Blood products are those biologicals derived from plasma or obtained by recombinant technologies. This overview covers the characteristics and classification of plasma proteins, the current status of products (albumin, immunoglobulins, coagulation factors and microcontent proteins), as well as the likely trends in the near future. Human serum albumin is one of the earliest, safest and most widely used proteins in the pharmaceutical field. The approval and development of high-purity plasma albumin, recombinant human albumin and HSA fusion proteins provide a favorable prospect for the therapeutic protein. Normal immunoglobulin contains antibodies to all the micro-organisms prevalent in the donor population. The IMIG is relatively simple to prepare and use, and the side effects are acceptable; IVIG is used mainly to treat patients with primary immunodeficiency syndromes; SCIG preparations can be used in selecting suitable patients for home therapy and have occurred fewer adverse systemic reactions; specific immunoglobulins contain concentrations of antibody to an individual organism or toxin at a higher titer than normal immunoglobulin and can not be replaced in clinical use. The plasma-derived or recombinant coagulation factors are used to treat the patients with congenital or acquired factor deficiency. The products such as Fibrinogen, FVII, FVIII, von Willebrand complex, FIX/PCC, FXI, FXIII and so on, have been widely used and proved to be effective. The development of recombinant FVIIa is now as a good bypassing product to haemophilia with inhibitors. The Fibrinogen and thrombin play a very important role in surgery hemostasis. Moreover, microcontent proteins including protein C, antithrombin, alpha 1-AT, tPA have been licensed and used in clinical treatment; a number of other small field proteins are under produced research or pre-clinical investment. The ongoing development of new recombinant plasma proteins is providing alternatives for patients, but the distinct position and the potential impact of plasma-derived preparations are unique, furthermore the development of new plasma protein is still a hot spot in global pharmaceutics. Nowadays, a relative difference exists in the development of blood products between our nation and developed countries, so the domestic manufacturers are faced with chances and challenges.
Biological Factors ; therapeutic use ; Blood ; Blood Coagulation Factors ; therapeutic use ; Blood Proteins ; therapeutic use ; China ; Humans ; Immunoglobulins ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Serum Albumin ; therapeutic use

OBJECTIVE: To evaluate the value of pharmacogenetic testing for improving the efficacy and safety of treatment with cyclosporine, tacrolimus, and cyclophosphamide (CTX) for PLA2R-related membranous nephropathy and for determing individualized and precise treatment plans for the patients. METHODS: A total of 63 patients with PLA2R-related membranous nephropathy hospitalized in the Department of Nephrology at our hospital from January, 2019 to October, 2021 were enrolled in this study. Thirty-three of the patients underwent pharmacogenetic testing before taking the immunosuppressive drugs selected based on the results of genetic screening for sensitive targets, and the other 30 patients were empirically given immunosuppressive drugs according to the guidelines (control group). The clinical efficacy and adverse effects of the immunosuppressive drugs were analyzed for all the patients. The two groups of patients were compared for demographic and biochemical parameters including 24-h urine protein, serum albumin, renal function, and serum anti-phospholipase A2 receptor antibody both before and at 3 months after the beginning of the treatment. RESULTS: Among the 33 patients undergoing pharmacogenetic testing, 51.5% showed a GG genotype for cyclosporine, and 61.6% had an AG genotype for tacrolimus; for CTX, 51.5% of the patients showed a homozygous deletion and 63.6% had an AA genotype. After treatment for 3 months, serum anti-phospholipase A2 receptor antibody, 24-h urine protein, and serum albumin levels were significantly improved in pharmacogenetic testing group as compared with the control group (P < 0.05). CONCLUSION Individualized and precise administration of immunosuppressive drugs based on pharmacogenetic testing better controls proteinuria and serum antiphospholipase A2 receptor antibodies and increases serum albumin level in patients with PLA2R-related membranous nephropathy.
Humans ; Autoantibodies ; Cyclosporine/therapeutic use* ; Glomerulonephritis, Membranous/diagnosis* ; Homozygote ; Immunosuppressive Agents/therapeutic use* ; Pharmacogenomic Testing ; Receptors, Phospholipase A2 ; Sequence Deletion ; Serum Albumin ; Tacrolimus/therapeutic use*

Carbamates ; therapeutic use ; Hepatitis C ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Interferons ; therapeutic use ; Macrocyclic Compounds ; Oligonucleotides, Antisense ; therapeutic use ; Quinolines ; RNA Replicase ; antagonists & inhibitors ; Serum Albumin ; therapeutic use ; Serum Albumin, Human ; Thiazoles ; therapeutic use ; Viral Hepatitis Vaccines ; therapeutic use

OBJECTIVETo investigate the effect of intralipid on protein consumption in severe burned patients. METHODS; Sixty-seven nonoperative patients with severe burns were divided into Intralipid treatment group and non-intralipid treatment group (control group), and the former was treated with 20% intralipid (500 ml once a day) from postburn day 4 for 10 consecutive days. Venous blood samples were collected from these patients for testing total protein, albumin, total cholesterol and triglyceride on postburn days 1, 7 and 14, respectively.

RESULTSThe levels of total protein, albumin, total cholesterol and triglyceride were within normal range on postburn day 1 in both groups, and only the albumin level was lowered in the groups on day 7 but at comparable magnitudes (32+/-4.83 vs 31+/-5.04 g/L, P<0.05). In contrast, the levels of total protein, albumin, total cholesterol and triglyceride were below the normal range on postburn day 14 in both groups, but intralipid treatment group showed more albumin loss than the control group (28+/-6.46 vs 23+/-7.03 g/L, P<0.01).

CONCLUSIONIntralipid (20%) provides good energy source to ameliorate albumin loss in severe burned patients.

Adolescent ; Adult ; Burns ; metabolism ; therapy ; Fat Emulsions, Intravenous ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Serum Albumin ; metabolism

Humans ; Liver Failure ; therapy ; Liver, Artificial ; Membranes, Artificial ; Plasma ; Plasma Exchange ; methods ; Plasma Substitutes ; therapeutic use ; Renal Dialysis ; methods ; Serum Albumin ; therapeutic use

Objective To explore the clinical characteristics and risk factors of systemic lupus erythematosus(SLE)complicated with cytomegalovirus infection(CMV). Methods The medical records of patients diagnosed with SLE at discharge in the Department of Immunology at Peking Union Medical College Hospital between July 1,2017 and April 1,2019 were retrospectively reviewed,and the clinical and laboratory data related to CMV infection were analyzed. Results Of the 231 patients with SLE,115(49.8%)had CMV infection.Among them,78(67.8%)were asymptomatic CMV infection and 37(32.2%)were diagnosed with CMV disease.Univariate analysis showed the number of organs involved(
Cyclophosphamide/therapeutic use* ; Cytomegalovirus Infections/epidemiology* ; Humans ; Immunosuppressive Agents/therapeutic use* ; Lupus Erythematosus, Systemic/drug therapy* ; Methylprednisolone/therapeutic use* ; Prednisolone/therapeutic use* ; Retrospective Studies ; Risk Factors ; Serum Albumin, Human/analysis*

The traditional diagnostic criteria of renal dysfunction in cirrhosis are a 50% increase in serum creatinine (SCr) with a final value above 1.5 mg/dL. This means that patients with milder degrees of renal dysfunction are not being diagnosed, and therefore not offered timely treatment. The International Ascites Club in 2015 adapted the term acute kidney injury (AKI) to represent acute renal dysfunction in cirrhosis, and defined it by an increase in SCr of 0.3 mg/dL (26.4 µmoL/L) in <48 hours, or a 50% increase in SCr from a baseline within ≤3 months. The severity of AKI is described by stages, with stage 1 represented by these minimal changes, while stages 2 and 3 AKI by 2-fold and 3-fold increases in SCr respectively. Hepatorenal syndrome (HRS), renamed AKI-HRS, is defined by stage 2 or 3 AKI that fulfils all other diagnostic criteria of HRS. Various studies in the past few years have indicated that these new diagnostic criteria are valid in the prediction of prognosis for patients with cirrhosis and AKI. The future in AKI diagnosis may include further refinements such as inclusion of biomarkers that can identify susceptibility for AKI, differentiating the various prototypes of AKI, or track its progression.
Acute Kidney Injury/complications/*diagnosis/drug therapy/pathology ; Biomarkers/blood ; Creatinine/blood ; Humans ; Liver Cirrhosis/*complications ; Prognosis ; Serum Albumin/therapeutic use ; Severity of Illness Index

BACKGROUNDThe nutritional support is one of the important therapeutic strategies for the elderly patients with severe sepsis, but there is controversial in choosing a parenteral nutrition formulation. This study was designed to compare the therapeutic effects of structured lipid emulsion, physically mixed medium, and long-chain fat emulsion in the treatment of severe sepsis in elderly patients.

METHODSA total number of 64 elder patients with severe sepsis were enrolled in the study. After a week of enteral nutritional support, the patients were randomly divided into research (structured lipid emulsion as parenteral alimentation) and control groups (physically mixed medium and long-chain fat emulsion as parenteral alimentation). The alterations of plasma albumin, lipid metabolism, and blood glucose level were recorded after parenteral alimentation and were compared between the two groups.

RESULTSThe plasma levels of albumin, prealbumin, cholesterol, and triglyceride were decreased in all the patients after one week of enteral nutritional support treatment (t = 7.78, P = 0.000; t = 10.21, P = 0.000; t = 7.99, P = 0.000; and t = 10.99, P = 0.000). Further parenteral alimentation with different lipid emulsions had significant effects on the serum prealbumin and albumin (t = 3.316, P = 0.002; t = 3.200, P = 0.002), whilst had no effects on the blood glucose and triglyceride level (t = 7.78, P = 0.000; t = 4.228, P = 0.000). In addition, the two groups had a significantly different Apache II score, ventilator time, and hospital stay time (t = -2.213, P = 0.031; t = 2.317, P = 0.024; t = 2.514, P = 0.015).

CONCLUSIONSThe structured lipid emulsion was safe as parenteral nutrition for elderly patients with severe sepsis. It was demonstrated to be superior to the physically mixed medium and long-chain fat emulsion with respect to the protein synthesis and prognosis.

Aged ; Emulsions ; Fat Emulsions, Intravenous ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Parenteral Nutrition ; methods ; Sepsis ; blood ; drug therapy ; Serum Albumin ; analysis ; Triglycerides ; blood

OBJECTIVETo explore the effect of Peitu Shengjin Recipe (PSR) on nutritional states and immune functions of stable phase chronic obstructive pulmonary disease (COPD) patients.

METHODSTotally 62 stable phase COPD patients were randomly assigned to the treatment group (30 cases) and the control group (32 cases). All patients inhaled Seretide (50/500 µg), twice per day. Besides, patients in the treatment group additionally received PSR, one dose per day. After three months of treatment, the COPD assessment test (CAT) score, the index of nutritional states [including body mass index (BMI) , thickness of skin fold (TSF), mid-arm muscle circumference (MAMC), serum albumin, serum prealbumin], and immune functions (including IgA, IgM, and IgG) were compared between the two groups.

RESULTSBy the end of the treatment, the CAT score decreased more obviously in the treatment group than in the control group (P < 0.05). The improvement of BMI, TSF, MAMC, serum albumin, and serum prealbumin was better in the treatment group than in the control group (P < 0.05). IgM and IgG also increased more in the treatment group (P < 0.05). There was no statistical difference in IgA between the two groups (P > 0.05).

CONCLUSIONSAdditionally use of PSR could improve nutritional states and immune functions of stable phase COPD patients to some extent. Meanwhile, it also could improve their health related quality of life.

Body Mass Index ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Nutritional Status ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; immunology ; Quality of Life ; Serum Albumin

PURPOSE: The modified Glasgow Prognostic Score (mGPS) consisting of serum C-reactive protein and albumin levels, shows significant prognostic value in several types of tumors. We evaluated the prognostic significance of mGPS in 285 patients with diffuse large B cell lymphoma (DLBCL), retrospectively. MATERIALS AND METHODS: According to mGPS classification, 204 patients (71.5%) had an mGPS of 0, 57 (20%) had an mGPS of 1, and 24 (8.5%) had an mGPS of 2. RESULTS: Our study found that high mGPS were associated with poor prognostic factors including older age, extranodal involvement, advanced disease stage, unfavorable International Prognostic Index scores, and the presence of B symptoms. The complete response (CR) rate after 3 cycles of R-CHOP chemotherapy was higher in patients with mGPS of 0 (53.8%) compared to those with mGPS of 1 (33.3%) or 2 (25.0%) (p=0.001). Patients with mGPS of 0 had significantly better overall survival (OS) than those with mGPS=1 and those with mGPS=2 (p=0.036). Multivariate analyses revealed that the GPS score was a prognostic factor for the CR rate of 3 cycle R-CHOP therapy (p=0.044) as well as OS (p=0.037). CONCLUSION: mGPS can be considered a potential prognostic factor that may predict early responses to R-CHOP therapy in DLBCL patients.
Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; C-Reactive Protein/*metabolism ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Female ; Glasgow Outcome Scale ; Humans ; Lymphoma, Large B-Cell, Diffuse/blood/*diagnosis/*drug therapy/mortality ; Male ; Middle Aged ; Multivariate Analysis ; Prednisone/therapeutic use ; Prognosis ; Remission Induction ; Retrospective Studies ; Serum Albumin/*metabolism ; Survival Rate ; Treatment Outcome ; Vincristine/therapeutic use