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病原体减少处理方法对 COVID-19 恢复期血浆免疫特性的影响。

Impact of pathogen reduction methods on immunological properties of the COVID-19 convalescent plasma.

机构信息

Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia.

Department of Clinical Immunology and Transfusion Medicine, Office of Medical Services, Lund, Sweden.

出版信息

Vox Sang. 2021 Jul;116(6):665-672. doi: 10.1111/vox.13056. Epub 2021 Mar 18.

Abstract

BACKGROUND AND OBJECTIVES

COVID-19 convalescent plasma is an experimental treatment against SARS-CoV-2. The aim of this study is to assess the impact of different pathogen reduction methods on the levels and virus neutralizing activity of the specific antibodies against SARS-CoV2 in convalescent plasma.

MATERIALS AND METHODS

A total of 140 plasma doses collected by plasmapheresis from COVID-19 convalescent donors were subjected to pathogen reduction by three methods: methylene blue (M)/visible light, riboflavin (R)/UVB and amotosalen (A)/UVA. To conduct a paired comparison, individual plasma doses were divided into 2 samples that were subjected to one of these methods. The titres of SARS-CoV2 neutralizing antibodies (NtAbs) and levels of specific immunoglobulins to RBD, S- and N-proteins of SARS-CoV-2 were measured before and after pathogen reduction.

RESULTS

The methods reduced NtAbs titres differently: among units with the initial titre 80 or above, 81% of units remained unchanged and 19% decreased by one step after methylene blue; 60% were unchanged and 40% decreased by one step after amotosalen; after riboflavin 43% were unchanged and 50% (7%, respectively) had a one-step (two-step, respectively) decrease. Paired two-sample comparisons (M vs. A, M vs. R and A vs. R) revealed that the largest statistically significant decrease in quantity and activity of the specific antibodies resulted from the riboflavin treatment.

CONCLUSION

Pathogen reduction with methylene blue or with amotosalen provides the greater likelihood of preserving the immunological properties of the COVID-19 convalescent plasma compared to riboflavin.

摘要

背景和目的

COVID-19 恢复期血浆是一种针对 SARS-CoV-2 的实验性治疗方法。本研究旨在评估不同病原体减少方法对恢复期血浆中针对 SARS-CoV2 的特异性抗体水平和病毒中和活性的影响。

材料和方法

共采集了 140 份 COVID-19 恢复期供体的血浆,通过血浆置换进行病原体减少处理,采用三种方法:亚甲蓝(M)/可见光、核黄素(R)/UVB 和氨甲喋呤(A)/UVA。为进行配对比较,将每个血浆剂量分为 2 份样本,分别采用其中一种方法进行处理。在病原体减少前后,测量 SARS-CoV2 中和抗体(NtAbs)的滴度和针对 SARS-CoV-2 的 RBD、S-和 N 蛋白的特异性免疫球蛋白水平。

结果

这些方法对 NtAbs 滴度的减少程度不同:在初始滴度为 80 或以上的单位中,81%的单位不变,19%的单位在亚甲蓝处理后降低一个滴度;60%不变,40%在氨甲喋呤处理后降低一个滴度;在核黄素处理后,43%不变,50%(分别为 7%)的单位有一个(两个,分别)的降低。配对双样本比较(M 与 A、M 与 R 和 A 与 R)表明,核黄素处理导致特异性抗体数量和活性的最大统计学显著降低。

结论

与核黄素相比,亚甲蓝或氨甲喋呤的病原体减少处理更有可能保持 COVID-19 恢复期血浆的免疫特性。

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