Molecular synergistic strategy to fabricate bilirubin medical adsorbent material for hyperbilirubinemia hemoperfusion

Neonatal hyperbilirubinemia (jaundice) is a common disease with high incidence. Currently, hemoperfusion (blood exchange transfusion) is always used for the treatment of severe hyperbilirubinemia. However, there are several limitations of blood exchange transfusion, such as the lack of a safe blood supply and blood transfusion complications, while the main problem of hemoperfusions is the inefficient performance of current bilirubin absorbent, which makes it impossible to administer to the neonatal hyperbilirubinemia cases. Identification of a bilirubin hemoperfusion adsorbent with overall excellent performance is the most crucial key to solving the above clinical problems. In this work, a novel bilirubin adsorbent was customized based on molecular design strategy, namely, functional polymeric microspheres were first fabricated by the copolymerization of glycidyl methacrylate with other monomers, and then modified with an amine component, followed by linking with a functional spacer molecule, and finally immobilized with a functional ligand (albumin). Its chemical and physical properties were characterized; its adsorption performances for bilirubin were investigated under clinical conditions; its medical safety were evaluated by hemolysis test, thrombotest, and platelet adhesion test. The results showed that the adsorbent had good adsorption performance for bilirubin compared to a popular commercial clinical bilirubin hemoperfusion column; and it also had excellent medical safety evaluations. This study sheds a new light on how to develop hemoperfusion bilirubin adsorbents with overall good clinical performance as well as a reference for later studies on this topic.