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FANG H, HONG Z, LI D, ZHANG H, SHI Y, LI X, SUN Z, CHEN W, ZHANG C, ZU Y. Formulation of international standards of Chinese medicine technology: clinical practice guide of Chinese medicine for cough. J TRADIT CHIN MED 2024; 44:396-402. [PMID: 38504546 PMCID: PMC10927410 DOI: 10.19852/j.cnki.jtcm.20231016.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 04/27/2023] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To formulate the first clinical practice guideline for the treatment of cough using Chinese medicine based on the grading of recommendations assessment, development, and evaluation (GRADE) systematic approach, including clinical evidence, evaluation of ancient literature, and expert consensus. METHODS In the process of development, the regulation of "evidence-based, consensus-assisted, and empirical" was followed, and a comprehensive systematic approach of recommendation assessment, GRADE, evidence-based evaluation, expert consensus, and the Delphi method was used. In the process of guideline development, evidence-based evaluation of ancient literature was included for the first time, and clinical evidence was fully integrated with clinical expert consensus. RESULTS The clinical practice guidelines for the treatment of cough with Chinese herbal medicine were developed after a comprehensive consideration of evidence-based evaluation and expert opinions. The guideline recommendations focused on recommending herbal compound decoctions and Chinese patent medicines for cough in different conditions. Based on the GRADE systematic approach, we conducted an evidence-based evaluation of the recommended Chinese patent medicines one by one; meanwhile, the expert consensus method was used to unify the recommendations of both. CONCLUSION Based on clinical evidence, ancient literature evaluation, and expert consensus, a clinical practice guideline for Traditional Chinese Medicine (TCM) in the treatment of cough was developed, providing the first current clinical practice guideline for domestic and foreign TCM and Western medicine practitioners, especially respiratory professionals at home and abroad.
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Affiliation(s)
- Hanyu FANG
- 1 Beijing University of Chinese medicine, Beijing 100029, China
- 2 Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029
- 3 National Center for Respiratory Medicine, Beijing 100029, China
| | - Zheng HONG
- 1 Beijing University of Chinese medicine, Beijing 100029, China
- 2 Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029
- 3 National Center for Respiratory Medicine, Beijing 100029, China
| | - Deming LI
- 4 Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Hongchun ZHANG
- 1 Beijing University of Chinese medicine, Beijing 100029, China
- 2 Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029
- 3 National Center for Respiratory Medicine, Beijing 100029, China
| | - Yihang SHI
- 5 Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- 6 Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Xiaojuan LI
- 5 Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- 6 Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Zengtao SUN
- 5 Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- 6 Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Wei CHEN
- 7 Center for Evidence-based Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Chuchu ZHANG
- 8 Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yaqi ZU
- 8 Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
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2
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Lee HA, Yang PS, Hsu CY. An International Standard RWD Database Designed - Taiwan Experience. Stud Health Technol Inform 2024; 310:1507-1508. [PMID: 38269719 DOI: 10.3233/shti231267] [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: 01/26/2024]
Abstract
The use of Real-World Data (RWD) in medical data analysis is nowadays required. RWD may come from electronic health records (EHRs), insurance claims, medical products, Internet of Things sensors, health screenings, etc. The goal of RWD is that the data used for analysis should not be affected by environmental variables, experimental control, research context settings, etc. RWD can effectively reduce the cost and improve the accuracy of medical research. The clinical data and patient self-report are integrated, cleaned and pre-processed, and the data format is unified and standardized by international standard formats to provide a structured database for clinical research by this study. An international standard real-world research database was established through the breast cancer database of a medical center in Taipei.
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Affiliation(s)
- Hsiu-An Lee
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Po-Sheng Yang
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of General Surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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3
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Zeng Q, Yang X, Lin BY, Li YZ, Huang G, Xu Y. Immunological Findings in a Group of Individuals Who Were Poor or Non-Responders to Standard Two-Dose SARS-CoV-2 Vaccines. Vaccines (Basel) 2023; 11. [PMID: 36851338 DOI: 10.3390/vaccines11020461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared a pandemic. However, data on the poor or non-responders to SARS-CoV-2 vaccines in the general population are limited. The objective of this study was to comprehensively compare the immunological characteristics of poor or non-responders to SARS-CoV-2 vaccines in the 18-59-year group with those in the ≥60-year group using internationally recognized cut-off values. The main outcome was effective seroconversion characterized by an anti-SARS-CoV-2 spike IgG level of at least a four-fold increase from baseline. Profiling of naïve immune cells was analyzed prior to vaccination to demonstrate baseline immunity. The outcomes of effective seroconversion in patients aged 18-59 years with those in patients aged ≥60 years were compared. The quantitative level of anti-spike IgG was significantly lower in individuals aged ≥60 and men aged 18-59 years. There were 7.5% of poor or non-responders among the 18-59 years and 11.7% of poor or non-responders in the ≥60 years using a four-fold increase parameter. There were 37.0-58.1% with low lymphocyte count (<1000/mm3), 33.3-45.2% with low CD4 cell counts (<500/mm3), and 74.1-96.8% with low B cell counts (<100/mm3) in the non-seroconversion group. An individual with an anti-SARS-CoV-2 spike IgG titer below 50 BAU/mL might be considered a poor or non-responder between 14 and 90 days after the last vaccine dose. Booster vaccination or additional protective measures should be recommended to poor or non-responders as soon as possible to reduce disease severity and mortality.
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4
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Knezevic I, Mattiuzzo G, Page M, Nuebling M, Griffiths E, Minor P. Complexity of serological assays and misunderstandings of WHO International Units. Clin Chem Lab Med 2022; 60:e223-e224. [PMID: 35858048 DOI: 10.1515/cclm-2022-0660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Affiliation(s)
| | - Giada Mattiuzzo
- Medicines and Healthcare Products Regulatory Agency, South Mimms, Potters Bar, UK
| | - Mark Page
- Medicines and Healthcare Products Regulatory Agency, South Mimms, Potters Bar, UK
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5
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Cantoni D, Mayora-Neto M, Nadesalingam A, Wells DA, Carnell GW, Ohlendorf L, Ferrari M, Palmer P, Chan ACY, Smith P, Bentley EM, Einhauser S, Wagner R, Page M, Raddi G, Baxendale H, Castillo-Olivares J, Heeney J, Temperton N. Neutralisation Hierarchy of SARS-CoV-2 Variants of Concern Using Standardised, Quantitative Neutralisation Assays Reveals a Correlation With Disease Severity; Towards Deciphering Protective Antibody Thresholds. Front Immunol 2022; 13:773982. [PMID: 35330908 PMCID: PMC8940306 DOI: 10.3389/fimmu.2022.773982] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 09/10/2021] [Accepted: 02/07/2022] [Indexed: 01/16/2023] Open
Abstract
The rise of SARS-CoV-2 variants has made the pursuit to define correlates of protection more troublesome, despite the availability of the World Health Organisation (WHO) International Standard for anti-SARS-CoV-2 Immunoglobulin sera, a key reagent used to standardise laboratory findings into an international unitage. Using pseudotyped virus, we examine the capacity of convalescent sera, from a well-defined cohort of healthcare workers (HCW) and Patients infected during the first wave from a national critical care centre in the UK to neutralise B.1.1.298, variants of interest (VOI) B.1.617.1 (Kappa), and four VOCs, B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma) and B.1.617.2 (Delta), including the B.1.617.2 K417N, informally known as Delta Plus. We utilised the WHO International Standard for anti-SARS-CoV-2 Immunoglobulin to report neutralisation antibody levels in International Units per mL. Our data demonstrate a significant reduction in the ability of first wave convalescent sera to neutralise the VOCs. Patients and HCWs with more severe COVID-19 were found to have higher antibody titres and to neutralise the VOCs more effectively than individuals with milder symptoms. Using an estimated threshold for 50% protection, 54 IU/mL, we found most asymptomatic and mild cases did not produce titres above this threshold.
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Affiliation(s)
- Diego Cantoni
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Kent & Greenwich, Chatham, United Kingdom
| | - Martin Mayora-Neto
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Kent & Greenwich, Chatham, United Kingdom
| | - Angalee Nadesalingam
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - David A Wells
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.,DIOSynVax, University of Cambridge, Cambridge, United Kingdom
| | - George W Carnell
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Luis Ohlendorf
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Matteo Ferrari
- DIOSynVax, University of Cambridge, Cambridge, United Kingdom
| | - Phil Palmer
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Andrew C Y Chan
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Peter Smith
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Emma M Bentley
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Sebastian Einhauser
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Ralf Wagner
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany.,Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Mark Page
- Division of Virology, National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | - Gianmarco Raddi
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Helen Baxendale
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Javier Castillo-Olivares
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan Heeney
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.,DIOSynVax, University of Cambridge, Cambridge, United Kingdom
| | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Kent & Greenwich, Chatham, United Kingdom
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6
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Abstract
Objectives: This article compares national standards for area measurements of
healthcare facilities in four countries and examines the risks
and differences that can arise when comparing building areas of
healthcare facilities internationally. Background: In the planning and management of healthcare facilities, the
utilization and comparison of building floor areas plays a major
role. Differences in terminology, classification, and
methodology help to reduce planning and cost risks when applied
on a local and national level. The proper allocation of building
floor space is vital in the design of room programs,
determination of floor space, construction costs, and operating
costs. Methods: Each of the four hospital area measurement standards is compared to
discern similarities and differences. Results: Most countries use a three-tier system of hospital area
measurement: building gross area, department gross area, and
department net area. Few differences were found between country
standards for department area, though the German standards do
not fully address this tier. Variation is found in whether a
country includes certain functions in the hospital area—such as
research space, shell space, or central energy plants—which can
have a significant impact on the overall hospital area. Conclusions: This article informs further development of individual country
standards and highlights principles to consider for
international hospital area comparison.
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7
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Jia H, Harikumar P, Atkinson E, Rigsby P, Wadhwa M. The First WHO International Standard for Harmonizing the Biological Activity of Bevacizumab. Biomolecules 2021; 11:biom11111610. [PMID: 34827607 PMCID: PMC8615914 DOI: 10.3390/biom11111610] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 11/22/2022] Open
Abstract
Several Bevacizumab products are approved for clinical use, with many others in late-stage clinical development worldwide. To aid the harmonization of potency assessment across different Bevacizumab products, the first World Health Organization (WHO) International Standard (IS) for Bevacizumab has been developed. Two preparations of a Bevacizumab candidate and comparator were assessed for their ability to neutralize and bind vascular endothelial growth factor (VEGF) using different bioassays and binding assays in an international collaborative study. Relative potency estimates were similar across different assays for the comparator or the duplicate-coded candidate sample. Variability in relative potency estimates was reduced when the candidate standard was used for calculation compared with various in-house reference standards, enabling harmonization in bioactivity evaluations. The results demonstrated that the candidate standard is suitable to serve as an IS for Bevacizumab, with assigned unitages for VEGF neutralization and VEGF binding activity. This standard coded 18/210 was established by the WHO Expert Committee on Biological Standardization, which is intended to support the calibration of secondary standards for product development and lifecycle management. The availability of IS 18/210 will help facilitate the global harmonization of potency evaluation to ensure patient access to Bevacizumab products with consistent safety, quality and efficacy.
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Affiliation(s)
- Haiyan Jia
- Division of Biotherapeutics, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (P.H.); (M.W.)
- Correspondence: ; Tel.: +44-1707-641413
| | - Parvathy Harikumar
- Division of Biotherapeutics, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (P.H.); (M.W.)
| | - Eleanor Atkinson
- Division of Technology Development and Infrastructure, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (E.A.); (P.R.)
| | - Peter Rigsby
- Division of Technology Development and Infrastructure, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (E.A.); (P.R.)
| | - Meenu Wadhwa
- Division of Biotherapeutics, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (P.H.); (M.W.)
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8
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Hu J, Wang JJ, Liu L, Wang XY, Gao Q, Zhang Y, Chen ZJ, Huo J. [Analysis of the results of international demand survey on Guideline for Clinical Practice of Acupuncture-Moxibustion: Migraine]. Zhongguo Zhen Jiu 2021; 41:799-804. [PMID: 34259416 DOI: 10.13703/j.0255-2930.20201101-k0003] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The survey is conducted prior to the development of international standard, Guideline for Clinical Practice of Acupuncture-Moxibustion: Migraine (Guideline) to determine the international demand. The survey includes 5 aspects, i.e. the application status of acupuncture and moxibustion abroad and the demand for the development of international standards, the priority of diseases developed by international standards, the necessity of the transformation of international standards from domestic standards, the key clinical problems to be solved by international standards, and the correlation between professional level and demand intention. The survey results show that the international demand of the Guideline is definite. Regarding the application range of acupuncture-moxibustion and the key clinical questions, the special consideration should be taken to the differences in the demands of the practitioners from different countries during the development of standard.
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Affiliation(s)
- Jing Hu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Jing-Jing Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Lu Liu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China; Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation
| | - Xiao-Yu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Qi Gao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yi Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Zhong-Jie Chen
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Jin Huo
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
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9
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Abstract
Serum anti-Mullerian hormone (AMH) is a widely used marker of functional ovarian reserve in the assessment and treatment of infertility. It is used to determine dosing of gonadotropins used for superovulation prior to in vitro fertilization, as well as to determine the degree of damage to ovarian reserve by cytotoxic treatments such as chemotherapy. AMH is also now used to predict proximity to menopause and potentially provides a sensitive and specific test for polycystic ovarian syndrome. Twenty one different AMH immunoassay platforms/methods are now commercially available. Of those compared, the random-access platforms are the most reliable. However, to date there has not been an agreed common international AMH reference preparation to standardize calibration between the various immunoassays. Recently, a purified human AMH preparation (code 16/190) has been investigated by the World Health Organization as a potential international reference preparation. However, this was only partially successful as commutability between it and serum samples was observed only in some but not all immunoassay methods. Development of a second generation reference preparation with wider commutability is proposed.
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Affiliation(s)
- Hang Wun Raymond Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - David Mark Robertson
- Discipline of Obstetrics & Gynaecology, School of Women’s & Children’s Health, University of New South Wales, Sydney, NSW, Australia
| | - Chris Burns
- Biotherapeutics Division, National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | - William Leigh Ledger
- Discipline of Obstetrics & Gynaecology, School of Women’s & Children’s Health, University of New South Wales, Sydney, NSW, Australia
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10
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Wadhwa M, Bird C, Atkinson E, Cludts I, Rigsby P. The First WHO International Standard for Adalimumab: Dual Role in Bioactivity and Therapeutic Drug Monitoring. Front Immunol 2021; 12:636420. [PMID: 33936049 PMCID: PMC8082443 DOI: 10.3389/fimmu.2021.636420] [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: 12/01/2020] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
The expanded availability of adalimumab products continues to widen patient access and reduce costs with substantial benefit to healthcare systems. However, the long-term success of these medicines is highly dependent on maintaining consistency in quality, safety and efficacy while minimizing any risk of divergence during life-cycle management. In recognition of this need and demand from global manufacturers, the World Health Organization (WHO) Expert Committee on Biological standardization established the WHO 1st International standard (IS) for Adalimumab (coded 17/236) in October 2019 with a defined unitage ascribed to each of the individual bioactivities evaluated in the study namely, TNF-α binding, TNF-α neutralization, complement dependent cytotoxicity and antibody-dependent cellular cytotoxicity. For development of the IS, two candidate standards were manufactured as per WHO recommendations. Analysis of extensive datasets generated by testing of a common set of samples including the candidate standards by multiple stakeholders including regulatory agencies using their own qualified assays in a large international collaborative study showed comparable biological activity for the tested candidates for the different activities. Use of a common standard significantly decreased the variability of bioassays and improved agreement in potency estimates. Data from this study clearly supports the utility of the IS as an important tool for assuring analytical assay performance, for bioassay calibration and validation, for identifying and controlling changes in bioactivity during life-cycle management and for global harmonization of adalimumab products. In addition, in a separate multi-center study which included involvement of hospital and clinical diagnostic laboratories, the suitability of the adalimumab IS for therapeutic drug monitoring assays was examined by analysis of data from testing of a common blind coded panel of adalimumab spiked serum samples representative of the clinical scenario along with the IS and in-house standards in diverse immunoassays/platforms. Both commercially available and in-house assays that are routinely used for assessing adalimumab trough levels were included. Excellent agreement in estimates for adalimumab content in the spiked samples was observed regardless of the standard or the method with inter-laboratory variability also similar regardless of the standard employed. This data, for the first time, provides support for the extended applicability of the IS in assays in use for therapeutic drug monitoring based on the mass content of the IS. The adalimumab IS, in fulfilling clinical demand, can help toward standardizing and harmonizing clinical monitoring assays for informed clinical decisions and/or personalized treatment strategies for better patient outcomes. Collectively, a significant role for the adalimumab IS in assuring the quality, safety and efficacy of adalimumab products globally is envisaged.
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Affiliation(s)
- Meenu Wadhwa
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Chris Bird
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Eleanor Atkinson
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Isabelle Cludts
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Peter Rigsby
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
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11
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Hirata A, Kodera S, Sasaki K, Gomez-Tames J, Laakso I, Wood A, Watanabe S, Foster KR. Human exposure to radiofrequency energy above 6 GHz: review of computational dosimetry studies. Phys Med Biol 2021; 66. [PMID: 33761473 DOI: 10.1088/1361-6560/abf1b7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 11/20/2020] [Accepted: 03/24/2021] [Indexed: 11/11/2022]
Abstract
International guidelines/standards for human protection from electromagnetic fields have been revised recently, especially for frequencies above 6 GHz where new wireless communication systems have been deployed. Above this frequency a new physical quantity 'absorbed/epithelial power density' has been adopted as a dose metric. Then, the permissible level of external field strength/power density is derived for practical assessment. In addition, a new physical quantity, fluence or absorbed energy density, is introduced for protection from brief pulses (especially for shorter than 10 s). These limits were explicitly designed to avoid excessive increases in tissue temperature, based on electromagnetic and thermal modeling studies but supported by experimental data where available. This paper reviews the studies on the computational modeling/dosimetry which are related to the revision of the guidelines/standards. The comparisons with experimental data as well as an analytic solution are also been presented. Future research needs and additional comments on the revision will also be mentioned.
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Affiliation(s)
- Akimasa Hirata
- Dept. of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan.,Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya Japan
| | - Sachiko Kodera
- Dept. of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Kensuke Sasaki
- National Institute of Information and Communications Technology, Tokyo, Japan
| | - Jose Gomez-Tames
- Dept. of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan.,Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya Japan
| | - Ilkka Laakso
- Dept. of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Andrew Wood
- Swinburne University of Technology Melbourne, Melbourne, Australia
| | - Soichi Watanabe
- National Institute of Information and Communications Technology, Tokyo, Japan
| | - Kenneth R Foster
- University of Pennsylvania, Philadelphia, PA, United States of America
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12
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Hu J, Wang XY, Gao Q, Chen ZJ, Huo J, Zhang Y, Wang JJ. [Transformation of the domestic standard ( Guideline for Clinical Practice of Acupuncture-Moxibustion: Migraine) to international standard: in the perspective of the differences in clinical questions]. Zhongguo Zhen Jiu 2021; 40:1245-9. [PMID: 33788497 DOI: 10.13703/j.0255-2930.20200309-k0003] [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: 11/06/2022]
Abstract
Through analyzing the differences in the clinical questions of Guideline for Clinical Practice of Acupuncture- Moxibustion: Migraine (Guideline) between the domestic standard and international standard (under development), the specific issues are determined in the transformation from domestic standard to international one. Taking acupuncture practitioners as investigation object, by means of the survey, the basic information and clinical questions were investigated. The survey results show that the following aspects should be supplemented in terms of the international requirements during the development of this international Guideline: suitable patient population, applicable types of disease, the optimal intervention time of acupuncture for migraine, common methods in treatment as well as the other involved health problems. Moreover, it needs to update the key clinical questions, recommended regimens for the newly supplemented types of disease, as well as the more specified assessment on therapeutic effect. The ultimate solution of these questions relies on the quality of clinical evidence.
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Affiliation(s)
- Jing Hu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Xiao-Yu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Qi Gao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Zhong-Jie Chen
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Jin Huo
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yi Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Jing-Jing Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
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Liu JT, Ren XY, Wang L, Wang WY, Han XJ. [ International standard ISO 22236 Traditional Chinese medicine- Thread-embedding acupuncture needle for single use: experience and recommendation]. Zhongguo Zhen Jiu 2021; 41:85-8. [PMID: 33559449 DOI: 10.13703/j.0255-2930.20200907-k0003] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The ISO 22236 Traditional Chinese medicine-Thread-embedding acupuncture needle for single use, as the first international standard (IS) in acupoint thread-embedding field, has been officially published by International Organization for Standardization (ISO) in 2020. The background of its development, difficulties and countermeasures in the process of development were reviewed, and the experience of standard development was summarized, aiming to provide methods and references for future IS development of acupuncture and moxibustion instruments. It is suggested that strengthening the discourse power in the process of IS development, increasing the compound talents cultivation for IS, valuing the importance of enterprises in the development of IS, and creating an advantageous environment for the development of IS are the keys to improve the level of standardization of acupuncture and moxibustion instruments and play a more important role in the IS development.
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Affiliation(s)
- Jun-Tian Liu
- Beijing Ren's Times Technology Co., Ltd. /Beijing REN Xiao-yan Acupoint Catgut Embedding Medical Research Center, Beijing 100035, China; Department of Acupuncture and Moxibustion, Huguosi Hospital of TCM, Beijing University of CM, Beijing 100035
| | - Xiao-Yan Ren
- Beijing Ren's Times Technology Co., Ltd. /Beijing REN Xiao-yan Acupoint Catgut Embedding Medical Research Center, Beijing 100035, China
| | - Lin Wang
- Beijing Ren's Times Technology Co., Ltd. /Beijing REN Xiao-yan Acupoint Catgut Embedding Medical Research Center, Beijing 100035, China
| | - Wen-Yan Wang
- Beijing Ren's Times Technology Co., Ltd. /Beijing REN Xiao-yan Acupoint Catgut Embedding Medical Research Center, Beijing 100035, China
| | - Xue-Jie Han
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences
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14
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Huo J, Chen ZJ, Gao Q, Wang XY, Zhang Y, Hu J, Wu XD, Wang JJ. [Analysis on international demand investigation for technical specification of acupuncture- moxibustionthe and its general rules of drafting]. Zhongguo Zhen Jiu 2021; 41:89-93. [PMID: 33559450 DOI: 10.13703/j.0255-2930.20200601-k0002] [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: 11/06/2022]
Abstract
The electronic questionnaire was adopted to survey the international demand on Technical Specification of Acupuncture-Moxibustion: General Rules of Drafting (General Rules for short) to explore the potential problems during the application and provide the evidence for the development of international standard of General Rules. A total of 102 valid questionnaires were collected from 18 countries and regions. The priority of the demand for international standard on the technical specification of acupuncture-moxibustion is filiform needle, moxibustion, electroacupuncture, cupping, auricular acupuncture, scalp acupuncture and scraping. One hundred experts (98.04%) at home and abroad believe the necessity of the international standard development of General Rules. The awareness rate of the existing national standard of General Rules is 71.57% and the foreign experts think that its expression may be "unclear" and the domestic experts think it may be "lack of practicability". The domestic experts hope to highlight the commonness in the scope of the international standard of General Rules and the foreign experts hope to retain more individuality. Regarding the specific questions during the technique manipulations of acupuncture-moxibustion, there are the big differences in "relevant terminology" "preoperative preparation" and "adverse reaction and contraindications" at home and abroad. In order to improve the international compatibility and applicability, it is necessary to give full consideration to the needs of different countries in the development of international standard of General Rules and balance as far as possible between refining "common problems" and satisfying "individual needs".
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Affiliation(s)
- Jin Huo
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Zhong-Jie Chen
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Qi Gao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Xiao-Yu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yi Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Jing Hu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Xiao-Dong Wu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Jing-Jing Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
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15
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Lai CJS, Wei XY, Qiu ZD, Tan T. [Design and application of quality standard of Dao-di herbs]. Zhongguo Zhong Yao Za Zhi 2020; 45:6072-6080. [PMID: 33496149 DOI: 10.19540/j.cnki.cjcmm.202027.601] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dao-di herbs, which are widely recognized as medicinal materials with a high quality and good efficacy in clinic, are now facing the dilemma of absence of standard. This study focused on a pivotal scientific problem of design and application of quality standard of Dao-di herbs, and systematically illustrated the general rules for the quality standard of Dao-di herbs involving "four rules, six core contents, and three key methods". The quality standard of Dao-di herbs shall be fully based on literatures as well as habitat, planting/breeding, processing, characters, chemical-pharmacological/toxic data. The common requirements for the quality standard of Dao-di herbs contain "clear source, explicit origin, rational indicator, gradable quality, and multiple detection methods". Notably, traditional experiences and modern techniques, quality tracing management system, "quality determination by distinguishing characters" method, rapid detection technology, effective/toxic substances control method, were comprehensively applied in this standard to purse the objectification, automation, and intellectualization of detection technology. Appearance characters, chemical components, and bioactive parameters, unified effective/toxic indicators, quality markers, and pharmacopeial control indicators and reasonable ranges were included in rigorous quality standards for Dao-di herbs. Besides, simple grading method shall be developed to guide the implementation of "high quality-high price" policy. Eventually, the new quality standards for Dao-di herbs will lead international standards and promote the high-quality development of Dao-di herbs.
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Affiliation(s)
- Chang-Jiang-Sheng Lai
- State Key Laboratory Breeding Base of Dao-di Herbs, National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700, China
| | - Xu-Ya Wei
- State Key Laboratory Breeding Base of Dao-di Herbs, National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700, China
| | - Zi-Dong Qiu
- State Key Laboratory Breeding Base of Dao-di Herbs, National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700, China
| | - Ting Tan
- National Pharmaceutical Engineering Center (NPEC) for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine Nanchang 330006, China
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16
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Fox B, Sharp G, Atkinson E, Roberts G, Rigsby P, Studholme L. The third international standard for anti-D immunoglobulin: international collaborative study to evaluate candidate preparations. Vox Sang 2019; 114:740-748. [PMID: 31321786 DOI: 10.1111/vox.12822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/14/2019] [Revised: 06/04/2019] [Accepted: 06/08/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The purpose of the study was to evaluate a lyophilized anti-D immunoglobulin preparation to serve as a replacement WHO International Standard for the calibration of potency assays of anti-D immunoglobulin products. Such products are used to prevent haemolytic disease of the foetus and newborn due to maternal alloanti-D. MATERIALS AND METHODS The candidate 3rd International Standard for anti-D immunoglobulin (16/332) was evaluated and calibrated against the 2nd International Standard for anti-D immunoglobulin (01/572), along with a coded duplicate, a second candidate preparation (16/278) and a comparability sample (16/272) in an international collaborative study. Twenty of 21 laboratories in 15 countries performed one or more of the three European Pharmacopoeia reference methods. RESULTS The overall geometric mean potency (from all methods) of the candidate 3rd International Standard, 16/332, was 296·6 IU/ampoule, with inter-laboratory variability, expressed as % GCV, of 4·7%. SE-HPLC of the immunoglobulin preparations demonstrated combined monomeric and dimeric IgG peak areas of >95% for all samples. Accelerated stability studies have shown both 16/332 and 16/278 to be very stable for long-term storage at -20°C. CONCLUSIONS Preparation 16/332 was established by the World Health Organisation Expert Committee on Biological Standardization as the 3rd International Standard for anti-D immunoglobulin with an assigned potency of 297 IU/ampoule.
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Affiliation(s)
- Bernard Fox
- Biotherapeutics Group, National Institute for Biological Standards and Control, Hertfordshire, UK
| | - Giles Sharp
- Biotherapeutics Group, National Institute for Biological Standards and Control, Hertfordshire, UK
| | - Eleanor Atkinson
- Division of Analytical & Biological Sciences, National Institute for Biological Standards and Control, Hertfordshire, UK
| | - Graham Roberts
- Biotherapeutics Group, National Institute for Biological Standards and Control, Hertfordshire, UK
| | - Peter Rigsby
- Division of Analytical & Biological Sciences, National Institute for Biological Standards and Control, Hertfordshire, UK
| | - Lucy Studholme
- Biotherapeutics Group, National Institute for Biological Standards and Control, Hertfordshire, UK
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18
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Baylis SA, Wallace P, McCulloch E, Niesters HGM, Nübling CM. Standardization of Nucleic Acid Tests: the Approach of the World Health Organization. J Clin Microbiol 2019; 57:e01056-18. [PMID: 30257900 DOI: 10.1128/JCM.01056-18] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The first World Health Organization (WHO) international standards (ISs) for nucleic acid amplification techniques were established two decades ago, with the initial focus on blood screening for three major viral targets, i.e., hepatitis C virus, hepatitis B virus, and human immunodeficiency virus 1. These reference materials have subsequently found utility in the diagnosis and monitoring of a wide range of infectious diseases in clinical microbiology laboratories worldwide. WHO collaborating centers develop ISs and coordinate international studies for their evaluation. The WHO Expert Committee on Biological Standardization is responsible for the endorsement of new standardization projects and the establishment of new and replacement ISs. Potencies of ISs are defined in international units (IU); the reporting in IU for assays calibrated with an IS (or secondary standards traceable to the IS) facilitates comparability of results for different assays and determination of assay parameters such as analytical sensitivities.
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Metcalfe C, Dougall T, Bird C, Rigsby P, Behr-Gross ME, Wadhwa M, Study POT. The first World Health Organization International Standard for infliximab products: A step towards maintaining harmonized biological activity. MAbs 2018; 11:13-25. [PMID: 30395763 PMCID: PMC6343779 DOI: 10.1080/19420862.2018.1532766] [Citation(s) in RCA: 7] [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] [Indexed: 12/28/2022] Open
Abstract
Due to the increase in the number of infliximab products, the need for global harmonization of the bioactivity of this monoclonal antibody was recognized by the World Health Organization (WHO). In response, the National Institute for Biological Standards and Control (NIBSC) developed the first international standard (IS) for infliximab, which targets tumour necrosis factor (TNF). Each ampoule is assigned values of 500 IU of TNF neutralizing activity and 500 IU of binding activity. Two preparations of infliximab were formulated and lyophilized at NIBSC prior to evaluation in a collaborative study for their suitability to serve as an IS for the in vitro biological activity of infliximab. The study involved participants using in vitro cell-based bioassays (TNF neutralization, antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity) and binding assays. The results of this study showed that the candidate preparation, coded 16/170, is suitable as an IS for infliximab bioactivity. This infliximab IS from NIBSC, is intended to support in vitro bioassay calibration and validation by defining international units of bioactivity. The proposed unitages, however, are not intended to revise product labelling or dosing requirements, as any decisions regarding this relies solely with the regulatory authorities. Furthermore, the infliximab IS is not intended for determining the specific activity of products, nor to serve any regulatory role in defining biosimilarity. We briefly discuss the future use of WHO international standards in supporting the global harmonisation of biosimilar infliximab products.
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Affiliation(s)
- Clive Metcalfe
- a Division of Biotherapeutics , National Institute for Biological Standards and Control (NIBSC) , South Mimms , Potters Bar, Hertfordshire , UK
| | - Thomas Dougall
- b Division of Technology Development and Infrastructure , National Institute for Biological Standards and Control , South Mimms , UK
| | - Chris Bird
- a Division of Biotherapeutics , National Institute for Biological Standards and Control (NIBSC) , South Mimms , Potters Bar, Hertfordshire , UK
| | - Peter Rigsby
- b Division of Technology Development and Infrastructure , National Institute for Biological Standards and Control , South Mimms , UK
| | - Marie-Emmanuelle Behr-Gross
- c Department of Biological Standardisation , OMCL Network & HealthCare (DBO), European Directorate for the Quality of Medicines and HealthCare (EDQM) , Strasbourg , France
| | - Meenu Wadhwa
- a Division of Biotherapeutics , National Institute for Biological Standards and Control (NIBSC) , South Mimms , Potters Bar, Hertfordshire , UK
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20
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Greninger AL, Roychoudhury P, Makhsous N, Hanson D, Chase J, Krueger G, Xie H, Huang ML, Saunders L, Ablashi D, Koelle DM, Cook L, Jerome KR. Copy Number Heterogeneity, Large Origin Tandem Repeats, and Interspecies Recombination in Human Herpesvirus 6A (HHV-6A) and HHV-6B Reference Strains. J Virol 2018; 92:e00135-18. [PMID: 29491155 PMCID: PMC5923074 DOI: 10.1128/jvi.00135-18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 01/24/2018] [Accepted: 02/21/2018] [Indexed: 12/17/2022] Open
Abstract
Quantitative PCR is a diagnostic pillar for clinical virology testing, and reference materials are necessary for accurate, comparable quantitation between clinical laboratories. Accurate quantitation of human herpesvirus 6A/B (HHV-6A/B) is important for detection of viral reactivation and inherited chromosomally integrated HHV-6A/B in immunocompromised patients. Reference materials in clinical virology commonly consist of laboratory-adapted viral strains that may be affected by the culture process. We performed next-generation sequencing to make relative copy number measurements at single nucleotide resolution of eight candidate HHV-6A and seven HHV-6B reference strains and DNA materials from the HHV-6 Foundation and Advanced Biotechnologies Inc. Eleven of 17 (65%) HHV-6A/B candidate reference materials showed multiple copies of the origin of replication upstream of the U41 gene by next-generation sequencing. These large tandem repeats arose independently in culture-adapted HHV-6A and HHV-6B strains, measuring 1,254 bp and 983 bp, respectively. The average copy number measured was between 5 and 10 times the number of copies of the rest of the genome. We also report the first interspecies recombinant HHV-6A/B strain with a HHV-6A backbone and a >5.5-kb region from HHV-6B, from U41 to U43, that covered the origin tandem repeat. Specific HHV-6A reference strains demonstrated duplication of regions at U1/U2, U87, and U89, as well as deletion in the U12-to-U24 region and the U94/U95 genes. HHV-6A/B strains derived from cord blood mononuclear cells from different laboratories on different continents with fewer passages revealed no copy number differences throughout the viral genome. These data indicate that large origin tandem duplications are an adaptation of both HHV-6A and HHV-6B in culture and show interspecies recombination is possible within the Betaherpesvirinae.IMPORTANCE Anything in science that needs to be quantitated requires a standard unit of measurement. This includes viruses, for which quantitation increasingly determines definitions of pathology and guidelines for treatment. However, the act of making standard or reference material in virology can alter its very accuracy through genomic duplications, insertions, and rearrangements. We used deep sequencing to examine candidate reference strains for HHV-6, a ubiquitous human virus that can reactivate in the immunocompromised population and is integrated into the human genome in every cell of the body for 1% of people worldwide. We found large tandem repeats in the origin of replication for both HHV-6A and HHV-6B that are selected for in culture. We also found the first interspecies recombinant between HHV-6A and HHV-6B, a phenomenon that is well known in alphaherpesviruses but to date has not been seen in betaherpesviruses. These data critically inform HHV-6A/B biology and the standard selection process.
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Affiliation(s)
- Alexander L Greninger
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Research Institute, Seattle, Washington, USA
| | - Pavitra Roychoudhury
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Research Institute, Seattle, Washington, USA
| | - Negar Makhsous
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Derek Hanson
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jill Chase
- HHV-6 Foundation, Santa Barbara, California, USA
| | - Gerhard Krueger
- Department of Pathology and Laboratory Medicine, University of Houston, Houston, Texas, USA
| | - Hong Xie
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Meei-Li Huang
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Lindsay Saunders
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | | | - David M Koelle
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Research Institute, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Linda Cook
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Keith R Jerome
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Research Institute, Seattle, Washington, USA
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Giuffrè AM, Capocasale M, Zappia C, Poiana M. Influence of High Temperature and Duration of Heating on the Sunflower Seed Oil Properties for Food Use and Bio-diesel Production. J Oleo Sci 2018; 66:1193-1205. [PMID: 29093378 DOI: 10.5650/jos.ess17109] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Two important problems for the food industry are oil oxidation and oil waste after frying. Sunflower seed oil is one of the vegetable oils most commonly used in the food industry. Two variables were applied to the low oleic sunflower seed oil in this work i.e. heating temperature (180-210-240°C) and time of heating (15-30-60-120 minutes), to study from the edible point of view the variations of its physico-chemical properties. After 120 minutes heating at 240°C the following was found: refractive index (1.476), free acidity (0.35%), K232 (2.87), K270 (3.71), antiradical activity (45.90% inhibition), total phenols (523 mg kg-1), peroxide value (17.00 meq kg-1), p-anisidine value (256.8) and Totox (271.7), all of which showed a constant deterioration. In relation to the use as a feedstock for bio-diesel production, after 120 minutes heating at 240℃ the following was found: acid value 0.70 mg KOH g-1 oil, iodine value 117.83 g I2 100 g-1 oil, oil stability index 0.67 h, kinematic viscosity (at 40°C) 77.85 mm2 s-1, higher heating value 39.86 MJ kg-1, density 933.34 kg/m3 and cetane number 67.04. The parameters studied in this work were influenced, in different ways, by the applied variables. Heating temperature between 180 and 210°C and 120 min heating duration were found to be the most appropriate conditions for sunflower seed oil both from the deep frying point of view and from a subsequent use as feedstock for bio-diesel production. In light of the vegetable oils' International standards for an edible use and for a bio-diesel production, findings of this work can be used to set heating temperature and heating duration to preserve as long possible the physico-chemical properties of a low oleic sunflower seed oil for both its edible use as a fat during cooking and for its re-use after frying.
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Affiliation(s)
| | - Marco Capocasale
- Dipartimento di AGRARIA. Università degli Studi Mediterranea di Reggio Calabria
| | - Clotilde Zappia
- Dipartimento di AGRARIA. Università degli Studi Mediterranea di Reggio Calabria
| | - Marco Poiana
- Dipartimento di AGRARIA. Università degli Studi Mediterranea di Reggio Calabria
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22
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Wu PK, Liao LP, Xu MQ, Yi BX. [Comparison of national standard GB/T 31774 and international standard ISO 18668 for Chinese medicines coding system]. Zhongguo Zhong Yao Za Zhi 2017; 42:2820-2823. [PMID: 29098844 DOI: 10.19540/j.cnki.cjcmm.20170426.003] [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] [Received: 04/01/2017] [Indexed: 11/18/2022]
Abstract
Coding rules for Chinese medicines and their codes (GB/T 31774-2015) was issued by General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China (AQSIQ) and Standardization Administration of the People's Republic of China (SAC) in 2015. Coding system for Chinese medicines (ISO 18668-1, 2, 3 and 4) series were issued one after another by International Organization for Standardization in 2016 and 2017. In this paper, the comparative study on the GB/T 31774 and ISO 18668-1, 2, 3 to 4 would be conducted to expound the similarities and differences among them. This essay aims at promoting the application of national and international standards of coding system in production and operation enterprises and the medical institutions of traditional Chinese medicine (TCM), reducing their repetitive investment to meet the Chinese medicine import and export trade requirement in future. Moreover, it provides the cornerstone and support for TCM standardization, and makes Chinese medicines standard gain dominance in field of international TCM standards, occupying the high ground of international market in the traditional medicine field of the world. It may promote the "Internet + TCM service" in our country, and let the Chinese medicine industry go out of the country and into the world to contribute to human health.
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Affiliation(s)
- Pei-Kai Wu
- Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.,Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Li-Ping Liao
- Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.,Health and Family Planning Commission of Shenzhen Municipality, Shenzhen 518020, China
| | - Mei-Qu Xu
- Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.,Macau University of Science and Technology, Macau 00853, China
| | - Bing-Xue Yi
- Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China
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23
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Prior S, Hufton SE, Fox B, Dougall T, Rigsby P, Bristow A. International standards for monoclonal antibodies to support pre- and post-marketing product consistency: Evaluation of a candidate international standard for the bioactivities of rituximab. MAbs 2017; 10:129-142. [PMID: 28985159 PMCID: PMC5836816 DOI: 10.1080/19420862.2017.1386824] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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] [Indexed: 01/31/2023] Open
Abstract
The intrinsic complexity and heterogeneity of therapeutic monoclonal antibodies is built into the biosimilarity paradigm where critical quality attributes are controlled in exhaustive comparability studies with the reference medicinal product. The long-term success of biosimilars will depend on reassuring healthcare professionals and patients of consistent product quality, safety and efficacy. With this aim, the World Health Organization has endorsed the need for public bioactivity standards for therapeutic monoclonal antibodies in support of current controls. We have developed a candidate international potency standard for rituximab that was evaluated in a multi-center collaborative study using participants' own qualified Fc-effector function and cell-based binding bioassays. Dose-response curve model parameters were shown to reflect similar behavior amongst rituximab preparations, albeit with some differences in potency. In the absence of a common reference standard, potency estimates were in poor agreement amongst laboratories, but the use of the candidate preparation significantly reduced this variability. Our results suggest that the candidate rituximab standard can support bioassay performance and improve data harmonization, which when implemented will promote consistency of rituximab products over their life-cycles. This data provides the first scientific evidence that a classical standardization exercise allowing traceability of bioassay data to an international standard is also applicable to rituximab. However, we submit that this new type of international standard needs to be used appropriately and its role not to be mistaken with that of the reference medicinal product.
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Affiliation(s)
- Sandra Prior
- a Molecular Immunology Section, Biotherapeutics Division, National Institute for Biological Standards and Control, South Mimms , Potters Bar , Hertfordshire , United Kingdom
| | - Simon E Hufton
- a Molecular Immunology Section, Biotherapeutics Division, National Institute for Biological Standards and Control, South Mimms , Potters Bar , Hertfordshire , United Kingdom
| | - Bernard Fox
- a Molecular Immunology Section, Biotherapeutics Division, National Institute for Biological Standards and Control, South Mimms , Potters Bar , Hertfordshire , United Kingdom
| | - Thomas Dougall
- b Technology Development and Infrastructure Division, National Institute for Biological Standards and Control, South Mimms , Potters Bar , Hertfordshire , United Kingdom
| | - Peter Rigsby
- b Technology Development and Infrastructure Division, National Institute for Biological Standards and Control, South Mimms , Potters Bar , Hertfordshire , United Kingdom
| | - Adrian Bristow
- b Technology Development and Infrastructure Division, National Institute for Biological Standards and Control, South Mimms , Potters Bar , Hertfordshire , United Kingdom
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24
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Ng S. [Differences and international standardization between acupuncture as therapy and as specialty]. Zhongguo Zhen Jiu 2017; 37:3-8. [PMID: 29231314 DOI: 10.13703/j.0255-2930.2017.01.001] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study is to explore the differences of definition and clinical roles as well as international standardization between acupuncture as therapy and as specialty, which can provide reference evidence for specialization and internationalization of acupuncture. Owing to the clinical efficacy and safety, the credibility and controversy both exist in acupuncture; moreover, there is a lack of fair definition and international precedent regarding acupuncture specialty. Therefore, it is particularly essential to objectively compare the differences of definitions and clinical roles as well as criteria of international standardization for acupuncture as therapy and as specialty. It is believed acupuncture standardization can draw lessons from the international medical standards, evidence-based medicine and acupuncture theory from the following three major projects:acupuncture safety and contraindications; acupuncture indications and treatment guidelines; acupuncture indication classified into 3 levels of evidence-based acupuncture disease spectrum, as objective evidence of indication of acupuncture specialty.
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Affiliation(s)
- Szetuen Ng
- Hong Kong Association of Traditional Chinese Medicine, Hong Kong 999077, China
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25
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Baylis SA, Blümel J, Mizusawa S, Matsubayashi K, Sakata H, Okada Y, Nübling CM, Hanschmann KMO. World Health Organization International Standard to harmonize assays for detection of hepatitis E virus RNA. Emerg Infect Dis 2013; 19:729-35. [PMID: 23647659 PMCID: PMC3647515 DOI: 10.3201/eid1905.121845] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [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] [Indexed: 01/09/2023] Open
Abstract
Nucleic acid amplification technique–based assays are a primary method for the detection of acute hepatitis E virus (HEV) infection, but assay sensitivity can vary widely. To improve interlaboratory results for the detection and quantification of HEV RNA, a candidate World Health Organization (WHO) International Standard (IS) strain was evaluated in a collaborative study involving 23 laboratories from 10 countries. The IS, code number 6329/10, was formulated by using a genotype 3a HEV strain from a blood donation, diluted in pooled human plasma and lyophilized. A Japanese national standard, representing a genotype 3b HEV strain, was prepared and evaluated in parallel. The potencies of the standards were determined by qualitative and quantitative assays. Assay variability was substantially reduced when HEV RNA concentrations were expressed relative to the IS. Thus, WHO has established 6329/10 as the IS for HEV RNA, with a unitage of 250,000 International Units per milliliter.
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Abstract
INTRODUCTION Blood glucose monitoring systems (BGMS) are used in the hospital environment to manage blood glucose levels in patients at the bedside. The International Organization for Standardization (ISO) 15197:2003 standard is currently used by regulatory bodies as a minimum requirement for the performance of BGMS, specific to self-testing. There are calls for the tightening of accuracy requirements and implementation of a standard specifically for point-of-care (POC) BGMS. METHODS The accuracy of six commonly used BGMS was assessed in a clinical setting, with 108 patients' finger stick capillary samples. Using the accuracy criteria from the existing standard and a range of tightened accuracy criteria, system performance was compared. Other contributors to system performance have been measured, including hematocrit sensitivity and meter error rates encountered in the clinical setting. RESULTS AND DISCUSSION Five of the six BGMS evaluated met current accuracy criteria within the ISO 15197 standard. Only the Optium Xceed system had >95% of all readings within a tightened criteria of ±12.5% from the reference at glucose levels ≥72 mg/dl (4 mmol/liter) and ±9 mg/dl (0.5 mmol/liter) at glucose levels <72 mg/dl (4 mmol/liter). The Nova StatStrip Xpress had the greatest number of error messages observed; Optium Xceed the least. OneTouch Ultra2, Nova StatStrip Xpress, Accu-Chek Performa, and Contour TS products were all significantly influenced by blood hematocrit levels. CONCLUSIONS From evidence obtained during this clinical evaluation, the Optium Xceed system is most likely to meet future anticipated accuracy standards for POC BGMS. In this clinical study, the results demonstrated the Optium Xceed product to have the highest level of accuracy, to have the lowest occurrence of error messages, and to be least influenced by blood hematocrit levels.
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