Rony R M Imtiaz Karim, Shokrani Alireza, Malhi Naseeb Kaur, Hussey Deborah, Mooney Rachael, Chen Zhen Bouman, Scott Tristan, Han Haiyong, Moore Jaeger, Liu Jiahui, Huang Wendong, Garcia-Ocaña Adolfo, Grant Maria B, Aboody Karen, Von Hoff Daniel, Natarajan Rama, Tompkins Joshua D
Department of Diabetes Complications, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA.
Arthur Riggs Diabetes and Metabolism Research Institute, City of Hope, Duarte, CA 91010, USA.
Biomolecules. 2025 Jul 12;15(7):1000. doi: 10.3390/biom15071000.
Therapeutic plasma exchange (TPE) is a blood purification technique which functions to remove pathological plasma constituents such as autoantibodies, inflammatory cytokines, immune complexes, and extracellular vesicles (EVs) that contribute to a range of disease states. In this review, we examine current and emerging indications for TPE across cardiovascular, metabolic, neurological, inflammatory, and oncological diseases. We cover emerging preclinical animal models and new applications, emphasizing the roles of cellular signaling and EV biology in mediating plasma functions, and discuss unique therapeutic "windows of opportunity" offered by TPE. We conclude that TPE is underutilized in both preventative and precision medicine, and that next generation TPE therapies will involve personalized plasma biomarker and modulation feedback, with synergistic plasma infusion therapies to mitigate age associated disease and promote tissue rejuvenation.
治疗性血浆置换(TPE)是一种血液净化技术,其作用是清除病理性血浆成分,如自身抗体、炎性细胞因子、免疫复合物和细胞外囊泡(EVs),这些成分会导致一系列疾病状态。在本综述中,我们研究了TPE在心血管、代谢、神经、炎症和肿瘤疾病中的当前及新兴适应症。我们涵盖了新兴的临床前动物模型和新应用,强调细胞信号传导和EV生物学在介导血浆功能中的作用,并讨论了TPE提供的独特治疗“机会窗口”。我们得出结论,TPE在预防医学和精准医学中都未得到充分利用,下一代TPE疗法将涉及个性化血浆生物标志物和调节反馈,以及协同血浆输注疗法,以减轻与年龄相关的疾病并促进组织年轻化。