Plasmapheresis

Human life is a form of existence of its proteins. The tissue injury as a biological phenomenon leads to a cascade of distortions and a change in the function of each individual protein. Simultaneously with the change of the polypeptides it is changed and biological role and activity of the cellular components of blood. Thus, in the separation of proteins and blood cells are introduced concepts: therapeutic plasmapheresis for separating human protein and therapeutic cytopheresis in separation and processing of blood cells. Discoverer of the principles of separation of human proteins and blood components in human blood is Scottish chemist Thomas Graham (1805-1869) at the University of Glasgow.

The therapeutic plasmapheresis is a process, wherein the output extracorporeal portions of the circulating blood of humans and this amount of blood is passed through a semipermeable membrane that separates the pathological proteins and remove them from the circulation. The same procedure can be performed by periodically placing the separated human blood in a centrifuge. Depending on the speed previously set to spin, can be divided into proteins from blood plasma, pathological disposed outside the body and the normal flow back into circulation. This separation of therapeutic proteins and cells known in the art as gravity separation of the cells.

The membrane as apheresis classical method of separation of components of blood using the methods of dialysis, filtration, etc.. Through produced chemically permeable membranes. Nanotechnology semi-permeable membranes are qualitatively new development in science and are derived from accelerated in the collider and loaded with extra energy protons of atoms. Natural change of the tertiary structure of a polypeptide in space makes it possible, depending on the applied pressure at the inlet of the membrane proteins to alter their conformation and to pass through the created channels nanotechnology. The sequential arrangement of several membranes one after the other with different sizes of nanotechnology channels leads to a selective separation of the polypeptides, which is known in the art as a cascade apheresis. Processing of nanotechnology channels immunologically active compound and the separation of plasma in such a membrane is termed scientific term selective immunoadsorption pathological polypeptides in blood plasma.

Historical plasma-cytopheresis procedures were started from ancient times in Egypt with medical bloodletting reflected in written works of Hippocrates and Galen. Plasmapheresis term derives from the Greek words plasma (integer) and apheresis (withdrawal). For the first time in 1914. John J. Abel and colleagues offer term plasmapheresis, which was formally adopted in world literature. Plasma is a treatment method for the extraction, processing, separation and return again in the bloodstream of the treated plasma. Plasma began as a technique to “give blood hire.” In clinical medicine plasma applied for the first time in 1959 by Skoog and Adams for treatment of patients with makroglobunemiya of Waldenstrom. Thus removal from the circulation of macroglobulyns leads to a decrease in blood viscosity and helps prevent hyperviscosity syndrome. In 1965 the US National Institute of Cancer develops apheresis technology and enables you to get through apheresis concentrates of the smallest cells from human blood, representing the first platelet concentrates. Such knowledge and technology are based on those developed for obtaining the concentrated human white blood cells – leukocytes, lymphocytes – as a manufacturing process for their treatment with extra body activation and return back into the circulatory system of the donor. Belgian doctor Albert Hustin and Dr. Luis Agote from Argentina were the first to apply sodium citrate to eliminate extra corporeal blood clotting. Thus, the blood outside the human body can be treated by various methods and, after removal of pathologic constituents from flowing back into the vascular system. In 1968, Bowman and team bring therapeutic apheresis in obstetrics and gynecologist in pregnant women with Rh-conflict. In 1983 Prof. Dr. Murray makes the first classical plasmapheresis in patients with myasthenia and poly radikulonevrit of Guillain-Barre. Thirty years later Chifligarov et al. published in Bulgaria his clinical experience of application of classical therapeutically plasma exchange in the treatment of patients with myasthenia gravis. In 2013, an international scientific conference in Bulgaria Kenarov et al., Chiligarov et al., Voinov et al. They reported results in the application of therapeutic apheresis with nano membrane in diseases of the nervous system. That same year, Petrov et al. (Board of the Society of Anesthesiologists in Bulgaria) adopt and publish national consensus on therapeutic apheresis for specialists in intensive care in Bulgaria. 2014 was approved by the MU Sofia, a program for training in highly specialized activity in medicine therapeutic apheresis. In 2014 Daskalov et al. Report to the National Conference of Neurology with international participation its results from the introduction of therapeutic plasmapheresis in diseases of the nervous system and neuromuscular synapse.

Plasmapheresis is a process in which the body of the patient is displayed on the liquid portion of the blood – plasma that contains a large amount of biologically active substances, regardless of their nature and molecular weight. The main mechanism of action of therapeutic plasmapheresis is efferent i. e. direct detoxification. By plasma from blood eliminated: various inflammatory mediators; circulating enzymes, hormones and peptides with different molecular weights; circulating immune complexes; endotoxins. The principle of operation of this method is to remove the blood and pathological conditionally pathological agents, which is the exact opposite of a conventional medical treatment with drugs using different chemical compounds. Though both types of treatment are fundamentally different, the method of directly purifying the blood prove its clinical efficacy and complement traditional therapy. Plasma is one of efferent methods that achieve the greatest detoxify the body and has the strong immunomodulation effect.