首都医科大学附属北京友谊医院肝病中心;吉林大学第一医院肝胆胰内科,传染病与病原生物学中心;
白蛋白是人血浆中含量最高的蛋白质,除维持血浆胶体渗透压外,还有物质转运、解毒、维持血管完整性、抗氧化、抗炎及免疫调控等功能。在肝病领域,目前白蛋白主要用于预防大量放腹水后循环功能障碍和治疗肝硬化低白蛋白血症和腹水、自发性腹膜炎以及肝肾综合征。研发重组人血白蛋白有助于降低人血白蛋白制品的潜在生物安全风险和大量依赖进口的弊端。由于缺乏对已上市人血白蛋白关键注册临床试验结果的借鉴,人血白蛋白的临床试验设计、实施和审评均面临诸多挑战。因此需要制药企业、临床医学、方法学以及评审监管等方面的专家,求真务实、锐意创新、协同攻关。
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下载次数 | 被引频次 | 阅读次数 |
[1] CARACENI P, O’BRIEN A, GINES P. Long-term albumin treatment in patients with cirrhosis and ascites[J]. J Hepatol, 2022, 76(6):1306-1317. DOI:10.1016/j.jhep.2022.03.005.
[2] MURPHY G, BRAYDEN DJ, CHEUNG DL, et al. Albumin-based delivery systems:Recent advances, challenges, and opportunities[J].J Control Release, 2025, 380:375-395. DOI:10.1016/j.jconrel.2025.01.035.
[3] FEATHERSTONE PJ, BALL CM. The development of albumin solutions in the second world war[J]. Anaesth Intensive Care, 2023, 51(4):236-238. DOI:10.1177/0310057X231174704.
[4] FEATHERSTONE PJ, BALL CM. From conflict to controversy:The use and abuse of human albumin solutions after the Second World War[J]. Anaesth Intensive Care, 2023, 51(6):368-371. DOI:10.1177/0310057X231199368.
[5] SANER FH, STUEBEN BO, HOYER DP, et al. Use or misuse of albumin in critical ill patients[J]. Diseases, 2023, 11(2):68. DOI:10.3390/diseases11020068.
[6] WIEDERMANN CJ, ZABOLI A, TURCATO G. Synthesis of expert opinions on fluid management in severe sepsis:A contextual review of human albumin and crystalloids[J]. Heart Lung, 2025, 70:339-359. DOI:10.1016/j.hrtlng.2025.01.010.
[7] GARCIA-TSAO G, ABRALDES JG, RICH NE, et al. AGA clinical practice update on the use of vasoactive drugs and intravenous albumin in cirrhosis:Expert review[J]. Gastroenterology, 2024, 166(1):202-210. DOI:10.1053/j.gastro.2023.10.016.
[8] CARACENI P, RIGGIO O, ANGELI P, et al. Long-term albumin administration in decompensated cirrhosis(ANSWER):An open-label randomised trial[J]. Lancet, 2018, 391(10138):2417-2429. DOI:10.1016/S0140-6736(18)30840-7.
[9] CHINA L, FREEMANTLE N, FORREST E, et al. A randomized trial of albumin infusions in hospitalized patients with cirrhosis[J]. N Engl J Med, 2021, 384(9):808-817. DOI:10.1056/NEJMoa2022166.
[10] SOLàE, SOLéC, SIMóN-TALERO M, et al. Midodrine and albumin for prevention of complications in patients with cirrhosis awaiting liver transplantation. A randomized placebo-controlled trial[J]. J Hepatol,2018, 69(6):1250-1259. DOI:10.1016/j.jhep.2018.08.006.
[11] CHRIS RUNKEN M, CARACENI P, FERNANDEZ J, et al. The cost-effectiveness of albumin in the treatment of decompensated cirrhosis in Germany, Italy, and Spain[J]. Health Econ Rev, 2019, 9(1):22.DOI:10.1186/s13561-019-0237-7.
[12] HASAN I, MURTI IS, BAYUPURNAMA P, et al. Cost-effectiveness of albumin in the treatment of decompensated cirrhosis in resourcelimited healthcare settings[J]. Drugs Context, 2024, 13:2024-2021-1. DOI:10.7573/dic.2024-1-1.
[13] BALDASSARRE M, NALDI M, ZACCHERINI G, et al. Determination of effective albumin in patients with decompensated cirrhosis:Clinical and prognostic implications[J]. Hepatology, 2021, 74(4):2058-2073. DOI:10.1002/hep.31798.
[14] ERSTAD BL. Introduction to the concept of effective albumin concentration[J]. Am J Health Syst Pharm, 2024, 82(1):5-11. DOI:10.1093/ajhp/zxae232.
[15] CHEN Z, HE Y, SHI B, et al. Human serum albumin from recombinant DNA technology:Challenges and strategies[J]. Biochim Biophys Acta, 2013, 1830(12):5515-5525. DOI:10.1016/j.bbagen.2013.04.037.
[16] ABRALDES JG, TREBICKA J, CHALASANI N, et al. Prioritization of therapeutic targets and trial design in cirrhotic portal hypertension[J]. Hepatology, 2019, 69(3):1287-1299. DOI:10.1002/hep.30314.
[17] TORP N, ISRAELSEN M, COENRAAD M, et al. Personalised human albumin in patients with cirrhosis and ascites:Design and rationale for the ALB-TRIAL-a randomised clinical biomarker validation trial[J]. BMJ Open, 2024, 14(2):e079309. DOI:10.1136/bmjopen-2023-079309.
[18] GENTILINI P, CASINI-RAGGI V, DI FIORE G, et al. Albumin improves the response to diuretics in patients with cirrhosis and ascites:Results of a randomized, controlled trial[J]. J Hepatol, 1999, 30(4):639-645. DOI:10.1016/s0168-8278(99)80194-9.
[19] CARACENI P, ANGELI P, PRATI D, et al. AISF-SIMTI position paper on the appropriate use of albumin in patients with liver cirrhosis:A2020 update[J]. Blood Transfus, 2021, 19(1):9-13. DOI:10.2450/2020.0414-20.
[20] KALO E, READ S, BAIG A, et al. Efficacy of albumin use in decompensated cirrhosis and real-world adoption in Australia[J]. JGH Open,2024, 8(9):e70029. DOI:10.1002/jgh3.70029.
基本信息:
DOI:
中图分类号:R977
引用信息:
[1]贾继东,牛俊奇.开拓创新、协同攻关,助力人血白蛋白的迭代研发及临床研究[J].临床肝胆病杂志,2025,41(03):401-403.
基金信息: