Heparin 2.0: A New Approach to the Infection Crisis.

Autor: Seffer MT; Medical Clinic V, Nephrology | Rheumatology | Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, Germany.; Microbial Proteomics, Helmholtz Centre for Infection Research, Braunschweig, Germany., Cottam D; Intensive Care Unit, Royal Surrey Hospital NHS Foundation Trust, Guildford, United Kingdom., Forni LG; Intensive Care Unit, Royal Surrey Hospital NHS Foundation Trust, Guildford, United Kingdom.; Department of Clinical & Experimental Medicine, School of Biosciences & Medicine, University of Surrey, Guildford, United Kingdom., Kielstein JT; Medical Clinic V, Nephrology | Rheumatology | Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, Germany, j.kielstein@klinikum-braunschweig.de.
Jazyk: angličtina
Zdroj: Blood purification [Blood Purif] 2021; Vol. 50 (1), pp. 28-34. Date of Electronic Publication: 2020 Jul 02.
DOI: 10.1159/000508647
Abstrakt: In April 2020, the US Food and Drug Administration granted emergency use authorization for certain medical devices to be used in patients with coronavirus disease 2019 (CO-VID-19). This included extracorporeal blood purification devices. This narrative review will give a brief overview regarding some of the extracorporeal devices that could be used to treat COVID-19 patients, including the Seraph® 100 Microbind® Affinity Blood Filter, produced by ExThera Medical (Martinez, CA, USA), first licensed in the European Economic Area in 2019. The Seraph® 100 contains ultrahigh molecular weight polyethylene beads with end point-attached heparin and is approved for the reduction of pathogens from the bloodstream either as a single agent or as an adjunct to conventional anti-infective agents. Bacteria, viruses, fungi, and toxins have been shown to bind to the immobilized heparin in a similar way to the interaction with heparan sulfate on the cell surface. This binding is nonreversible and as such, the pathogens are removed from the bloodstream. In this review, we describe the pathophysiological basis and rationale for using heparin for pathogen removal from the blood as well as exploring the technology behind the adaptation of heparin to deprive it of its systemic anticoagulant activity. In addition, we summarize the in vitro data as well as the available preclinical testing and published clinical reports. Finally, we discuss the enormous potential of this technology in an era of increasing antibiotic resistance and high mortality associated with sepsis and consider the application of this as a possible treatment option for COVID-19.
(© 2020 S. Karger AG, Basel.)
Databáze: MEDLINE
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