Blood plasma is the liquid component of blood that remains after red blood cells, white blood cells, platelets, and other cellular components are removed. It accounts for about 55% of total blood volume. Plasma serves to transport nutrients, waste, antibodies, proteins, and hormones as it flows through the bloodstream. Several lifesaving medical products can be derived from blood plasma through complex fractionation processes. These plasma derivatives play a crucial role in treating various medical conditions.
Immunoglobulin Therapies
One of the main types of plasma derivatives are immunoglobulins, also known as antibodies. There are five main classes of immunoglobulins in plasma - IgG, IgA, IgM, IgD, and IgE. Immunoglobulin G (IgG) therapy involves administering concentrated IgG extracts to treat several immune disorders. Intravenous IgG (IVIG) is widely used for primary immunodeficiencies where a person is missing or has non-functioning antibodies. It is also effective for numerous autoimmune disorders like Guillain-Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy, and Kawasaki disease. Subcutaneous IgG (SCIG) involves self-administered injections under the skin to deliver therapy over a period of time.
Coagulation Factors for Blood Plasma Derivatives
Blood Plasma Derivatives also include several coagulation factors required for normal blood clotting. Hemophilia A and B are genetic bleeding disorders caused due to a deficiency in coagulation factors VIII and IX respectively. Intravenous administration of purified or recombinant forms of these factors is the standard treatment for preventing and controlling bleeding episodes in hemophilia patients. Other derivatives like prothrombin complex concentrate and fibrinogen concentrate are used to treat coagulation factor deficiencies. They help replace missing clotting factors through factor replacement therapy.
Albumin - A Multi-Purpose Protein
Albumin is the most abundant plasma protein produced by the liver. It maintains oncotic pressure in blood vessels and transports various molecules including hormones, fatty acids, and metabolites. Medicinal albumin obtained from plasma is used as a volume expander in conditions like trauma/shock, burns, surgery, and liver disease. It replaces lost fluid in blood vessels due to severe bleeding or drainage of fluid into body cavities/tissues. Albumin preparations are also commonly used as stabilizers and excipients in drug formulations, vaccines and other biotherapeutic products.
Plasma-Derived Immunoglobulins Improve Platelet Function
Another application of plasma derivatives is in treating platelet disorders. Thrombocytopenia is a low platelet count condition affecting blood clotting ability. Intravenous immunoglobulin (IVIG) therapy helps improve platelet counts and functions. It does so by reducing the production of autoantibodies against platelets and modifying abnormal immune mechanisms targeting platelets for destruction. This therapy is used for immune thrombocytopenic purpura (ITP), a disease where the immune system destroys the patient's own platelets. IVIG benefits have also been demonstrated in other autoimmune mediated thrombocytopenias like systemic lupus erythematosus.
Production and Safety of Plasma Derivatives
Plasma derivatives are produced on an industrial scale through fractionation of pooled plasma collected from thousands of eligible blood donors. This plasma is rigorously screened and tested for transfusion transmissible infections like HIV, hepatitis, and others. Sophisticated viral clearance/inactivation steps during manufacturing further reduce pathogen risks. The final products are lyophilized into stable powders that can remain potent for years when stored properly. With advances in technology, the fractionation process yields higher purity concentrates than ever before. Rigorous quality controls ensure these life-extending therapies are made available as safely as possible for patient benefit.
Role of Plasma Protein Therapies in Chronic Diseases
Plasma derivatives play a central role in managing many chronic diseases and medical conditions. For example, immunoglobulin replacement therapy is a cornerstone of treatment for primary antibody deficiencies. It improves patient survival and quality of life by preventing life-threatening bacterial infections. Similarly, prothrombin complex concentrates and factor VIII/IX therapies are life-extending treatments for hemophilia that allow freedom from crippling bleeds. Albumin finds utility in a broad array of clinical scenarios involving fluid volume loss. And IVIG effectively treats immune thrombocytopenic purpura, enabling patients to lead normal active lives. Overall, these plasma protein therapies continue to offer hope and longevity to patients suffering from serious genetic disorders and chronic health conditions.
Research Advancements with Plasma Derivatives
A continued goal in the field is developing safer, more effective plasma derivative therapies. Scientists are working on recombinant and monoclonal antibody approaches to replicate immunoglobulins without relying on plasma donations. For hemophilia, longer acting factors are actively being researched to provide protection from bleeding for significantly longer duration with each infusion.
other innovative areas being explored include engineered antibody therapeutics against targeted disease pathways, antibody drug conjugates for cancer therapy, and pathogen-specific immunoglobulin products. As science advances, newer developments from plasma derivatives hold promise to revolutionize treatment options available for both rare and common chronic diseases.
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