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Pucca MB, Camphora AL. The potential risks of equine serum therapy in transmitting new infectious diseases: lessons from a post-pandemic era. Front Public Health 2024; 12:1366929. [PMID: 38420034 PMCID: PMC10899399 DOI: 10.3389/fpubh.2024.1366929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/05/2024] [Indexed: 03/02/2024] Open
Affiliation(s)
- Manuela B. Pucca
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Campus Araraquara, São Paulo, Brazil
| | - Ana Lucia Camphora
- Independent Researcher on Intersections of Modern and Contemporary Equine Cultures, Rio de Janeiro, Brazil
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2
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Vitharana S, Stillahn JM, Katayama DS, Henry CS, Manning MC. Application of Formulation Principles to Stability Issues Encountered During Processing, Manufacturing, and Storage of Drug Substance and Drug Product Protein Therapeutics. J Pharm Sci 2023; 112:2724-2751. [PMID: 37572779 DOI: 10.1016/j.xphs.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 07/24/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
The field of formulation and stabilization of protein therapeutics has become rather extensive. However, most of the focus has been on stabilization of the final drug product. Yet, proteins experience stress and degradation through the manufacturing process, starting with fermentaition. This review describes how formulation principles can be applied to stabilize biopharmaceutical proteins during bioprocessing and manufacturing, considering each unit operation involved in prepration of the drug substance. In addition, the impact of the container on stabilty is discussed as well.
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Affiliation(s)
| | - Joshua M Stillahn
- Legacy BioDesign LLC, Johnstown, CO 80534, USA; Department of Chemistry, Colorado State University, Fort Collins, CO 80523, USA
| | | | - Charles S Henry
- Department of Chemistry, Colorado State University, Fort Collins, CO 80523, USA
| | - Mark Cornell Manning
- Legacy BioDesign LLC, Johnstown, CO 80534, USA; Department of Chemistry, Colorado State University, Fort Collins, CO 80523, USA.
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3
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da Costa CBP, Carvalho VRD, Ferreira LLC, Mattos JLC, Garcia LDM, Antunes MDS, Martins FJ, Ratcliffe NA, Cisne R, Castro HC. Production of hyperimmune sera: a study of digestion and fractionation methodologies for the purification process of heterologous immunoglobulins. TOXIN REV 2022. [DOI: 10.1080/15569543.2022.2124421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Camila Braz Pereira da Costa
- Instituto Vital Brazil, Niterói, Brazil
- Programa de Pós-graduação em Ciências e Biotecnologia, Instituto de Biologia, Universidade Federal Fluminense, Niterói, Brazil
| | | | | | | | | | | | - Francislene Juliana Martins
- Programa de Pós-graduação em Ciências e Biotecnologia, Instituto de Biologia, Universidade Federal Fluminense, Niterói, Brazil
- Faculdade de Farmácia, Universidade Federal Fluminense, Niterói, Brazil
| | - Norman A. Ratcliffe
- Programa de Pós-graduação em Ciências e Biotecnologia, Instituto de Biologia, Universidade Federal Fluminense, Niterói, Brazil
- Department of Biosciences, Swansea University, Swansea, UK
| | - Rafael Cisne
- Programa de Pós-graduação em Ciências e Biotecnologia, Instituto de Biologia, Universidade Federal Fluminense, Niterói, Brazil
| | - Helena C. Castro
- Programa de Pós-graduação em Ciências e Biotecnologia, Instituto de Biologia, Universidade Federal Fluminense, Niterói, Brazil
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4
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Marques RF, Quintilio W, Knirsch MC, Fucase TM, Spencer PJ, Stephano MA. Action of Bromelain and Ficin on horse anti Bothrops sp venom Antibodies. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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5
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Mender MM, Bolton F, Berry C, Young M. Antivenom: An immunotherapy for the treatment of snakebite envenoming in sub-Saharan Africa. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2021; 129:435-477. [PMID: 35305724 DOI: 10.1016/bs.apcsb.2021.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Snakebite envenoming (SBE) leads to significant morbidity and mortality, resulting in over 90,000 deaths and approximately 400,000 amputations annually. In sub-Saharan Africa (SSA) alone, SBE accounts for over 30,000 deaths per annum. Since 2017, SBE has been classified as a priority Neglected Tropical Disease (NTD) by the World Health Organisation (WHO). The major species responsible for mortality from SBE within SSA are from the Bitis, Dendroaspis, Echis and Naja genera. Pharmacologically active toxins such as metalloproteinases, serine proteinases, 3-finger toxins, kunitz-type toxins, and phospholipase A2s are the primary snake venom components. These toxins induce cytotoxicity, coagulopathy, hemorrhage, and neurotoxicity in envenomed victims. Antivenom is currently the only available venom-specific treatment for SBE and contains purified equine or ovine polyclonal antibodies, collected from donor animals repeatedly immunized with low doses of adjuvanted venom. The resulting plasma or serum contains a high titre of specific antibodies, which can then be collected and stored until required. The purified antibodies are either whole IgG, monovalent fragment antibody (Fab) or divalent fragment antibody F(ab')2. Despite pharmacokinetic and pharmacodynamic differences, all three are effective in the treatment of SBE. No antivenom is without adverse reactions but, the level of their impact and severity varies from benign early adverse reactions to the rarely occurring fatal anaphylactic shock. However, the major side effects are largely reversible with immediate administration of adrenaline and corticosteroids. There are 16 different antivenoms marketed within SSA, but the efficacy and safety profiles are only published for less than 50% of these products.
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Affiliation(s)
- Mender M Mender
- School of Bioscience, Cardiff University, Cardiff, United Kingdom; Department of Research and Development, MicroPharm Ltd, Newcastle Emlyn, United Kingdom.
| | - Fiona Bolton
- Department of Research and Development, MicroPharm Ltd, Newcastle Emlyn, United Kingdom
| | - Colin Berry
- School of Bioscience, Cardiff University, Cardiff, United Kingdom
| | - Mark Young
- School of Bioscience, Cardiff University, Cardiff, United Kingdom
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6
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Gutiérrez JM, Teixeira CFP, Fan HW. Instituto Butantan and Instituto Clodomiro Picado: A long-standing partnership in science, technology, and public health. Toxicon 2021; 202:75-81. [PMID: 34562498 DOI: 10.1016/j.toxicon.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/26/2022]
Abstract
Instituto Butantan (São Paulo, Brazil) and Instituto Clodomiro Picado (San José, Costa Rica) are public institutions devoted to scientific and technological research, production of antivenoms and other immunobiologicals, and a variety of public health interventions aimed at confronting the problem of snakebite envenoming in their countries and elsewhere. In the context of the 120th anniversary of Instituto Butantan, this work describes the historical developments in the relationship between these institutions, which has evolved into a solid cooperation platform in science, technology, and public health. The relationship between Instituto Butantan and Costa Rica started early in the 20th century, with the provision of Brazilian antivenoms to Costa Rica through the coordination of Instituto Butantan and the health system of Costa Rica, with the leadership of Clodomiro Picado Twight. After the decade of 1980, a prolific collaborative network has been established between Instituto Butantan and Instituto Clodomiro Picado (founded in 1970) in the areas of scientific and technological research in pharmacology, biochemistry, experimental pathology, immunology, and public health, as well as in antivenom development, production, preclinical evaluation, and quality control. In addition, both institutions have played a key role in the integration of regional efforts in Latin America to create a network of public institutions devoted to antivenom production and quality control, in close coordination with the Pan American Health Organization (PAHO). This long-standing partnership is an example of a highly productive south-south cooperation under a frame of solidarity and public well-being.
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Affiliation(s)
- José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, 11501, Costa Rica.
| | | | - Hui Wen Fan
- Núcleo de Produção de Soros, Instituto Butantan, São Paulo, Brazil
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7
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Alape-Girón A, Moreira-Soto A, Arguedas M, Brenes H, Buján W, Corrales-Aguilar E, Díaz C, Echeverri A, Flores-Díaz M, Gómez A, Hernández A, Herrera M, León G, Macaya R, Molina-Mora JA, Mora J, Narayanan A, Sanabria A, Sánchez A, Sánchez L, Segura Á, Segura E, Solano D, Soto C, Stynoski JL, Vargas M, Villalta M, Drexler JF, Gutiérrez JM. Heterologous Hyperimmune Polyclonal Antibodies Against SARS-CoV-2: A Broad Coverage, Affordable, and Scalable Potential Immunotherapy for COVID-19. Front Med (Lausanne) 2021; 8:743325. [PMID: 34552950 PMCID: PMC8450768 DOI: 10.3389/fmed.2021.743325] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/13/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alberto Alape-Girón
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
- School of Medicine University of Costa Rica, San Pedro, Costa Rica
| | - Andrés Moreira-Soto
- Institute of Virology, Charité Medical University of Berlin, Berlin, Germany
| | - Mauricio Arguedas
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Hebleen Brenes
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud, Ministry of Health, Cartago, Costa Rica
| | - Willem Buján
- School of Medicine University of Costa Rica, San Pedro, Costa Rica
- Caja Costarricense del Seguro Social, San Jose, Costa Rica
| | - Eugenia Corrales-Aguilar
- Research Center for Tropical Diseases, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Cecilia Díaz
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
- School of Medicine University of Costa Rica, San Pedro, Costa Rica
| | - Ann Echeverri
- Caja Costarricense del Seguro Social, San Jose, Costa Rica
| | - Marietta Flores-Díaz
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Aarón Gómez
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Andrés Hernández
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - María Herrera
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Guillermo León
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Román Macaya
- Caja Costarricense del Seguro Social, San Jose, Costa Rica
| | - José Arturo Molina-Mora
- Research Center for Tropical Diseases, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Javier Mora
- Research Center for Tropical Diseases, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Aarthi Narayanan
- National Center for Biodefense and Infectious Diseases, College of Science, George Mason University, Fairfax, VA, United States
| | | | - Andrés Sánchez
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Laura Sánchez
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Álvaro Segura
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Eduardo Segura
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Daniela Solano
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Claudio Soto
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud, Ministry of Health, Cartago, Costa Rica
| | - Jennifer L. Stynoski
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Mariángela Vargas
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Mauren Villalta
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
| | - Jan Felix Drexler
- Institute of Virology, Charité Medical University of Berlin, Berlin, Germany
| | - José María Gutiérrez
- Instituto Clodomiro Picado, School of Microbiology, University of Costa Rica, San Pedro, Costa Rica
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8
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Patra A, Herrera M, Gutiérrez JM, Mukherjee AK. The application of laboratory-based analytical tools and techniques for the quality assessment and improvement of commercial antivenoms used in the treatment of snakebite envenomation. Drug Test Anal 2021; 13:1471-1489. [PMID: 34089574 DOI: 10.1002/dta.3108] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/18/2022]
Abstract
Snakebite envenomation is a public health problem of high impact, particularly for the developing world. Antivenom, which contains whole or protease-digested immunoglobulin G, purified from the plasma of hyper-immunized animals (mainly horses), is the mainstay for the treatment of snakebite envenomation. The success of antivenom therapy depends upon its ability to abrogate or reduce the local and systemic toxicity of envenomation. In addition, antivenom administration must be safe for the patients. Therefore, antivenom manufacturers must ensure that these products are effective and safe in the treatment of envenomations. Antivenom efficacy and safety are determined by the physicochemical characteristics of formulations, purity of the immunoglobulin fragments and antibodies, presence of protein aggregates, endotoxin burden, preservative load, and batch to batch variation, as well as on the ability to neutralize the most important toxins of the venoms against which the antivenom is designed. In this context, recent studies have shown that laboratory-based simple analytical techniques, for example, size exclusion chromatography, sodium dodecyl sulphate polyacrylamide gel electrophoresis, mass spectrometry, immunological profiling including immuno-turbidimetry and enzyme-linked immunosorbent assays, Western blotting, immune-chromatographic technique coupled to mass spectrometry analysis, reverse-phase high performance liquid chromatography, spectrofluorometric analysis, in vitro neutralization of venom enzymatic activities, and other methodologies, can be applied for the assessment of antivenom quality, safety, stability, and efficacy. This article reviews the usefulness of different analytical techniques for the quality assessment of commercial antivenoms. It is suggested that these tests should be applied for screening the quality of commercial antivenoms before their preclinical and clinical assessment.
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Affiliation(s)
- Aparup Patra
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, India
| | - María Herrera
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Ashis K Mukherjee
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, India.,Life Science Division, Institute of Advanced Study in Science and Technology, Vigyan Path, Garchuk, Paschim Boragaon, Guwahati, 781035, India
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9
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Abstract
Influenza is an extremely contagious respiratory disease, which predominantly affects the upper respiratory tract. There are four types of influenza virus, and pigs and chickens are considered two key reservoirs of this virus. Equine influenza (EI) virus was first identified in horses in 1956, in Prague. The influenza A viruses responsible for EI are H7N7 and H3N8. Outbreaks of EI are characterized by their visible and rapid spread, and it has been possible to isolate and characterize H3N8 outbreaks in several countries. The clinical diagnosis of this disease is based on the clinical signs presented by the infected animals, which can be confirmed by performing complementary diagnostic tests. In the diagnosis of EI, in the field, rapid antigen detection tests can be used for a first approach. Treatment is based on the management of the disease and rest for the animal. Regarding the prognosis, it will depend on several factors, such as the animal's vaccination status. One of the important points in this disease is its prevention, which can be done through vaccination. In addition to decreasing the severity of clinical signs and morbidity during outbreaks, vaccination ensures immunity for the animals, reducing the economic impact of this disease.
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10
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Gu C, Chai M, Liu J, Wang H, Du W, Zhou Y, Tan WS. Expansion of Transdifferentiated Human Hepatocytes in a Serum-Free Microcarrier Culture System. Dig Dis Sci 2020; 65:2009-2023. [PMID: 31722057 DOI: 10.1007/s10620-019-05925-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Bioartificial livers (BALs) have attracted much attention as potential supportive therapies for liver diseases. A serum-free microcarrier culture strategy for the in vitro high-density expansion of human-induced hepatocyte-like cells (hiHeps) suitable for BALs was studied in this article. METHODS hiHeps were transdifferentiated from human fibroblasts by the lentiviral overexpression of FOXA3, HNF1A, and HNF4A. Cells were cultured on microcarriers, their proliferation was evaluated by cell count and CCK-8 assays, and their function was evaluated by detecting liver function parameters in the supernatant, including urea secretion, albumin synthesis, and lactate dehydrogenase levels. The expressions of hepatocyte function-associated genes of hiHeps were measured by qRT-PCR in 2D and 3D conditions. The expression of related proteins during fibronectin promotes cell adhesion, and proliferation on microcarrier was detected by western blotting. RESULTS During microcarrier culture, the optimal culture conditions during the adherence period were the use of half-volume high-density inoculation, Cytodex 3 at a concentration of 3 mg/mL, a cell seeding density of 2.0 × 105 cells/mL, and a stirring speed of 45 rpm. The final cell density in self-developed, chemically defined serum-free medium (SFM) reached 2.53 × 106 cells/mL, and the maximum increase in expansion was 12.61-fold. In addition, we found that fibronectin (FN) can promote hiHep attachment and proliferation on Cytodex 3 microcarriers and that this pro-proliferative effect was mediated by the integrin-β1/FAK/ERK/CyclinD1 signaling pathway. Finally, the growth and function of hiHeps on Cytodex 3 in SFM were close to those of hiHeps on Cytodex 3 in hepatocyte maintenance medium (HMM), and cells maintained their morphology and function after harvest on microcarriers. CONCLUSIONS Serum-free microcarrier culture has important implications for the expansion of a sufficient number of hiHeps prior to the clinical application of BALs.
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Affiliation(s)
- Ce Gu
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
| | - Miaomiao Chai
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
| | - Jiaxing Liu
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
| | - Hui Wang
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
| | - Wenjing Du
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
| | - Yan Zhou
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, 200237, People's Republic of China.
| | - Wen-Song Tan
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
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11
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Malekghasemi S, Majidi J, Daneshvar H, Abdolalizadeh J, Aghebati-Maleki L. Production and purification of polyclonal antibody against attenuated and wild type Leishmania infantum in dogs. Hum Antibodies 2020; 28:191-195. [PMID: 32176637 DOI: 10.3233/hab-200406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Antibodies are still widely used in several programs including early research, imaging, Targeting drug delivery system, Affinity chromatography, flowcytometry technic, diagnosis and treatment. Purification of antibody is a standard approach for detection of infection agent in different species. The reservoir hosts for Leishmania infantum are Dogs and they have active role in the transmission of leishmania to humans by the bite of a sand fly belonging to genus Phlebotomus and Lutzomiya. Consequently, elimination of dogs in endemic areas and vaccination of dogs contributes to reduction of the human and canine VL cases. Serological antibody tests such as IFAT (Indirect Fluorescent Antbody Test), DFAT (Direct Fluorescent Antbody Test), ELISA (Enzyme-Linked Immunosorbent Assay), PCR (Polymerase chain Reaction Assay) have been extensively used to investigate canine infection with L. infantum. In this study we produced and purified polyclonal antibody against attenuated and wild type leishmania infantum in dogs. Anti-leishmania in dog serums precipitated with ammonium sulphate. The IgG recovered from ammonium sulphate precipitation was subject to ion exchange chromatography (IEC) and the purity of IgG was confirmed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) under reduced condition. The purity of proteins were above 95% and then purified IgG was conjugated with FITC. We determined optimum titer of dog IgG by observation parasites under fluorescent microscope. The optimum dilution of prepared FITC conjugated dog IgG was 1: 400. This polyclonal antibody can be used for other applications in research, diagnosis and clinic.
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Affiliation(s)
- Somaiyeh Malekghasemi
- Departmant of Immunology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Jafar Majidi
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Daneshvar
- Departmant of Immunology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Jalal Abdolalizadeh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Aghebati-Maleki
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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12
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Knudsen C, Ledsgaard L, Dehli RI, Ahmadi S, Sørensen CV, Laustsen AH. Engineering and design considerations for next-generation snakebite antivenoms. Toxicon 2019; 167:67-75. [DOI: 10.1016/j.toxicon.2019.06.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/22/2019] [Accepted: 06/03/2019] [Indexed: 11/27/2022]
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13
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León G, Vargas M, Segura Á, Herrera M, Villalta M, Sánchez A, Solano G, Gómez A, Sánchez M, Estrada R, Gutiérrez JM. Current technology for the industrial manufacture of snake antivenoms. Toxicon 2018; 151:63-73. [DOI: 10.1016/j.toxicon.2018.06.084] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/28/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022]
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14
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Burnouf T. What can be learned in the snake antivenom field from the developments in human plasma derived products? Toxicon 2018; 146:77-86. [PMID: 29621528 DOI: 10.1016/j.toxicon.2018.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/20/2018] [Accepted: 04/01/2018] [Indexed: 10/17/2022]
Abstract
Human plasma-derived medicinal products and snake antivenom immunoglobulins are unique and complex therapeutic protein products. Human plasma products are obtained by fractionating large pools of plasma collected from blood plasma donors. They comprise a wide range of protein products, including polyvalent and hyperimmune immunoglobulins, coagulation factors, albumin, and various protease inhibitors that are transfused to patients affected by congenital or acquired protein deficiencies, immunological disorders, or metabolic diseases. Snake antivenoms are manufactured from pools of plasma collected from animals, typically horses, which have been immunized against snake venoms. Transfusing antivenoms is the cornerstone therapy to treat patients affected by snakebite envenoming. Over the last thirty years, much technical and regulatory evolution has been implemented to ensure that this class of biologicals meets modern quality requirements. The purpose of this review is to compare the main developments that took place in plasma production, protein fractionation, pathogen safety, quality control, preclinical and clinical studies, and regulations of these products. We also analyze whether both fields have been influencing and cross-fertilizing each other technically and in regulatory aspects to reach modern safety and efficacy standards at global levels, and how experience in the human plasma fractionation industry can further impact the manufacture of snake antivenom and that of other animal-derived antisera.
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Affiliation(s)
- Thierry Burnouf
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan, ROC; International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan, ROC.
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15
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Torgeman A, Mador N, Dorozko M, Lifshitz A, Eschar N, White MD, Wolf DG, Epstein E. Efficacy of inactivation of viral contaminants in hyperimmune horse plasma against botulinum toxin by low pH alone and combined with pepsin digestion. Biologicals 2017. [PMID: 28633975 DOI: 10.1016/j.biologicals.2017.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Assuring viral safety of horse plasma-derived products is fundamental for ethical and regulatory reasons. We previously demonstrated the ability of pepsin digestion at low pH to inactivate West Nile and Sindbis viruses in horse plasma. The present study further examined the efficiency of pepsin digestion to inactivate four additional viruses: HSV-1 and BVDV (lipid-enveloped), BPV and Reo-3 (nonenveloped). These viruses were spiked into hyperimmunized horse plasma against botulinum toxin and subjected to low pH (3.2) alone or combined with pepsin digestion (1200 units/ml). Peptic digestion inactivated the lipid-enveloped viruses, whereas the nonenveloped viruses were unaffected. Interestingly, HSV-1 was rapidly inactivated by acidic pH alone (≥4.9 ± 0.6 log10), whereas a non-robust but meaningful BVDV inactivation (2.9 ± 0.7 log10) was achieved by combined low pH and pepsin. The current study demonstrated the ability of low pH alone and in combination with pepsin digestion to inactivate enveloped viral contaminants in anti-toxin horse plasma.
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Affiliation(s)
- Amram Torgeman
- Department of Biotechnology, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Nurit Mador
- Department of Clinical Microbiology and Infectious Diseases, Hadassah University Hospital, 91120 Jerusalem, Israel
| | - Marina Dorozko
- Department of Clinical Microbiology and Infectious Diseases, Hadassah University Hospital, 91120 Jerusalem, Israel
| | - Aliza Lifshitz
- Department of Clinical Microbiology and Infectious Diseases, Hadassah University Hospital, 91120 Jerusalem, Israel
| | | | - Moshe D White
- Department of Biotechnology, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Dana G Wolf
- Department of Clinical Microbiology and Infectious Diseases, Hadassah University Hospital, 91120 Jerusalem, Israel
| | - Eyal Epstein
- Department of Biotechnology, Israel Institute for Biological Research, Ness-Ziona, Israel.
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Ozkan O, Yağmur EA. Neutralization Capacity of Monovalant Antivenom Against Existing Lethal Scorpions in the Turkish Scorpiofauna. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2017; 16:653-660. [PMID: 28979319 PMCID: PMC5603874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this study, Mesobuthus gibbosus and Mesobuthus eupeus eupeus venom samples were compared for lethality, in-vivo effects and proteins. Neutralization capacity of monovalent Androctonus crassicauda antivenom (RSHA anti-Ac) was tested against the lethal effects of the venoms. Venom was obtained from mature scorpions by electrical stimulation of the telson. The lethality of the venom and potency of Horse RSHA anti-Ac were determined in Swiss mice. The protein profiles of the scorpion venoms were analysed by NuPAGE® 4-12% gradient Bis-Tris gel followed by Coomassie blue staining. Western blotting was performed to determine immunogenic compounds in the venom samples. The median lethal doses of M. e. eupeus, M.gibbosus scorpion and A.crassicauda venoms were determined to be 1.92 mg/kg by i.v. injection route, 0.67 mg/kg and 0.24 mg/kg by s.c. injection route, respectively. A.crassicauda (Olivier, 1807) venom was used as control. One millilitre of the RSHA anti-Ac neutralises 23 LD50 of M. e. eupeus, 32 LD50 of M.gibbosus and 42 LD50 of A. crassicauda venom in mice. Analysis of electrophoresis indicates that three scorpion venoms posses low molecular weight proteins. Immunoblotting indicated that RSHA anti-Ac strongly reacted with both the specific venom and Mesobuthus species venoms which have antigenic similarity. The result of our study showed that M.e. eupeus and M.gibbosus could be medically important scorpions for humans, particullary children. The RSHA anti-Ac can be used in the treatment of envenomation by M. e.eupeus and M.gibbosus scorpion stings.
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Affiliation(s)
- Ozcan Ozkan
- Department of Biology, Çankırı Karatekin University, Çankırı, Turkey.
| | - Ersen Aydın Yağmur
- Alaşehir Vocational School, Celal Bayar University, Alaşehir, Manisa, Turkey.
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Dixit R, Herz J, Dalton R, Booy R. Benefits of using heterologous polyclonal antibodies and potential applications to new and undertreated infectious pathogens. Vaccine 2016; 34:1152-61. [PMID: 26802604 PMCID: PMC7131169 DOI: 10.1016/j.vaccine.2016.01.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Passive immunotherapy using polyclonal antibodies (immunoglobulins) has been used for over a century in the treatment and post-exposure prophylaxis of various infections and toxins. Heterologous polyclonal antibodies are obtained from animals hyperimmunised with a pathogen or toxin. AIMS The aims of this review are to examine the history of animal polyclonal antibody therapy use, their development into safe and effective products and the potential application to humans for emerging and neglected infectious diseases. METHODS A literature search of OVID Medline and OVID Embase databases was undertaken to identify articles on the safety, efficacy and ongoing development of polyclonal antibodies. The search contained database-specific MeSH and EMTREE terms in combination with pertinent text-words: polyclonal antibodies and rare/neglected diseases, antivenins, immunoglobulins, serum sickness, anaphylaxis, drug safety, post marketing surveillance, rabies, human influenza, Dengue, West Nile, Nipah, Hendra, Marburg, MERS, Hemorrhagic Fever Virus, and Crimean-Congo. No language limits were applied. The final search was completed on 20.06.2015. Of 1960 articles, title searches excluded many irrelevant articles, yielding 303 articles read in full. Of these, 179 are referenced in this study. RESULTS Serum therapy was first used in the 1890s against diphtheria. Early preparation techniques yielded products contaminated with reactogenic animal proteins. The introduction of enzymatic digestion, and purification techniques substantially improved their safety profile. The removal of the Fc fragment of antibodies further reduces hypersensitivity reactions. Clinical studies have demonstrated the efficacy of polyclonal antibodies against various infections, toxins and venoms. Products are being developed against infections for which prophylactic and therapeutic options are currently limited, such as avian influenza, Ebola and other zoonotic viruses. CONCLUSIONS Polyclonal antibodies have been successfully applied to rabies, envenomation and intoxication. Polyclonal production provides an exciting opportunity to revolutionise the prognosis of both longstanding neglected tropical diseases as well as emerging infectious threats to humans.
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Affiliation(s)
- Rashmi Dixit
- The Children's Hospital, Westmead, Sydney, Australia.
| | | | | | - Robert Booy
- The Children's Hospital, Westmead, Sydney, Australia
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18
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Boukharta M, Azlmat S, Elharrak M, Ennaji MM. Multiple alignment comparison of the non-structural genes of three strains of equine influenza viruses (H3N8) isolated in Morocco. BMC Res Notes 2015; 8:471. [PMID: 26404167 PMCID: PMC4581100 DOI: 10.1186/s13104-015-1441-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/11/2015] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Three equine influenza viruses, A/equine/Nador/1/1997(H3N8), A/equine/Essaouira/2/2004(H3N8), and A/equine/Essaouira/3/2004(H3N8), were isolated from different Equidae during local respiratory disease outbreaks in Morocco in 1997 and 2004. Their non-structural (NS) genes were amplified and sequenced. RESULTS The results show high homology of NS nucleotide sequences of A/equine/Nador/1/1997 with European strains (i.e., A/equine/newmarket/2/93 and A/equine/Grobois/1/1998) and clustered into the European lineage. However, NS gene of A/equine/Essaouira/2/2004(H3N8) and A/equine/Essaouira/3/2004(H3N8) strains indicated high homology with equine influenza strains that had circulated before 1990 (A/equine/Fontainbleu/1/1979(H3N8), which belonged to a pre-divergent phase Amino acid sequence comparison of the NS1 protein with reference strain A/equine/Miami/1963(H3N8) shows that the A/equine/Nador/1/1997(H3N8) strain has 12 substitutions at the residues D/24/N, R/44/K, S/48/I, R/67/Q, A/86/V, E/139/K, A/112/T, E/186/K, L/185/F, A/223/E, S/213/T and S/228/P. In both A/equine/Essaouira/2/2004(H3N8) and A/equine/Essaouira/3/2004(H3N8) strains, the NS1 sequences present one common mutation at the residue: S/228/P. CONCLUSION It seems that all of these substitutions are not produced at the key residues of the RNA-binding domain (RBD) and the effector domain (ED). Consequently, we can suppose that they will not affect the potency of inhibition of cellular defences, and the virulence of the Moroccan equine strains will be maintained.
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Affiliation(s)
- Mohamed Boukharta
- Laboratory of Virology, Microbiology and Quality/ETB, Faculty of Sciences and Techniques, Mohammedia, University Hassan II Mohammedia-Casablanca, PO BOX 146, Quartier Yasmina, Mohammedia, 20650, Morocco.
| | - Souad Azlmat
- Department of Biology, Instruction Military Hospital Med V Rabat, University Mohammed V Souissi, Rabat, Morocco.
| | - Mehdi Elharrak
- Society of Pharmaceutical and Veterinary Products, Virology Laboratory, Av Hassan II, BP 4569, Rabat, Morocco.
| | - My Mustapha Ennaji
- Laboratory of Virology, Microbiology and Quality/ETB, Faculty of Sciences and Techniques, Mohammedia, University Hassan II Mohammedia-Casablanca, PO BOX 146, Quartier Yasmina, Mohammedia, 20650, Morocco.
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Salunkhe V, van der Meer PF, de Korte D, Seghatchian J, Gutiérrez L. Development of blood transfusion product pathogen reduction treatments: A review of methods, current applications and demands. Transfus Apher Sci 2015; 52:19-34. [DOI: 10.1016/j.transci.2014.12.016] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Abstract
At laboratory scale, several methods for the purification of immunoglobulins from plasma or serum are available. However, not all of them are equally applicable when the scale-up to the level of the pharmaceutical industry is intended. In this case, among other factors, it must be taken into account the performance and the cost and quality of the end product. Here we present a method of purification based on the differential precipitation of plasma proteins with caprylic acid in a single step that is simple and cheap and can be easily scaled up. This methodology has been successfully applied to the development and production of pharmaceutical product, such as therapeutic antisera where immunoglobulin fraction is the unique active pharmaceutical ingredient.
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Affiliation(s)
- Victor Morais
- Department of Biotechnology, Institute of Hygiene, University of the Republic, Av. Alfredo Navarro 3051, Montevideo, 11600, Uruguay,
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21
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León G, Herrera M, Segura Á, Villalta M, Vargas M, Gutiérrez JM. Pathogenic mechanisms underlying adverse reactions induced by intravenous administration of snake antivenoms. Toxicon 2013; 76:63-76. [PMID: 24055551 DOI: 10.1016/j.toxicon.2013.09.010] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 09/01/2013] [Accepted: 09/11/2013] [Indexed: 11/28/2022]
Abstract
Snake antivenoms are formulations of immunoglobulins, or immunoglobulin fragments, purified from the plasma of animals immunized with snake venoms. Their therapeutic success lies in their ability to mitigate the progress of toxic effects induced by snake venom components, when administered intravenously. However, due to diverse factors, such as deficient manufacturing practices, physicochemical characteristics of formulations, or inherent properties of heterologous immunoglobulins, antivenoms can induce undesirable adverse reactions. Based on the time lapse between antivenom administration and the onset of clinical manifestations, the World Health Organization has classified these adverse reactions as: 1 - Early reactions, if they occur within the first hours after antivenom infusion, or 2 - late reactions, when occurring between 5 and 20 days after treatment. While all late reactions are mediated by IgM or IgG antibodies raised in the patient against antivenom proteins, and the consequent formation of immune complexes, several mechanisms may be responsible for the early reactions, such as pyrogenic reactions, IgE-mediated reactions, or non IgE-mediated reactions. This work reviews the hypotheses that have been proposed to explain the mechanisms involved in these adverse reactions to antivenoms. The understanding of these pathogenic mechanisms is necessary for the development of safer products and for the improvement of snakebite envenomation treatment.
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Affiliation(s)
- Guillermo León
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
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22
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Khoobdel M, Nayeri Fasaei B, Zahraei Salehi T, Khosravi M, Taheri M, Koochakzadeh A, Masihipour B, Motedayen MH, Akbari S. The production of monovalent and anti-idiotype antivenom against Mesobuthus eupeus (Scorpionida: Buthidae) venom in rabbits. Toxicon 2013; 76:44-9. [PMID: 24055069 DOI: 10.1016/j.toxicon.2013.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 08/30/2013] [Accepted: 09/06/2013] [Indexed: 11/28/2022]
Abstract
The antivenom production against poisonous creatures encounters a number of difficulties. Interestingly, according to the network theory the conventional antigens are not necessarily needed for producing antibodies against the venoms. In this investigation, the antivenom against Mesobuthus eupeus venom was produced based on the aforementioned theory. Polyclonal antibodies against M. eupeus venom were obtained from the immunized rabbits and the specific antibodies were isolated. After separation of Fab2, immunization process and production of the monovalent and anti-idiotype, these antivenoms were analyzed for the determination of their neutralizing power. The level of the produced antibodies in different stages of this study was also measured by ELISA assay. Four hundred and fifty micrograms of the venom can be neutralized by 4.2, 18 and 291 mg of monovalent, polyvalent and anti-idiotype antivenom, respectively. The ELISA results revealed that idiotypic antigens were six times more immunogenic than anti-idiotypes. The anti-idiotype antivenom can be produced on a large scale with minimum venom consumption. In addition, they are non-toxicant in immunized animals and can be used as a vaccine in people at the risk of scorpion stings.
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Affiliation(s)
- M Khoobdel
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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23
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Caricati CP, Oliveira‐Nascimento L, Yoshida JT, Stephano MA, Caricati ATP, Raw I. Safety of snake antivenom immunoglobulins: efficacy of viral inactivation in a complete downstream process. Biotechnol Prog 2013; 29:972-9. [PMID: 23804299 PMCID: PMC7161767 DOI: 10.1002/btpr.1758] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/14/2013] [Indexed: 12/26/2022]
Abstract
Viral safety remains a challenge when processing a plasma-derived product. A variety of pathogens might be present in the starting material, which requires a downstream process capable of broad viral reduction. In this article, we used a wide panel of viruses to assess viral removal/inactivation of our downstream process for Snake Antivenom Immunoglobulin (SAI). First, we screened and excluded equine plasma that cross-reacted with any model virus, a procedure not published before for antivenoms. In addition, we evaluated for the first time the virucidal capacity of phenol applied to SAI products. Among the steps analyzed in the process, phenol addition was the most effective one, followed by heat, caprylic acid, and pepsin. All viruses were fully inactivated only by phenol treatment; heat, the second most effective step, did not inactivate the rotavirus and the adenovirus used. We therefore present a SAI downstream method that is cost-effective and eliminates viruses to the extent required by WHO for a safe product.
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Affiliation(s)
| | | | - J. T. Yoshida
- Faculdade de Ciências FarmacêuticasUniversidade de Sao Paulo (USP)Sao PauloSPBrazil
| | - M. A. Stephano
- Faculdade de Ciências FarmacêuticasUniversidade de Sao Paulo (USP)Sao PauloSPBrazil
| | | | - I. Raw
- Instituto ButantanSao PauloSPBrazil
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24
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Sánchez Y, Noa E, Alfonso W, Dubed M, Alvarez G, Navea L, Montes de Oca N, Lobaina L, Díaz E. Safety of the production process of SURFACEN(®) to inactivate and remove virus. Biologicals 2013; 41:254-60. [PMID: 23665304 DOI: 10.1016/j.biologicals.2013.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 03/30/2013] [Accepted: 04/06/2013] [Indexed: 11/20/2022] Open
Abstract
SURFACEN(®) is a biological product produced from pig lungs. Since these animals can be potential sources of microbial pathogens such as viruses, the manufacturing process of this product should guarantee safety from health hazards. The SURFACEN(®) production procedure is capable of effective viral clearance (inactivation/removal) by involving two stages of organic solvent extraction followed by acetone precipitation and heat treatment. In this study, we evaluated the clearance capacity of these four stages for a wide range of viruses by performing spiking experiments. Residual contamination was assessed using a Tissue Culture Infectious Dose assay (log10 TCID50). The validation study demonstrated that, for all viruses tested, the TCID50 titers were reduced by more than 2 log10 in each stage. Total log reduction values achieved were between ≥17.82 log10 and ≥27.93 log10, depending on the virus physical properties, titer, and the number of processing stages applied. Results indicated that the production procedure of SURFACEN(®) can inactivate or remove contaminant viruses from the raw material.
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Affiliation(s)
- Yordank Sánchez
- AIDS Research Laboratory, Autopista Nacional y Carretera de Jamaica, San José de las Lajas, CP 32700, Mayabeque, Cuba.
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25
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Studies on the fractionation of equine antivenom IgG by combinations of ammonium sulfate and caprylic acid. Toxicon 2012; 60:1022-9. [DOI: 10.1016/j.toxicon.2012.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 06/05/2012] [Accepted: 07/18/2012] [Indexed: 11/18/2022]
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26
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A study on the use of caprylic acid and ammonium sulfate in combination for the fractionation of equine antivenom F(ab′)2. Biologicals 2012; 40:338-44. [DOI: 10.1016/j.biologicals.2012.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 05/17/2012] [Accepted: 05/20/2012] [Indexed: 11/19/2022] Open
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27
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Gutiérrez JM. Improving antivenom availability and accessibility: science, technology, and beyond. Toxicon 2012; 60:676-87. [PMID: 22781134 DOI: 10.1016/j.toxicon.2012.02.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 02/23/2012] [Indexed: 01/15/2023]
Abstract
Snakebite envenomings constitute a serious and neglected public health problem. Despite the fact that effective treatment exists, i.e. administration of animal-derived antivenoms, the availability and accessibility of these life-saving immunobiologicals is deficitary in various parts of the world, particularly in sub-Saharan Africa and some regions of Asia. This article discusses some of the problems that need to be circumvented in order to improve the availability and accessibility of antivenoms. The conglomerate of antivenom manufacturers is highly heterogeneous in terms of technological base, qualification of staff, implementation of Good Manufacturing Practices (GMPs), and volume of production. Therefore, improvements in antivenom quality and availability should be based on strategies tailored to the situation of each region or country; in this context, three different scenarios are discussed. Accessibility of antivenoms demands concerted efforts at multiple levels, including raising the awareness of public health authorities on the relevance of the problem, implementing innovative antivenom purchasing schemes, strengthening national distribution channels on the basis of robust epidemiological information, improving the cold chain and the provision of health services in remote rural settings, supporting the correct use of antivenoms, and promoting the involvement of local community organizations in various aspects of prevention and management. These tasks should be envisaged in terms of synergistic, interprogrammatic and intersectorial interventions, with the participation of many players.
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Affiliation(s)
- José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
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28
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Low pH formulation of whole IgG antivenom: Impact on quality, safety, neutralizing potency and viral inactivation. Biologicals 2012; 40:129-33. [DOI: 10.1016/j.biologicals.2011.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 11/16/2011] [Accepted: 11/23/2011] [Indexed: 11/19/2022] Open
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Morais V, Massaldi H. A model mechanism for protein precipitation by caprylic acid: Application to plasma purification. Biotechnol Appl Biochem 2012; 59:50-4. [DOI: 10.1002/bab.68] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 12/06/2011] [Indexed: 12/27/2022]
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30
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Validation of model virus removal and inactivation capacity of an erythropoietin purification process. Biologicals 2011; 39:430-7. [PMID: 21982851 DOI: 10.1016/j.biologicals.2011.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 09/05/2011] [Accepted: 09/06/2011] [Indexed: 11/22/2022] Open
Abstract
Human erythropoietin (hEpo) production requires mammalian cells able to make complex post-translational modifications to guaranty its biological activity. As mammalian cell can be reservoir of pathogenic viruses and several animal origin components are usually used in the cultivation of mammalian cells, hEpo contamination with viruses is something of great concern. As consequence, this study investigated the viral removal and inactivation capacity of a recombinant-hEpo (rec-hEpo) purification process. Canine parvovirus, Human poliovirus type-2, Bovine viral diarrhea virus and Human immunodeficiency virus type-1 were used for measuring process viral removal and inactivation capacities. In conclusion, this study corroborated that the assessed rec-hEpo purification process has enough capacity (5.0-19.4 Logs) for removing and inactivating these model viruses and sodium hydroxide demonstrated to be a robust sanitization solution for chromatography columns (5.0 (PV-2)-6.7 (CPV) Logs).
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31
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Williams DJ, Gutiérrez JM, Calvete JJ, Wüster W, Ratanabanangkoon K, Paiva O, Brown NI, Casewell NR, Harrison RA, Rowley PD, O'Shea M, Jensen SD, Winkel KD, Warrell DA. Ending the drought: new strategies for improving the flow of affordable, effective antivenoms in Asia and Africa. J Proteomics 2011; 74:1735-67. [PMID: 21640209 DOI: 10.1016/j.jprot.2011.05.027] [Citation(s) in RCA: 181] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 04/30/2011] [Accepted: 05/11/2011] [Indexed: 01/13/2023]
Abstract
The development of snake antivenoms more than a century ago should have heralded effective treatment of the scourge of snakebite envenoming in impoverished, mostly rural populations around the world. That snakebite still exists today, as a widely untreated illness that maims, kills and terrifies men, women and children in vulnerable communities, is a cruel anachronism. Antivenom can be an effective, safe and affordable treatment for snakebites, but apathy, inaction and the politicisation of public health have marginalised both the problem (making snakebite arguably the most neglected of all neglected tropical diseases) and its solution. For lack of any coordinated approach, provision of antivenoms has been pushed off the public health agenda, leading to an incongruous decline in demand for these crucial antidotes, excused and fed by new priorities, an absence of epidemiological data, and a poor regulatory framework. These factors facilitated the infiltration of poor quality products that degrade user confidence and undermine legitimate producers. The result is that tens of thousands are denied an essential life-saving medicine, allowing a toll of human suffering that is a summation of many individual catastrophes. No strategy has been developed to address this problem and to overcome the intransigence and inaction responsible for the global tragedy of snakebite. Attempts to engage with the broader public health community through the World Health Organisation (WHO), GAVI, and other agencies have failed. Consequently, the toxinology community has taken on a leadership role in a new approach, the Global Snakebite Initiative, which seeks to mobilise the resources, skills and experience of scientists and clinicians for whom venoms, toxins, antivenoms, snakes and snakebites are already fields of interest. Proteomics is one such discipline, which has embraced the potential of using venoms in bio-discovery and systems biology. The fields of venomics and antivenomics have recently evolved from this discipline, offering fresh hope for the victims of snakebites by providing an exciting insight into the complexities, nature, fundamental properties and significance of venom constituents. Such a rational approach brings with it the potential to design new immunising mixtures from which to raise potent antivenoms with wider therapeutic ranges. This addresses a major practical limitation in antivenom use recognised since the beginning of the 20th century: the restriction of therapeutic effectiveness to the specific venom immunogen used in production. Antivenomic techniques enable the interactions between venoms and antivenoms to be examined in detail, and if combined with functional assays of specific activity and followed up by clinical trials of effectiveness and safety, can be powerful tools with which to evaluate the suitability of current and new antivenoms for meeting urgent regional needs. We propose two mechanisms through which the Global Snakebite Initiative might seek to end the antivenom drought in Africa and Asia: first by establishing a multidisciplinary, multicentre, international collaboration to evaluate currently available antivenoms against the venoms of medically important snakes from specific nations in Africa and Asia using a combination of proteomic, antivenomic and WHO-endorsed preclinical assessment protocols, to provide a validated evidence base for either recommending or rejecting individual products; and secondly by bringing the power of proteomics to bear on the design of new immunising mixtures to raise Pan-African and Pan-Asian polyvalent antivenoms of improved potency and quality. These products will be subject to rigorous clinical assessment. We propose radically to change the basis upon which antivenoms are produced and supplied for the developing world. Donor funding and strategic public health alliances will be sought to make it possible not only to sustain the financial viability of antivenom production partnerships, but also to ensure that patients are relieved of the costs of antivenom so that poverty is no longer a barrier to the treatment of this important, but grossly neglected public health emergency.
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Affiliation(s)
- David J Williams
- Australian Venom Research Unit, Department of Pharmacology, University of Melbourne, Parkville, Vic, 3010, Australia.
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Antivenoms for the treatment of snakebite envenomings: The road ahead. Biologicals 2011; 39:129-42. [DOI: 10.1016/j.biologicals.2011.02.005] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 02/22/2011] [Indexed: 11/18/2022] Open
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Chippaux JP. [Emergency immunotherapy: snake and scorpion antivenoms]. Biol Aujourdhui 2010; 204:61-70. [PMID: 20950577 DOI: 10.1051/jbio/2009042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Indexed: 05/30/2023]
Abstract
Passive immunotherapy was discovered in 1894. It is the only etiological treatment of envenomations by snakes or scorpions. Immunotherapy is based on administration of antibodies produced by an animal hyperimmunised against venom. Improvement of whole antivenomous sera was obtained, first by separating the antibodies from other components of blood plasma, then by using enzyme digestion of immunoglobulins G and, finally, by purifying the final product. Efficacy and also tolerance were significantly increased. Antivenom administration should be performed through the intravascular route to ensure better diffusion and to facilitate the complexion with the venom. The sale of antivenoms, in particular in Africa, is considerably reduced since about thirty years and is not in adequacy with the epidemiologic needs. In addition to the high cost of the current products, the difficulties of supplying, storage and use seem at the origin of this rejection by both the health staff and the victims who resort massively to traditional medicine. Whereas WHO reminds the rules of production and use of the antivenoms to producers and authorities in charge of drug regulations, it appears that the accessibility of the antivenoms depends on a concerted effort from all the actors, coordinated by health authorities: producers, distributers, manufacturers and public. Beyond technological improvements necessary in antivenom production, the strategy to be implemented must include the strict evaluation of the needs based on epidemiologic studies, the share of cost recovery between all the actors, and the optimization of the therapeutic protocol to make it applicable in remote health centres. Once confidence towards immunotherapy will be restored, mortality will be significantly reduced.
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Affiliation(s)
- Jean-Philippe Chippaux
- Unité de recherche Santé de la mère et de l'enfant en milieu tropical, (IRD UR010), Université Paris Descartes, 4 avenue de l'Observatoire, Paris Cedex 06, France.
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Chippaux JP. [Guidelines for the production, control and regulation of snake antivenom immunoglobulins]. Biol Aujourdhui 2010; 204:87-91. [PMID: 20950580 DOI: 10.1051/jbio/2009043] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Although frequent and severe, envenomations represent a neglected public health problem in most of the developing countries. Access to antivenoms is poor, mainly in Sub-Saharan Africa, and remains a major concern to World Health Organization (WHO). Since 2007, WHO committed international experts to propose guidelines aiming to improve the manufacture, quality control, registration and use of antivenoms. These guidelines, which will published soon, should promote access to antivenoms, and their use by health services, leading in the short term to a significant decrease of snakebite morbidity and mortality.
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Affiliation(s)
- Jean-Philippe Chippaux
- Unité de recherche Santé de la mère et de l'enfant en milieu tropical, (IRD UR010), Université Paris Descartes, 4 avenue de l'Observatoire, Paris Cedex 06, France.
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35
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Nguyen L. [Production of highly purified therapeutic immunoglobulins (HPTI): analysis of a purification process]. Biol Aujourdhui 2010; 204:55-9. [PMID: 20950576 DOI: 10.1051/jbio/2009050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Heterologous immunoglobulins have been used for more than a century for human therapeutic use. Introduction of fractionation and purification steps for the production of these heterologous immunoglobulins has allowed an improvement in their tolerance. Historically, the fractionation and purification steps consisted in one precipitation with 30% of ammonium sulfate followed by a hydrolysis with pepsin at acid pH. More recently, the addition of purification steps like ion-exchange chromatography and the addition of viral safety steps like pasteurization have allowed to improve the purity of these products and to reduce the risk of adverse events. Today, the more efficient processes are able to reach a proportion of about 95% in F(ab')(2) fragments with less than 0.5% of aggregates and polymers ensuring an optimal safety profile of these products.
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Affiliation(s)
- Ludovic Nguyen
- Sanofi Pasteur, Opérations Industrielles, Marcy l'Étoile, France.
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36
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Validation of a simple, rapid and cost effective method for the estimation of caprylic acid and sodium caprylate from biological products using NEFA-C kit. Biologicals 2010; 38:321-4. [DOI: 10.1016/j.biologicals.2009.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 10/09/2009] [Accepted: 10/19/2009] [Indexed: 11/19/2022] Open
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37
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Segura Á, León G, Su CY, Gutiérrez JM, Burnouf T. Assessment of the impact of solvent/detergent treatment on the quality and potency of a whole IgG equine antivenom. Biologicals 2009; 37:306-12. [DOI: 10.1016/j.biologicals.2009.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 04/24/2009] [Accepted: 05/18/2009] [Indexed: 11/30/2022] Open
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38
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Herrera M, Meneses F, Gutiérrez JM, León G. Development and validation of a reverse phase HPLC method for the determination of caprylic acid in formulations of therapeutic immunoglobulins and its application to antivenom production. Biologicals 2009; 37:230-4. [DOI: 10.1016/j.biologicals.2009.02.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 02/18/2009] [Accepted: 02/19/2009] [Indexed: 10/20/2022] Open
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39
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Simpson ID, Jacobsen IM. Antisnake Venom Production Crisis—Who Told Us It Was Uneconomic and Unsustainable? Wilderness Environ Med 2009; 20:144-55. [DOI: 10.1580/08-weme-con-273r1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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40
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Simpson ID, Norris RL. The global snakebite crisis--a public health issue misunderstood, not neglected. Wilderness Environ Med 2009; 20:43-56. [PMID: 19364169 DOI: 10.1580/08-weme-con-263.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The global problem of venomous snakebite continues to attract attention despite it being described as a "neglected" issue. The current focus of the World Health Organization (WHO) remains anti-snake venom quality, although "availability and sustainability" of supply are consistently described as the key issues. Sustainability of antivenom supply has been elusive, with cost and pricing in developing countries being cited as the major reasons. The current WHO approach fails to explore the cost issue, but rather focuses on quality improvements, which may well adversely affect the costs of a product already perceived to be 'unaffordable.' The reference to cost and price indicates a marketing-based perspective may well give more relevant solutions to the snakebite crisis. This paper introduces a marketing model to examine global snakebite and to identify if the current approach is relevant and effective. The "4 Ps" model examines if the correct products are available, whether sufficient information exists concerning estimated market size, whether the assumptions frequently made about the costs of the product are correct and fully understood, if the product is promoted properly, and whether the method by which the product reaches the end user is optimum. The resulting analysis demonstrates that the current approach is characterized by a misunderstanding of the nature of the global snakebite problem. Further, a lack of implementation of key solutions, such as training doctors in developing countries with relevant protocols, has inevitably led to a lack of improvement in the snakebite arena over the last 30 years.
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41
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Chromatographic purification of equine immunoglobulin G F(ab)2 from plasma. J Chromatogr B Analyt Technol Biomed Life Sci 2008; 876:109-15. [DOI: 10.1016/j.jchromb.2008.10.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2008] [Revised: 09/09/2008] [Accepted: 10/17/2008] [Indexed: 11/18/2022]
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42
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León G, Segura Á, Herrera M, Otero R, de Siqueira França FO, Barbaro KC, Cardoso JLC, Wen FH, de Medeiros CR, Prado JCL, Malaque CMS, Lomonte B, Gutiérrez JM. Human heterophilic antibodies against equine immunoglobulins: assessment of their role in the early adverse reactions to antivenom administration. Trans R Soc Trop Med Hyg 2008; 102:1115-9. [DOI: 10.1016/j.trstmh.2008.04.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 04/25/2008] [Accepted: 04/25/2008] [Indexed: 10/21/2022] Open
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43
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Application of methods for viral clearance in stem cell production. In Vitro Cell Dev Biol Anim 2007; 43:371-8. [PMID: 17934782 DOI: 10.1007/s11626-007-9059-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2007] [Accepted: 09/10/2007] [Indexed: 10/22/2022]
Abstract
Regenerative medicine therapies will allow in the future the transplant of cells of human origin in some diseases that until now have been incurable. The assurance of the safety and quality, especially from a microbiological point of view, is very important for these therapeutic products. Depending on the starting material, there are several sources of pathogen presence, mainly human viruses. Also, the use of feeders of animal origin as layers in which the stem cells can grow may permit the transmission of animal pathogens to these cells. However, cell sources are limited due to the low availability of spare in vitro fecundation human embryos and the low rate of success in the derivation of human stem cell lines. Thus, in several cases, it will be necessary to evaluate the possibility of removing or inactivating these microorganisms. In this paper, we summarize the main methods of viral clearance and we have provided an overview of the main features taking into account in the viral clearance techniques.
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Mpandi M, Schmutz P, Legrand E, Duc R, Geinoz J, Henzelin-Nkubana C, Giorgia S, Clerc O, Genoud D, Weber T. Partitioning and inactivation of viruses by the caprylic acid precipitation followed by a terminal pasteurization in the manufacturing process of horse immunoglobulins. Biologicals 2007; 35:335-41. [PMID: 17470396 DOI: 10.1016/j.biologicals.2007.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 01/17/2006] [Accepted: 02/21/2007] [Indexed: 11/26/2022] Open
Abstract
Caprylic acid (octanoic acid), has been used for over 50 years as a stabilizer of human albumin during pasteurization. In addition caprylic acid is of great interest, by providing the advantage of purifying mammalian immunoglobulins and clearing viruses infectivity in a single step. Exploiting these two properties, we sequentially used the caprylic acid precipitation and the pasteurization to purify horse hyperimmune globulins used in the manufacturing of Sérocytol. To evaluate the effectiveness of the process for the removal/inactivation of viruses, spiking studies were carried out for each dedicated step. Bovine viral diarrhoea virus (BVDV), pseudorabies virus (PRV), encephalomyocarditis virus (EMCV) and minute virus of mice (MVM) were used for the virological validation. Our data show that the treatment with caprylic acid 5% (v/v) can effectively be used as well to purify or to ensure viral safety of immunoglobulins. Caprylic acid precipitation was very efficient in removing and/or inactivating enveloped viruses (PRV, BVDV) and moderately efficient against non-enveloped viruses (MVM, ECMV). However the combination with the pasteurization ensured an efficient protection against both enveloped and non-enveloped viruses. So that viruses surviving to the caprylic acid precipitation will be neutralized by pasteurization. Significant log reduction were achieved > or =9 log(10) for enveloped viruses and 4 log(10) for non-enveloped viruses, providing the evidence of a margin of viral safety achieved by our manufacturing process. Its a simple and non-expensive manufacturing process of immunoglobulins easily validated that we have adapted to a large production scale with a programmable operating system.
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Affiliation(s)
- M Mpandi
- R & D, Serolab s.a., Chemin de la Vulliette 4, CP 36, 1000 Lausanne 25, Switzerland.
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45
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Burnouf T, Terpstra F, Habib G, Seddik S. Assessment of viral inactivation during pH 3.3 pepsin digestion and caprylic acid treatment of antivenoms. Biologicals 2007; 35:329-34. [PMID: 17363271 DOI: 10.1016/j.biologicals.2006.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2006] [Revised: 11/07/2006] [Accepted: 11/13/2006] [Indexed: 11/22/2022] Open
Abstract
Antivenoms are manufactured by the fractionation of animal plasma which may possibly be contaminated by infectious agents pathogenic to humans. This study was carried out to determine whether pre-existing antivenom production steps, as carried out by EgyVac in Egypt, may reduce viral risks. Two typical manufacturing steps were studied by performing down-scaled viral inactivation experiments: (a) a pH 3.3 pepsin digestion of diluted plasma at 30 degrees C for 1h, and (b) a caprylic acid treatment of a purified F(ab')2 fragment fraction at 18 degrees C for 1h. Three lipid-enveloped (LE) viruses [bovine viral diarrhoea virus (BVDV), pseudorabies virus (PRV), and vesicular stomatitis virus (VSV)] and one non-lipid-enveloped (NLE) virus [encephalomyocarditis virus (EMC)] were used as models. Kinetics of inactivation was determined by taking samples at 3 time-points during the treatments. The pH 3.3 pepsin digestion resulted in complete clearance of PRV (>7.0 log(10)) and in almost complete reduction of VSV (>4.5 but < or =6.4 log(10)), and in a limited inactivation of BVDV (1.7 log(10)). EMC inactivation was > or =2.5 but < or =5.7 log(10). The caprylic acid treatment resulted in complete inactivation of the 3 LE viruses tested: BVDV (>6.6 log(10)), PRV (>6.6 log(10)), and VSV (>7.0 log(10)). For EMC no significant reduction was obtained (0.7 log(10)). Cumulative reduction was >13.6, >11.5, >8.3 and > or =2.5 for PRV, VSV, BVDV and EMC, respectively. Therefore the current manufacturing processes of at least some animal antisera already include production steps that can ensure robust viral inactivation of LE viruses and moderate inactivation of a NLE virus.
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Affiliation(s)
- Thierry Burnouf
- Human Plasma Product Services, 18 rue Saint-Jacques, F-59000 Lille, France.
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46
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Bryant BJ, Klein HG. Pathogen inactivation: the definitive safeguard for the blood supply. Arch Pathol Lab Med 2007; 131:719-33. [PMID: 17488157 DOI: 10.5858/2007-131-719-pitdsf] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2007] [Indexed: 11/06/2022]
Abstract
CONTEXT Pathogen inactivation provides a proactive approach to cleansing the blood supply. In the plasma fractionation and manufacturing industry, pathogen inactivation technologies have been successfully implemented resulting in no transmission of human immunodeficiency, hepatitis C, or hepatitis B viruses by US-licensed plasma derivatives since 1985. However, these technologies cannot be used to pathogen inactivate cellular blood components. Although current blood donor screening and disease testing has drastically reduced the incidence of transfusion-transmitted diseases, there still looms the threat to the blood supply of a new or reemerging pathogen. Of particular concern is the silent emergence of a new agent with a prolonged latent period in which asymptomatic infected carriers would donate and spread infection. OBJECTIVE To review and summarize the principles, challenges, achievements, prospective technologies, and future goals of pathogen inactivation of the blood supply. DATA SOURCES The current published English-language literature from 1968 through 2006 and a historical landmark article from 1943 are integrated into a review of this subject. CONCLUSIONS The ultimate goal of pathogen inactivation is to maximally reduce the transmission of potential pathogens without significantly compromising the therapeutic efficacy of the cellular and protein constituents of blood. This must be accomplished without introducing toxicities into the blood supply and without causing neoantigen formation and subsequent antibody production. Several promising pathogen inactivation technologies are being developed and clinically tested, and others are currently in use. Pathogen inactivation offers additional layers of protection from infectious agents that threaten the blood supply and has the potential to impact the safety of blood transfusions worldwide.
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Affiliation(s)
- Barbara J Bryant
- National Institutes of Health, Warren G. Magnuson Clinical Center, Department of Transfusion Medicine, 10 Center Dr, MSC-1184, Building 10, Room 1C711, Bethesda, MD 20894-1184, USA.
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Horneman DA, Ottens M, van der Wielen LAM, Keurentjes JTF. Viral clearance using surfactant-aided size-exclusion chromatography. AIChE J 2007. [DOI: 10.1002/aic.11145] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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48
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Gutiérrez JM, Higashi HG, Wen FH, Burnouf T. Strengthening antivenom production in Central and South American public laboratories: Report of a workshop. Toxicon 2007; 49:30-5. [PMID: 17084428 DOI: 10.1016/j.toxicon.2006.09.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Accepted: 09/12/2006] [Indexed: 12/01/2022]
Abstract
A workshop on antivenom production in Central and South American public laboratories was performed at Instituto Butantan, Sao Paulo, Brazil, from June 12 to June 16, 2006, under the auspices of the program CYTED. The activity was attended by representatives of public laboratories from Costa Rica, Colombia, Perú, Bolivia, Brazil, and Uruguay. Representatives of the World Health Organization (WHO) and the Brazilian Ministry of Health also participated in the workshop. The political, institutional and technological issues related with antivenom manufacture and distribution in these countries were discussed. Current problems on antivenom production and distribution were analyzed, and the need to strengthen collaborative links between countries was stressed, particularly regarding training programs, transfer of technology, and distribution of antivenoms, with the involvement of the Pan American Health Organization and the WHO. Future workshops on other relevant issues, such as quality control and regulatory policies, are being planned, together with collaborative research efforts between the laboratories.
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Affiliation(s)
- José María Gutiérrez
- Facultad de Microbiología, Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Costa Rica.
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49
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Abstract
Envenoming resulting from snake bites is an important public health hazard in many regions of the world, yet public health authorities have given little attention to the problem.
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Affiliation(s)
- José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
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