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José M, Marzo N, Pons B, Herrerias A, López L, Faro M, López M, Jorquera JI. Flebogamma® DIF (intravenous immunoglobulin) purification process effectively eliminates procoagulant activities. Biologicals 2013; 41:393-9. [DOI: 10.1016/j.biologicals.2013.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/22/2013] [Accepted: 08/11/2013] [Indexed: 11/27/2022] Open
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Interactions of formulation excipients with proteins in solution and in the dried state. Adv Drug Deliv Rev 2011; 63:1053-73. [PMID: 21756953 DOI: 10.1016/j.addr.2011.06.011] [Citation(s) in RCA: 257] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 06/18/2011] [Accepted: 06/23/2011] [Indexed: 12/12/2022]
Abstract
A variety of excipients are used to stabilize proteins, suppress protein aggregation, reduce surface adsorption, or to simply provide physiological osmolality. The stabilizers encompass a wide variety of molecules including sugars, salts, polymers, surfactants, and amino acids, in particular arginine. The effects of these excipients on protein stability in solution are mainly caused by their interaction with the protein and the container surface, and most importantly with water. Some excipients stabilize proteins in solution by direct binding, while others use a number of fundamentally different mechanisms that involve indirect interactions. In the dry state, any effects that the excipients confer to proteins through their interactions with water are irrelevant, as water is no longer present. Rather, the excipients stabilize proteins through direct binding and their effects on the physical properties of the dried powder. This review will describe a number of mechanisms by which the excipients interact with proteins in solution and with various interfaces, and their effects on the physical properties of the dried protein structure, and explain how the various interaction forces are related to their observed effects on protein stability.
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Buchacher A, Schluga P, Müllner J, Schreiner M, Kannicht C, Weinberger J. Anticomplementary activity of IVIG concentrates - important assay parameters and impact of IgG polymers. Vox Sang 2010; 98:e209-18. [DOI: 10.1111/j.1423-0410.2009.01271.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Radosevich M, Burnouf T. Intravenous immunoglobulin G: trends in production methods, quality control and quality assurance. Vox Sang 2009; 98:12-28. [PMID: 19660029 DOI: 10.1111/j.1423-0410.2009.01226.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Intravenous immunoglobulin G (IVIG) is now the leading product obtained by fractionation of human plasma. It is the standard replacement therapy in primary and acquired humoral deficiency, and is also used for immunomodulatory therapy in various autoimmune disorders and transplantation. Over the last 30 years, the production processes of IVIG have evolved dramatically, gradually resulting in the development of intact IgG preparations safe to administer intravenously, with normal half-life and effector functions, prepared at increased yield, and exhibiting higher pathogen safety. This article reviews the developments that have led to modern IVIG preparations, the current methods used for plasma collection and fractionation, the safety measures implemented to minimize the risks of pathogen transmission and the major quality control tests that are available for product development and as part of mandatory batch release procedures.
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Teschner W, Butterweck HA, Auer W, Muchitsch EM, Weber A, Liu SL, Wah PS, Schwarz HP. A new liquid, intravenous immunoglobulin product (IGIV 10%) highly purified by a state-of-the-art process. Vox Sang 2007; 92:42-55. [PMID: 17181590 DOI: 10.1111/j.1423-0410.2006.00846.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES The ultimate goal was to generate an industrial-scale process suitable to produce a high-yield, safe and stable immunoglobulin G (IgG) preparation for intravenous administration, which is ready to use for customer convenience. This new liquid 10% IgG preparation (IGIV 10%) was compared to Gammagard SD, a licenced lyophilized immunoglobulin in biochemical and preclinical testing. MATERIALS AND METHODS The new process, which includes three dedicated virus clearance steps, is a streamlined combination of the currently applied and well-established manufacturing procedures. The biochemical characterization is done by standard methods focusing on purity, integrity and functionality of the preparation. Efficacy is demonstrated in vivo by mouse protection testing and in vitro by opsonization and protein A affinity chromatography. Pharmacokinetics in rats is evaluated after a single intravenous dose. The anaphylactoid potential is determined in rats and in guinea pigs, while thrombogenicity is assessed in a rabbit model. The influence of the products on vital functions is tested on dogs, while acute toxicity studies are carried out on mice and rats. RESULTS The biochemical characterization data demonstrate the high purity of monomeric IgG in the product. The mouse protection test showed that the protective activity against systemic bacterial infections of IGIV 10% is at least as good as the reference Gammagard SD. This result is supported by the broad spectrum of antibodies in high titres against bacteria and viruses and the high functional integrity of the IgG molecule (> or = 90% functionally intact IgG) in IGIV 10%. The opsonic activity of all IGIV 10% lots is similar to the one of the reference Gammagard SD. In safety and thrombogenicity studies, no adverse effects of IGIV 10% were observed. Pharmacokinetic studies showed no statistically significant differences between the two products. In the acute toxicity animal studies, IGIV 10% compared favourably to the reference Gammagard SD. CONCLUSIONS The new manufacturing process enables the production of a highly purified IgG preparation for intravenous administration. The product has an IgG subclass distribution similar to plasma and contains a broad spectrum of functionally intact antibodies. Preclinical studies demonstrate that the liquid IGIV 10% combines excellent qualities of efficacy, safety and tolerability.
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Parkkinen J, Rahola A, von Bonsdorff L, Tölö H, Törmä E. A modified caprylic acid method for manufacturing immunoglobulin G from human plasma with high yield and efficient virus clearance. Vox Sang 2006; 90:97-104. [PMID: 16430667 DOI: 10.1111/j.1423-0410.2005.00731.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES The increasing demand for intravenous immunoglobulin (IVIG) necessitates the development of improved plasma fractionation methods, providing higher immunoglobulin G (IgG) recovery. Here, we describe a new IVIG production process resulting in a high yield of IgG and effective reduction of physico-chemically resistant viruses. MATERIALS AND METHODS IgG was purified from Cohn fraction II+III by caprylic acid treatment, polyethylene glycol precipitation, anion-exchange chromatography, nanofiltration and ultrafiltration. Stability of the purified IgG was studied in different formulations. Virus reduction was studied with two viruses: bovine viral diarrhoea virus, assessed by an infectivity assay; and human parvovirus B19, assessed by polymerase chain reaction. RESULTS The combination of caprylic acid treatment with polyethylene glycol precipitation and a single anion-exchange chromatography yielded polymer-free, pure IgG. The purified IgG could be filtered through a small pore-size virus filter (Millipore V-NFP) with high throughput and excellent yield. The formulated product was stable as a 100 g/l IgG solution. Bovine viral diarrhoea virus was effectively inactivated by the caprylic acid treatment, and parvovirus B19 was effectively removed in the polyethylene glycol precipitation and nanofiltration stages, the total reduction of parvovirus being approximately 14 log10. CONCLUSIONS The new process gives pure and stable IgG solution with an average yield of 4.8 g of IgG per kg of recovered plasma and has a very high capacity to remove even physico-chemically resistant viruses.
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Affiliation(s)
- J Parkkinen
- Finnish Red Cross Blood Service, Helsinki, Finland.
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Buchacher A, Iberer G. Purification of intravenous immunoglobulin G from human plasma – aspects of yield and virus safety. Biotechnol J 2006; 1:148-63. [PMID: 16892245 DOI: 10.1002/biot.200500037] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Plasma-derived intravenous immunoglobulin (IVIG) preparations have been successfully applied for the prophylactic prevention of infectious diseases in immunodeficient patients. In addition to its replacement therapy of primary and secondary antibody deficiencies, IVIG has found increased use in autoimmune and inflammatory diseases. IVIG has become the major plasma product on the global blood product market. The world wide consumption nearly tripled between 1992 and 2003, from 19.4 to 52.6 tons. Classical manufacturing processes of IVIG, but also new strategies for purification are discussed with respect to practicability and yield. Ethanol fractionation is still the basis for most IVIG processes, although isolation and purification of immunoglobulin G (IgG) by chromatography has gained ground. The efficiency of virus inactivation methods and virus removal techniques in terms of logarithmic reduction factors are analyzed, but also the IgG losses are taken into consideration. Some of these methods also have the ability to separate prions. High pathogen safety and high yields have become the dominant goals of the plasma fractionation industry.
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Affiliation(s)
- Andrea Buchacher
- Octapharma Pharmazeutika Produktions GmbH, Oberlaaerstrasse 235, 1100 Vienna, Austria.
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Szenczi A, Kardos J, Medgyesi GA, Závodszky P. The effect of solvent environment on the conformation and stability of human polyclonal IgG in solution. Biologicals 2005; 34:5-14. [PMID: 16168667 DOI: 10.1016/j.biologicals.2005.06.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2004] [Revised: 05/19/2005] [Accepted: 06/23/2005] [Indexed: 12/22/2022] Open
Abstract
Stability of therapeutic IgG preparations is an important issue as adequate efficacy and safety has to be ensured throughout a long shelf life. To this end, denaturation and aggregation have to be avoided. In many cases sugars are applied for stabilizing IgG in relatively high concentration (5-10%). However, certain sugars (sucrose, maltose) are responsible for adverse effects including renal failure. In this work we reassessed the effect of pH and stabilizers to optimize the solvent environment and minimize the amount of additives without endangering quality and stability. Since both biological function and aggregation depend on the conformational properties of individual IgG molecules, two sensitive and rapid physical methods were introduced to assess conformational changes and structural stability as a function of pH and addition of standard stabilizers. It was observed that the conformational stability decreases with decreasing pH, while the resistance against aggregation improves. The optimum pH range for storage is 5.0-6.0, as a compromise between conformational stability and the tendency for oligomerization. Intriguingly, additives in physiologically acceptable concentration have no effect on the thermal stability of IgG. On the other hand, glucose or sorbitol, even at a concentration as low as 1%, have significant effect on the tertiary structure as revealed by near-UV-CD spectroscopy, reflecting changes in the environment of aromatic side-chains. Although, 0.3% leucine does not increase conformational stability, it decreases the aggregation tendency even more efficiently than 1% glucose or sorbitol. Both pH and storage temperature are decisive factors for the long-term stability of IgG solutions. An increase in the dimer content was observed upon storage at 5 degrees C which was partly reverted upon incubation at 37 degrees C. Storage at temperatures higher than 5 degrees C may help to maintain an optimal proportion of dimers. Regarding the known side effects, and their limited stabilizing capacity at low concentration, it is advisable to omit sugars at intravenous immunoglobulin (IVIG) formulation. Hydrophobic amino acids give promising alternatives.
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Affiliation(s)
- Arpád Szenczi
- Institute of Enzymology, Biological Research Center, Hungarian Academy of Sciences, H-1113, Karolina út 29, Budapest, Hungary
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Remington KM, Trejo SR, Buczynski G, Li H, Osheroff WP, Brown JP, Renfrow H, Reynolds R, Pifat DY. Inactivation of West Nile virus, vaccinia virus and viral surrogates for relevant and emergent viral pathogens in plasma-derived products. Vox Sang 2004; 87:10-8. [PMID: 15260817 PMCID: PMC7169325 DOI: 10.1111/j.1423-0410.2004.00530.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background and Objectives Human plasma is the source of a wide variety of therapeutic proteins, yet it is also a potential source of viral contamination. Recent outbreaks of emergent viral pathogens, such as West Nile virus, and the use of live vaccinia virus as a vaccine have prompted a reassessment of the viral safety of plasma‐derived products. The purpose of this study was to evaluate the efficacy of current viral inactivation methods for West Nile and vaccinia viruses and to reassess the use of model viruses to predict inactivation of similar viral pathogens. Materials and Methods Virus‐spiked product intermediates were processed using a downscaled representation of various manufacturing procedures. Virus infectivity was measured before and after processing to determine virus inactivation. Results The results demonstrated effective inactivation of West Nile virus, vaccinia virus and a model virus, bovine viral diarrhoea virus, during pasteurization, solvent/detergent treatment and caprylate treatment. Caprylate provided rapid and effective inactivation of West Nile virus, vaccinia virus, duck hepatitis B virus and Sindbis virus. Inactivation of West Nile virus was similar to that of bovine viral diarrhoea virus. Conclusions This study demonstrates that procedures used to inactivate enveloped viruses in manufacturing processes can achieve inactivation of West Nile virus and vaccinia virus. In addition, the data support the use of model viruses to predict the inactivation of similar emergent viral pathogens.
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Affiliation(s)
- K M Remington
- Preclinical Research and Pathogen Safety, Biological Products Division, Bayer Health Care, LLC, Research Triangle Park, NC 27709, USA.
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Quigley JD, Strohbehn RE, Kost CJ, O'Brien MM. Formulation of colostrum supplements, colostrum replacers and acquisition of passive immunity in neonatal calves. J Dairy Sci 2001; 84:2059-65. [PMID: 11573786 PMCID: PMC7157919 DOI: 10.3168/jds.s0022-0302(01)74650-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Provision of an adequate mass of IgG from maternal colostrum is essential to health and survival of neonatal calves. Colostrum supplements (CS) have been developed to provide supplemental immunoglobulin when maternal colostrum is of poor quality. However, colostrum replacers (CR) that provide > or = 100 g of IgG have not been formulated. Our objective was to determine the absorption of IgG in newborn calves fed CS derived from bovine serum or CR derived from bovine immunoglobulin concentrate. The CS were prepared by collecting, processing, and spray drying bovine serum and blending with other ingredients to provide 45 to 50 g of IgG per dose. The CR were prepared by further processing bovine serum to increase IgG concentration to > 50% IgG and blending with other ingredients to provide 100 to 122 g of IgG per dose. Holstein calves (n = 160) were fed 90 to 244 g of IgG from CS or CR in 1 or 2 feedings in two experiments. Blood was collected from each calf by jugular venipuncture at 0 and 24 h of age and plasma IgG was determined by turbidimetric immunoassay. Apparent efficiency of IgG absorption was calculated. Plasma IgG concentrations at 24 h of age were indicative of IgG intake and averaged 5.5 to 14.1 g/L in calves fed CS and CR. Mean apparent efficiency of IgG absorption in calves fed CS was 25 and 28% in experiments 1 and 2, respectively. Mean apparent efficiency of IgG absorption in calves fed CR ranged from 19 to 32% and were affected by method of processing and number of times fed. Treatment of plasma with polyethylene glycol reduced the efficiency of IgG absorption in experiment 1. The addition of animal fat to CR had no effect on IgG absorption. A second feeding of CR increased plasma IgG, but efficiency of absorption was reduced. Mean body weights at 60 d of age were not affected by treatment and ranged from 64.3 to 78.2 kg. Plasma IgG concentration in calves fed > or = 122 g of IgG from Ig concentrate approached (9.9 g/L) or exceeded 10 g/L, indicating successful transfer of passive immunity. Provision of IgG to prevent failure of passive transfer is possible with CR containing >20% IgG when fed at 454 g per dose.
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Uemura Y, Baba T, Hasegawa Y, Yanagihara O, Matsumoto K, Kawai T. Development of control serum for microbial antibody tests. Biologicals 2001; 29:39-43. [PMID: 11482891 DOI: 10.1006/biol.2001.0274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Control sera are an essential component of in-vitro clinical diagnostic reagents. We have developed a control serum for HBsAg, anti-HCV, anti-HIV and anti- Treponema pallidum testing. Since this control serum is prepared from human plasma, we paid special attention to viral safety. We incorporated three viral inactivation methods into the manufacturing process that maintain the necessary characteristics of a stable control serum.
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Affiliation(s)
- Y Uemura
- R & D Division, International Reagents Corporation, 1-1-2, Murotani, Nishi-ku, Kobe, 651-2241, Japan.
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Chang CE, Eo HG, Lee YS, Chung SK, Shin JS, Lah YK, Park CW, Jung JT, Huh JW, Lee SM. Human intravenous immunoglobulin preparation and virus inactivation by pasteurization and solvent detergent treatment. Prep Biochem Biotechnol 2000; 30:177-97. [PMID: 10919559 DOI: 10.1080/10826060008544957] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Human intravenous immunoglobulin (IVIG) solutions were prepared by two different methods and compared to each other. The crude immunoglobulin fraction obtained from Cohn-Oncley fractionation of plasma was further purified and subjected to virus inactivation, either by polyethylene glycol precipitation and pasteurization at 60 degrees C for 10 hours, or by ion exchange chromatography and solvent/detergent treatment. The final preparations, formulated in 5% immunoglobulin solutions were characterized by in vitro analyses of biochemical and biological properties and compared with the samples of other manufacturer's IVIG solution products. The critical properties evaluated in this study were purity, molecular intactness, and the biological functions such as Fc function and anticomplementary activity. Virus inactivation and removal by processing steps and by deliberate virucidal steps, as described above, were tested on various human pathogenic viruses, such as human immunodeficiency and experimental model viruses. The tested viruses were successfully inactivated and removed. We conclude that the intravenous immunoglobulins prepared by two different methods, as described above, provide an equivalent viral safety and quality.
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Affiliation(s)
- C E Chang
- Korea Green Cross Corporation, Yongin, Kyunggi-do
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Stangel M, Hartung HP, Marx P, Gold R. Intravenous immunoglobulin treatment of neurological autoimmune diseases. J Neurol Sci 1998; 153:203-14. [PMID: 9511879 DOI: 10.1016/s0022-510x(97)00292-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Intravenous immunoglobulin (IVIg) has been widely used in neurological diseases during the last decade. The current indications of IVIg in neurological diseases are reviewed and discussed on the basis of the available experimental data and clinical trials. Compared to other immunomodulating treatments used in neurological diseases, IVIg has only few side effects with a small risk of transmission of infectious agents. Good clinical evidence for the effectiveness is available for Guillain-Barré-Syndrome, chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy. In conditions like myasthenia gravis and myositis favourable effects of IVIg were reported, but future studies have to be awaited. For all other neurological conditions where IVIg has been administered, there is currently no support for the use of IVIg other than in controlled trials. In conclusion, IVIg is a promising immunomodulary therapy that has been shown to be effective in some neurological autoimmune diseases. Routine use in neurological practice should be restricted to diseases for which a positive effect has been proven in controlled trials. For all other conditions no definite recommendations can presently be made.
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Affiliation(s)
- M Stangel
- Department of Neurology, Universitätklinikum Benjamin Franklin, Berlin, Germany
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Ando Y, Yamashita T, Nakamura M, Tanaka Y, Hashimoto M, Tashima K, Suhr O, Uemura Y, Obayashi K, Terazaki H, Suga M, Uchino M, Ando M. Down regulation of a harmful variant protein by replacement of its normal protein. BIOCHIMICA ET BIOPHYSICA ACTA 1997; 1362:39-46. [PMID: 9434098 DOI: 10.1016/s0925-4439(97)00054-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To compensate for the hypoprotein and hypoalbuminemia of familial amyloidotic polyneuropathy (FAP) patients, 800 ml of fresh frozen plasma (FFP) was intravenously administered and change in total and variant transthyretin (TTR) levels were measured in the plasma. After injection of FFP, total plasma TTR levels were elevated and variant TTR levels decreased from 24 to 48 h, accompanied by an elevation of plasma total protein, albumin levels and TTR levels. To elucidate the mechanism of this phenomenon, a large amount of purified normal TTR from normal human plasma was intravenously injected in mice and FAP patients. By intravenous injection of 3 mg of the purified TTR to C57Black6, the expression of TTR mRNA decreased from 6 to 24 h post injection, and gradually increased up to 48 h post injection. After injecting 400 mg of normal TTR in each of 3 FAP patients, total plasma TTR levels were elevated and variant TTR levels decreased significantly from 24 to 48 h. These results suggested that down regulation of the harmful protein by replacement of its normal form of the protein occurred by this method. This phenomenon should be applied as the basis for one of the useful methods for decreasing the harmful proteins in the circulation.
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Affiliation(s)
- Y Ando
- Department of Internal Medicine, Kumamoto University School of Medicine, Japan
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Bridonneau P, Marcilly H, Vernois-Martin M, Goigoux P, Bourdel V, Laulan A, Deramoudt FX, Desmadril M, Sitbon M, Basuyaux B, Steinbuch M, Schmitthaeusler R. Liquid pasteurization of an immunoglobulin preparation without stabilizer: effects on its biological and biochemical properties. Vox Sang 1996; 70:203-9. [PMID: 9123924 DOI: 10.1111/j.1423-0410.1996.tb01327.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Intravenous immunoglobulins (IVIg) purified by cold ethanol fractionation have a very good safety record with regard to the transmission of many viruses. However, a few cases of non-A-non-B hepatitis have been described after intravenous injection of some immunoglobulin preparations. To ensure even higher safety for our IVIg, an additional virus inactivation step, based on pasteurization, was developed. The heating of aqueous IVIg was performed without stabilizer, and at a very low salt concentration (< 1 mM) at acidic pH. No generation of polymer was detected after pasteurization and a significant decrease in the proportion of dimers was observed. Analysis of the secondary structure by circular dichroism showed a very slight change in the secondary structure. The biological properties of the Fc region as well as the Fab region were not affected by the pasteurization. Our method has several advantages: (1) improvement of viral safety; (2) there is no need to add stabilizer which may stabilize viral particles, and (3) the absence of any hypotensive effect and low anticomplementary activity indicates a good clinical tolerance of IgG preparation.
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Affiliation(s)
- P Bridonneau
- Fondation Nationale de la Transfusion Sanguine, Recherche et Développement, Les Ulis, France
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González M, Murature DA, Fidelio GD. Thermal stability of human immunoglobulins with sorbitol. A critical evaluation. Vox Sang 1995; 68:1-4. [PMID: 7725666 DOI: 10.1111/j.1423-0410.1995.tb02535.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The effect of the additive sorbitol on the thermal stabilization of human IgG was investigated by differential scanning calorimetry and size exclusion chromatography. In the presence of 33% sorbitol, the temperature at which denaturation of IgG began (Ti) was increased from 52 to 65 degrees C. Similarly, the temperature of the maximum heat capacity (Tmax) was increased from 69 to 76 degrees C. Sorbitol also decreased dimer aggregation and the extent of oligomerization during heating compared with IgG dissolved in phosphate buffer. Sorbitol at 33% prevented massive protein denaturation but a 10-15% of oligomerization of high molecular weight aggregates with turbidity could not be avoided when heating for 10 h at 60 degrees C. The use of sorbitol 33% to avoid heat denaturation of human IgG during viral inactivation did not prevent protein aggregation or the appearance of turbidity. Consequently, further processing will be required to achieve a product suitable for pharmaceutical use.
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Affiliation(s)
- M González
- Departamento de Química Biológica, Fac. de Ciencias Químicas, Universidad Nacional de Córdoba, Argentina
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Zuhrie SR, Webster AD, Davies R, Fay AC, Wallington TB. A prospective controlled crossover trial of a new heat-treated intravenous immunoglobulin. Clin Exp Immunol 1995; 99:10-5. [PMID: 7813100 PMCID: PMC1534151 DOI: 10.1111/j.1365-2249.1995.tb03465.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Twenty-one patients with primary immunoglobulin deficiency were enrolled in a crossover study to test the efficacy and safety of Alphaglobin in comparison with the licensed preparations Sandoglobulin and Gamimune. There was no statistical difference in these parameters between Alphaglobin and Sandoglobulin/Gamimune. The level of total serum IgG and specific IgG to pneumococcal polysaccharides was similar in individual patients when they were receiving Alphaglobin or one of the other products. Transient increases in serum alanine transferase occurred in five patients on Sandoglobulin/Gamimune and two patients on Alphaglobin. Some patients showed a rise in total serum IgM afterwards, indicating a response to infection. However, serum hepatitis C virus (HCV) RNA was not found during the alanine transferase (ALT) rises, and IgM antibody to hepatitis A virus (HAV) was negative afterwards. We conclude that Alphaglobin is a safe, well tolerated and clinically efficacious treatment for patients with primary antibody deficiency.
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Affiliation(s)
- S R Zuhrie
- Immunodeficiency Research Group, Clinical Research Centre, Harrow, UK
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18
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Uemura Y, Yang YH, Heldebrant CM, Takechi K, Yokoyama K. Inactivation and elimination of viruses during preparation of human intravenous immunoglobulin. Vox Sang 1994; 67:246-54. [PMID: 7863623 DOI: 10.1111/j.1423-0410.1994.tb01246.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We report here the results of our evaluation of virus inactivation during the manufacturing steps of two intravenous immunoglobulin (IGIV) preparations. Virus inactivation and/or removal by processing steps, such as ethanol fractionation and polyethylene glycol precipitation, and deliberate virucidal steps, such as solvent/detergent treatment and pasteurization, were tested on a variety of human pathogenic and experimental model viruses, including human immunodeficiency, Hepatitis C, Mumps, Vaccinia, Chikungunya, Vesicular Stomatitis, Sindbis, and ECHO viruses. All viruses were successfully inactivated and/or eliminated by the processing steps studied. In some cases, however, multiple steps were required. We conclude that the incorporation of steps deliberately designed to inactivate or remove viruses during the production of IGIV provides an extra measure of viral safety.
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Affiliation(s)
- Y Uemura
- Alpha Therapeutic Corporation, Los Angeles, CA 90032
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19
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Affiliation(s)
- R I Schiff
- Division of Allergy and Immunology, Duke University Medical Center, Dunham, NC 27710
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20
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Dunsmore KP, Friedman HS, Kurtzberg J. The uses of intravenous immunoglobulin in pediatrics. An update. Crit Rev Oncol Hematol 1992; 12:67-90. [PMID: 1590942 DOI: 10.1016/1040-8428(92)90085-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- K P Dunsmore
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27710
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Rawal B, Yen TS, Vyas GN, Busch M. Leukocyte filtration removes infectious particulate debris but not free virus derived from experimentally lysed HIV-infected cells. Vox Sang 1991; 60:214-8. [PMID: 1926828 DOI: 10.1111/j.1423-0410.1991.tb00908.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We used in vitro model of storage-induced leukocyte degradation in blood to experimentally characterize the infectivity of the debris of lymphocytes harboring human immunodeficiency virus (HIV-1). The leukocyte filtration process removed both intact HIV-infected H9 cells and the particulate debris, but failed to remove the cell-free HIV released from lysed cells. These data suggest that the leukocyte filtration of donor blood soon after collection would optimally reduce the particulate infectious burden of blood for transfusions.
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Affiliation(s)
- B Rawal
- Department of Laboratory Medicine, University of California, San Francisco
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Abstract
Plasma protein solutions such as albumin and intramuscular immune globulin have long histories of viral safety. Coagulation factor concentrates as traditionally manufactured frequently transmitted HBV, HCV, and HIV. Indeed, it is probable that every vial of concentrate contained infectious HCV. Modern coagulation factor concentrates have a greatly improved safety record arising, principally, from the implementation of virucidal procedures. It is interesting to note that the same methods that failed to substantially reduce NANBHV transmission in clinical studies are those that were found to inactivate less than 10(4) ID50 of HIV, HBV, and/or HCV in preclinical studies (Table 17-5). Implementation even of these methods nearly eliminated the transmission of HIV by coagulation factor concentrates. A summary of the results of the most successful procedures is given in Table 17-10. The results show 0/564 patients had evidence of HIV transmission, 6/151 patients had evidence of HBV transmission, and 2/301 patients had evidence of HCV transmission. As compared with those procedures described in Table 17-5, the greater kill of HIV, HBV, and NANBHV demonstrated preclinically, and the improved clinical results, are most notable. The data, examined in terms of units transfused, are presented in Figure 17-1. Since the average adult hemophiliac in the United States receives 80,000 units of clotting factor per year, the best of the concentrates show safety over the equivalent of at least 10-human-years of treatment. Are the best of today's coagulation factor concentrates safe from the transmission of HBV, NANBHV (including HCV), and HIV. Given the limited number of patients eligible for clinical studies, and the length, difficulty, and expense of such studies, the best answer comes from a knowledge of the initial virus load coupled with information regarding virus removal, serendipitous inactivation, and intentional sterilization. A recently completed analysis of these factors (Horowitz 1990) indicates that the best of the modern coagulation factor concentrates are likely to be as safe as albumin (Figure 17-2).
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Abstract
A method of pasteurising a concentrate of factor I (C3b inactivator) prepared from human blood plasma is described. As well as obtaining a high yield of factor I by this virus inactivation procedure it is furthermore possible, by adjustment of the stabiliser concentration, to obtain a very pronounced reduction in the concentration of factor B, a component of the complement system which is unwanted in the treatment of factor I deficiency. The product so produced is in two respects superior to plasma infusions for factor I replacement therapy: it has been submitted to virus inactivation and factor B depletion.
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Affiliation(s)
- K O Alsøe
- Biopharmaceuticals Division, Novo-Nordisk a/s, Gentofte, Denmark
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