血液接触材料表面抗血栓改性新策略:构建纤溶活性表面

New Antithrombotic Strategy for Surface Modification of Blood Contacting Materials: Construction of Fibrinolytic Surfaces

异体材料表面引起血栓形成是限制血液接触器件成功应用的主要问题之一.传统的表面抗血栓改性策略主要基于"抑制纤维蛋白(初级血栓)形成"这一基本设计思路,然而大量实践证明,异体材料在接触血液时,凝血反应是不可避免的.纤溶表面的概念突破了传统抗血栓思路,从"溶解纤维蛋白"的角度设计材料表面,使其在接触血液环境时,充分调动人体纤溶系统,从而迅速溶解初步形成但尚未对人体造成危害的血栓.在过去十几年中,以加拿大麦克马斯特大学的Brash课题组以及作者课题组为代表的研究团队们已经充分证实了纤溶表面这一概念的可行性,并发展了多种构建纤溶表面的方法.本专论详细介绍了这些研究进展,并展望了该领域未来的发展方向,旨在激发更多的研究者关注这个尚未全面开发但却极具潜力和重要性的材料表面抗血栓的新概念和新方法,进而推动其实现在血液接触器件方面的成功应用.

Clotting and thrombosis remain one of the most serious problems in the development of blood contacting devices. Strategies for developing antithrombotic surfaces are generally based on the idea of preventing clot formation. However, they have so far met with only limited success since coagulation appears to be inevitable when a foreign surface is in contact with blood. Alternatively, by designing the surface effectively to mimic the fibrinolytic system in the vasculature,it may be possible for clots to be lysed as they form. Over the past two decades, work on the fibrinolytic surface concept has established its validity. In this review we elaborate this concept and discuss ways in which such a surface could be realized. Developments in this area to the present time are reviewed, and some perspectives for future research are presented. We hope that this review may serve to stimulate additional research on this neglected but promising and potentially important approach to blood compatibility.