and analyzed CP therapy as a potential treatment for COVID-19. We summarized the technical progress of CP in recruitment, plasma treatment, antibody titer detection, and its clinical treatment experiences in avian influenza virus, MERS-CoV, SARS-CoV, EBOV, SARS-CoV-2 and other viral infections, and adverse events related to plasma transfusion. Some case reports on CP therapies and retrospective analysis suggest that CP can reduce case fatality rate (CFR), so it can be used as a potential treatment for COVID-19.

Key words: Coronavirus, disease, 19, Convalescent, plasma, Randomized, controlled, trial

中图分类号:

R457

朱鑫方, 王苑, 杜丹心, 夏荣. 康复者恢复期血浆在病毒性疾病治疗中的研究进展[J]. 临床输血与检验, 2020, 22(4): 337-342.

ZHU Xin-fang, WANG Yuan, DU Dan-xin, et al.. Research Progress in the Convalescent Plasma Therapy of Virus Infection[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2020, 22(4): 337-342.

参考文献

[1] Burnouf T, Seghatchian J.Ebola virus convalescent blood products:where we are now and where we may need to go[J]. Transfus Apher Sci, 2014, 51(2):120-125.
[2] Rajam G, Sampson J, Carlone G M, et al.An augmented passive immune therapy to treat fulminant bacterial infections[J]. Recent Pat Antiinfect Drug Discov, 2010, 5(2):157-167.
[3] Who Mers-Cov Research Group. State of knowledge and data gaps of middle east respiratory syndrome coronavirus (MERS-CoV) in humans[J]. PLoS Curr, 2013, 5:ecurrents.outbreaks.0bf719e352e7478f8ad85fa30127ddb8.
[4] Burnouf T, Radosevich M. Treatment of severe acute respiratory syndrome with convalescent plasma[J]. Xianggang Yi Xue Za Zhi, 2003, 9(4):309;author reply 310.
[5] Zhou BP, Zhong NS, Guan Y.Treatment with convalescent plasma for influenza A (H5N1) infection[J]. N Engl J Med, 2007, 357(14):1450-1451.
[6] Cheng Y, Wong R, Soo Y O, et al.Use of convalescent plasma therapy in SARS patients in Hong Kong[J]. Eur J Clin Microbiol Infect Dis, 2005, 24(1):44-46.
[7] World Health Organization. Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks. Interim guidance for national health authorities and blood transfusion services [EB/OL].(2014-10-01). https://apps.who.int/iris/handle/10665/135591.
[8] Wu XX, Gao HN, Wu HB, et al.Successful treatment of avian-origin influenza A (H7N9) infection using convalescent plasma[J]. Int J Infect Dis, 2015, 41:3-5.
[9] 国家卫生健康委员会, 国家中医药管理局.关于印发新型冠状病毒肺炎诊疗方案 (试行第七版) 通知[EB/OL].(2020-03-03). http://www.gov.cn/zhengce/zhengceku/2020-03/04/content_5486705.htm.
[10] 国家卫生健康委办公厅, 中央军委后勤保障部卫生局. 关于印发新冠肺炎康复者恢复期血浆临床治疗方案(试行第二版)的通知[EB/OL]. (2020-03-04). http://www.gov.cn/zhengce/zhengceku/2020-03/05/content_5487145.htm.
[11] Keller MA, Stiehm ER.Passive immunity in prevention and treatment of infectious diseases[J]. Clin Microbiol Rev, 2000, 13(4):602-614.
[12] Luke TC, Casadevall A, Watowich SJ, et al.Hark back:passive immunotherapy for influenza and other serious infections[J]. Crit Care Med, 2010, 38(4 Suppl):e66-e73.
[13] Dodd RY.Emerging pathogens and their implications for the blood supply and transfusion transmitted infections[J]. Br J Haematol, 2012, 159(2):135-142.
[14] Lai KY, Ng WY, Cheng FF.Human Ebola virus infection in West Africa:a review of available therapeutic agents that target different steps of the life cycle of Ebola virus[J]. Infect Dis Poverty, 2014, 3:43.
[15] World Health Organization.Experimental therapies: growing interest in the use of whole blood or plasma from recovered Ebola patients (convalescent therapies)[EB/OL].(2014-09-26). https://www.who.int/mediacentre/news/ebola/26-september-2014/en/.
[16] Picker SM.Current methods for the reduction of blood-borne pathogens:a comprehensive literature review[J]. Trasfusione Del Sangue, 2013, 11(3):343-348.
[17] Liumbruno GM, Franchini M.Solvent/detergent plasma:pharmaceutical characteristics and clinical experience[J].J Thromb Thrombolysis, 2015, 39(1):118-128.
[18] Lozano M, Cid J, Müller TH.Plasma treated with methylene blue and light:clinical efficacy and safety profile[J]. Transfus Med Rev, 2013, 27(4):235-240.
[19] Eickmann M, Gravemann U, Handke W, et al.Inactivation of Ebola virus and Middle East respiratory syndrome coronavirus in platelet concentrates and plasma by ultraviolet C light and methylene blue plus visible light, respectively[J]. Transfusion, 2018, 58(9):2202-2207.
[20] 许金波, 段淑敏, 周锡鹏, 等. 亚甲蓝/光化学法灭活血浆中的SARS冠状病毒[J]. 军事医学科学院院刊, 2005, 29(2):142-144.
[21] 王霞, 潘彤, 李红珠, 等. 血液制品病毒灭活系统应用的研究进展[J]. 国际检验医学杂志, 2015, 36(19):2872-2874.
[22] Hung IF, To KK, Lee C K, et al.Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection[J]. Clin Infect Dis, 2011, 52(4):447-456.
[23] Clegg JCS, Lloyd G.Ebola haemorrhagic fever in Zaire, 1995[J]. Curr Opin Infect Dis, 1995, 8(4):225-228.
[24] Hemming VG.Use of intravenous immunoglobulins for prophylaxis or treatment of infectious diseases[J]. Clin Diagn Lab Immunol, 2001, 8(5):859-863.
[25] Nour B, Green M, Michaels M, et al.Parvovirus B19 infection in pediatric transplant patients[J]. Transplantation, 1993, 56(4):835-838.
[26] Zingher A, Mortimer P. Convalescent whole blood, plasma and serum in the prophylaxis of measles:JAMA, 12 April, 1926;1180-1187[J]. Rev Med Virol, 2005, 15(6):407-418;discussion 418-21.
[27] Young MK, Nimmo GR, Cripps AW, et al. Post-exposure passive immunisation for preventing measles[J]. Cochrane Database Syst Rev, 2014(4):CD010056.
[28] Kong LK, Zhou BP.Successful treatment of avian influenza with convalescent plasma[J]. Xianggang Yi Xue Za Zhi, 2006, 12(6):489.
[29] Beigel JH, Luke TC.A study in scarlet-convalescent plasma for severe influenza[J].Crit Care Med, 2012, 40(3):1027-1028.
[30] Hui DS, Lee N.Adjunctive therapies and immunomodulating agents for severe influenza[J]. Influenza Other Respir Viruses, 2013, 7(Suppl 3):52-59.
[31] Jahrling PB, Frame JD, Rhoderick JB, et al.Endemic Lassa fever in Liberia.IV.Selection of optimally effective plasma for treatment by passive immunization[J]. Trans R Soc Trop Med Hyg, 1985, 79(3):380-384.
[32] Luke TC, Kilbane EM, Jackson JL, et al.Meta-analysis:convalescent blood products for Spanish influenza pneumonia:a future H5N1 treatment?[J]. Ann Intern Med, 2006, 145(8):599-609.
[33] Hung IFN, To KKW, Lee CK, et al.Hyperimmune IV immunoglobulin treatment:a multicenter double-blind randomized controlled trial for patients with severe 2009 influenza A(H1N1) infection[J]. Chest, 2013, 144(2):464-473.
[34] 刘水腾, 周伯平, 杨大国, 等. 深圳市首例H5N1型人禽流感临床报告[J]. 中华传染病杂志, 2007, 25(1):29-32.
[35] Stockman LJ, Bellamy R, Garner P.SARS:systematic review of treatment effects[J].PLoS Med, 2006, 3(9):e343. DOI:10.1371/journal.pmed.0030343.
[36] Yeh KM, Chiueh TS, Siu LK, et al.Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital[J]. J Antimicrob Chemother, 2005, 56(5):919-922.
[37] Soo YO, Cheng Y, Wong R, et al.Retrospective comparison of convalescent plasma with continuing high-dose methylprednisolone treatment in SARS patients[J]. Clin Microbiol Infect, 2004, 10(7):676-678.
[38] Mair-Jenkins J, Saavedra-Campos M, Baillie JK, et al.The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology:a systematic review and exploratory meta-analysis[J]. J Infect Dis, 2015, 211(1):80-90.
[39] WHO. Position Paper on Collection and Use of Convalescent Plasma or Serum as an Element in Middle East Respiratory Syndrome Coronavirus Response[EB/OL].https://www.who.int/bloodproducts/brn/BRN_PositionPaperConvPlasmaMERSCoV_March2014.pdf?ua=1.
[40] Modjarrad K, Moorthy VS, Ben Embarek P, et al.A roadmap for MERS-CoV research and product development:report from a World Health Organization consultation[J]. Nat Med, 2016, 22(7):701-705.
[41] Luke T, Wu H, Zhao JC, et al. Human polyclonal immunoglobulin G from transchromosomic bovines inhibits MERS-CoV in vivo[J]. Sci Transl Med, 2016, 8(326):326ra21.
[42] van Doremalen N, Falzarano D, Ying T L, et al. Efficacy of antibody-based therapies against Middle East respiratory syndrome coronavirus (MERS-CoV) in common marmosets[J]. Antiviral Res, 2017, 143:30-37.
[43] Arabi Y, Balkhy H, Hajeer AH, et al.Feasibility, safety, clinical, and laboratory effects of convalescent plasma therapy for patients with Middle East respiratory syndrome coronavirus infection:a study protocol[J]. Springerplus, 2015, 4:709.
[44] Arabi YM, Hajeer AH, Luke T, et al.Feasibility of using convalescent plasma immunotherapy for MERS-CoV infection, saudi Arabia[J]. Emerging Infect Dis, 2016, 22(9):1554-1561.
[45] Chun S, Chung CR, Ha YE, et al.Possible transfusion-related acute lung injury following convalescent plasma transfusion in a patient with middle east respiratory syndrome[J]. Ann Lab Med, 2016, 36(4):393-395.
[46] Ansumana R, Jacobsen KH, Sahr F, et al.Ebola in Freetown area, Sierra Leone——a case study of 581 patients[J]. N Engl J Med, 2015, 372(6):587-588.
[47] Colebunders RL, Cannon RO.Large-scale convalescent blood and plasma transfusion therapy for Ebola virus disease[J]. J Infect Dis, 2015, 211(8):1208-1210.
[48] Burnouf T, Dye JM, Abayomi A, et al.Convalescent plasma and the dose of Ebola virus antibodies[J]. N Engl J Med, 2017, 376(13):1296-1297.
[49] Brown JF, Dye JM, Tozay S, et al.Anti-Ebola virus antibody levels in convalescent plasma and viral load after plasma infusion in patients with Ebola virus disease[J]. J Infect Dis, 2018, 218(4):555-562.
[50] Mora-Rillo M, Arsuaga M, Ramírez-Olivencia G, et al.Acute respiratory distress syndrome after convalescent plasma use:treatment of a patient with Ebola virus disease contracted in Madrid, Spain[J]. Lancet Respir Med, 2015, 3(7):554-562.
[51] Jacob ST, Crozier I, Fischer WA 2nd, et al. Ebola virus disease[J]. Nat Rev Dis Primers, 2020, 6(1):13.
[52] Enria D, Fernandez N, Briggiler A, et al.Importance of dose of neutralising antibodies in treatment of Argentine haemorrhagic fever with immune plasma[J]. Lancet, 1984, 324(8397):255-256.
[53] Enria DA, Maiztegui JI.Antiviral treatment of Argentine hemorrhagic fever[J]. Antiviral Res, 1994, 23(1):23-31.
[54] Ruggiero HA, Pérez Isquierdo F, Milani HA, et al.Treatment of Argentine hemorrhagic fever with convalescent's plasma.4433 cases[J]. Presse Med, 1986, 15(45):2239-2242.
[55] 陆贤吉, 马幼丽. 临床输血不良反应调查分析[J]. 临床血液学杂志(输血与检验), 2015, 28(4):724-725.
[56] Jongerius I, Porcelijn L, van Beek A E, et al. The role of complement in transfusion-related acute lung injury[J]. Transfus Med Rev, 2019, 33(4):236-242.
[57] Gulland A.First Ebola treatment is approved by WHO[J]. BMJ, 2014, 349(sep087):g5539.

康复者恢复期血浆在病毒性疾病治疗中的研究进展

Research Progress in the Convalescent Plasma Therapy of Virus Infection

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

编辑推荐

Metrics

本文评价

关于本刊

作者中心

在线期刊

访问统计

联系我们

[1]	王世春, 阮潜瑛, 刁荣华, 喻荷莲, 戚超, 宋敏, 王珊, 姚春艳. COVID-19流行期间采供血工作特点及对策^*[J]. 临床输血与检验, 2020, 22(5): 454-457.
[2]	王云, 赵长城, 谷妍, 姚余有, 刘杨, 岳莉, 石玉如, 查晓丹, 戚应杰. 80例新型冠状病毒感染肺炎患者相关血液检测指标分析[J]. 临床输血与检验, 2020, 22(4): 360-366.
[3]	李营, 张树超, 张少强, 程聪, 王海燕. 康复者血浆治疗新型冠状病毒肺炎疗效分析1例[J]. 临床输血与检验, 2020, 22(4): 366-370.
[4]	杨俊鸿, 胡文杰, 杨丹蓉, 何涛, 黄霞. 新型冠状病毒肺炎疫情期间献血相关血管迷走神经反应预防措施及监测效果分析[J]. 临床输血与检验, 2020, 22(4): 376-379.
[5]	李剑平, 李晓丰, 赵立哲, 王宏阳, 李伟伟, 林园, 刘景汉. 输血相关治疗应用于新冠病毒肺炎救治中的思考^*[J]. 临床输血与检验, 2020, 22(3): 228-232.
[6]	刘奇, 王世春, 姚春艳. 血浆置换在病毒性呼吸道传染病细胞因子风暴治疗中的作用^*[J]. 临床输血与检验, 2020, 22(3): 236-241.
[7]	叶盛, 沈燕, 陈津, 戴宇东, 傅强. 新型冠状病毒肺炎疫情期间成分献血场所与工作流程的再造[J]. 临床输血与检验, 2020, 22(3): 241-245.
[8]	中国输血协会临床输血管理学委员会. 新型冠状病毒肺炎疫情期间2 309家医院输血科（血库）生物安全防护调查分析^*[J]. 临床输血与检验, 2020, 22(3): 249-252.
[9]	应上云, 赵轶伦, 原勇, 朱娟, 张珂, 骆建钢, 戴宇东. 新型冠状病毒肺炎（COVID-19）疫情期间应急团体献血现场的防控管理策略[J]. 临床输血与检验, 2020, 22(3): 253-258.
[10]	黄琼, 徐云云, 刘海燕, 李宗光, 吴萍, 胡安群. 新型冠状病毒肺炎患者IgM抗体与血细胞计数及C反应蛋白的相关性研究^*[J]. 临床输血与检验, 2020, 22(3): 322-325.