Human albumin: Focus on liver disease (Chinese) | Page 8

要功能结构域 ( 金属结合域 、 半胱氨酸 -34 结构域和 结合位点 ) 可以用钴结合试验 、 质谱或电子顺磁共振
第四 , 仍需更多严格设计和实施的临床研究为白蛋白 在肝硬化人群中的治疗策略提供证据 。
18
分别进行评估 , 从而建立 “ 有效白蛋白浓度 ” 模型 ,
以提高白蛋白输注的疗效 、 降低治疗成本 。 第二 , 商 品化白蛋白溶液中具有活性功能的巯基白蛋白含量仅
19
占 50 % 左右 , 近 40 % 以 HNA1 的形式存在 , 迫切需
要新的方法提高白蛋白的质量以提升白蛋白的疗效 。 第三 , 亟需深入研究肝硬化患者发生低蛋白血症的机 制 , 阐明机制才能制定纠正低蛋白血症的有效措施 。
参考文献 :
1 Rockey DC , Bell PD , Hill JA . Fibrosis -a common pathway to organ injury and failure . N Engl J Med 2015 ; 372:1138 – 49 . 2 European Association for the Study of the Liver . EASL clinical practice guidelines for the management of patients with decompensated cirrhosis . J Hepatol 2018 ; 69:406 – 60 . 3 Clària J et al . Systemic inflammation in decompensated cirrhosis : characterization and role in acute-on-chronic liver failure . Hepatology 2016 ; 64:1249 – 64 . 4 Pasparakis M , Vandenabeele P . Necroptosis and its role in inflammation . Nature 2015 ; 517:311 – 20 . 5 Bernsmeier C et al . Patients with acute-on-chronic liver
failure have increased numbers of regulatory immune cells expressing the receptor tyrosine kinase Mertk . Gastroenterology 2015 ; 148:603 – 15 . 6 Bernsmeier C et al . CD14 + CD15- HLA-DR- myeloidderived suppressor cells impair antimicrobial responses in patients with acute-on-chronic liver failure . Gut 2018 ; 67 : 1155 – 67 . 7 Korf H et al . Inhibition of glutamine synthetase in monocytes from patients with acute-on-chronic liver failure resuscitates their antibacterial and inflammatory capacity . Gut 2019 ; 68:1872 – 83 . 8 Angus DC , van der Poll T . Severe sepsis and septic shock . N Engl J Med 2013 ; 369:840 – 51 . 9 Ganeshan K et al . Energetic
trade-offs and hypometabolic states promote disease tolerance . Cell 2019 ; 177 : 399 – 413 . 10 Moreau R et al . Blood metabolomics uncovers inflammation-associated mitochondrial dysfunction as a potential mechanism underlying ACLF . J Hepatol 2020 ; 72 : 688 – 701 . 11 Fernández J et al . Effects of albumin treatment on systemic and portal hemodynamics and systemic inflammation in patients with decompensated cirrhosis . Gastroenterology 2019 ; 157:149 – 62 . 12 Arroyo V , García-Martinez R , Salvatella X . Human serum albumin , systemic inflammation , and cirrhosis . J Hepatol 2014 ; 61:396 – 407 .
13 Alcaraz-Quiles J et al . Oxidized albumin triggers a cytokine storm in leukocytes through p38 mitogen-activated protein kinase : role in systemic inflammation in decompensated cirrhosis . Hepatology 2018 ; 68:1937 – 52 . 14 Jalan R , Bernardi M . Effective albumin concentration and cirrhosis mortality : from concept to reality . J Hepatol 2013 ; 59:918 – 20 . 15 Caraceni P et al . Longterm albumin administration in decompensated cirrhosis ( ANSWER ): an open-label randomised trial . Lancet 2018 ; 391:2417 – 29 . 16 Di Pascoli M et al . Long-term administration of human albumin improves survival in patients with cirrhosis and refractory ascites .
Liver Int 2019 ; 39:98 – 105 . 17 Solà E et al . Midodrine and albumin for prevention of complications in patients with cirrhosis awaiting liver transplantation . A randomized placebo-controlled trial . J Hepatol 2018 ; 69:1250 – 9 . 18 Garcia-Martinez R et al . Immunomodulatory and antioxidant function of albumin stabilises the endothelium and improves survival in a rodent model of chronic liver failure . J Hepatol 2015 ; 62:799 – 806 . 19 Oettl K , Marsche G . Redox state of human serum albumin in terms of cysteine-34 in health and disease . Methods Enzymol 2010 ; 474:181 – 95 .
8 | 2021 | hospitalpharmacyeurope . com