Bilirubin Removal by Polymeric Adsorbents for Hyperbilirubinemia Therapy

Abstract

Hyperbilirubinemia, presenting as jaundice, is a life‐threatening critical illness in newborn babies and acute severe hepatic failure patients. Over the past few decades, extracorporeal hemoadsorption by adsorbent therapy has been widely applied in the treatment of hyperbilirubinemia. The capability of hemoadsorption depends on the adsorbents. Most of the clinically used bilirubin adsorbents are made up of styrene/divinylbenzene copolymer and quaternary ammonium salt, which usually have poor biocompatibility and weak mechanical strength. To overcome the drawbacks of commercial polymer adsorbents, advanced synthetic and natural polymers with/without nanomaterials have been designed, and novel adsorbent fabrication technologies have also been developed. In this review, the adsorption mechanism of bilirubin adsorbents has been summarized, which is the basic criterion in adsorbent development. Furthermore, the preparation method, adsorption mechanism, relative merits and practicability of the emerging bilirubin adsorbents have been evaluated. Based on the existing studies, this work highlights the future direction of the efforts on how to design and develop bilirubin adsorbents with good overall clinical performance. Perhaps this study can change traditional perspectives and propose new strategies for bilirubin clearance from the aspects of pathogenic mechanisms, metabolic pathways, and material‐based innovation.

Metal–organic framework-based adsorbents for blood purification: progress, challenges, and prospects

“…3,[14][15][16] In both HD and HP, adsorbing materials are applied and play critical roles in toxin clearance. [17][18][19] For example, currently reported HD membranes are normally mixed matrix membranes (MMMs), consisting of sorbent fillers and polymeric matrix. 4,11,12 Via the synergistic effect of ultrafiltration and adsorption, toxic molecules are cleared more thoroughly.…”

“…Nowadays, various materials ranging from inorganic metal oxides to organic resins are employed as adsorbents in the field of blood purification. 18,20,21 Among them, there are similarities of large surface area, considerable porosity, or strong interactions. Although the adsorption capacity is enhanced in most cases, the capability for selective toxin adsorption is still inadequate.…”

Theory-Driven Tailoring of the Microenvironment of Quaternary Ammonium Binding Sites on Electrospun Nanofibers for Efficient Bilirubin Removal in Hemoperfusion

“…How to quickly and effectively remove excess bilirubin from blood is an urgent issue that needs to be solved. At present, blood purification therapy has the most therapeutic effect on patients with hyperbilirubinemia in clinical practice [ 4 ]. Blood purification therapy mainly includes blood replacement, hemodialysis, and hemoperfusion adsorption [ 5 ].…”