Transfusion Medicine Research, Cerus Corporation, Concord, California, USA.
Department of Physiology and Biophysics, School of Medicine, University of California Irvine, Irvine, California, USA.
Transfusion. 2022 Mar;62(3):570-583. doi: 10.1111/trf.16819. Epub 2022 Feb 12.
COVID-19 convalescent plasma (CCP), from donors recovered from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, is one of the limited therapeutic options currently available for the treatment of critically ill patients with COVID-19. There is growing evidence that CCP may reduce viral loads and disease severity; and reduce mortality. However, concerns about the risk of transfusion-transmitted infections (TTI) and other complications associated with transfusion of plasma, remain. Amotosalen/UVA pathogen reduction treatment (A/UVA-PRT) of plasma offers a mitigation of TTI risk, and when combined with pooling has the potential to increase the diversity of the polyclonal SARS-CoV-2 neutralizing antibodies.
This study assessed the impact of A/UVA-PRT on SARS-CoV-2 antibodies in 42 CCP using multiple complimentary assays including antigen binding, neutralizing, and epitope microarrays. Other mediators of CCP efficacy were also assessed.
A/UVA-PRT did not negatively impact antibodies to SARS-CoV-2 and other viral epitopes, had no impact on neutralizing activity or other potential mediators of CCP efficacy. Finally, immune cross-reactivity with other coronavirus antigens was observed raising the potential for neutralizing activity against other emergent coronaviruses.
The findings of this study support the selection of effective CCP combined with the use of A/UVA-PRT in the production of CCP for patients with COVID-19.
COVID-19 恢复期血浆(CCP)来自从严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染中康复的供体,是目前治疗 COVID-19 重症患者的有限治疗选择之一。越来越多的证据表明,CCP 可能降低病毒载量和疾病严重程度;并降低死亡率。然而,人们仍然担心与输注血浆相关的输血传播感染(TTI)和其他并发症的风险。对血浆进行氨甲酰磷/UVA 病原体减少处理(A/UVA-PRT)可以降低 TTI 的风险,并且当与汇集相结合时,有可能增加 SARS-CoV-2 多克隆中和抗体的多样性。
本研究使用包括抗原结合、中和和表位微阵列在内的多种互补检测方法,评估了 42 份 CCP 中 A/UVA-PRT 对 SARS-CoV-2 抗体的影响。还评估了 CCP 疗效的其他介质。
A/UVA-PRT 对 SARS-CoV-2 抗体和其他病毒表位没有负面影响,对中和活性或 CCP 疗效的其他潜在介质没有影响。最后,观察到与其他冠状病毒抗原的免疫交叉反应,这提高了对其他新兴冠状病毒的中和活性的潜力。
这项研究的结果支持选择有效的 CCP,并结合 A/UVA-PRT 用于生产 COVID-19 患者的 CCP。