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Wasilewicz A, Bojkova D, Beniddir MA, Cinatl J, Rabenau HF, Grienke U, Rollinger JM, Kirchweger B. Molecular networking unveils anti-SARS-CoV-2 constituents from traditionally used remedies. J Ethnopharmacol 2024; 319:117206. [PMID: 37783406 DOI: 10.1016/j.jep.2023.117206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Plants and fungi have a long tradition in ethnopharmacology for the treatment of infectious diseases including viruses. Many of these natural products have also been used to combat SARS-CoV-2 infections or symptoms of the post- and long-COVID form, owing to the scarcity of clinically approved therapeutics. AIM OF THE STUDY The ongoing threat posed by SARS-CoV-2, along with the rapidly evolving new variants, requires the development of new antiviral compounds. The aim of this study was to identify anti-SARS-CoV-2 herbal and fungal extracts used in traditional medicine against acute respiratory infection, inflammation, and related symptoms. Additionally, we sought to characterize their bioactive constituents. MATERIALS AND METHODS The antiviral activity and cell cytotoxicity of 179 herbal and fungal extracts were evaluated using two SARS-CoV-2 infection assays in Caco-2 cells. 19 plant extracts with and without anti-SARS-CoV-2 activity underwent detailed dereplication using molecular networking. RESULTS Extracts from Angelica sinensis (Oliv.) Diels roots, Annona squamosa L. seeds, Azadirachta indica A. Juss. fruits, Buddleja officinalis Maxim. flowers, Burkea africana Hook. bark and Clinopodium menthifolium (Host) Stace aerial parts showed a potent anti SARS-CoV-2 activity (IC50 < 5 μg/ml) with only moderate cytotoxicity (CC50 > 60 μg/ml, Caco-2). By performing the dereplication with a bioactivity-featured molecular network (MN) on the extract library level, rather than on the level of individual extracts, we could pinpoint compounds characteristic for active extracts. Thus, a straight-forward identification of potential anti-SARS-CoV-2 natural compounds was achieved prior to any fractionation or isolation efforts. CONCLUSIONS A sophisticated hyphenation of empirical knowledge with MS-based bioinformatics and automated compound annotation was applied to decipher the chemical space of the investigated extracts. The correlation with experimentally assessed anti-SARS-CoV-2 activities helped in predicting compound classes and structural elements relevant for the antiviral activities. Consequently, this accelerated the identification of constituents from the investigated mixtures with inhibitory effects against SARS-CoV-2.
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Affiliation(s)
- Andreas Wasilewicz
- Department of Pharmaceutical Sciences, Division of Pharmacognosy, University of Vienna, Josef-Holaubek-Platz 2, 1090, Vienna, Austria; Vienna Doctoral School of Pharmaceutical, and Sport Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090, Vienna, Austria.
| | - Denisa Bojkova
- Institute of Medical Virology, University Hospital Frankfurt, Paul-Ehrlich-Straβe 40, 60596, Frankfurt am Main, Germany.
| | - Mehdi A Beniddir
- Équipe Chimie des Substances Naturelles, BioCIS, CNRS, Université Paris-Saclay, 17 Avenue des Sciences, 91400, Orsay, France.
| | - Jindrich Cinatl
- Institute of Medical Virology, University Hospital Frankfurt, Paul-Ehrlich-Straβe 40, 60596, Frankfurt am Main, Germany.
| | - Holger F Rabenau
- Institute of Medical Virology, University Hospital Frankfurt, Paul-Ehrlich-Straβe 40, 60596, Frankfurt am Main, Germany.
| | - Ulrike Grienke
- Department of Pharmaceutical Sciences, Division of Pharmacognosy, University of Vienna, Josef-Holaubek-Platz 2, 1090, Vienna, Austria.
| | - Judith M Rollinger
- Department of Pharmaceutical Sciences, Division of Pharmacognosy, University of Vienna, Josef-Holaubek-Platz 2, 1090, Vienna, Austria.
| | - Benjamin Kirchweger
- Department of Pharmaceutical Sciences, Division of Pharmacognosy, University of Vienna, Josef-Holaubek-Platz 2, 1090, Vienna, Austria.
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Enssle JC, Campe J, Moter A, Voit I, Gessner A, Yu W, Wolf S, Steffen B, Serve H, Bremm M, Huenecke S, Lohoff M, Vehreschild M, Rabenau HF, Widera M, Ciesek S, Oellerich T, Imkeller K, Rieger MA, von Metzler I, Ullrich E. Cytokine-responsive T- and NK-cells portray SARS-CoV-2 vaccine-responders and infection in multiple myeloma patients. Leukemia 2024; 38:168-180. [PMID: 38049509 PMCID: PMC10776400 DOI: 10.1038/s41375-023-02070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 12/06/2023]
Abstract
Patients with multiple myeloma (MM) routinely receive mRNA-based vaccines to reduce COVID-19-related mortality. However, whether disease- and therapy-related alterations in immune cells and cytokine-responsiveness contribute to the observed heterogeneous vaccination responses is unclear. Thus, we analyzed peripheral blood mononuclear cells from patients with MM during and after SARS-CoV-2 vaccination and breakthrough infection (BTI) using combined whole-transcriptome and surface proteome single-cell profiling with functional serological and T-cell validation in 58 MM patients. Our results demonstrate that vaccine-responders showed a significant overrepresentation of cytotoxic CD4+ T- and mature CD38+ NK-cells expressing FAS+/TIM3+ with a robust cytokine-responsiveness, such as type-I-interferon-, IL-12- and TNF-α-mediated signaling. Patients with MM experiencing BTI developed strong serological and cellular responses and exhibited similar cytokine-responsive immune cell patterns as vaccine-responders. This study can expand our understanding of molecular and cellular patterns associated with immunization responses and may benefit the design of improved vaccination strategies in immunocompromised patients.
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Affiliation(s)
- Julius C Enssle
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Julia Campe
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Alina Moter
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Isabel Voit
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Alec Gessner
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Weijia Yu
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Wolf
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Björn Steffen
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
| | - Hubert Serve
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Melanie Bremm
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Sabine Huenecke
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Michael Lohoff
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University, Marburg, Germany
| | - Maria Vehreschild
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Infectious Diseases, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
| | - Marek Widera
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
- German Centre for Infection Research, external partner site, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
| | - Thomas Oellerich
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Katharina Imkeller
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Edinger Institute (Neurological Institute), Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, MSNZ Group of Computational Immunology, Frankfurt am Main, Germany
- University Cancer Center (UCT), Frankfurt am Main, Germany
| | - Michael A Rieger
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
- Cardio-Pulmonary Institute, Frankfurt am Main, Germany
| | - Ivana von Metzler
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Evelyn Ullrich
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany.
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany.
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany.
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany.
- University Cancer Center (UCT), Frankfurt am Main, Germany.
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Eggers M, Schwebke I, Blümel J, Brandt F, Fickenscher H, Gebel J, Hübner N, Müller JA, Rabenau HF, Rapp I, Reiche S, Steinmann E, Steinmann J, Zwicker P, Suchomel M. Suitable Disinfectants with Proven Efficacy for Genetically Modified Viruses and Viral Vectors. Viruses 2023; 15:2179. [PMID: 38005856 PMCID: PMC10675031 DOI: 10.3390/v15112179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Viral disinfection is important for medical facilities, the food industry, and the veterinary field, especially in terms of controlling virus outbreaks. Therefore, standardized methods and activity levels are available for these areas. Usually, disinfectants used in these areas are characterized by their activity against test organisms (i.e., viruses, bacteria, and/or yeasts). This activity is usually determined using a suspension test in which the test organism is incubated with the respective disinfectant in solution to assess its bactericidal, yeasticidal, or virucidal activity. In addition, carrier methods that more closely reflect real-world applications have been developed, in which microorganisms are applied to the surface of a carrier (e.g., stainless steel frosted glass, or polyvinyl chloride (PVC)) and then dried. However, to date, no standardized methods have become available for addressing genetically modified vectors or disinfection-resistant oncolytic viruses such as the H1-parvovirus. Particularly, such non-enveloped viruses, which are highly resistant to disinfectants, are not taken into account in European standards. This article proposes a new activity claim known as "virucidal activity PLUS", summarizes the available methods for evaluating the virucidal activity of chemical disinfectants against genetically modified organisms (GMOs) using current European standards, including the activity against highly resistant parvoviridae such as the adeno-associated virus (AAV), and provides guidance on the selection of disinfectants for pharmaceutical manufacturers, laboratories, and clinical users.
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Affiliation(s)
- Maren Eggers
- Laboratory Prof. Dr. G. Enders MVZ GbR, Rosenbergstr. 85, 70193 Stuttgart, Germany
- Expert Committee on Virus Disinfection of the German Association for the Control of Viral Diseases (DVV) e.V. and the Society for Virology (GfV) e.V., 69126 Heidelberg, Germany;
| | - Ingeborg Schwebke
- Expert Committee on Virus Disinfection of the German Association for the Control of Viral Diseases (DVV) e.V. and the Society for Virology (GfV) e.V., 69126 Heidelberg, Germany;
| | - Johannes Blümel
- Paul-Ehrlich-Institute, Department of Virology, Paul-Ehrlich-Straße 51-56, 63225 Langen, Germany;
| | - Franziska Brandt
- Federal Institute for Drugs and Medical Devices, Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany;
| | - Helmut Fickenscher
- Institute for Infection Medicine, Christian-Albrechts-University Kiel, University Clinic Schleswig-Holstein, Bruinswiker Straße 4, 24105 Kiel, Germany;
| | - Jürgen Gebel
- VAH c/o Institute for Hygiene and Public Health, Venusberg-Campus 1, 53127 Bonn, Germany;
| | - Nils Hübner
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, W. Rathenaustr. 49, 17475 Greifswald, Germany; (N.H.); (P.Z.)
| | - Janis A. Müller
- Institute of Virology, Hans-Meerwein Straße 2, 35043 Marburg, Germany;
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596 Frankfurt, Germany;
| | - Ingrid Rapp
- Boehringer Ingelheim Therapeutics GmbH, Beim Braunland 1, 88416 Ochsenhausen, Germany;
| | - Sven Reiche
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Department of Experimental Animal Facilities and Biorisk Management, Suedufer 10, 17493 Greifswald-Insel Riems, Germany;
| | - Eike Steinmann
- Department for Molecular & Medical Virology, Ruhr University Bochum, 44801 Bochum, Germany;
| | - Jochen Steinmann
- Dr. Bill + Partner GmbH Institute for Hygiene and Microbiology, Norderoog 2, 28259 Bremen, Germany;
| | - Paula Zwicker
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, W. Rathenaustr. 49, 17475 Greifswald, Germany; (N.H.); (P.Z.)
| | - Miranda Suchomel
- Institute of Hygiene and Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria;
- Austrian Society for Hygiene, Microbiology and Preventive Medicine (ÖGHMP) c/o MAW, Freyung 6/3, 1010 Vienna, Austria
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4
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Ovcar E, Patyna S, Kohmer N, Heckel-Kratz E, Ciesek S, Rabenau HF, Hauser IA, de Groot K. Riding the Omicron BA.5 Wave: Improved Humoral Response after Vaccination with Bivalent Omicron BA.4-5-Adapted mRNA SARS-CoV-2 Vaccine in Chronic Hemodialysis Patients. Vaccines (Basel) 2023; 11:1428. [PMID: 37766105 PMCID: PMC10537021 DOI: 10.3390/vaccines11091428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Hemodialysis patients faced an excess morbidity and mortality during the COVID-19 pandemic. We evaluated the effect of second-generation mRNA vaccines against Omicron BA.4 and BA.5 variants of SARS-CoV-2 on humoral immunity. The study population comprised 66 adult hemodialysis patients who have encountered four SARS-CoV-2 antigen contacts through vaccination or infection. We assessed their humoral response using an anti-SARS-CoV-2 spike receptor binding domain IgG antibody assay (S-RBD-ab), measuring neutralizing antibodies against ancestral strain of SARS-CoV-2, Delta, and Omicron in a surrogate virus neutralization test (SVNT), and specifically against BA.5 in a plaque reduction neutralization test (PRNT) before and four weeks after vaccination with Comirnaty Original/Omicron BA.4-5. During the following six months, SARS-CoV-2 infections and symptom severity were documented. The bivalent mRNA vaccine led to a 7.6-fold increase in S-RBD-ab levels and an augmented inhibition of the Omicron variant in SVNT by 35% (median). Seroconversion in the Omicron BA.5-specific PRNT was attained by in 78.4% of previously negative patients (29/37). Levels of S-RBD-ab correlated with inhibition in the Omicron-specific SVNT and neutralization titers in the BA.5-PRNT. Eleven SARS-CoV-2 infections occurred in the six-month follow-up, none of which took a life-threatening course. The bivalent mRNA vaccine improved the SARS-CoV-2 virus variant-specific humoral immunity in chronic hemodialysis patients. Measurement of S-RBD-ab can be used in hemodialysis patients to estimate their humoral immunity status against Omicron BA.5.
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Affiliation(s)
- Eugen Ovcar
- Department of Internal Medicine 4, Nephrology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
- KfH Kuratorium for Dialysis and Transplantation, 63069 Offenbach am Main, Germany
- Department of Internal Medicine III, Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, 63069 Offenbach am Main, Germany
| | - Sammy Patyna
- Department of Internal Medicine 4, Nephrology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
- German Center for Infection Research, External Partner Site, 60596 Frankfurt am Main, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Ingeborg A Hauser
- Department of Internal Medicine 4, Nephrology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Kirsten de Groot
- KfH Kuratorium for Dialysis and Transplantation, 63069 Offenbach am Main, Germany
- Department of Internal Medicine III, Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, 63069 Offenbach am Main, Germany
- University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
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Vierbaum L, Wojtalewicz N, Grunert HP, Zimmermann A, Scholz A, Goseberg S, Kaiser P, Duehring U, Drosten C, Corman V, Niemeyer D, Rabenau HF, Obermeier M, Nitsche A, Michel J, Puyskens A, Huggett JF, O'Sullivan DM, Busby E, Cowen S, Vallone PM, Cleveland MH, Falak S, Kummrow A, Schellenberg I, Zeichhardt H, Kammel M. Results of German external quality assessment schemes for SARS-CoV-2 antigen detection. Sci Rep 2023; 13:13206. [PMID: 37580353 PMCID: PMC10425338 DOI: 10.1038/s41598-023-40330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/08/2023] [Indexed: 08/16/2023] Open
Abstract
The COVID-19 pandemic illustrated the important role of diagnostic tests, including lateral flow tests (LFTs), in identifying patients and their contacts to slow the spread of infections. INSTAND performed external quality assessments (EQA) for SARS-CoV-2 antigen detection with lyophilized and chemically inactivated cell culture supernatant of SARS-CoV-2 infected Vero cells. A pre-study demonstrated the suitability of the material. Participants reported qualitative and/or quantitative antigen results using either LFTs or automated immunoassays for five EQA samples per survey. 711 data sets were reported for LFT detection in three surveys in 2021. This evaluation focused on the analytical sensitivity of different LFTs and automated immunoassays. The inter-laboratory results showed at least 94% correct results for non-variant of concern (VOC) SARS-CoV-2 antigen detection for viral loads of ≥ 4.75 × 106 copies/mL and SARS-CoV-2 negative samples. Up to 85% had success for a non-VOC viral load of ~ 1.60 × 106 copies/mL. A viral load of ~ 1.42 × 107 copies/mL of the Delta VOC was reported positive in > 96% of results. A high specificity was found with almost 100% negative SARS-CoV-2 antigen results for HCoV 229E and HCoV NL63 positive samples. Quantitative results correlated with increasing SARS-CoV-2 viral load but showed a broad scatter. This study shows promising SARS-CoV-2 antigen test performance of the participating laboratories, but further investigations with the now predominant Omicron VOC are needed.
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Affiliation(s)
- Laura Vierbaum
- INSTAND E.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223, Düsseldorf, Germany.
| | - Nathalie Wojtalewicz
- INSTAND E.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223, Düsseldorf, Germany
| | - Hans-Peter Grunert
- GBD Gesellschaft für Biotechnologische Diagnostik mbH, Berlin, Potsdamer Chaussee 80, 14129, Berlin, Germany
| | - Anika Zimmermann
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Potsdamer Chaussee 80, 14129, Berlin, Germany
| | - Annemarie Scholz
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Potsdamer Chaussee 80, 14129, Berlin, Germany
| | - Sabine Goseberg
- INSTAND E.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223, Düsseldorf, Germany
| | - Patricia Kaiser
- INSTAND E.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223, Düsseldorf, Germany
| | - Ulf Duehring
- GBD Gesellschaft für Biotechnologische Diagnostik mbH, Berlin, Potsdamer Chaussee 80, 14129, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité - University Medicine Berlin; National Consultant Laboratory for Coronaviruses; German Centre for Infection Research, Berlin, Berlin, Germany
| | - Victor Corman
- Institute of Virology, Charité - University Medicine Berlin; National Consultant Laboratory for Coronaviruses; German Centre for Infection Research, Berlin, Berlin, Germany
| | - Daniela Niemeyer
- Institute of Virology, Charité - University Medicine Berlin; National Consultant Laboratory for Coronaviruses; German Centre for Infection Research, Berlin, Berlin, Germany
| | - Holger F Rabenau
- Institute of Virology, Charité - University Medicine Berlin; National Consultant Laboratory for Coronaviruses; German Centre for Infection Research, Berlin, Berlin, Germany
| | - Martin Obermeier
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Frankfurt, Hessen, Germany
| | | | - Janine Michel
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Andreas Puyskens
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Jim F Huggett
- National Measurement Laboratory, LGC, Teddington, Middlesex, UK
- School of Biosciences and Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | | | - Eloise Busby
- National Measurement Laboratory, LGC, Teddington, Middlesex, UK
| | - Simon Cowen
- National Measurement Laboratory, LGC, Teddington, Middlesex, UK
| | - Peter M Vallone
- NIST, National Institute of Standards and Technology, Applied Genetics Group, Biomolecular Measurement Division, Materials Measurement Laboratory, Gaithersburg, MD, USA
| | - Megan H Cleveland
- NIST, National Institute of Standards and Technology, Applied Genetics Group, Biomolecular Measurement Division, Materials Measurement Laboratory, Gaithersburg, MD, USA
| | - Samreen Falak
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | | | - Ingo Schellenberg
- INSTAND E.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223, Düsseldorf, Germany
- Institute of Bioanalytical Sciences, Center of Life Sciences, Anhalt University of Applied Sciences, Bernburg, Saxony-Anhalt, Germany
| | - Heinz Zeichhardt
- INSTAND E.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223, Düsseldorf, Germany
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Potsdamer Chaussee 80, 14129, Berlin, Germany
- GBD Gesellschaft für Biotechnologische Diagnostik mbH, Berlin, Potsdamer Chaussee 80, 14129, Berlin, Germany
| | - Martin Kammel
- INSTAND E.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223, Düsseldorf, Germany
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Potsdamer Chaussee 80, 14129, Berlin, Germany
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Koehm M, Klippstein M, Dauth S, Hallmann K, Kohmer N, Burkhardt H, Ciesek S, Geisslinger G, Rabenau HF, Behrens F. Impact of different classes of immune-modulating treatments on B cell-related and T cell-related immune response before and after COVID-19 booster vaccination in patients with immune-mediated diseases and primary immunodeficiency: a cohort study. RMD Open 2023; 9:e003094. [PMID: 37652553 PMCID: PMC10476126 DOI: 10.1136/rmdopen-2023-003094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/23/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES To evaluate the potential of immunosuppressed patients to mount B-cell and T-cell responses to COVID-19 booster vaccination (third vaccination). METHODS Patients with primary immunodeficiency (PID), immune-mediated inflammatory diseases (IMIDs) on CD20-depleting treatment with rituximab (RTX), or IMIDs treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biological disease-modifying antirheumatic drug (bDMARDs) were included and assessed before (baseline visit (BL)) and 2, 4 and 8 weeks after COVID-19 booster vaccination. Serum B-cell responses were assessed by antibody levels against SARS-CoV-2 spike protein (anti-spike IgG antibody (S-AB)) and a surrogate virus neutralisation test (sVNT). T-cell responses were assessed by an interferon gamma release assay (IGRA). RESULTS Fifty patients with PID (n=6), treated with RTX therapy (n=13), or treated with csDMARDs/bDMARDs (n=31) were included. At BL, anti-S-AB titres in PID and csDMARD/bDMARD-treated patients were low (although significantly higher than RTX patients); measures of B-cell-mediated response increased significantly after booster vaccination. In the RTX cohort, low BL anti-S-AB and sVNT values did not improve after booster vaccination, but patients had significantly elevated IGRA responses post booster vaccination compared with the other groups. csDMARD/bDMARD-treated patients showed the highest BL values in all three assays with greater increases in all parameters after booster vaccination compared with patients with PID. CONCLUSION Patients with IMID on therapeutic B-cell depletion have low anti-S-AB and sVNT values before and after booster vaccination but show significantly higher levels of IGRA compared with other immunosuppressed patients, suggesting an underlying mechanism attempting to compensate compromised humoral immunity by upregulating T-cell responsiveness. PID appears to have a stronger impact on antiviral immune response than csDMARD/bDMARD treatment.
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Affiliation(s)
- Michaela Koehm
- Department of Rheumatology, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Maximilian Klippstein
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Stephanie Dauth
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Konstantin Hallmann
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Harald Burkhardt
- Department of Rheumatology, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Virology, German Centre for Infection Research, Frankfurt am Main, Germany
| | - Gerd Geisslinger
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Goethe University, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Frank Behrens
- Department of Rheumatology, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
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7
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Wasilewicz A, Zwirchmayr J, Kirchweger B, Bojkova D, Cinatl J, Rabenau HF, Rollinger JM, Beniddir MA, Grienke U. Discovery of anti-SARS-CoV-2 secondary metabolites from the heartwood of Pterocarpus santalinus using multi-informative molecular networking. Front Mol Biosci 2023; 10:1202394. [PMID: 37347040 PMCID: PMC10280016 DOI: 10.3389/fmolb.2023.1202394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/24/2023] [Indexed: 06/23/2023] Open
Abstract
A pigment-depleted extract from the heartwood of Pterocarpus santalinus L. f. (PS-DE) showed promising anti-SARS-CoV-2 activity with an IC50 of 29.9 μg/mL in Caco-2-F03 cells. To determine the potential active constituents within the extract prior to isolation, multi-informative molecular network (MN) was applied. Therefore, the extract was separated by high-performance counter-current chromatography (HPCCC) into 11 fractions which were subsequently tested for anti-SARS-CoV-2 activity and analysed by UPLC-tandem mass spectrometry (MS2). The resulting MN combines the bioactivity data of the fractions with the MS2 data. The MN analysis led to the targeted isolation of seven compounds including one pterocarpan (7) reported for the first time as constituent of P. santalinus and four so far undescribed natural products (NPs) that belong to the compound classes of arylpropanes (9), isoflavanones (10) coumestans (16) and 3-arylcoumarins (17), respectively. In total, 15 constituents from the heartwood of P. santalinus and one synthetic isoflavonoid that is structurally related to the natural metabolites were tested for anti-SARS-CoV-2 activity. Thereby, the two pterocarpans (-)-homopterocarpin (5) and (-)-medicarpin (2), the stilbene (E)-pterostilbene (1) and the isoflavonoid 7-O-methylgenistein (11) showed a distinct antiviral activity with IC50 values of 17.2, 33.4, 34.7, and 37.9 µM, respectively, and no cytotoxic effects against Caco-2-F03 cells (CC50 > 100 µM). In addition, a structure-activity relationship (SAR) was proposed indicating structural requirements of pterocarpans for anti-SARS-CoV-2 activity. The herein presented results support the implementation of multi-informative molecular networks as powerful tool for dereplication and targeted isolation of bioactive NPs.
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Affiliation(s)
- Andreas Wasilewicz
- Division of Pharmacognosy, Department of Pharmaceutical Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
- Vienna Doctoral School of Pharmaceutical, Nutritional, Sport Sciences, University of Vienna, Vienna, Austria
| | - Julia Zwirchmayr
- Division of Pharmacognosy, Department of Pharmaceutical Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Benjamin Kirchweger
- Division of Pharmacognosy, Department of Pharmaceutical Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Denisa Bojkova
- Institute of Medical Virology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Jindrich Cinatl
- Institute of Medical Virology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Holger F. Rabenau
- Institute of Medical Virology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Judith M. Rollinger
- Division of Pharmacognosy, Department of Pharmaceutical Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Mehdi A. Beniddir
- Équipe Chimie des Substances Naturelles, BioCIS, Centre National de la Recherche Scientifique (CNRS), Université Paris-Saclay, Orsay, France
| | - Ulrike Grienke
- Division of Pharmacognosy, Department of Pharmaceutical Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
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8
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Kohmer N, Rabenau HF, Rilling V, Ciesek S, Enders M, Eggers M. Polio type 2 and 3 eradication: Relevance to the immunity status of individuals living in Germany, 2005-2020. J Clin Virol 2023; 164:105471. [PMID: 37130476 DOI: 10.1016/j.jcv.2023.105471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/28/2023] [Accepted: 04/24/2023] [Indexed: 05/04/2023]
Abstract
Since October 2019, poliovirus type 3 (PV3) has been certified as globally eradicated, and further laboratory use of PV3 will be restricted according to the WHO Polio Eradication Initiative and containment measures. To examine a possible gap in PV3 immunity and a lack of immunity against poliovirus type 2 (PV2), which was already declared as eradicated in 2015, neutralising antibodies against polioviruses (PV) of individuals living in Germany (n = 91,530 samples; mainly outpatients (≈90%) who received immune status testing) were investigated from 2005 to 2020 (age distribution: <18 years 15.8%, 18-64 years 71.2% and ≥65 years 9.5% for 2005-2015; <18 years 19.6%, 18-64 years 67% and ≥65 years 11.5% for 2016-2020). The results showed that the proportion of sera exclusively lacking antibodies against PV3 was 10.6% in 2005-2015 and 9.6% in 2016-2020 and against PV2 2.8% in 2005-2015. As there is decreased protection against PV3 and to detect potential antigenically (immune escape) variant PVs not covered by used vaccines, we recommend continued testing of PV1 and PV3.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596, Frankfurt, Germany.
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596, Frankfurt, Germany
| | - Veronika Rilling
- Laboratory Prof. Gisela Enders MVZ GbR, 70193, Stuttgart, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596, Frankfurt, Germany; German Centre for Infection Research, External Partner Site, 60323, Frankfurt, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), 60596, Frankfurt, Germany
| | - Martin Enders
- Laboratory Prof. Gisela Enders MVZ GbR, 70193, Stuttgart, Germany
| | - Maren Eggers
- Laboratory Prof. Gisela Enders MVZ GbR, 70193, Stuttgart, Germany
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9
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Bojkova D, Zöller N, Tietgen M, Steinhorst K, Bechtel M, Rothenburger T, Kandler JD, Schneider J, Corman VM, Ciesek S, Rabenau HF, Wass MN, Kippenberger S, Göttig S, Michaelis M, Cinatl J. Repurposing of the antibiotic nitroxoline for the treatment of mpox. J Med Virol 2023; 95:e28652. [PMID: 36897017 DOI: 10.1002/jmv.28652] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023]
Abstract
The antiviral drugs tecovirimat, brincidofovir, and cidofovir are considered for mpox (monkeypox) treatment despite a lack of clinical evidence. Moreover, their use is affected by toxic side-effects (brincidofovir, cidofovir), limited availability (tecovirimat), and potentially by resistance formation. Hence, additional, readily available drugs are needed. Here, therapeutic concentrations of nitroxoline, a hydroxyquinoline antibiotic with a favourable safety profile in humans, inhibited the replication of 12 mpox virus isolates from the current outbreak in primary cultures of human keratinocytes and fibroblasts and a skin explant model by interference with host cell signalling. Tecovirimat, but not nitroxoline, treatment resulted in rapid resistance development. Nitroxoline remained effective against the tecovirimat-resistant strain and increased the anti-mpox virus activity of tecovirimat and brincidofovir. Moreover, nitroxoline inhibited bacterial and viral pathogens that are often co-transmitted with mpox. In conclusion, nitroxoline is a repurposing candidate for the treatment of mpox due to both antiviral and antimicrobial activity. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Denisa Bojkova
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Nadja Zöller
- Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Manuela Tietgen
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Katja Steinhorst
- Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Marco Bechtel
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Tamara Rothenburger
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Joshua D Kandler
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Julia Schneider
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Infection Research (DZIF), Berlin, Germany
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Infection Research (DZIF), Berlin, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany.,German Center for Infection Research, DZIF, External partner site, Frankfurt am Main, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Mark N Wass
- School of Biosciences, University of Kent, Canterbury, UK
| | - Stefan Kippenberger
- Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Stephan Göttig
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University, Frankfurt am Main, Germany
| | | | - Jindrich Cinatl
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany.,Dr. Petra Joh-Forschungshaus, Frankfurt am Main, Germany
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10
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Kohmer N, Stein S, Schenk B, Grikscheit K, Metzler M, Rabenau HF, Widera M, Herrmann E, Wicker S, Ciesek S. Heterologous prime-boost immunization with ChAdOx1-S and BNT162b2: reactogenicity and immunogenicity in a prospective cohort study. Int J Infect Dis 2023; 128:166-175. [PMID: 36587839 PMCID: PMC9800011 DOI: 10.1016/j.ijid.2022.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/21/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Regarding reactogenicity and immunogenicity, heterologous COVID-19 vaccination regimens are considered as an alternative to conventional immunization schemes. METHODS Individuals receiving either heterologous (ChAdOx1-S [AstraZeneca, Cambridge, UK]/BNT162b2 [Pfizer-BioNTech, Mainz, Germany]; n = 306) or homologous (messenger RNA [mRNA]-1273 [Moderna, Cambridge, Massachusetts, USA]; n = 139) vaccination were asked to participate when receiving their second dose. Reactogenicity was assessed after 1 month, immunogenicity after 1, 3, and/or 6 months, including a third dose, through SARS-CoV-2 antispike immunoglobulin G, surrogate virus neutralization test, and a plaque reduction neutralization test against the Delta (B.1.167.2) and Omicron (B.1.1.529; BA.1) variants of concern. RESULTS The overall reactogenicity was lower after heterologous vaccination. In both cohorts, SARS-CoV-2 antispike immunoglobulin G concentrations waned over time with the heterologous vaccination demonstrating higher neutralizing activity than homologous mRNA vaccination after 3 months to low neutralizing levels in the Delta plaque reduction neutralization test after 6 months. At this point, 3.2% of the heterologous and 11.4% of the homologous cohort yielded low neutralizing activity against Omicron. After a third dose of an mRNA vaccine, ≥99% of vaccinees demonstrated positive neutralizing activity against Delta. Depending on the vaccination scheme and against Omicron, 60% to 87.5% of vaccinees demonstrated positive neutralizing activity. CONCLUSION ChAdOx1-S/BNT162b2 vaccination demonstrated an acceptable reactogenicity and immunogenicity profile. A third dose of an mRNA vaccine is necessary to maintain neutralizing activity against SARS-CoV-2. However, variants of concern-adapted versions of the vaccines would be desirable.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.
| | - Shivana Stein
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Barbara Schenk
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Katharina Grikscheit
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Melinda Metzler
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - Sabine Wicker
- Occupational Health Service, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany; German Centre for Infection Research, External Partner Site, Frankfurt, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Frankfurt, Germany.
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11
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Wasilewicz A, Kirchweger B, Bojkova D, Abi Saad MJ, Langeder J, Bütikofer M, Adelsberger S, Grienke U, Cinatl
Jr. J, Petermann O, Scapozza L, Orts J, Kirchmair J, Rabenau HF, Rollinger JM. Identification of Natural Products Inhibiting SARS-CoV-2 by Targeting Viral Proteases: A Combined in Silico and in Vitro Approach. J Nat Prod 2023; 86:264-275. [PMID: 36651644 PMCID: PMC9885530 DOI: 10.1021/acs.jnatprod.2c00843] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Indexed: 05/24/2023]
Abstract
In this study, an integrated in silico-in vitro approach was employed to discover natural products (NPs) active against SARS-CoV-2. The two SARS-CoV-2 viral proteases, i.e., main protease (Mpro) and papain-like protease (PLpro), were selected as targets for the in silico study. Virtual hits were obtained by docking more than 140,000 NPs and NP derivatives available in-house and from commercial sources, and 38 virtual hits were experimentally validated in vitro using two enzyme-based assays. Five inhibited the enzyme activity of SARS-CoV-2 Mpro by more than 60% at a concentration of 20 μM, and four of them with high potency (IC50 < 10 μM). These hit compounds were further evaluated for their antiviral activity against SARS-CoV-2 in Calu-3 cells. The results from the cell-based assay revealed three mulberry Diels-Alder-type adducts (MDAAs) from Morus alba with pronounced anti-SARS-CoV-2 activities. Sanggenons C (12), O (13), and G (15) showed IC50 values of 4.6, 8.0, and 7.6 μM and selectivity index values of 5.1, 3.1 and 6.5, respectively. The docking poses of MDAAs in SARS-CoV-2 Mpro proposed a butterfly-shaped binding conformation, which was supported by the results of saturation transfer difference NMR experiments and competitive 1H relaxation dispersion NMR spectroscopy.
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Affiliation(s)
- Andreas Wasilewicz
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Vienna
Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Benjamin Kirchweger
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Denisa Bojkova
- Institute
of Medical Virology, University Hospital
Frankfurt, Paul-Ehrlich-Straße
40, 60596 Frankfurt
am Main, Germany
| | - Marie Jose Abi Saad
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Vienna
Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Julia Langeder
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Vienna
Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Matthias Bütikofer
- Swiss
Federal Institute of Technology, Laboratory of Physical Chemistry, ETH Zurich, Vladimir-Prelog-Weg 1-5/10, 8093 Zurich, Switzerland
| | - Sigrid Adelsberger
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Vienna
Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Ulrike Grienke
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Jindrich Cinatl
Jr.
- Institute
of Medical Virology, University Hospital
Frankfurt, Paul-Ehrlich-Straße
40, 60596 Frankfurt
am Main, Germany
| | - Olivier Petermann
- Pharmaceutical
Biochemistry Group, School of Pharmaceutical Sciences, University of Geneva, 1205 Geneva, Switzerland
- Institute
of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1205 Geneva, Switzerland
| | - Leonardo Scapozza
- Pharmaceutical
Biochemistry Group, School of Pharmaceutical Sciences, University of Geneva, 1205 Geneva, Switzerland
- Institute
of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1205 Geneva, Switzerland
| | - Julien Orts
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Johannes Kirchmair
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Holger F. Rabenau
- Institute
of Medical Virology, University Hospital
Frankfurt, Paul-Ehrlich-Straße
40, 60596 Frankfurt
am Main, Germany
| | - Judith M. Rollinger
- Department
of Pharmaceutical Sciences, University of
Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
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12
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Mutlak H, Wicker S, Behrend D, Rabenau HF, Piekarski F, Zacharowski K, Raimann FJ. [Evaluation of Characteristics and Management of Influenza Patients in Relation to the STIKO Vaccination Recommendation During the 2017/2018 Season]. Gesundheitswesen 2023; 85:103-110. [PMID: 34624909 DOI: 10.1055/a-1633-3748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Every year a large number of patients is suffering from influenza infection with often severe outcome. The influenza season 2017/2018 was characterized by a high number of cases (in Germany>346,000 laboratory-confirmed cases), but also by a high rate of hospitalizations with sometimes severe clinical outcome - also in the group of patients under 60 years. AIM The aim of the present study was to find out whether patients not fullfilling the STIKO vaccination recommendation in the 2017/18 season were suffering from a worse outcome. MATERIALS AND METHODS All laboratory-confirmed influenza patients at Frankfurt University Hospital were retrospectively analyzed for disease severity with respect to the primary endpoint. Secondary endpoints were defined as demographic data, length of hospital stay, previous illnesses, intensive care therapy and its duration, drug therapy, and mortality. RESULTS Fifty-one of 303 patients (16.8%) required intensive care treatments. Of these 51, 46 patients (90.2%) belonged to the group that should have been vaccinated according to the vaccination recommendations according to STIKO, 5 patients (9.8%) did not belong to this group (p=0.434). Of the 51 ICU patients, 16 (31.4%) died. All deceased were from the group with vaccination recommendation (p=0.120). CONCLUSIONS Based on these data, it appears that severe disease progression occurs in both the group of patients with and without STIKO vaccination recommendation, but deaths occur only in the group of patients with recommendation.
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Affiliation(s)
- Haitham Mutlak
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Frankfurt am Main, Deutschland.,Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Sana Klinikum Offenbach GmbH, Offenbach, Deutschland
| | - Sabine Wicker
- Betriebsärztlicher Dienst, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Frankfurt, Deutschland
| | - David Behrend
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Frankfurt am Main, Deutschland.,Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Hospital zum heiligen Geist, Frankfurt, Deutschland
| | - Holger F Rabenau
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Frankfurt am Main, Deutschland
| | - Florian Piekarski
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Frankfurt am Main, Deutschland
| | - Kai Zacharowski
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Frankfurt am Main, Deutschland
| | - Florian Jürgen Raimann
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Frankfurt am Main, Deutschland
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13
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Bojkova D, Bechtel M, Rothenburger T, Steinhorst K, Zöller N, Kippenberger S, Schneider J, Corman VM, Uri H, Wass MN, Knecht G, Khaykin P, Wolf T, Ciesek S, Rabenau HF, Michaelis M, Cinatl J. Drug Sensitivity of Currently Circulating Mpox Viruses. N Engl J Med 2023; 388:279-281. [PMID: 36577096 DOI: 10.1056/nejmc2212136] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Hannah Uri
- University of Kent, Canterbury, United Kingdom
| | - Mark N Wass
- University of Kent, Canterbury, United Kingdom
| | | | | | - Timo Wolf
- University Hospital, Frankfurt am Main, Germany
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14
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Gutmann D, Scheuch G, Lehmkühler T, Herrlich LS, Landeis A, Hutter M, Stephan C, Vehreschild M, Khodamoradi Y, Gossmann AK, King F, Weis F, Weiss M, Rabenau HF, Graf J, Donath H, Schubert R, Zielen S. Aerosol measurement identifies SARS-CoV 2 PCR positive adults compared with healthy controls. Environ Res 2023; 216:114417. [PMID: 36162469 PMCID: PMC9507996 DOI: 10.1016/j.envres.2022.114417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/24/2022] [Accepted: 09/20/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND SARS-CoV-2 is spread primarily through droplets and aerosols. Exhaled aerosols are generated in the upper airways through shear stress and in the lung periphery by 'reopening of collapsed airways'. Aerosol measuring may detect highly contagious individuals ("super spreaders or super-emitters") and discriminate between SARS-CoV-2 infected and non-infected individuals. This is the first study comparing exhaled aerosols in SARS-CoV-2 infected individuals and healthy controls. DESIGN A prospective observational cohort study in 288 adults, comprising 64 patients testing positive by SARS CoV-2 PCR before enrollment, and 224 healthy adults testing negative (matched control sample) at the University Hospital Frankfurt, Germany, from February to June 2021. Study objective was to evaluate the concentration of exhaled aerosols during physiologic breathing in SARS-CoV-2 PCR-positive and -negative subjects. Secondary outcome measures included correlation of aerosol concentration to SARS-CoV-2 PCR results, change in aerosol concentration due to confounders, and correlation between clinical symptoms and aerosol. RESULTS There was a highly significant difference in respiratory aerosol concentrations between SARS-CoV-2 PCR-positive (median 1490.5/L) and -negative subjects (median 252.0/L; p < 0.0001). There were no significant differences due to age, sex, smoking status, or body mass index. ROC analysis showed an AUC of 0.8918. CONCLUSIONS Measurements of respiratory aerosols were significantly elevated in SARS-CoV-2 positive individuals, which helps to understand the spread and course of respiratory viral infections, as well as the detection of highly infectious individuals.
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Affiliation(s)
- Desireé Gutmann
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany.
| | - Gerhard Scheuch
- GS Bio-Inhalation GmbH, Headquarters & Logistics, Gemuenden, Germany
| | - Timon Lehmkühler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Laura-Sabine Herrlich
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Anton Landeis
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Martin Hutter
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Christoph Stephan
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Maria Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Ann-Kathrin Gossmann
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Florian King
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Frederik Weis
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Maximilian Weiss
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Juergen Graf
- Medical Director, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Helena Donath
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Ralf Schubert
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Stefan Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
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Vierbaum L, Wojtalewicz N, Kaufmann A, Goseberg S, Kaiser P, Grunert HP, Dühring U, Zimmermann A, Scholz A, Michel J, Nitsche A, Rabenau HF, Obermeier M, Schellenberg I, Zeichhardt H, Kammel M. Results of the first German external quality assessment scheme for the detection of monkeypox virus DNA. PLoS One 2023; 18:e0285203. [PMID: 37115793 PMCID: PMC10146505 DOI: 10.1371/journal.pone.0285203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND In May 2022, the monkeypox virus (MPXV) spread into non-endemic countries and the global community was quick to test the lessons learned from the SARS-CoV-2 pandemic. Due to its symptomatic resemblance to other diseases, like the non-pox virus varicella zoster (chickenpox), polymerase chain reaction methods play an important role in correctly diagnosing the rash-causing pathogen. INSTAND quickly established a new external quality assessment (EQA) scheme for MPXV and orthopoxvirus (OPXV) DNA detection to assess the current performance quality of the laboratory tests. METHODS We analyzed quantitative and qualitative data of the first German EQA for MPXV and OPXV DNA detection. The survey included one negative and three MPXV-positive samples with different MPX viral loads. The threshold cycle (Ct) or other measures defining the quantification cycle (Cq) were analyzed in an assay-specific manner. A Passing Bablok fit was used to investigate the performance at laboratory level. RESULTS 141 qualitative datasets were reported by 131 laboratories for MPXV detection and 68 qualitative datasets by 65 laboratories for OPXV detection. More than 96% of the results were correctly identified as negative and more than 97% correctly identified as positive. An analysis of the reported Ct/Cq values showed a large spread of these values of up to 12 Ct/Cq. Nevertheless, there is a good correlation of results for the different MPXV concentrations at laboratory level. Only a few quantitative results in copies/mL were reported (MPXV: N = 5; OPXV: N = 2), but the results correlated well with the concentration differences between the EQA samples, which were to a power of ten each. CONCLUSION The EQA results show that laboratories performed well in detecting both MPXV and OPXV. However, Ct/Cq values should be interpreted with caution when conclusions are drawn about the viral load as long as metrological traceability is not granted.
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Affiliation(s)
- Laura Vierbaum
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
| | - Nathalie Wojtalewicz
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
| | - Anne Kaufmann
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
| | - Sabine Goseberg
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
| | - Patricia Kaiser
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
| | | | - Ulf Dühring
- GBD Gesellschaft für Biotechnologische Diagnostik mbH, Berlin, Germany
| | - Anika Zimmermann
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Germany
| | - Annemarie Scholz
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Germany
| | - Janine Michel
- Robert Koch-Institute, Centre for Biological Threats and Special Pathogens, Highly Pathogenic Viruses, German Consultant Laboratory for Poxviruses, Berlin, Germany
| | - Andreas Nitsche
- Robert Koch-Institute, Centre for Biological Threats and Special Pathogens, Highly Pathogenic Viruses, German Consultant Laboratory for Poxviruses, Berlin, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Frankfurt, Hesse, Germany
| | | | - Ingo Schellenberg
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
- Institute of Bioanalytical Sciences, Center of Life Sciences, Anhalt University of Applied Sciences, Bernburg, Saxony-Anhalt, Germany
| | - Heinz Zeichhardt
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
- GBD Gesellschaft für Biotechnologische Diagnostik mbH, Berlin, Germany
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Germany
| | - Martin Kammel
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Dusseldorf, Germany
- GBD Gesellschaft für Biotechnologische Diagnostik mbH, Berlin, Germany
- IQVD GmbH, Institut für Qualitätssicherung in der Virusdiagnostik, Berlin, Germany
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16
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Eggers M, Exner M, Gebel J, Ilschner C, Rabenau HF, Schwebke I. Hygiene and disinfection measures for monkeypox virus infections. GMS Hyg Infect Control 2022; 17:Doc18. [PMID: 36531784 PMCID: PMC9727782 DOI: 10.3205/dgkh000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In Germany, recommendations on infection prevention and control of current virus outbreaks are given as communications by the Association for Applied Hygiene e.V. (VAH) together with the joint Disinfectant Commission of the German Association for the Control of Virus Diseases e.V. (DVV) and the Society of Virology* (GfV). The DVV was founded in 1954 in response to the ongoing threat to the population from polio and was given its current name in 1977. The DVV is supported by the Federal Ministry of Health, the Ministries of Health of the Federal States, scientific societies, as well as social foundations and organisations. Private individuals cannot be members of the DVV. The Society of Virology e.V. (GfV) is a scientific society for all virological fields in Germany, Austria and Switzerland, and is thus the largest virological society in Europe. With numerous commissions, guidelines and statements, it is the authoritative contact for research, healthcare and politics. The joint commission "Virus Disinfection" of these scientific societies focuses on the efficacy of chemical disinfection procedures against viruses. The VAH bundles the expertise of scientific societies and experts on infection prevention and is particularly committed to the quality assurance of hygiene measures. With the VAH disinfectant list, the association provides the standard reference for the selection of high-quality disinfection procedures. This disinfectant list has a tradition of more than 60 years in Germany. The original German version of this document was published in August 2022 and has now been made available to the international professional public in English. The document contains recommendations on hygiene and disinfection measures for monkeypox virus infections. Disinfectants against monkeypox must have at least proven efficacy against enveloped viruses (active against enveloped viruses); products with the efficacy ranges "limited virucidal activity" and "virucidal" can also be used. The disinfectant list of the VAH or the disinfectant list of the Robert Koch Institute are available for the selection of products. Especially in the case of contamination with crust or scab material, it should be noted that protein contamination can have a protective or stabilising effect on monkeypox. Therefore, cleaning - before disinfection - should always be carried out in this situation. Preventive measures such as vaccination and hygiene in the vicinity of people with monkeypox must be taken to prevent transmission to small children, pregnant women or people with a pronounced immune deficiency.
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Affiliation(s)
- Maren Eggers
- Association for Applied Hygiene e.V. (VAH), Bonn, Germany,Society of Virology (GfV), Heidelberg, Germany,Disinfectant Commission of the German Association for the Control of Virus Diseases e.V. (DVV), Kiel, Germany,Labor Prof. Gisela Enders MVZ GbR, Stuttgart, Germany,*To whom correspondence should be addressed: Maren Eggers, Labor Prof. Gisela Enders MVZ GbR, Head of VirologyRosenbergstr. 85, 70193, Stuttgart, Germany, E-mail:
| | - Martin Exner
- Association for Applied Hygiene e.V. (VAH), Bonn, Germany,German Society of Hospital Hygiene (DGKH), Berlin, Germany,University Hospital Bonn, Bonn, Germany
| | - Jürgen Gebel
- Association for Applied Hygiene e.V. (VAH), Bonn, Germany,University Hospital Bonn, Bonn, Germany
| | - Carola Ilschner
- Association for Applied Hygiene e.V. (VAH), Bonn, Germany,University Hospital Bonn, Bonn, Germany
| | - Holger F. Rabenau
- Society of Virology (GfV), Heidelberg, Germany,Disinfectant Commission of the German Association for the Control of Virus Diseases e.V. (DVV), Kiel, Germany,University Hospital Frankfurt, Germany
| | - Ingeborg Schwebke
- Society of Virology (GfV), Heidelberg, Germany,Disinfectant Commission of the German Association for the Control of Virus Diseases e.V. (DVV), Kiel, Germany
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Affiliation(s)
- Ana M Groh
- Center of Internal Medicine, Infectious Diseases Unit, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Christoph Stephan
- Center of Internal Medicine, Infectious Diseases Unit, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
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18
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Ovcar E, Patyna S, Kohmer N, Heckel-Kratz E, Ciesek S, Rabenau HF, Hauser IA, de Groot K. Increasing but insufficient neutralizing activity against Omicron-BA.1 after a second booster dose of mRNA-1273 vaccine in chronic hemodialysis patients. Clin Kidney J 2022; 15:2346-2348. [PMID: 36381372 PMCID: PMC9664578 DOI: 10.1093/ckj/sfac211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Eugen Ovcar
- KfH Nierenzentrum Offenbach , Offenbach/Main, Germany
- Department of Internal Medicine III , Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, Offenbach/Main, Germany
| | - Sammy Patyna
- Department of Internal Medicine III, Division of Nephrology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
- German Centre for Infection Research , External partner site Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME) , Branch Translational Medicine and Pharmacology, Frankfurt , Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | - Ingeborg A Hauser
- Department of Internal Medicine III, Division of Nephrology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | - Kirsten de Groot
- KfH Nierenzentrum Offenbach , Offenbach/Main, Germany
- Department of Internal Medicine III , Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, Offenbach/Main, Germany
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Hoehl S, Toptan T, F. Rabenau H, Ciesek S. The Relapse Phenomenon in Mild COVID Treated With Nirmatrelvir/Ritonavir in an Immunocompetent Patient. Dtsch Arztebl Int 2022; 119:619-620. [PMID: 36507731 PMCID: PMC9756324 DOI: 10.3238/arztebl.m2022.0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 05/25/2022] [Accepted: 06/30/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Sebastian Hoehl
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt
| | - Tuna Toptan
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt
| | | | - Sandra Ciesek
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt
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20
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Grikscheit K, Rabenau HF, Ghodratian Z, Widera M, Wilhelm A, Toptan Grabmair T, Hoehl S, Layer E, Helfritz F, Ciesek S. Characterization of the Antibody and Interferon-Gamma Release Response after a Second COVID-19 Booster Vaccination. Vaccines (Basel) 2022; 10:vaccines10071163. [PMID: 35891326 PMCID: PMC9323888 DOI: 10.3390/vaccines10071163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/28/2022] [Accepted: 07/14/2022] [Indexed: 11/26/2022] Open
Abstract
The emergence of SARS-CoV-2 Omicron subvariants prompted countries to call for accelerated booster vaccinations to limit disease and transmission. Here, we characterized correlates of protection over time after the second booster or after Omicron BA.1 infection comparing variants of concern (VOCs). Sera from subjects before and two and seven weeks after the second booster or after Omicron infection were examined for the level of Spike receptor-binding-domain (RBD)-specific antibodies. Furthermore, neutralizing antibodies (nABs) were characterized in in vitro neutralization assays comparing the variants of concern Alpha, Beta, Delta, and Omicron BA.1 and BA.2 against the ancestral strain B.1. Here, the second booster resulted in an increase in anti-RBD-IgG-antibodies, remaining nearly constant over time, accompanied by an increase in nABs against B.1 and the VOCs Alpha, Beta, Delta, and Omicron BA.1 and BA.2. However, compared to B.1, the neutralizing capacity against the Omicron subvariants remained low and was limited after the second booster vaccination. This indicates that antibody-mediated protection against infection with this VOC is unlikely, as evidenced by the fact that three individuals of our study cohort became infected with Omicron BA.1 after the second booster. T cell activation was measured by interferon-gamma release assays in a subgroup of subjects and was increased in all subjects tested after the second booster vaccination, correlating with the amount of Spike-specific antibodies. In subjects with Omicron BA.1 breakthrough infection, a significant increase in nABs to all VOCs studied was observed independently of booster vaccinations. Taken together, our data indicate that a second booster or Omicron BA.1 infection mediate a substantial increase in anti-Spike IgG antibodies; however, infection with Omicron BA.1 induced a stronger increase in neutralizing antibodies against the different VOCs
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Affiliation(s)
- Katharina Grikscheit
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Zahra Ghodratian
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Alexander Wilhelm
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Tuna Toptan Grabmair
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Emily Layer
- Health Protection Authority of the City of Frankfurt am Main, 60313 Frankfurt am Main, Germany;
| | - Fabian Helfritz
- Bürgerhospital Frankfurt, Nibelungenallee 37-41, 60318 Frankfurt am Main, Germany;
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
- German Centre for Infection Research (DZIF), Partner Site Frankfurt, 60596 Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology, Branch Translational Medicine and Pharmcology, 60596 Frankfurt am Main, Germany
- Correspondence:
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21
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Kohmer N, Kortenbusch M, Berger A, Rühl C, Ciesek S, Salla S, Rabenau HF. Suitability of Different Diagnostic Platforms for Virological Testing of Blood Samples from Cornea Donors. Transfus Med Hemother 2022; 49:379-387. [PMID: 36654977 PMCID: PMC9768292 DOI: 10.1159/000524250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/09/2022] [Indexed: 01/21/2023] Open
Abstract
Background To minimize the risk of disease transmission in cornea transplantation, donor screening for blood-derived viral infections is mandatory. Ideally, pre-mortem blood samples are used, but based on availability, cadaveric blood samples of cornea donors may also be used. However, serological and nucleic acid amplification tests (NATs) need to be validated for the use of cadaveric specimens. Methods Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV) 1/2, and Treponema pallidum (syphilis)-specific serological and/or NAT assays were validated on different platforms (Abbott Alinity i, Alinity m, Roche Cobas 6800, and Roche Cobas AmpliPrep/Cobas TaqMan (CAP/CTM)) using (un)spiked paired pre- and post-mortem cornea donor blood samples from the same individual (up to 23.83 h after death) of 28 individuals in accordance with the specifications of the German Federal Institute for Vaccines and Biomedicines (Paul-Ehrlich-Institut [PEI]). In addition, routinely HBV-, HCV- and HIV-PCR-negative tested post-mortem blood samples of 24 individuals were used to assess NAT specificity. Results For the majority of serological parameters on the Abbott Alinity i (HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HIV, anti-HTLV 1/2, and anti-Treponema pallidum), ratios of generated test results of (un)spiked paired pre- and post-mortem blood samples differed ≤25%, with an agreement of qualitative pre- and post-mortem test results ranging from 91.2 to 100%. For NAT parameters (HBV, HCV, and HIV) on the Cobas 6800, Alinity m, and CAP/CTM, no significant deviation in virus concentrations (factor >5) of spiked pre- and post-mortem blood samples could be observed. Ct-values of corresponding internal controls did also not differ significantly (>1.5 Ct-values). In addition, no false-positive test results were generated when specificity was assessed. Conclusion Overall, fluctuations of test results for serological and NAT parameters in pre- and post-mortem blood samples examined in this study, were only limited and within the range of what is also observed when routinely testing fresh patient specimens. We conclude that all examined assays are eligible for the screening of blood samples taken up to about 24 h after the occurrence of death.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Marhild Kortenbusch
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Cornelia Rühl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany,German Centre for Infection Research, External Partner Site Frankfurt, Frankfurt, Germany,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt, Germany
| | - Sabine Salla
- Department of Ophthalmology, RTWH Aachen University, Aachen, Germany
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany,*Holger F. Rabenau,
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22
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Enssle JC, Campe J, Büchel S, Moter A, See F, Grießbaum K, Rieger MA, Wolf S, Ballo O, Steffen B, Serve H, Rabenau HF, Widera M, Bremm M, Huenecke S, Ciesek S, von Metzler I, Ullrich E. Enhanced but variant-dependent serological and cellular immune responses to third-dose BNT162b2 vaccination in patients with multiple myeloma. Cancer Cell 2022; 40:587-589. [PMID: 35588736 PMCID: PMC9116569 DOI: 10.1016/j.ccell.2022.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Julius C Enssle
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
| | - Julia Campe
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Sarah Büchel
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Alina Moter
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Frederic See
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Katharina Grießbaum
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Michael A Rieger
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany; Cardio-Pulmonary Institute, Frankfurt am Main, Germany
| | - Sebastian Wolf
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
| | - Olivier Ballo
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Björn Steffen
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Hubert Serve
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
| | - Holger F Rabenau
- Insitute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Marek Widera
- Insitute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Melanie Bremm
- Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sabine Huenecke
- Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Insitute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; German Centre for Infection Research (DZIF), External partner site, Frankfurt am Main, Germany; Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt am Main, Germany
| | - Ivana von Metzler
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany.
| | - Evelyn Ullrich
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
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Kohmer N, Rabenau HF, Ciesek S, Krämer BK, Göttmann U, Keller C, Rose D, Blume C, Thomas M, Lammert A, Lammert A. Heterologous immunization with BNT162b2 followed by mRNA-1273 in dialysis patients: seroconversion and presence of neutralizing antibodies. Nephrol Dial Transplant 2022; 37:1132-1139. [PMID: 35099023 PMCID: PMC9383412 DOI: 10.1093/ndt/gfac018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The vital renal replacement therapy makes it impossible for dialysis patients to distance themselves socially. This results in a high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and developing coronavuris disease 2019, with excess mortality due to disease burden and immunosuppression. We determined the efficacy of a 100-µg booster of mRNA-1273 (Moderna, Cambridge, MA, USA) 6 months after two doses of BNT162b2 (BioNTech/Pfizer, Mainz, Germany/New York, USA) in 194 SARS-CoV-2-naïve dialysis patients. METHODS Anti-SARS-CoV-2 spike antibodies were measured with the Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics, Mannheim, Germany) 4 and 10-12 weeks after two doses of BNT162b2 as well as 4 weeks after the mRNA-1273 booster. The presence of neutralizing antibodies was measured by the SARS-CoV-2 Surrogate Virus Neutralization Test (GenScript Biotech, Piscataway, NJ, USA). Two different cut-offs for positivity were used, one according to the manufacturer's specifications and one correlating with positivity in a plaque reduction neutralization test (PRNT). Receiver operating characteristics analyses were performed to match the anti-SARS-CoV-2 spike antibody cut-offs with the cut-offs in the surrogate neutralization assay accordingly. RESULTS Any level of immunoreactivity determined by the anti-SARS-CoV-2 spike antibody assay was found in 87.3% (n = 144/165) and 90.6% (n = 164/181) of patients 4 and 10-12 weeks, respectively, after two doses of BNT162b2. This was reduced to 68.5% or 60.6% 4 weeks and 51.7% or 35.4% 10-12 weeks, respectively, when using the ROC cut-offs for neutralizing antibodies in the surrogate neutralization test (manufacturer's cut-off ≥103 U/mL and cut-off correlating with PRNT ≥196 U/mL). Four weeks after the mRNA-1273 booster, the concentration of anti-SARS-CoV-2 spike antibodies increased to 23 119.9 U/mL and to 97.3% for both cut-offs of neutralizing antibodies. CONCLUSION Two doses of BNT162b2 followed by one dose of mRNA-1273 within 6 months in patients receiving maintenance dialysis resulted in significant titres of SARS-CoV-2 spike antibodies. While two doses of mRNA vaccine achieved adequate humoral immunity in a minority, the third vaccination boosts the development of virus-neutralizing quantities of SARS-CoV-2 spike antibodies (against wild-type SARS-CoV-2) in almost all patients.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
- German Centre for Infection Research, External Partner Site, Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology, Branch Translational Medicine and Pharmacology, Frankfurt, Germany
| | - Bernhard K Krämer
- Department of Medicine V, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Mannheim Institute for Innate Immunoscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Uwe Göttmann
- Department of Medicine V, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Nierenzentrum Worms, Germany
| | - Christine Keller
- Praxis für Stoffwechsel- und Nierenerkrankungen, Zentrum für Dialyse und Apherese, Grünstadt, Germany
| | - Daniela Rose
- Department of Medicine V, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Praxis für Stoffwechsel- und Nierenerkrankungen, Zentrum für Dialyse und Apherese, Grünstadt, Germany
| | - Carsten Blume
- Praxis für Stoffwechsel- und Nierenerkrankungen, Zentrum für Dialyse und Apherese, Grünstadt, Germany
| | - Michael Thomas
- Praxis für Stoffwechsel- und Nierenerkrankungen, Zentrum für Dialyse und Apherese, Grünstadt, Germany
| | - Alexander Lammert
- Department of Medicine V, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Praxis für Stoffwechsel- und Nierenerkrankungen, Zentrum für Dialyse und Apherese, Grünstadt, Germany
| | - Anne Lammert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Patyna S, Eckes T, Koch BF, Sudowe S, Oftring A, Kohmer N, Rabenau HF, Ciesek S, Avaniadi D, Steiner R, Hauser IA, Pfeilschifter JM, Betz C. Impact of Moderna mRNA-1273 Booster Vaccine on Fully Vaccinated High-Risk Chronic Dialysis Patients after Loss of Humoral Response. Vaccines (Basel) 2022; 10:vaccines10040585. [PMID: 35455334 PMCID: PMC9029590 DOI: 10.3390/vaccines10040585] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 12/18/2022] Open
Abstract
The long-term effect of protection by two doses of SARS-CoV-2 vaccination in patients receiving chronic intermittent hemodialysis (CIHD) is an urging question. We investigated the humoral and cellular immune response of 42 CIHD patients who had received two doses of SARS-CoV-2 vaccine, and again after a booster vaccine with mRNA-1273 six months later. We measured antibody levels and SARS-CoV-2-specific surrogate neutralizing antibodies (SNA). Functional T cell immune response to vaccination was assessed by quantifying interferon-γ (IFN-γ) and IL-2 secreting T cells specific for SARS-CoV-2 using an ELISpot assay. Our data reveal a moderate immune response after the second dose of vaccination, with significantly decreasing SARS-CoV-2-specific antibody levels and less than half of the study group showed neutralizing antibodies six months afterwards. Booster vaccines increased the humoral response dramatically and led to a response rate of 89.2% for antibody levels and a response rate of 94.6% for SNA. Measurement in a no response/low response (NR/LR) subgroup of our cohort, which differed from the whole group in age and rate of immunosuppressive drugs, indicated failure of a corresponding T cell response after the booster vaccine. We strongly argue in favor of a regular testing of surrogate neutralizing antibodies and consecutive booster vaccinations for CIHD patients to provide a stronger and persistent immunity.
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Affiliation(s)
- Sammy Patyna
- Division of Nephrology, Department of Internal Medicine III, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (B.F.K.); (D.A.); (R.S.); (I.A.H.); (C.B.)
- Institute of General Pharmacology and Toxicology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (T.E.); (A.O.); (J.M.P.)
- Correspondence:
| | - Timon Eckes
- Institute of General Pharmacology and Toxicology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (T.E.); (A.O.); (J.M.P.)
| | - Benjamin F. Koch
- Division of Nephrology, Department of Internal Medicine III, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (B.F.K.); (D.A.); (R.S.); (I.A.H.); (C.B.)
| | | | - Anke Oftring
- Institute of General Pharmacology and Toxicology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (T.E.); (A.O.); (J.M.P.)
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (N.K.); (H.F.R.); (S.C.)
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (N.K.); (H.F.R.); (S.C.)
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (N.K.); (H.F.R.); (S.C.)
- German Centre for Infection Research, External Partner Site, 60323 Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt, Germany
| | - Despina Avaniadi
- Division of Nephrology, Department of Internal Medicine III, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (B.F.K.); (D.A.); (R.S.); (I.A.H.); (C.B.)
| | - Rahel Steiner
- Division of Nephrology, Department of Internal Medicine III, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (B.F.K.); (D.A.); (R.S.); (I.A.H.); (C.B.)
| | - Ingeborg A. Hauser
- Division of Nephrology, Department of Internal Medicine III, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (B.F.K.); (D.A.); (R.S.); (I.A.H.); (C.B.)
| | - Josef M. Pfeilschifter
- Institute of General Pharmacology and Toxicology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (T.E.); (A.O.); (J.M.P.)
| | - Christoph Betz
- Division of Nephrology, Department of Internal Medicine III, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany; (B.F.K.); (D.A.); (R.S.); (I.A.H.); (C.B.)
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Vierbaum L, Wojtalewicz N, Grunert HP, Lindig V, Duehring U, Drosten C, Corman V, Niemeyer D, Ciesek S, Rabenau HF, Berger A, Obermeier M, Nitsche A, Michel J, Mielke M, Huggett J, O’Sullivan D, Busby E, Cowen S, Vallone PM, Cleveland MH, Falak S, Kummrow A, Keller T, Schellenberg I, Zeichhardt H, Kammel M. RNA reference materials with defined viral RNA loads of SARS-CoV-2-A useful tool towards a better PCR assay harmonization. PLoS One 2022; 17:e0262656. [PMID: 35051208 PMCID: PMC8775330 DOI: 10.1371/journal.pone.0262656] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/03/2022] [Indexed: 12/19/2022] Open
Abstract
SARS-CoV-2, the cause of COVID-19, requires reliable diagnostic methods to track the circulation of this virus. Following the development of RT-qPCR methods to meet this diagnostic need in January 2020, it became clear from interlaboratory studies that the reported Ct values obtained for the different laboratories showed high variability. Despite this the Ct values were explored as a quantitative cut off to aid clinical decisions based on viral load. Consequently, there was a need to introduce standards to support estimation of SARS-CoV-2 viral load in diagnostic specimens. In a collaborative study, INSTAND established two reference materials (RMs) containing heat-inactivated SARS-CoV-2 with SARS-CoV-2 RNA loads of ~107 copies/mL (RM 1) and ~106 copies/mL (RM 2), respectively. Quantification was performed by RT-qPCR using synthetic SARS-CoV-2 RNA standards and digital PCR. Between November 2020 and February 2021, German laboratories were invited to use the two RMs to anchor their Ct values measured in routine diagnostic specimens, with the Ct values of the two RMs. A total of 305 laboratories in Germany were supplied with RM 1 and RM 2. The laboratories were requested to report their measured Ct values together with details on the PCR method they used to INSTAND. This resultant 1,109 data sets were differentiated by test system and targeted gene region. Our findings demonstrate that an indispensable prerequisite for linking Ct values to SARS-CoV-2 viral loads is that they are treated as being unique to an individual laboratory. For this reason, clinical guidance based on viral loads should not cite Ct values. The RMs described were a suitable tool to determine the specific laboratory Ct for a given viral load. Furthermore, as Ct values can also vary between runs when using the same instrument, such RMs could be used as run controls to ensure reproducibility of the quantitative measurements.
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Affiliation(s)
- Laura Vierbaum
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, North Rhine-Westphalia, Germany
| | - Nathalie Wojtalewicz
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, North Rhine-Westphalia, Germany
| | | | - Vanessa Lindig
- IQVD GmbH, Institut fuer Qualitaetssicherung in der Virusdiagnostik, Berlin, Germany
| | - Ulf Duehring
- GBD Gesellschaft fuer Biotechnologische Diagnostik mbH, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité - University Medicine Berlin; National Consultant Laboratory for Coronaviruses; German Centre for Infection Research, Berlin, Germany
| | - Victor Corman
- Institute of Virology, Charité - University Medicine Berlin; National Consultant Laboratory for Coronaviruses; German Centre for Infection Research, Berlin, Germany
| | - Daniela Niemeyer
- Institute of Virology, Charité - University Medicine Berlin; National Consultant Laboratory for Coronaviruses; German Centre for Infection Research, Berlin, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Frankfurt, Hesse, Germany
- German Centre for Infection Research, External partner site Frankfurt, Hesse, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology, Branch Translational Medicine and Pharmacology, Frankfurt, Hesse, Germany
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Frankfurt, Hesse, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Frankfurt, Hesse, Germany
| | | | - Andreas Nitsche
- Robert Koch-Institute, Centre for Biological Threats and Special Pathogens, Berlin, Germany
| | - Janine Michel
- Robert Koch-Institute, Centre for Biological Threats and Special Pathogens, Berlin, Germany
| | - Martin Mielke
- Robert Koch-Institute, Department for Infectious Diseases, Berlin, Germany
| | - Jim Huggett
- National Measurement Laboratory, LGC, Teddington, Middlesex, United Kingdom
- Faculty of Health & Medical Science, School of Biosciences & Medicine, University of Surrey, Guildford, United Kingdom
| | - Denise O’Sullivan
- National Measurement Laboratory, LGC, Teddington, Middlesex, United Kingdom
| | - Eloise Busby
- National Measurement Laboratory, LGC, Teddington, Middlesex, United Kingdom
| | - Simon Cowen
- National Measurement Laboratory, LGC, Teddington, Middlesex, United Kingdom
| | - Peter M. Vallone
- Materials Measurement Laboratory, Biomolecular Measurement Division, NIST, National Institute of Standards and Technology, Applied Genetics Group, Gaithersburg, Massachusetts, United States of America
| | - Megan H. Cleveland
- Materials Measurement Laboratory, Biomolecular Measurement Division, NIST, National Institute of Standards and Technology, Applied Genetics Group, Gaithersburg, Massachusetts, United States of America
| | - Samreen Falak
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | | | | | - Ingo Schellenberg
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, North Rhine-Westphalia, Germany
- Institute of Bioanalytical Sciences, Center of Life Sciences, Anhalt University of Applied Sciences, Bernburg, Saxony-Anhalt, Germany
| | - Heinz Zeichhardt
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, North Rhine-Westphalia, Germany
- GBD Gesellschaft fuer Biotechnologische Diagnostik mbH, Berlin, Germany
- IQVD GmbH, Institut fuer Qualitaetssicherung in der Virusdiagnostik, Berlin, Germany
| | - Martin Kammel
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, North Rhine-Westphalia, Germany
- IQVD GmbH, Institut fuer Qualitaetssicherung in der Virusdiagnostik, Berlin, Germany
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Gutmann D, Donath H, Herrlich L, Lehmkühler T, Landeis A, Ume ER, Hutter M, Goßmann AK, Weis F, Weiß M, Rabenau HF, Zielen S. Exhaled Aerosols in SARS-CoV-2 Polymerase Chain Reaction-Positive Children and Age-Matched-Negative Controls. Front Pediatr 2022; 10:941785. [PMID: 35923787 PMCID: PMC9339682 DOI: 10.3389/fped.2022.941785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Children and adolescents seem to be less affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease in terms of severity, especially until the increasing spread of the omicron variant in December 2021. Anatomical structures and lower number of exhaled aerosols may in part explain this phenomenon. In a cohort of healthy and SARS-CoV-2 infected children, we compared exhaled particle counts to gain further insights about the spreading of SARS-CoV-2. MATERIALS AND METHODS In this single-center prospective observational trial, a total of 162 children and adolescents (age 6-17 years), of whom 39 were polymerase chain reaction (PCR)-positive for SARS-CoV-2 and 123 PCR-negative, were included. The 39 PCR-positive children were compared to 39 PCR-negative age-matched controls. The data of all PCR-negative children were analyzed to determine baseline exhaled particle counts in children. In addition, medical and clinical history was obtained and spirometry was measured. RESULTS Baseline exhaled particle counts were low in healthy children. Exhaled particle counts were significantly increased in SARS-CoV-2 PCR-positive children (median 355.0/L; range 81-6955/L), compared to age-matched -negative children (median 157.0/L; range 1-533/L; p < 0.001). CONCLUSION SARS-CoV-2 PCR-positive children exhaled significantly higher levels of aerosols than healthy children. Overall children had low levels of exhaled particle counts, possibly indicating that children are not the major driver of the SARS-CoV-2 pandemic. TRIAL REGISTRATION [ClinicalTrials.gov], Identifier [NCT04739020].
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Affiliation(s)
- Desiree Gutmann
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Helena Donath
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Laura Herrlich
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Timon Lehmkühler
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Anton Landeis
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Emily R Ume
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Martin Hutter
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | | | - Frederik Weis
- Palas GmbH, Partikel- und Lasermesstechnik, Karlsruhe, Germany
| | - Maximilian Weiß
- Palas GmbH, Partikel- und Lasermesstechnik, Karlsruhe, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Stefan Zielen
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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27
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Westhaus S, Rabenau HF. Neutralization Assay for SARS-CoV-2 Infection: Plaque Reduction Neutralization Test. Methods Mol Biol 2022; 2452:353-360. [PMID: 35554916 DOI: 10.1007/978-1-0716-2111-0_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Neutralization assays are often used as part of research and diagnostics to detect neutralizing antibodies and to determine a possible protective antibody titer after infection or vaccination. Here we describe a conventional plaque reduction neutralization test (PRNT) to check the presence of antibodies against SARS-CoV-2 in patient samples (serum or plasma).
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Affiliation(s)
- Sandra Westhaus
- Institue of Medical Viroogy, University of Frankfurt, Goethe-University, Frankfurt, Germany.
| | - Holger F Rabenau
- Institue of Medical Viroogy, University of Frankfurt, Goethe-University, Frankfurt, Germany
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28
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Eggers M, Baumann A, Lilienthal N, Steinmann E, Steinmann J, Hübner NO, Rabenau HF, Weinheimer V, Schwebke I. [Disinfectants during the COVID-19 pandemic: a challenge]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:86-95. [PMID: 34878564 PMCID: PMC8652094 DOI: 10.1007/s00103-021-03457-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/03/2021] [Indexed: 12/31/2022]
Abstract
Disinfection measures have become more important as a result of the COVID-19 pandemic in Germany. The increased need for disinfectants at the beginning of the pandemic required temporary legal regulations in order to provide a sufficient quantity of products for the necessary disinfection in the medical sector on the one hand and for the additional demand in the population on the other. For this purpose, the Federal Institute for Drugs and Medical Devices (BfArM) and the Federal Institute for Occupational Safety and Health (BAuA) issued a general ruling, which is explained in more detail in this article. The focus was on measures for hygienic hand disinfection. However, other applications such as surface disinfection in relation to pandemic respiratory diseases are also addressed. The experience gained in ensuring the supply of disinfectants that are effective and safe to use should be used to prepare for further pandemics.
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Affiliation(s)
- Maren Eggers
- Kommission für Virusdesinfektion, Deutsche Vereinigung zur Bekämpfung der Viruskrankheiten (DVV) e. V., Geschäftsstelle Kiel, Kiel, Deutschland.
- Gesellschaft für Virologie (GfV) e. V., Geschäftsstelle Heidelberg, Heidelberg, Deutschland.
- Labor Prof. G. Enders MVZ GbR, Rosenbergstraße 85, 70193, Stuttgart, Deutschland.
| | - Anna Baumann
- Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Bonn, Deutschland
| | - Nils Lilienthal
- Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Bonn, Deutschland
| | - Eike Steinmann
- Abteilung für Molekulare & Medizinische Virologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Jochen Steinmann
- Dr. Brill + Partner GmbH Institut für Hygiene und Mikrobiologie, Bremen, Deutschland
| | - Nils-Olaf Hübner
- Institut für Hygiene und Umweltmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Holger F Rabenau
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Viola Weinheimer
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Dortmund, Deutschland
| | - Ingeborg Schwebke
- Kommission für Virusdesinfektion, Deutsche Vereinigung zur Bekämpfung der Viruskrankheiten (DVV) e. V., Geschäftsstelle Kiel, Kiel, Deutschland
- Gesellschaft für Virologie (GfV) e. V., Geschäftsstelle Heidelberg, Heidelberg, Deutschland
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29
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Berneck BS, Rockstroh A, Barzon L, Sinigaglia A, Vocale C, Landini MP, Rabenau HF, Schmidt-Chanasit J, Ulbert S. Serological differentiation of West Nile virus and Usutu virus induced antibodies by envelope proteins with modified cross-reactive epitopes. Transbound Emerg Dis 2021; 69:2779-2787. [PMID: 34919790 DOI: 10.1111/tbed.14429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/01/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
West Nile virus (WNV) and Usutu virus (USUV) are mosquito-borne viruses belonging to the Japanese encephalitis virus serocomplex within the genus Flavivirus. Due to climate change and the expansion of mosquito vectors, flaviviruses are becoming endemic in increasing numbers of countries. WNV infections are reported with symptoms ranging from mild fever to severe neuro invasive disease. Until now, only a few USUV infections have been reported in humans, mostly with mild symptoms. The serological diagnosis and differentiation between flavivirus infections in general and between WNV and USUV in particular are challenging due the high degree of cross-reacting antibodies, especially of those directed against the conserved fusion loop (FL) domain of the envelope (E) protein. We have previously shown that E proteins containing four amino acid mutations in and near the FL strongly reduce the binding of cross-reactive antibodies leading to diagnostic technologies with improved specificities. Here, we expanded the technology to USUV and analyzed the differentiation of USUV and WNV induced antibodies in humans. IgG ELISAs modified by an additional competition step with the heterologous antigen resulted in overall specificities of 93.94% for WNV Equad and 92.75% for USUV Equad. IgM antibodies against WNV could be differentiated from USUV IgM in a direct comparison using both antigens. The data indicate the potential of the system to diagnose antigenically closely related flavivirus infections. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Beatrice Sarah Berneck
- Fraunhofer Institute for Cell Therapy and Immunology, Perlickstr. 1, Leipzig, 04103, Germany
| | - Alexandra Rockstroh
- Fraunhofer Institute for Cell Therapy and Immunology, Perlickstr. 1, Leipzig, 04103, Germany
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, Padova, 35121, Italy
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, Padova, 35121, Italy
| | - Caterina Vocale
- CRREM. Unità Operativa di Microbiologia, IRCCS Policlinico di S. Orsola, Via Massarenti 9, Bologna, 40138, Italy
| | - Maria Paola Landini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies-CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Holger F Rabenau
- Institute of Medical Virology, University Hospital Frankfurt, Paul-Ehrlich-Str. 40, Frankfurt, 60596, Germany
| | - Jonas Schmidt-Chanasit
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, Hamburg, 20359, Germany
| | - Sebastian Ulbert
- Fraunhofer Institute for Cell Therapy and Immunology, Perlickstr. 1, Leipzig, 04103, Germany
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von Metzler I, Campe J, Huenecke S, Raab MS, Goldschmidt H, Schubert R, Rabenau HF, Ciesek S, Serve H, Ullrich E. COVID-19 in multiple-myeloma patients: cellular and humoral immunity against SARS-CoV-2 in a short- and long-term view. J Mol Med (Berl) 2021; 100:463-470. [PMID: 34657968 PMCID: PMC8520766 DOI: 10.1007/s00109-021-02114-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/21/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023]
Abstract
Abstract Multiple myeloma patients are often treated with immunomodulatory drugs, proteasome inhibitors, or monoclonal antibodies until disease progression. Continuous therapy in combination with the underlying disease frequently results in severe humoral and cellular immunodeficiency, which often manifests in recurrent infections. Here, we report on the clinical management and immunological data of three multiple-myeloma patients diagnosed with COVID-19. Despite severe hypogammaglobulinemia, deteriorated T cell counts, and neutropenia, the patients were able to combat COVID-19 by balanced response of innate immunity, strong CD8+ and CD4+ T cell activation and differentiation, development of specific T-cell memory subsets, and development of anti-SARS-CoV-2 type IgM and IgG antibodies with virus-neutralizing capacities. Even 12 months after re-introduction of lenalidomide maintenance therapy, antibody levels and virus-neutralizing antibody titers remained detectable, indicating persisting immunity against SARS-CoV-2. We conclude that in MM patients who tested positive for SARS-CoV-2 and were receiving active MM treatment, immune response assessment could be a useful tool to help guide decision-making regarding the continuation of anti-tumor therapy and supportive therapy. Key messages Immunosuppression due to multiple myeloma might not be the crucial factor that is affecting the course of COVID-19. In this case, despite pre-existing severe deficits in CD4+ T-cell counts and IgA und IgM deficiency, we noticed a robust humoral and cellular immune response against SARS-CoV-2. Evaluation of immune response and antibody titers in MM patients that were tested positive for SARS-CoV-2 and are on active MM treatment should be performed on a larger scale; the findings might affect further treatment recommendations for COVID-19, MM treatment re-introduction, and isolation measures.
Supplementary information The online version contains supplementary material available at 10.1007/s00109-021-02114-x.
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Affiliation(s)
- Ivana von Metzler
- Department of Hematology and Oncology, Johann Wolfgang Goethe University, Frankfurt, Germany.
| | - Julia Campe
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
- Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sabine Huenecke
- Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Marc S Raab
- Department of Medicine V, University Hospital Heidelberg, and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Medicine V, University Hospital Heidelberg, and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Ralf Schubert
- Division for Allergy, Pneumology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital, Goethe-University, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
- German Centre for Infection Research, External Partner Site, 60323, Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596, Frankfurt, Germany
| | - Hubert Serve
- Department of Hematology and Oncology, Johann Wolfgang Goethe University, Frankfurt, Germany
- German Cancer Consortium (DKTK) partner site Frankfurt/Mainz, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Evelyn Ullrich
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
- Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
- German Cancer Consortium (DKTK) partner site Frankfurt/Mainz, Frankfurt am Main, Germany.
- Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.
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31
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Plenzig S, Holz F, Bojkova D, Kettner M, Cinatl J, Verhoff MA, Birngruber CG, Ciesek S, Rabenau HF. Detection and infectivity of SARS-CoV-2 in exhumated corpses. Int J Legal Med 2021; 135:2531-2536. [PMID: 34302215 PMCID: PMC8302458 DOI: 10.1007/s00414-021-02670-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/13/2021] [Indexed: 12/19/2022]
Abstract
Postmortem detection of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) after the exhumation of a corpse can become important, e.g. in the case of subsequent medical malpractice allegations. To date, data on possible detection periods [e.g. by reverse transcription polymerase chain reaction (RT-PCR)] or on the potential infectivity of the virus after an exhumation are rare. In the present study, these parameters were examined in two cases with a time span of approximately 4 months between day of death and exhumation. Using SARS-CoV-2 RT-PCR on swabs of both lungs and the oropharynx detection was possible with cycle threshold (Ct) values of about 30 despite signs of beginning decay. RT-PCR testing of perioral and perinasal swabs and swabs collected from the inside of the body bag, taken to estimate the risk of infection of those involved in the exhumation, was negative. Cell culture-based infectivity testing was negative for both, lung and oropharyngeal swabs. In one case, RT-PCR testing at the day of death of an oropharyngeal swab showed almost identical Ct values as postmortem testing of an oropharyngeal swab, impressively demonstrating the stability of viral RNA in the intact corpse. However, favorable climatic conditions in the grave have to be taken into account, as it was wintertime with constant low temperatures. Nevertheless, it was possible to demonstrate successful postmortem detection of SARS-CoV-2 infection following exhumation even after months in an earth grave.
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Affiliation(s)
- S Plenzig
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, Kennedyallee 104, 60596, Frankfurt am Main, Germany.
| | - F Holz
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, Kennedyallee 104, 60596, Frankfurt am Main, Germany
| | - D Bojkova
- Institute of Medical Virology, Goethe University, University Hospital Frankfurt, Paul-Ehrlich-Straße 40, 60596, Frankfurt am Main, Germany
| | - M Kettner
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, Kennedyallee 104, 60596, Frankfurt am Main, Germany
| | - J Cinatl
- Institute of Medical Virology, Goethe University, University Hospital Frankfurt, Paul-Ehrlich-Straße 40, 60596, Frankfurt am Main, Germany
| | - M A Verhoff
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, Kennedyallee 104, 60596, Frankfurt am Main, Germany
| | - C G Birngruber
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, Kennedyallee 104, 60596, Frankfurt am Main, Germany
| | - S Ciesek
- Institute of Medical Virology, Goethe University, University Hospital Frankfurt, Paul-Ehrlich-Straße 40, 60596, Frankfurt am Main, Germany.,German Centre for Infection Research, External Partner Site, 60323, Frankfurt am Main, Germany.,Branch Translational Medicine and Pharmacology, Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), 60596, Frankfurt am Main, Germany
| | - H F Rabenau
- Institute of Medical Virology, Goethe University, University Hospital Frankfurt, Paul-Ehrlich-Straße 40, 60596, Frankfurt am Main, Germany
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32
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Widera M, Wilhelm A, Hoehl S, Pallas C, Kohmer N, Wolf T, Rabenau HF, Corman VM, Drosten C, Vehreschild MJGT, Goetsch U, Gottschalk R, Ciesek S. Limited neutralization of authentic SARS-CoV-2 variants carrying E484K in vitro. J Infect Dis 2021; 224:1109-1114. [PMID: 34223909 PMCID: PMC8344430 DOI: 10.1093/infdis/jiab355] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/02/2021] [Indexed: 12/14/2022] Open
Abstract
Whether monoclonal antibodies are able to neutralise SARS-CoV-2 variants of concern has been investigated using pseudoviruses. In this study we show that bamlanivimab, casirivimab, and imdevimab efficiently neutralise authentic SARS-CoV-2 including variant B.1.1.7 (Alpha) but variants B.1.351 (Beta) and P.2 (Zeta) were resistant against bamlanivimab and partially to casirivimab.
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Affiliation(s)
- Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Alexander Wilhelm
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Christiane Pallas
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Timo Wolf
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Germany.,University Center for Infectious Diseases (UCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Infection Research, DZIF, Braunschweig, Germany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Infection Research, DZIF, Braunschweig, Germany
| | - Maria J G T Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Germany.,University Center for Infectious Diseases (UCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Udo Goetsch
- Public Health Department of the City of Frankfurt am Main, Frankfurt am Main, Germany
| | - Rene Gottschalk
- Public Health Department of the City of Frankfurt am Main, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Center for Infection Research, DZIF, Braunschweig, Germany.,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt am Main, Germany
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33
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Widera M, Westhaus S, Rabenau HF, Hoehl S, Bojkova D, Cinatl J, Ciesek S. Evaluation of stability and inactivation methods of SARS-CoV-2 in context of laboratory settings. Med Microbiol Immunol 2021; 210:235-244. [PMID: 34196781 PMCID: PMC8245923 DOI: 10.1007/s00430-021-00716-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/19/2021] [Indexed: 02/02/2023]
Abstract
The novel coronavirus SARS-CoV-2 is the causative agent of the acute respiratory disease COVID-19, which has become a global concern due to its rapid spread. Laboratory work with SARS-CoV-2 in a laboratory setting was rated to biosafety level 3 (BSL-3) biocontainment level. However, certain research applications in particular in molecular biology require incomplete denaturation of the proteins, which might cause safety issues handling contaminated samples. In this study, we evaluated lysis buffers that are commonly used in molecular biological laboratories for their ability to inactivate SARS-CoV-2. In addition, viral stability in cell culture media at 4 °C and on display glass and plastic surfaces used in laboratory environment was analyzed. Furthermore, we evaluated chemical and non-chemical inactivation methods including heat inactivation, UV-C light, addition of ethanol, acetone-methanol, and PFA, which might be used as a subsequent inactivation step in the case of insufficient inactivation. We infected susceptible Caco-2 and Vero cells with pre-treated SARS-CoV-2 and determined the tissue culture infection dose 50 (TCID50) using crystal violet staining and microscopy. In addition, lysates of infected cells and virus containing supernatant were subjected to RT-qPCR analysis. We have found that guanidine thiocyanate and most of the tested detergent containing lysis buffers were effective in inactivation of SARS-CoV-2, however, the M-PER lysis buffer containing a proprietary detergent failed to inactivate the virus. In conclusion, careful evaluation of the used inactivation methods is required especially for non-denaturing buffers. Additional inactivation steps might be necessary before removal of lysed viral samples from BSL-3.
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Affiliation(s)
- Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt am Main, Goethe University, Paul-Ehrlich-Str.40, 60596, Frankfurt am Main, Germany.
| | - Sandra Westhaus
- Institute for Medical Virology, University Hospital Frankfurt am Main, Goethe University, Paul-Ehrlich-Str.40, 60596, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt am Main, Goethe University, Paul-Ehrlich-Str.40, 60596, Frankfurt am Main, Germany
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital Frankfurt am Main, Goethe University, Paul-Ehrlich-Str.40, 60596, Frankfurt am Main, Germany
| | - Denisa Bojkova
- Institute for Medical Virology, University Hospital Frankfurt am Main, Goethe University, Paul-Ehrlich-Str.40, 60596, Frankfurt am Main, Germany
| | - Jindrich Cinatl
- Institute for Medical Virology, University Hospital Frankfurt am Main, Goethe University, Paul-Ehrlich-Str.40, 60596, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt am Main, Goethe University, Paul-Ehrlich-Str.40, 60596, Frankfurt am Main, Germany.,German Center for Infection Research, DZIF, 60596, Braunschweig, Germany.,Branch Translational Medicine and Pharmacology, Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), 60596, Frankfurt am Main, Germany
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34
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Hoffmüller P, Brüggemann M, Eggermann T, Ghoreschi K, Haase D, Hofmann J, Hunfeld KP, Koch K, Meisel C, Michl P, Müller J, Müller C, Rabenau HF, Reinhardt D, Riemenschneider MJ, Sachs UJ, Sack U, Stenzinger A, Streichert T, von Neuhoff N, Weichert W, Weinstock C, Zimmermann S, Spitzenberger F. Advisory opinion of the AWMF Ad hoc Commission In-vitro Diagnostic Medical Devices regarding in-vitro diagnostic medical devices manufactured and used only within health institutions established in the Union according to Regulation (EU) 2017/746 (IVDR). Ger Med Sci 2021; 19:Doc08. [PMID: 34194291 PMCID: PMC8204380 DOI: 10.3205/000295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Indexed: 11/30/2022]
Abstract
In view of the approaching application date of Regulation (EU) 2017/746 ("IVDR") and the resulting EU-wide, harmonized requirements for in-vitro diagnostic medical devices (IVD) manufactured and used within European health institutions, the Ad hoc Commission IVD of the German Association of the Scientific Medical Societies (AWMF) takes a national position on the details of the requirements and conditions related to the use of these IVD products. The Ad hoc Commission IVD emphasizes the relevance of examination procedures developed in medical laboratories, especially in the field of orphan diseases and new diagnostic markers. The IVDR sets an adequate regulatory framework for IVD manufactured and used within health institutions as long as these requirements are fulfilled with reliability and in accordance with the current state of the art in medical laboratory sciences. At the same time, the IVDR requirements have to be regarded under a pragmatic view and in accordance with the quality management systems approved within the different EU Member States. On the one hand, the mandatory requirements of the RiLiBÄK play an essential role in Germany. On the other hand, elements of voluntarily applicable international standards may support the fulfilment of product requirements for safety and performance according to Annex I of the IVDR. Both the complexity and possible solutions for the implementation of the IVDR requirements are discussed on the basis of examples such as the required documentation, performance evaluation and software validation. The Ad hoc Commission IVD recommends that, while aiming at a preferably EU-wide harmonized interpretation of the IVDR requirements, the flexibility in medical laboratory diagnostics necessary for patient care, including the use of IVD from in-house production, should be emphasized.
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Affiliation(s)
| | - Monika Brüggemann
- Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO)
| | | | | | - Detlef Haase
- Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO)
| | | | - Klaus-Peter Hunfeld
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM).,Gesellschaft zur Förderung der Qualitätssicherung in medizinischen Laboratorien (INSTAND e.V.)
| | - Katharina Koch
- Gesellschaft für Toxikologische und Forensische Chemie (GTFCh)
| | | | - Patrick Michl
- Deutsche Gesellschaft für Gastroenterologie, Verdauung und Stoffwechsel (DGVS)
| | - Jens Müller
- Gesellschaft für Thrombose- und Hämostaseforschung (GTH)
| | - Carsten Müller
- Deutsche Gesellschaft für Klinische Pharmakologie und Therapie (DGKliPa).,Deutsche Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL)
| | | | - Dirk Reinhardt
- Gesellschaft für pädiatrische Onkologie und Hämatologie (GPOH)
| | | | - Ulrich J Sachs
- Gesellschaft für Thrombose- und Hämostaseforschung (GTH)
| | - Ulrich Sack
- Deutsche Gesellschaft für Immunologie (DGfI)
| | | | - Thomas Streichert
- Deutsche Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL)
| | | | | | - Christof Weinstock
- Deutsche Gesellschaft für Transfusionsmedizin und Immunhämatologie (DGTI)
| | - Stefan Zimmermann
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM).,Paul-Ehrlich-Gesellschaft (PEG)
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Kohmer N, Rühl C, Ciesek S, Rabenau HF. Utility of Different Surrogate Enzyme-Linked Immunosorbent Assays (sELISAs) for Detection of SARS-CoV-2 Neutralizing Antibodies. J Clin Med 2021; 10:2128. [PMID: 34069088 PMCID: PMC8157164 DOI: 10.3390/jcm10102128] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/21/2022] Open
Abstract
The plaque reduction neutralization test (PRNT) is a preferred method for the detection of functional, SARS-CoV-2 specific neutralizing antibodies from serum samples. Alternatively, surrogate enzyme-linked immunosorbent assays (ELISAs) using ACE2 as the target structure for the detection of neutralization-competent antibodies have been developed. They are capable of high throughput, have a short turnaround time, and can be performed under standard laboratory safety conditions. However, there are very limited data on their clinical performance and how they compare to the PRNT. We evaluated three surrogate immunoassays (GenScript SARS-CoV-2 Surrogate Virus Neutralization Test Kit (GenScript Biotech, Piscataway Township, NJ, USA), the TECO® SARS-CoV-2 Neutralization Antibody Assay (TECOmedical AG, Sissach, Switzerland), and the Leinco COVID-19 ImmunoRank™ Neutralization MICRO-ELISA (Leinco Technologies, Fenton, MO, USA)) and one automated quantitative SARS-CoV-2 Spike protein-based IgG antibody assay (Abbott GmbH, Wiesbaden, Germany) by testing 78 clinical samples, including several follow-up samples of six BNT162b2 (BioNTech/Pfizer, Mainz, Germany/New York, NY, USA) vaccinated individuals. Using the PRNT as a reference method, the overall sensitivity of the examined assays ranged from 93.8 to 100% and specificity ranged from 73.9 to 91.3%. Weighted kappa demonstrated a substantial to almost perfect agreement. The findings of our study allow these assays to be considered when a PRNT is not available. However, the latter still should be the preferred choice. For optimal clinical performance, the cut-off value of the TECO assay should be individually adapted.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596 Frankfurt, Germany; (N.K.); (C.R.); (S.C.)
| | - Cornelia Rühl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596 Frankfurt, Germany; (N.K.); (C.R.); (S.C.)
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596 Frankfurt, Germany; (N.K.); (C.R.); (S.C.)
- German Centre for Infection Research, External Partner Site, 60323 Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt, Germany
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596 Frankfurt, Germany; (N.K.); (C.R.); (S.C.)
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36
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Luppa PB, Rabenau HF, Gässler N, Huzly D, Nauck M, Reischl U, Schoerner C, Zeichhardt H. Rational clinical use of near-patient analytical systems for molecular detection of infectious agents. J LAB MED 2021. [DOI: 10.1515/labmed-2021-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Tests for diagnosing infectious diseases (ID-POCT) play a special role among the available point-of-care testing (POCT) methods.
Methods
A systematic literature search was performed in PubMed. Based on this literature review and our own experience, aspects associated with using molecular biological methods in the diagnostic amplification of pathogen DNA/RNA (nucleic acid testing = NAT) and/or signal amplification were discussed in an interdisciplinary manner. This resulted in the following recommendations for the near-patient use of NAT methods.
Results
Due to the current rise in the use of near-patient NAT testing (e.g., using disposable cartridges), recommendations are made for their implementation and appropriate clinical use in the hospital setting. Particular emphasis is placed on the analytical quality of the results. Furthermore, internal best-practice rules and selection criteria are proposed to ensure rapid diagnosis. Equally important are a medically valid interpretation of results and compliance with hygiene requirements. These recommendations emphasize that near-patient NAT should always be procured in conjunction with a (preferably) multidisciplinary institution responsible for POCT and knowledge of the test specifications and risks, as well as quality assurance need to be in place before they are carried out.
Conclusions
These recommendations are intended to improve patient safety and to avoid economically questionable expenditures.
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Affiliation(s)
- Peter B. Luppa
- Institute of Clinical Chemistry and Pathobiochemistry, University Hospital rechts der Isar der Technischen Universität München , Munich , Germany
| | - Holger F. Rabenau
- Institute of Medical Virology, Universitätsklinikum Frankfurt/Main , Frankfurt/Main , Germany
| | - Norbert Gässler
- Center for Laboratory Diagnostics, St. Bernward Hospital , Hildesheim , Germany
| | - Daniela Huzly
- Institute of Virology, Universitätsklinikum Freiburg , Freiburg , Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, Universitätsmedizin Greifswald , Greifswald , Germany
| | - Udo Reischl
- Institute of Clinical Microbiology and Hygiene, Universitätsklinikum Regensburg , Regensburg , Germany
| | - Christoph Schoerner
- Microbiology Institute – Clinical Microbiology, Immunology and Hygiene, Universitätsklinikum Erlangen , Erlangen , Germany
| | - Heinz Zeichhardt
- IQVD GmbH – Institut für Qualitätssicherung in der Virusdiagnostik , Berlin , Germany
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Pruß A, Chandrasekar A, Sánchez-Ibáñez J, Lucas-Samuel S, Kalus U, Rabenau HF. Algorithms for the Testing of Tissue Donors for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus. Transfus Med Hemother 2021; 48:12-22. [PMID: 33708048 DOI: 10.1159/000513179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/18/2020] [Indexed: 12/11/2022] Open
Abstract
Background Although transmission of pathogenic viruses through human tissue grafts is rare, it is still one of the most serious dreaded risks of transplantation. Therefore, in addition to the detailed medical and social history, a comprehensive serologic and molecular screening of the tissue donors for relevant viral markers for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) is necessary. In the case of reactive results in particular, clear decisions regarding follow-up testing and the criteria for tissue release must be made. Methods Based on the clinical relevance of the specific virus markers, the sensitivity of the serological and molecular biological methods used and the application of inactivation methods, algorithms for tissue release are suggested. Results Compliance with the preanalytical requirements and assessment of a possible hemodilution are mandatory requirements before testing the blood samples. While HIV testing follows defined algorithms, the procedures for HBV and HCV diagnostics are under discussion. Screening and decisions for HBV are often not as simple, e.g., due to cases of occult HBV infection, false-positive anti-HBc results, or early window period positive HBV NAT results. In the case of HCV diagnostics, modern therapies with direct-acting antivirals, which are often associated with successful treatment of the infection, should be included in the decision. Conclusion In HBV and HCV testing, a high-sensitivity virus genome test should play a central role in diagnostics, especially in the case of equivocal serology, and it should be the basis for the decision to release the tissue. The proposed test algorithms and decisions are also based on current European recommendations and standards for safety and quality assurance in tissue and cell banking.
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Affiliation(s)
- Axel Pruß
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Akila Chandrasekar
- National Health Service Blood and Transplant (NHSBT), Liverpool, United Kingdom
| | - Jacinto Sánchez-Ibáñez
- Tissue Establishment and Cryobiology Unit, University Hospital A Coruña, A Coruña, Spain
| | - Sophie Lucas-Samuel
- Safety and Quality Department, Agence de la Biomédecine, Saint-Denis Cedex, France
| | - Ulrich Kalus
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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38
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Weiss R, Guchlerner L, Loth AG, Leinung M, Wicker S, Kempf VAJ, Berger A, Rabenau HF, Ciesek S, Stöver T, Diensthuber M. Typical symptoms of common otorhinolaryngological diseases may mask a SARS-CoV-2 infection. Eur Arch Otorhinolaryngol 2021; 278:3551-3558. [PMID: 33677653 PMCID: PMC7937047 DOI: 10.1007/s00405-021-06726-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/24/2021] [Indexed: 12/13/2022]
Abstract
Purpose Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) replicates predominantly in the upper respiratory tract and is primarily transmitted by droplets and aerosols. Taking the medical history for typical COVID-19 symptoms and PCR-based SARS-CoV-2 testing have become established as screening procedures. The aim of this work was to describe the clinical appearance of SARS-CoV-2-PCR positive patients and to determine the SARS-CoV-2 contact risk for health care workers (HCW). Methods The retrospective study included n = 2283 SARS-CoV-2 PCR tests from n = 1725 patients with otorhinolaryngological (ORL) diseases performed from March to November 2020 prior to inpatient treatment. In addition, demographic data and medical history were assessed. Results n = 13 PCR tests (0.6%) were positive for SARS-CoV-2 RNA. The positive rate showed a significant increase during the observation period (p < 0.01). None of the patients had clinical symptoms that led to a suspected diagnosis of COVID-19 before PCR testing. The patients were either asymptomatic (n = 4) or had symptoms that were interpreted as symptoms typical of the ORL disease or secondary diagnoses (n = 9). Conclusion The identification of SARS-CoV-2-positive patients is a considerable challenge in clinical practice. Our findings illustrate that taking a medical history alone is of limited value and cannot replace molecular SARS-CoV-2 testing, especially for patients with ORL diseases. Our data also demonstrate that there is a high probability of contact with SARS-CoV-2-positive patients in everyday clinical practice, so that the use of personal protective equipment, even in apparently “routine cases”, is highly recommended.
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Affiliation(s)
- Roxanne Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/M, Germany
| | - Leon Guchlerner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/M, Germany
| | - Andreas G Loth
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/M, Germany
| | - Martin Leinung
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/M, Germany
| | - Sabine Wicker
- Occupational Health Service, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/M, Germany
| | - Volkhard A J Kempf
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Str. 40, 60596, Frankfurt/M, Germany.,University Center of Competence for Infection Control of the State of Hesse, Goethe University, Paul-Ehrlich-Str. 40, 60596, Frankfurt/M, Germany
| | - Annemarie Berger
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Str. 40, 60596, Frankfurt/M, Germany
| | - Holger F Rabenau
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Str. 40, 60596, Frankfurt/M, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Str. 40, 60596, Frankfurt/M, Germany.,German Centre for Infection Research, External Partner Site, Frankfurt, Germany.,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt, Germany
| | - Timo Stöver
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/M, Germany
| | - Marc Diensthuber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/M, Germany.
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Kohmer N, Rabenau HF, Hoehl S, Kortenbusch M, Ciesek S, Berger A. Comparative analysis of point-of-care, high-throughput and laboratory-developed SARS-CoV-2 nucleic acid amplification tests (NATs). J Virol Methods 2021; 291:114102. [PMID: 33607117 PMCID: PMC7885623 DOI: 10.1016/j.jviromet.2021.114102] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/07/2021] [Accepted: 02/12/2021] [Indexed: 12/17/2022]
Abstract
Multiple nucleic acid amplification tests (NATs) are available for the detection of SARS-CoV-2 in clinical specimens, including Laboratory Developed Tests (LDT), commercial high-throughput assays and point-of-care tests. Some assays were just recently released and there is limited data on their clinical performance. We compared the Xpert® Xpress SARS-CoV-2 (Cepheid) and Vivalytic VRI Panel (Schnelltest COVID-19) (Bosch) point-of-care tests with four high-throughput assays and one LDT, the cobas® SARS-CoV-2 test (Roche), the Allplex™ 2019-nCoV Assay (Seegene), the SARS-CoV-2 AMP (Abbott) Kit, the RealStar® SARS-CoV-2 RT-PCR Kit 1.0 (altona) as well as an assay using a SARS-CoV-2 RdRP gene specific primer and probe set. Samples from patients with confirmed SARS-CoV-2 infection, samples from the first and second SARS-CoV-2-PCR External Quality Assessment (EQA) (INSTAND e.V.) and a 10-fold serial dilution of a SARS-CoV-2 cell culture (SARS-CoV-2 Frankfurt 1) supernatant were examined. We determined that the NAT assays examined had a high specificity. Assays using the N gene as target demonstrated the highest sensitivity in the serial dilution panel, while all examined NAT assays showed a comparable sensitivity when testing clinical and EQA samples.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Marhild Kortenbusch
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany; German Centre for Infection Research, External partner site, Frankfurt, Germany; Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.
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Kohmer N, Toptan T, Pallas C, Karaca O, Pfeiffer A, Westhaus S, Widera M, Berger A, Hoehl S, Kammel M, Ciesek S, Rabenau HF. The Comparative Clinical Performance of Four SARS-CoV-2 Rapid Antigen Tests and Their Correlation to Infectivity In Vitro. J Clin Med 2021; 10:328. [PMID: 33477365 PMCID: PMC7830733 DOI: 10.3390/jcm10020328] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
Due to globally rising numbers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, resources for real-time reverse-transcription polymerase chain reaction (rRT-PCR)-based testing have been exhausted. In order to meet the demands of testing and reduce transmission, SARS-CoV-2 antigen-detecting rapid diagnostic tests (Ag-RDTs) are being considered. These tests are fast, inexpensive, and simple to use, but whether they detect potentially infectious cases has not been well studied. We evaluated three lateral flow assays (RIDA®QUICK SARS-CoV-2 Antigen (R-Biopharm), SARS-CoV-2 Rapid Antigen Test (Roche)), and NADAL® COVID-19 Ag Test (Nal von Minden GmbH, Regensburg, Germany) and one microfluidic immunofluorescence assay (SARS-CoV-2 Ag Test (LumiraDx GmbH, Cologne, Germany)) using 100 clinical samples. Diagnostic rRT-PCR and cell culture testing as a marker for infectivity were performed in parallel. The overall Ag-RDT sensitivity for rRT-PCR-positive samples ranged from 24.3% to 50%. However, for samples with a viral load of more than 6 log10 RNA copies/mL (22/100), typically seen in infectious individuals, Ag-RDT positivity was between 81.8% and 100%. Only 51.6% (33/64) of the rRT-PCR-positive samples were infectious in cell culture. In contrast, three Ag-RDTs demonstrated a more significant correlation with cell culture infectivity (61.8-82.4%). Our findings suggest that large-scale SARS-CoV-2 Ag-RDT-based testing can be considered for detecting potentially infective individuals and reducing the virus spread.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Tuna Toptan
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Christiane Pallas
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Onur Karaca
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Annika Pfeiffer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Sandra Westhaus
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Marek Widera
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
| | - Martin Kammel
- Institut fuer Qualitaetssicherung in der Virusdiagnostik-IQVD der GmbH, 14129 Berlin, Germany;
- INSTAND Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V., 40223 Duesseldorf, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
- German Centre for Infection Research, External Partner Site, 60323 Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt, Germany
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (T.T.); (C.P.); (O.K.); (A.P.); (S.W.); (M.W.); (A.B.); (S.H.)
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Lüsebrink N, Kieslich M, Rabenau HF, Schlößer RL, Buxmann H. Retrospectively diagnosing congenital cytomegalovirus infections in symptomatic infants is challenging. Acta Paediatr 2021; 110:197-202. [PMID: 32281152 DOI: 10.1111/apa.15305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/28/2022]
Abstract
AIM Our aim was to analyse the diagnostic workup of hospitalised infants with symptoms of congenital cytomegalovirus (CMV) infections. METHODS This retrospective study was carried out at the University Hospital Frankfurt, Germany, from 2008 to 2017 on infants aged 4 weeks to 12 months presenting with neurological symptoms consistent with congenital CMV infections. RESULTS We studied 117 infants, and workup data for CMV infections were available for 84%. Of these, 54% were immunoglobulin G- and immunoglobulin M-seronegative for CMV or immunoglobulin G-seropositive with no viral shedding. Congenital CMV infection was excluded in these cases. In 16%, the CMV workup was incomplete, precluding a definitive diagnosis. Dried blood spots (DBS) were requested from 30%. CMV polymerase chain reaction was negative in 19 of these 29 infants, and CMV deoxyribonucleic acid detection confirmed congenital CMV infections in six patients. DBS had been destroyed in line with German law in four cases. Congenital CMV infections were diagnosed (5%) or excluded (62%) in 67% of patients and unanswered in the remaining 33%. CONCLUSION Diagnoses of congenital CMV infections were widely considered and found in 5%. CMV was not stringently investigated in all patients or remained elusive due to German law on destroying DBS.
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Affiliation(s)
- Natalia Lüsebrink
- Department of Neurology, Neurometabolics and Prevention Clinic for Children and Adolescents University Hospital Frankfurt/Main Frankfurt/Main Germany
| | - Matthias Kieslich
- Department of Neurology, Neurometabolics and Prevention Clinic for Children and Adolescents University Hospital Frankfurt/Main Frankfurt/Main Germany
| | - Holger F. Rabenau
- Department of Hygiene Institute for Medical Virology University Hospital Frankfurt/Main Frankfurt/Main Germany
| | - Rolf L. Schlößer
- Department of Neonatology Clinic for Children and Adolescents University Hospital Frankfurt/Main Frankfurt/Main Germany
| | - Horst Buxmann
- Department of Neonatology Clinic for Children and Adolescents University Hospital Frankfurt/Main Frankfurt/Main Germany
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42
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Neef V, Buxmann H, Rabenau HF, Zacharowski K, Raimann FJ. Characterization of neonates born to mothers with SARS-CoV-2 infection: Review and meta-analysis. Pediatr Neonatol 2021; 62:11-20. [PMID: 33334687 PMCID: PMC7585378 DOI: 10.1016/j.pedneo.2020.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/30/2020] [Accepted: 10/12/2020] [Indexed: 12/23/2022] Open
Abstract
Characterization of neonates born to mothers with SARS-CoV-2 infection has been partially carried out. There has been no systematic review providing a holistic neonatal presentation including possible vertical transmission. A systematic literature search was performed using PubMed, Google Scholar and Web of Science up to June, 6 2020. Studies on neonates born to mothers with SARS-CoV-2 infection were included. A binary random effect model was used for prevalence and 95% confidence interval. 32 studies involving 261 neonates were included in meta-analysis. Most neonates born to infected mothers did not show any clinical abnormalities (80.4%). Clinical features were dyspnea in 11 (42.3%) and fever in 9 newborns (19.1%). Of 261 neonates, 120 neonates were tested for infection, of whom 12 (10.0%) tested positive. Swabs from placenta, cord blood and vaginal secretion were negative. Neonates are mostly non affected by the mother's SARS-CoV-2 infection. The risk of vertical transmission is low.
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Affiliation(s)
- Vanessa Neef
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University Frankfurt, Germany
| | - Horst Buxmann
- CLinic for Children and Adolescents, Division for Neonatology, University Hospital Frankfurt, Goethe University Frankfurt, Germany
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Germany
| | - Kai Zacharowski
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University Frankfurt, Germany
| | - Florian J. Raimann
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University Frankfurt, Germany,Corresponding author. Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern Kai 7, Frankfurt, 60590, Germany. Fax: +49 69 6301 5881
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43
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Kohmer N, Westhaus S, Rühl C, Ciesek S, Rabenau HF. Clinical performance of different SARS-CoV-2 IgG antibody tests. J Med Virol 2020; 92:2243-2247. [PMID: 32510168 PMCID: PMC7300776 DOI: 10.1002/jmv.26145] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 12/28/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) serological assays are urgently needed for rapid diagnosis, contact tracing, and for epidemiological studies. So far, there is limited data on how commercially available tests perform with real patient samples, and if positive tested samples show neutralizing abilities. Focusing on IgG antibodies, we demonstrate the performance of two enzyme‐linked immunosorbent assay (ELISA) assays (Euroimmun SARS‐CoV‐2 IgG and Vircell COVID‐19 ELISA IgG) in comparison to one lateral flow assay (FaStep COVID‐19 IgG/IgM Rapid Test Device) and two in‐house developed assays (immunofluorescence assay [IFA] and plaque reduction neutralization test [PRNT]). We tested follow up serum/plasma samples of individuals polymerase chain reaction‐diagnosed with COVID‐19. Most of the SARS‐CoV‐2 samples were from individuals with moderate to the severe clinical course, who required an in‐patient hospital stay. For all examined assays, the sensitivity ranged from 58.8 to 76.5% for the early phase of infection (days 5‐9) and from 93.8% to 100% for the later period (days 10‐18). With the exception of one sample, all positive tested COVID‐19 follow up‐samples, using the commercially available assays examined (including the in‐house developed IFA), demonstrated neutralizing properties in the PRNT. Regarding specificity, some samples of endemic coronavirus (HCoV‐OC43, HCoV‐229E) and Epstein Barr virus‐infected individuals cross‐reacted in the ELISA assays and IFA, in one case generating a false‐positive result.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Westhaus
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Cornelia Rühl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.,German Centre for Infection Research, External partner site, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
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Corman VM, Rabenau HF, Adams O, Oberle D, Funk MB, Keller-Stanislawski B, Timm J, Drosten C, Ciesek S. SARS-CoV-2 asymptomatic and symptomatic patients and risk for transfusion transmission. Transfusion 2020; 60:1119-1122. [PMID: 32361996 PMCID: PMC7267331 DOI: 10.1111/trf.15841] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 01/12/2023]
Abstract
Oral swabs, sputum, and blood samples from 18 asymptomatic and symptomatic patients with SARS‐CoV‐2 infection were examined using RT‐PCR testing in order to assess the risk of transfusion‐related transmission. In asymptomatic patients as well as patients with flu‐like symptoms and fever, no SARS‐CoV‐2 RNA could be detected in the blood or serum despite a clearly positive result in all throat swabs. As patients with symptoms of infectious disease will not be admitted to blood donation, the risk for transfusion transmission of SARS‐CoV‐2 seems to be negligible.
See editorial on page 1111–1114, in this issue
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Affiliation(s)
- Victor M Corman
- Institute for Virology, Charité University Hospital, Berlin, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt, Germany
| | - Ortwin Adams
- Institute for Virology, University Hospital Düsseldorf, Faculty of Medicine, University Düsseldorf, Düsseldorf, Germany
| | - Doris Oberle
- Department Safety of Drugs and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany
| | - Markus B Funk
- Department Safety of Drugs and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Jörg Timm
- Institute for Virology, University Hospital Düsseldorf, Faculty of Medicine, University Düsseldorf, Düsseldorf, Germany
| | - Christian Drosten
- Institute for Virology, Charité University Hospital, Berlin, Germany.,German Centre for Infection Research, DZIF, Braunschweig, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt, Germany.,German Centre for Infection Research, DZIF, Braunschweig, Germany
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Rabenau HF, Schwebke I, Blümel J, Eggers M, Glebe D, Rapp I, Sauerbrei A, Steinmann E, Steinmann J, Willkommen H, Wutzler P. Guideline for testing chemical disinfectants regarding their virucidal activity within the field of human medicine : as of December 1st, 2014 Prepared by the German Association for the Control of Virus Diseases (DVV) and the Robert Koch Institute (RKI). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:645-655. [PMID: 32274539 DOI: 10.1007/s00103-020-03115-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Holger F Rabenau
- Institute for med. Virology, University Hospital Frankfurt, Frankfurt/Main, Germany
| | | | | | - Maren Eggers
- Labor Prof. Dr. G. Enders MVZ GbR, Rosenbergstraße 85, 70193, Stuttgart, Germany.
| | - Dieter Glebe
- Institute for med. Virology, University Gießen, Gießen, Germany
| | - Ingrid Rapp
- Laboratory Dr. Merk & Colleagues, Ochsenhausen, Germany
| | - Andreas Sauerbrei
- Institute of Virology and Antiviral Therapy, University Jena, Jena, Germany
| | - Eike Steinmann
- Department for Molecular & Medical Virology, Ruhr-University Bochum, Bochum, Germany
| | - Jochen Steinmann
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | | | - Peter Wutzler
- Institute of Virology and Antiviral Therapy, University Jena, Jena, Germany
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Hoehl S, Berger A, Ciesek S, Rabenau HF. Thirty years of CMV seroprevalence-a longitudinal analysis in a German university hospital. Eur J Clin Microbiol Infect Dis 2020; 39:1095-1102. [PMID: 31989374 PMCID: PMC7225192 DOI: 10.1007/s10096-020-03814-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/12/2020] [Indexed: 01/20/2023]
Abstract
Human cytomegalovirus (CMV) is a significant cause of morbidity and mortality in patient groups at risk. We have previously shown that the anti-CMV IgG seroprevalence in an urban region of Germany has changed over the last decades. Overall, a decline from 63.7 to 57.25% had been observed between 1988–1997 and 1998–2008 (p < 0,001). Here, we continuously follow the trends to the most recent decade 2009 to 2018. In a retrospective analysis, we determined the seroprevalence of CMV IgG antibodies in our patient cohort, stratified by gender and selected groups at risk (e.g., patients with HIV infection; women of childbearing age). The overall prevalence of anti-CMV IgG non-significantly declined further from 57.25% in 1998–2008 to 56.48% in 2009–2018 (p = 0.881). Looking at gender differences, overall CMV seroprevalence in males declined to 52.82% (from 55.54% in 1998–2008; p = 0.0254), while it non-significantly increased in females to 59.80%. The high seroprevalence in patients with a known HIV infection further increased from 87.46% in 1998–2008 to 92.93% in the current period (p = 0.9999). In women of childbearing age, no significant changes over the last three decades could be observed. The CMV seroprevalence in oncological patients was determined to be 60.64%. Overall, the former significant decline of CMV seroprevalence between the decades 1988–1997 and 1998–2008 in this urban region of Germany slowed down to a non-significant decrease of 0.77% (1998–2008 vs. 2009–2018). This might be an indicator that CMV seroprevalence has reached a plateau.
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Affiliation(s)
- Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany.
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany.
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Michaelis M, Kleinschmidt MC, Bojkova D, Rabenau HF, Wass MN, Cinatl J. Omeprazole Increases the Efficacy of Acyclovir Against Herpes Simplex Virus Type 1 and 2. Front Microbiol 2019; 10:2790. [PMID: 31849920 PMCID: PMC6901432 DOI: 10.3389/fmicb.2019.02790] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/18/2019] [Indexed: 12/30/2022] Open
Abstract
Omeprazole was shown to improve the anti-cancer effects of the nucleoside analogue 5-fluorouracil. Here, we combined omeprazole with the antiviral nucleoside analogues ribavirin and acyclovir. Omeprazole did not affect the antiviral effects of ribavirin in non-toxic concentrations up to 80 μg/mL but increased the acyclovir-mediated effects on herpes simplex virus 1 and 2 (HSV-1 and -2) replication in a dose-dependent manner. Omeprazole alone reduced HSV-1 and -2 titers [but not HSV-induced formation of cytopathogenic effects (CPE)] at concentrations ≥40 μg/mL. However, it exerted substantially stronger effects on acyclovir activity and also increased acyclovir activity at lower concentrations that did not directly interfere with HSV replication. Omeprazole 80 μg/mL caused a 10.8-fold (Vero cells) and 47.7-fold (HaCaT cells) decrease of the acyclovir concentrations that reduced HSV-1-induced CPE formation by 50% (IC50). In HSV-2-infected cells, omeprazole 80 μg/mL reduced the acyclovir IC50 by 7.3- (Vero cells) and 12.9-fold (HaCaT cells). In HaCaT cells, omeprazole 80 μg/mL reduced the HSV-1 titer in the presence of acyclovir 1 μg/mL by 1.6 × 105-fold and the HSV-2 titer in the presence of acyclovir 2 μg/mL by 9.2 × 103-fold. The proton pump inhibitors pantoprazole, rabeprazole, lansoprazole, and dexlansoprazole increased the antiviral effects of acyclovir in a similar fashion as omeprazole, indicating this to be a drug class effect. In conclusion, proton pump inhibitors increase the anti-HSV activity of acyclovir and are candidates for antiviral therapies in combination with acyclovir, in particular for topical preparations for the treatment of immunocompromised individuals who are more likely to suffer from severe complications.
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Affiliation(s)
- Martin Michaelis
- Industrial Biotechnology Centre, School of Biosciences, University of Kent, Canterbury, United Kingdom
| | - Malte C Kleinschmidt
- Institut für Medizinische Virologie, Klinikum der Goethe-Universität, Frankfurt am Main, Germany
| | - Denisa Bojkova
- Institut für Medizinische Virologie, Klinikum der Goethe-Universität, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institut für Medizinische Virologie, Klinikum der Goethe-Universität, Frankfurt am Main, Germany
| | - Mark N Wass
- Industrial Biotechnology Centre, School of Biosciences, University of Kent, Canterbury, United Kingdom
| | - Jindrich Cinatl
- Institut für Medizinische Virologie, Klinikum der Goethe-Universität, Frankfurt am Main, Germany
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48
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Berger A, Salla S, Keppler OT, Rabenau HF. HCV RNA Testing of Plasma Samples from Cornea Donors: Suitability of Plasma Samples Stored at 4 °C for up to 8 Days. Transfus Med Hemother 2017; 44:39-44. [PMID: 28275332 DOI: 10.1159/000449207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/11/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The HCV RNA testing of potential cornea donors frequently relies on blood samples stored pre mortem. The recommended storage time of maximum 72 h frequently excludes a significant fraction of donors. METHODS The influence of storage time of EDTA plasma samples at 4 °C on the viral load measured with the Roche HCV Quantitative Test vs. 2.0 was evaluated for 43 samples from HCV-positive individuals. RESULTS The mean reduction of the viral load after 4 °C storage for 6-8 days was 0.46 log10 IU/ml (range +0.17 to -1.66 log10 IU/ml). After 1-3 days a mean loss of 0.19 log10 IU/ml (range +0.30 to -1.41 log10 IU/ml) and after 3-5 days of 0.32 log10 IU/ml (range +0.36 to -1.81 log10 IU/ml) was observed. In 23.3% of samples, a viral load reduction ≥ 1 log10 IU/ml (1.0-1.81 log10 IU/ml) was found after prolonged storage (5-8 days). In none of the samples did the HCV load fall below the detection limit. CONCLUSION Plasma storage for up to 8 days can quantitatively reduce the HCV RNA load, yet has no influence on the reliability of a qualitative HCV RNA detection by this ultrasensitive test to determine the HCV status of serologically negative cornea donors.
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Affiliation(s)
- Annemarie Berger
- Institute of Medical Virology, Hospital of the Goethe University of Frankfurt, Frankfurt/M., Germany
| | - Sabine Salla
- Department of Ophthalmology, RWTH Aachen University, Germany
| | - Oliver T Keppler
- Institute of Medical Virology, Hospital of the Goethe University of Frankfurt, Frankfurt/M., Germany; Max von Pettenkofer-Institute, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Holger F Rabenau
- Institute of Medical Virology, Hospital of the Goethe University of Frankfurt, Frankfurt/M., Germany
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49
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Abstract
BACKGROUND AND AIM Healthcare workers (HCW) are at risk of occupational infections and can also transmit diseases to patients. The acceptance of measures to improve safety is linked to knowledge and risk awareness of HCW. The purpose of our study was to ascertain the knowledge and risk awareness of nursing staff regarding occupational infections and vaccinations as well as the frequency of needlestick injuries (NSI) in relation to the level of education. METHODS In the context of a conference on nursing, an anonymous questionnaire was distributed to the participants. RESULTS AND CONCLUSIONS Nursing staff had insufficient knowledge of viral occupational infections with regard to the actual hazard. At the same time, more than 60 % of the respondents rated the probability of contracting occupational infections as "pretty high" to "very high". In addition, 62.1 % of the study participants also stated that they did not feel sufficiently trained to care for patients with highly contagious or rare infectious diseases. Intensified training and awareness programs for nursing personnel are required to increase the knowledge of occupational infections.
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Affiliation(s)
- S Wicker
- Betriebsärztlicher Dienst, Universitätsklinikum Frankfurt
| | - H F Rabenau
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt
| | | | - R Schalk
- Institut für Pflegeentwicklung und Nursing Research, Universitätsklinikum Frankfurt
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50
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Rabenau HF, Bannert N, Berger A, Donoso Mantke O, Eberle J, Enders M, Fickenscher H, Grunert HP, Gürtler L, Heim A, Huzly D, Kaiser R, Korn K, Nick S, Kücherer C, Nübling M, Obermeier M, Panning M, Zeichhardt H. [Not Available]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:1025. [PMID: 26275568 DOI: 10.1007/s00103-015-2214-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Holger F Rabenau
- Nationales Referenzzentrum für Retroviren, Universitätsklinikum Frankfurt, Frankfurt, Deutschland
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