Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy.
Transfusion. 2012 May;52(5):953-62. doi: 10.1111/j.1537-2995.2011.03425.x. Epub 2011 Nov 14.
The safety of plasma-derived products is of concern for possible transmission of variant Creutzfeldt-Jakob disease. The absence of validated screening tests requires the use of procedures to remove or inactivate prions during the manufacture of plasma-derived products to minimize the risk of transmission. These procedures need proper validation studies based on spiking human plasma or intermediate fractions of plasma fractionation with prions in a form as close as possible to that present in blood.
Human albumin was spiked with low-speed or high-speed supernatants of 263K scrapie-infected hamster brain homogenates. Spiked albumin was then passed through a cascade of filters from 100 nm down to 20 to 15 nm. Residual infectivity was measured by bioassay.
The overall removal of infectivity spiked into albumin through serial nanofiltration steps was 4 to 5 logs using low-speed supernatant and 2 to 3 logs with high-speed supernatant.
These findings confirm the utility of nanofiltration in removing infectivity from plasma (or other products) spiked with scrapie brain homogenate supernatants. However, efficiency is diminished using supernatants that have been ultracentrifuged to reduce aggregated forms of the infectious agent. Thus, filtration removal data based on experiments using "standard" low-speed centrifugation supernatants might overestimate the amount of prion removal in plasma or urine-derived therapeutic products.
血浆衍生产品的安全性令人关注,因为可能会传播变异型克雅氏病。由于缺乏经过验证的筛选测试,因此在制造血浆衍生产品时需要使用程序来去除或灭活朊病毒,以最大程度地降低传播风险。这些程序需要根据用朊病毒感染的人类血浆或血浆分离的中间级分进行适当的验证研究,这些朊病毒的形式尽可能接近血液中的形式。
将低速或高速 263K 仓鼠脑匀浆感染性 scrapie 的上清液加入人血白蛋白中。然后,将加样的白蛋白通过从 100nm 降至 20nm 至 15nm 的级联过滤器。通过生物测定法测量残留感染性。
通过连续的纳米过滤步骤,用低速上清液对白蛋白中加入的感染性物质的总体去除率为 4 至 5 个对数,用高速上清液的去除率为 2 至 3 个对数。
这些发现证实了纳米过滤在从用 scrapie 脑匀浆上清液加样的血浆(或其他产品)中去除感染性方面的有效性。然而,使用已经过超速离心以减少传染性剂的聚集形式的上清液时,效率会降低。因此,基于使用“标准”低速离心上清液进行实验的过滤去除数据可能会高估血浆或尿液衍生的治疗产品中朊病毒的去除量。