Raster Johannes, Zimmermann Kathrin, Wesche Jan, Aurich Konstanze, Greinacher Andreas, Selleng Kathleen
Abteilung Transfusionsmedizin, Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany.
Institut für Medizinische Mikrobiologie, Universitätsmedizin Greifswald, Greifswald, Germany.
Transfus Med Hemother. 2021 May;48(3):148-153. doi: 10.1159/000514485. Epub 2021 Feb 25.
In the light of the ongoing SARS-CoV-2 pandemic, convalescent plasma is a treatment option for CO-VID-19. In contrast to usual therapeutic plasma, the therapeutic agents of convalescent plasma do not represent clotting factor activities, but immunoglobulins. Quarantine storage of convalescent plasma as a measure to reduce the risk of pathogen transmission is not feasible. Therefore, pathogen inactivation (e.g., Theraflex®-MB, Macopharma, Mouvaux, France) is an attractive option. Data on the impact of pathogen inactivation by methylene blue (MB) treatment on antibody integrity are sparse.
Antigen-specific binding capacity was tested before and after MB treatment of plasma ( = 10). IgG and IgM isoagglutinin titers were tested by agglutination in increasing dilutions. Furthermore, the binding of anti-EBV and anti-tetanus toxin IgG to their specific antigens was assessed by ELISA, and IgG binding to Fc receptors was assessed by flow cytometry using THP-1 cells expressing FcRI and FcRII.
There was no significant difference in the isoagglutinin titers, the antigen binding capacity of anti-EBV and anti-tetanus toxin IgG, as well as the Fc receptor binding capacity before and after MB treatment of plasma.
MB treatment of plasma does not inhibit the binding capacity of IgM and IgG to their epitopes, or the Fc receptor interaction of IgG. Based on these results, MB treatment of convalescent plasma is appropriate to reduce the risk of pathogen transmission if quarantine storage is omitted.
鉴于正在肆虐的新型冠状病毒肺炎疫情,康复期血浆是治疗新冠肺炎的一种选择。与常规治疗性血浆不同,康复期血浆的治疗成分并非凝血因子活性物质,而是免疫球蛋白。将康复期血浆进行隔离储存以降低病原体传播风险并不可行。因此,病原体灭活(例如使用法国穆沃的Macopharma公司生产的Theraflex®-MB)是一个有吸引力的选择。关于亚甲蓝(MB)处理对抗体完整性影响的数据较少。
对10份血浆进行MB处理前后,检测其抗原特异性结合能力。通过递增稀释后的凝集试验检测IgG和IgM同种凝集素滴度。此外,采用酶联免疫吸附测定法评估抗EB病毒和抗破伤风毒素IgG与其特异性抗原的结合情况,并使用表达FcRI和FcRII的THP-1细胞,通过流式细胞术评估IgG与Fc受体的结合情况。
血浆经MB处理前后,同种凝集素滴度、抗EB病毒和抗破伤风毒素IgG的抗原结合能力以及Fc受体结合能力均无显著差异。
血浆的MB处理不会抑制IgM和IgG与其表位的结合能力,也不会抑制IgG与Fc受体的相互作用。基于这些结果,如果不进行隔离储存,对康复期血浆进行MB处理适合降低病原体传播风险。