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Ganeshkumar A, Muthuselvam M, de Lima PMN, Rajaram R, Junqueira JC. Current Perspectives of Antifungal Therapy: A Special Focus on Candida auris. J Fungi (Basel) 2024; 10:408. [PMID: 38921394 PMCID: PMC11205254 DOI: 10.3390/jof10060408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
Candida auris is an emerging Candida sp. that has rapidly spread all over the world. The evidence regarding its origin and emerging resistance is still unclear. The severe infection caused by this species results in significant mortality and morbidity among the elderly and immunocompromised individuals. The development of drug resistance is the major factor associated with the therapeutic failure of existing antifungal agents. Previous studies have addressed the antifungal resistance profile and drug discovery for C. auris. However, complete coverage of this information in a single investigation is not yet available. In this review, we have mainly focused on recent developments in therapeutic strategies against C. auris. Based on the available information, several different approaches were discussed, including existing antifungal drugs, chemical compounds, essential oils, natural products, antifungal peptides, immunotherapy, antimicrobial photodynamic therapy, drug repurposing, and drug delivery systems. Among them, synthetic chemicals, natural products, and antifungal peptides are the prime contributors. However, a limited number of resources are available to prove the efficiency of these potential therapies in clinical usage. Therefore, we anticipate that the findings gathered in this review will encourage further in vivo studies and clinical trials.
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Affiliation(s)
- Arumugam Ganeshkumar
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12245-000, SP, Brazil;
- Department of Materials Physics, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences (SIMTS), Chennai 602105, Tamil Nadu, India
| | - Manickam Muthuselvam
- Department of Biotechnology, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu, India;
| | - Patricia Michelle Nagai de Lima
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12245-000, SP, Brazil;
| | - Rajendren Rajaram
- Department of Marine Science, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu, India;
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12245-000, SP, Brazil;
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Novel Intravenous Immunoglobulin Therapy for the Prevention and Treatment of Candida auris and Candida albicans Disseminated Candidiasis. mSphere 2023; 8:e0058422. [PMID: 36688668 PMCID: PMC9942587 DOI: 10.1128/msphere.00584-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Disseminated candidiasis is a life-threatening disease and remains the most common bloodstream infection in hospitalized patients in the United States. Despite the availability of modern antifungal therapy, the crude mortality rate in the last decade has remained unacceptably high. Novel approaches are urgently needed to supplement or replace current antifungal therapies. In our study, we show that human intravenous immunoglobulin (IVIG) can provide protection against Candida auris and Candida albicans disseminated infections in A/J and C57BL/6 mouse models. The protective efficacy of IVIG is evidenced by the prolonged survival of mice with invasive candidiasis that were treated with human IVIG alone or in combination with amphotericin B. Our previous studies have led to the identification of a panel of Candida cell surface peptide and glycan epitopes, which are targeted by protective mouse monoclonal antibodies (mAbs) against invasive candidiasis. Of interest, the peptide- and glycan-specific IgGs could be detected in all 18 human IVIG samples. In particular, the specific IVIG lots with the highest protective peptide- and glycan-related IgGs provided the best protection. The combination of IVIG and amphotericin B had enhanced efficacy in protection compared to monotherapy against both multidrug-resistant (MDR) C. auris and C. albicans, with evidence of significantly prolonged survival and lower fungal burdens in targeted organs. This study provides evidence that the protective effects of IVIG were associated with the protective antibodies found in normal human donor sera against pathogenic Candida, and IVIG can be a novel therapy or adjunctive therapy with modern antifungal drugs against disseminated candidiasis. IMPORTANCE Since current antifungal treatments are ineffective in the immunocompromised population and no vaccine is available for humans, hope remains that antibody preparations selected for specific fungal antigens may make it possible to reduce the incidence and mortality of invasive candidiasis. Intravenous immunoglobulin (IVIG) has long been approved as a standard treatment for patients with immunodeficiency disorders who are also susceptible to fungal infection. IVIG has been widely used as prophylaxis or supplemental treatment for sepsis and septic shock; however, this form of adjunctive therapy lacks convincing data to establish its efficacy. In this study, 18 samples from commercial IVIG preparations were screened and evaluated by enzyme-linked immunosorbent assays (ELISAs); Candida peptide- and glycan-specific IgGs were detected with various titers among all IVIG lots. Importantly, significantly reduced organ fungal burdens and mortality were demonstrated in IVIG-treated mouse models of invasive candidiasis. IVIG lots with higher titers of Candida-specific IgGs provided better protection. These findings are important in (i) selecting Candida-specific IVIG therapy that may overcome several shortcomings of conventional IVIG therapy by targeting specific antigens responsible for disease pathogenesis, (ii) enhancing protective efficacy, and (iii) validating data from our previous studies and those of others showing that antibodies combined with conventional antifungal drugs provided enhanced resistance to disease. To our knowledge, this study is the first to demonstrate that human IVIG samples contain protective IgGs targeting Candida cell surface antigens and can be a novel therapy or adjunctive therapy with modern antifungal drugs against disseminated candidiasis.
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Pedraza-Sánchez S, Cruz-González A, Palmeros-Rojas O, Gálvez-Romero JL, Bellanti JA, Torres M. Polyvalent human immunoglobulin for infectious diseases: Potential to circumvent antimicrobial resistance. Front Immunol 2023; 13:987231. [PMID: 36713426 PMCID: PMC9880058 DOI: 10.3389/fimmu.2022.987231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/05/2022] [Indexed: 01/11/2023] Open
Abstract
Antimicrobial resistance (AMR) is a global health problem that causes more than 1.27 million deaths annually; therefore, it is urgent to focus efforts on solving or reducing this problem. The major causes of AMR are the misuse of antibiotics and antimicrobials in agriculture, veterinary medicine, and human medicine, which favors the selection of drug-resistant microbes. One of the strategies proposed to overcome the problem of AMR is to use polyvalent human immunoglobulin or IVIG. The main advantage of this classic form of passive immunization is its capacity to enhance natural immunity mechanisms to eliminate bacteria, viruses, or fungi safely and physiologically. Experimental data suggest that, for some infections, local administration of IVIG may produce better results with a lower dose than intravenous application. This review presents evidence supporting the use of polyvalent human immunoglobulin in AMR, and the potential and challenges associated with its proposed usage.
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Affiliation(s)
- Sigifredo Pedraza-Sánchez
- Unidad de Bioquímica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico,*Correspondence: Martha Torres, ; Sigifredo Pedraza-Sánchez,
| | - Adrián Cruz-González
- Facultad de Ciencias, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Oscar Palmeros-Rojas
- Área de matemáticas, preparatoria agrícola, Universidad Autónoma Chapingo, Texcoco, Mexico
| | | | | | - Martha Torres
- Subdirección de Investigación Biomédica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico,*Correspondence: Martha Torres, ; Sigifredo Pedraza-Sánchez,
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Ravindranath MH, El Hilali F, Amato-Menker CJ, El Hilali H, Selvan SR, Filippone EJ. Role of HLA-I Structural Variants and the Polyreactive Antibodies They Generate in Immune Homeostasis. Antibodies (Basel) 2022; 11:antib11030058. [PMID: 36134954 PMCID: PMC9495617 DOI: 10.3390/antib11030058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022] Open
Abstract
Cell-surface HLA-I molecules consisting of β2-microglobulin (β2m) associated heavy chains (HCs), referred to as Face-1, primarily present peptides to CD8+ T-cells. HCs consist of three α-domains, with selected amino acid sequences shared by all alleles of all six isoforms. The cell-surface HLA undergoes changes upon activation by pathological conditions with the expression of β2m-free HCs (Face-2) resulting in exposure of β2m-masked sequences shared by almost all alleles and the generation of HLA-polyreactive antibodies (Abs) against them. Face-2 may homodimerize or heterodimerize with the same (Face-3) or different alleles (Face-4) preventing exposure of shared epitopes. Non-allo immunized males naturally carry HLA-polyreactive Abs. The therapeutic intravenous immunoglobulin (IVIg) purified from plasma of thousands of donors contains HLA-polyreactive Abs, admixed with non-HLA Abs. Purified HLA-polyreactive monoclonal Abs (TFL-006/007) generated in mice after immunizing with Face-2 are documented to be immunoregulatory by suppressing or activating different human lymphocytes, much better than IVIg. Our objectives are (a) to elucidate the complexity of the HLA-I structural variants, and their Abs that bind to both shared and uncommon epitopes on different variants, and (b) to examine the roles of those Abs against HLA-variants in maintaining immune homeostasis. These may enable the development of personalized therapeutic strategies for various pathological conditions.
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Affiliation(s)
- Mepur H. Ravindranath
- Department of Hematology and Oncology, Children’s Hospital, Los Angeles, CA 90027, USA
- Emeritus Research Scientist, Terasaki Foundation Laboratory, Santa Monica, CA 90064, USA
- Correspondence:
| | - Fatiha El Hilali
- Medico-Surgical, Biomedicine and Infectiology Research Laboratory, The Faculty of Medicine and Pharmacy of Laayoune & Agadir, Ibn Zohr University, Agadir 80000, Morocco
| | - Carly J. Amato-Menker
- Department of Microbiology, Immunology, and Cell Biology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Hajar El Hilali
- Medico-Surgical, Biomedicine and Infectiology Research Laboratory, The Faculty of Medicine and Pharmacy of Laayoune & Agadir, Ibn Zohr University, Agadir 80000, Morocco
| | - Senthamil R. Selvan
- Division of Immunology and Hematology Devices, OHT 7: Office of In Vitro Diagnostics, Office of Product Evaluation and Quality, Center for Devices and Radiological Health, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
| | - Edward J. Filippone
- Division of Nephrology, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19145, USA
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Ding G, Chen G, Vinturache A, Zhang Y, Li Z. Eczema Herpeticum in an Infant. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:4468-4469. [PMID: 34503938 DOI: 10.1016/j.jaip.2021.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Guodong Ding
- Department of Pediatric Respiratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guifeng Chen
- Department of Pediatrics, the First People's Hospital of Jiashan, Zhejiang, China
| | - Angela Vinturache
- Department of Obstetrics & Gynecology, Queen Elizabeth II Hospital, Alberta, Canada
| | - Yongjun Zhang
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Zhongjie Li
- Department of Pediatrics, the First People's Hospital of Jiashan, Zhejiang, China.
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Labarrere CA, Kassab GS. Pattern Recognition Proteins: First Line of Defense Against Coronaviruses. Front Immunol 2021; 12:652252. [PMID: 34630377 PMCID: PMC8494786 DOI: 10.3389/fimmu.2021.652252] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/31/2021] [Indexed: 01/08/2023] Open
Abstract
The rapid outbreak of COVID-19 caused by the novel coronavirus SARS-CoV-2 in Wuhan, China, has become a worldwide pandemic affecting almost 204 million people and causing more than 4.3 million deaths as of August 11 2021. This pandemic has placed a substantial burden on the global healthcare system and the global economy. Availability of novel prophylactic and therapeutic approaches are crucially needed to prevent development of severe disease leading to major complications both acutely and chronically. The success in fighting this virus results from three main achievements: (a) Direct killing of the SARS-CoV-2 virus; (b) Development of a specific vaccine, and (c) Enhancement of the host's immune system. A fundamental necessity to win the battle against the virus involves a better understanding of the host's innate and adaptive immune response to the virus. Although the role of the adaptive immune response is directly involved in the generation of a vaccine, the role of innate immunity on RNA viruses in general, and coronaviruses in particular, is mostly unknown. In this review, we will consider the structure of RNA viruses, mainly coronaviruses, and their capacity to affect the lungs and the cardiovascular system. We will also consider the effects of the pattern recognition protein (PRP) trident composed by (a) Surfactant proteins A and D, mannose-binding lectin (MBL) and complement component 1q (C1q), (b) C-reactive protein, and (c) Innate and adaptive IgM antibodies, upon clearance of viral particles and apoptotic cells in lungs and atherosclerotic lesions. We emphasize on the role of pattern recognition protein immune therapies as a combination treatment to prevent development of severe respiratory syndrome and to reduce pulmonary and cardiovascular complications in patients with SARS-CoV-2 and summarize the need of a combined therapeutic approach that takes into account all aspects of immunity against SARS-CoV-2 virus and COVID-19 disease to allow mankind to beat this pandemic killer.
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Affiliation(s)
| | - Ghassan S Kassab
- California Medical Innovations Institute, San Diego, CA, United States
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Omma A, Erden A, Armağan B, Güven SC, Karakaş Ö, Şahiner ES, Erdem D, İzdeş S, Ateş İ, Küçükşahin O. A single center experience of intravenous immunoglobulin treatment in Covid-19. Int Immunopharmacol 2021; 98:107891. [PMID: 34153671 PMCID: PMC8200303 DOI: 10.1016/j.intimp.2021.107891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/26/2021] [Accepted: 06/11/2021] [Indexed: 12/12/2022]
Abstract
Background Intravenous immunoglobulins (IVIg) have been used in management of severe Covid-19. Here in this study, we report our single-center experience regarding IVIg treatment in management of severe Covid-19. Materials and Method Among hospitalized adult Covid-19 patients between April 1 and December 31, 2020, patients with confirmed diagnosis of Covid-19 who had Brescia-COVID respiratory severity scale score ≥ 3, hyperinflammation and received IVIg treatment in addition to standard of care were retrospectively investigated. We grouped IVIg recipients into three according to reasons for IVIg administration: Group 1 patients requiring anti-inflammatory treatment but complicated with secondary infection and/or sepsis , group 2 patients with Covid-19 related complications including progressive disease refractory to other anti-inflammatory agents, myocarditis, adult multisystem inflammatory syndrome, hemophagocytic lymphohystiocytosis like syndrome and group 3 patients with other complications non-specific to Covid-19. Mortality and clinical data was compared among groups. Results A total of 46 IVIg recipients were enrolled. Group 1 comprised 17 (36.9%), group 2 comprised 18 (39.1%) and group 3 comprised 11 (23.9%) patients. No significant differences in means of age, gender and comorbidities were observed among groups. Mortality was significantly lower in group 3 when compared to group 1 (64.7% vs 18.2%, p = 0.016) and close to significance when compared to group 2 (50% vs 18.2% p = 0.087). Conclusions IVIg seemed to be used mostly in severe, refractory and complicated cases in our population. As a rescue agent in severe cases refractory to other anti-inflammatory strategies, 33.7% survival rate was observed with IVIg.
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Affiliation(s)
- Ahmet Omma
- Ministry of Health Ankara City Hospital, Clinic of Rheumatology, Ankara 06800, Turkey
| | - Abdulsamet Erden
- Ministry of Health Ankara City Hospital, Clinic of Rheumatology, Ankara 06800, Turkey
| | - Berkan Armağan
- Ministry of Health Ankara City Hospital, Clinic of Rheumatology, Ankara 06800, Turkey
| | - Serdar Can Güven
- Ministry of Health Ankara City Hospital, Clinic of Rheumatology, Ankara 06800, Turkey.
| | - Özlem Karakaş
- Ministry of Health Ankara City Hospital, Clinic of Rheumatology, Ankara 06800, Turkey
| | - Enes Seyda Şahiner
- Ministry of Health Ankara City Hospital, Clinic of Internal Medicine, Ankara 06800, Turkey
| | - Deniz Erdem
- University of Health Sciences, School of Medicine, Ankara City Hospital, Department of Anesthesia and Resuscitation, Ankara 06800, Turkey
| | - Seval İzdeş
- Yıldırım Beyazıt University, School of Medicine, Department of Anesthesiology and Reanimation-Critical Care, Ankara 06800, Turkey
| | - İhsan Ateş
- University of Health Sciences, School of Medicine, Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Orhan Küçükşahin
- Yıldırım Beyazıt University, School of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara 06800, Turkey
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Immune-Based Therapy for COVID-19. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:449-468. [PMID: 33973194 DOI: 10.1007/978-3-030-63761-3_26] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel zoonotic virus identified as the cause of coronavirus disease 2019 (COVID-19) that has crossed species and infected humans. In order to develop new insights on the immune-based treatments against this disease, it is vital to understand the immunopathology of the COVID-19, implications of the immune response to SARS-CoV-2, and immune dysfunction in response to SARS-CoV-2. There is no approved drug for the treatment of COVID-19. It is, thus, promising to design immune-based treatments that inhibit the infectious mechanism of the virus, improve the inadequate immune response, or regulate the hyperactivated immune response in severely ill patients. According to the antiviral immune response against the virus, antibody-based immunotherapies of COVID-19 include injection of convalescent plasma from recovered patients, high-dose intravenous immunoglobulins (IVIG), monoclonal antibodies, and polyclonal antibodies. Also, cell-based treatment, vaccine-based approaches, cytokine-based immunotherapy, immune checkpoint inhibitors, JAK inhibitors, decoy receptors, and immunosuppressive drugs are discussed in this chapter.
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Kumar D, Gauthami S, Bayry J, Kaveri SV, Hegde NR. Antibody Therapy: From Diphtheria to Cancer, COVID-19, and Beyond. Monoclon Antib Immunodiagn Immunother 2021; 40:36-49. [PMID: 33900819 DOI: 10.1089/mab.2021.0004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The dawn of the 20th century saw the formative years of developments in immunology. In particular, immunochemistry, specifically pertaining to antibodies, was extensively studied. These studies laid the foundations for employing antibodies in a variety of ways. Not surprisingly, antibodies have been used for applications ranging from biomedical research to disease diagnostics and therapeutics to evaluation of immune responses during natural infection and those elicited by vaccines. Despite recent advancements in cellular immunology and the excitement of T cell therapy, use of antibodies represents a large proportion of immunotherapeutic approaches as well as clinical interventions. Polyclonal antibodies in the form of plasma or sera continue to be used to treat a number of diseases, including autoimmune disorders, cancers, and infectious diseases. Historically, antisera to toxins have been the longest serving biotherapeutics. In addition, intravenous immunoglobulins (IVIg) have been extensively used to treat not only immunodeficiency conditions but also autoimmune disorders. Beyond the simplistic suppositions of their action, the IVIg have also unraveled the immune regulatory and homeostatic ramifications of their use. The advent of monoclonal antibodies (MAbs), on the other hand, has provided a clear pathway for their development as drug molecules. MAbs have found a clear place in the treatment of cancers and extending lives and have been used in a variety of other conditions. In this review, we capture the important developments in the therapeutic applications of antibodies to alleviate disease, with a focus on some of the recent developments.
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Affiliation(s)
| | - Sulgey Gauthami
- National Institute of Animal Biotechnology, Hyderabad, India
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France.,Indian Institute of Technology Palakkad, Palakkad, Kerala, India
| | - Srinivas V Kaveri
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France.,Centre National de la Recherche Scientifique (CNRS) Bureau India, IFI, New Delhi, India
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Lima IFP, Matos FRD, Bernardino ÍDM, Santana ITS, Vieira WDA, Blumenberg C, Siqueira WL, Paranhos LR. RANK, RANKL, and OPG in Dentigerous Cyst, Odontogenic Keratocyst, and Ameloblastoma: A Meta-Analysis. Braz Dent J 2021; 32:16-25. [PMID: 33913997 DOI: 10.1590/0103-6440202103387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/12/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to assess and compare RANK, RANKL, and OPG immunoexpression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma. The protocol was registered in PROSPERO (CRD42018105543). Seven databases (Embase, Lilacs, LIVIVO, PubMed, Scopus, SciELO, and Web of Science) were the primary search sources and two databases (Open Grey and Open Thesis) partially captured the "grey literature". Only cross sectional studies were included. The JBI Checklist assessed the risk of bias. A meta-analysis with random effects model estimated the values from the OPG and RANKL ratio reported by the individual studies and respective 95% confidence intervals. The heterogeneity among studies was assessed with I2 statistics. Only nine studies met the inclusion criteria and were considered in the analyses. The studies were published from 2008 to 2018. Two studies presented low risk of bias, while seven studies presented moderate risk. The meta-analysis showed the highest OPG>RANKL ratio for dentigerous cyst (ES=43.3%; 95% CI=14.3-74.8) and odontogenic keratocyst (ES=36.8%; 95% CI=18.8-56.7). In contrast, the highest OPG<RANKL ratio was found for ameloblastoma (ES=73.4%; 95% CI=55.4-88.4) and it was higher in the stromal region compared to the odontogenic epithelial region. The results may explain the aggressive potential of ameloblastoma from the higher OPG<RANKL ratio in this tumor, while it was lower for dentigerous cyst and odontogenic keratocyst.
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Affiliation(s)
- Igor Felipe Pereira Lima
- Department of Oral Pathology, School of Dentistry, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Cauane Blumenberg
- Department of Social Medicine, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Luiz Renato Paranhos
- Department of Preventive and Community Dentistry, UFU - Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
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Nabih HK. Importance of immunoglobulin therapy for COVID-19 patients with lymphocytopenia. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2021; 45:46. [PMID: 33642851 PMCID: PMC7897881 DOI: 10.1186/s42269-021-00502-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/10/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The global coronavirus disease 2019 (COVID-19) was announced as pandemic by the World Health Organization (WHO). With the increased number of infected and dead victims daily all over the world, it becomes necessary to stop or overcome its rapid spread.Main bodyAlthough the production of vaccine or even specified effective anti-virus may take about six months to a year, intravenous immunoglobulin (IVIg) may be clinically used as a safe treatment to save and improve the quality of life of patients with a variety of immunodeficiency diseases such as lymphocytopenia, which is a common clinical feature in COVID-19. CONCLUSION Through the current review, it was concluded that this passive immunization may promote the immunity to better fight against the virus, so the survival of the patients could be kept longer. The efficacy of immunotherapy with IVIg would be greater if the immune IgG antibodies were collected from convalescent plasma therapy.
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Affiliation(s)
- Heba K. Nabih
- Medical Biochemistry Department, Medical Research Division, National Research Centre, 33 El Bohouth St. (Former El Tahrir St.), Dokki, P.O. 12622, Giza, Egypt
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Chronic Lymphocytic Leukemia-Induced Humoral Immunosuppression: A Systematic Review. Cells 2020; 9:cells9112398. [PMID: 33147729 PMCID: PMC7693361 DOI: 10.3390/cells9112398] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 12/22/2022] Open
Abstract
Secondary immunodeficiency is observed in all patients with chronic lymphocytic leukemia (CLL) in varying degrees. The aim of the study was to review the available literature data on patients with CLL, with particular regard to the pathogenesis of the disease and the impact of humoral immunity deficiency on the clinical and therapeutic approach. A systematic literature review was carried out by two independent authors who searched PubMed databases for studies published up to January 2020. Additionally, Google Scholar was used to evaluate search results and support manual research. The search resulted in 240 articles eligible for analysis. After all criteria and filters were applied, 22 studies were finally applied to the analysis. The data analysis showed that the clinical heterogeneity of CLL patients correlates with the diversity of molecular abnormalities determining the clinical picture of the disease, the analysis of which enables setting therapeutic targets. Additionally, in improving the therapeutic method, it is worth introducing supportive therapies with the use of vaccines, antibiotics and/or immunoglobins. Moreover, humoral immunodeficiency in CLL has a strong influence on the risk of infection in patients for whom infections are a major cause of morbidity and mortality.
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Kubota-Koketsu R, Terada Y, Yunoki M, Sasaki T, Nakayama EE, Kamitani W, Shioda T. Neutralizing and binding activities against SARS-CoV-1/2, MERS-CoV, and human coronaviruses 229E and OC43 by normal human intravenous immunoglobulin derived from healthy donors in Japan. Transfusion 2020; 61:356-360. [PMID: 33104267 DOI: 10.1111/trf.16161] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/06/2020] [Accepted: 09/18/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND There are several types of coronaviruses that infect humans and cause disease. The latest is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is an emerging global threat with no current effective treatment. Normal intravenous immunoglobulin (N-IVIG) has been administered to coronavirus disease 2019 (COVID-19) patients to control severe inflammation and the cellular immune response. However, the neutralizing activity of N-IVIG against SARS-CoV-2 has not yet been fully evaluated. The aim of this study was to determine whether N-IVIG manufactured before the start of the COVID-19 pandemic contained IgG antibodies against the circulating human coronaviruses (HCoVs) that cross-react with the highly pathogenic coronaviruses SARS-CoV-1, Middle East respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2. No cases of SARS-CoV-1 or MERS-CoV have been reported in Japan. STUDY DESIGN AND METHODS The neutralizing and binding activities of N-IVIG against SARS-CoV-1, MERS-CoV, SARS-CoV-2, HCoV 229E, and HCoV OC43 were evaluated. Nine N-IVIG lots manufactured between 2000 and 2018, derived from donors in Japan, were tested. Binding activity was evaluated by indirect immunofluorescence assay. RESULTS None of the N-IVIG lots tested displayed neutralizing or binding activity against SARS-CoV-1, MERS-CoV, or SARS-CoV-2. However, they displayed substantial neutralizing and binding activity against HCoV OC43 and weak neutralizing and substantial binding activity against HCoV 229E. CONCLUSION N-IVIG derived from healthy donors in Japan before the start of the COVID-19 pandemic had no direct effect against SARS-CoV-2. Further studies are warranted to determine the effects of N-IVIG manufactured after the start of the COVID-19 pandemic against SARS-CoV-2.
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Affiliation(s)
- Ritsuko Kubota-Koketsu
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Yutaka Terada
- Laboratory of Clinical Research on Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Mikihiro Yunoki
- Research and Development Division, Japan Blood Products Organization, Tokyo, Japan
| | - Tadahiro Sasaki
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Emi E Nakayama
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Wataru Kamitani
- Laboratory of Clinical Research on Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infectious Diseases and Host Defense, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Tatsuo Shioda
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
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14
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Natural Antibodies: from First-Line Defense Against Pathogens to Perpetual Immune Homeostasis. Clin Rev Allergy Immunol 2020; 58:213-228. [PMID: 31161341 DOI: 10.1007/s12016-019-08746-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Natural antibodies (nAbs) are most commonly defined as immunoglobulins present in the absence of pathological conditions or deliberate immunizations. Occurrence of nAbs in germ- and antigen-free mice suggest that their production is driven, at least in part, by self-antigens. Accordingly, nAbs are constituted of natural autoantibodies (nAAbs), and can belong to the IgM, IgG, or IgA subclasses. These nAbs provide immediate protection against infection while the adaptive arm of the immune system mounts a specific and long-term response. Beyond immediate protection from infection, nAbs have been shown to play various functional roles in the immune system, which include clearance of apoptotic debris, suppression of autoimmune and inflammatory responses, regulation of B cell responses, selection of the B cell repertoires, and regulation of B cell development. These various functions of nAbs are afforded by their reactivity, which is broad, cross-reactive, and shown to recognize evolutionarily fixed epitopes shared between foreign and self-antigens. Furthermore, nAbs have unique characteristics that also contribute to their functional roles and set them apart from antigen-specific antibodies. In further support for the role of nAbs in the protection against infections and in the maintenance of immune homeostasis, the therapeutic preparation of polyclonal immunoglobulins, intravenous immunoglobulin (IVIG), rich in nAbs is commonly used in the replacement therapy of primary and secondary immunodeficiencies and in the immunotherapy of a large number of autoimmune and inflammatory diseases. Here, we review several topics on nAbs features and functions, and therapeutic applications in human diseases.
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15
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Mansourabadi AH, Sadeghalvad M, Mohammadi-Motlagh HR, Rezaei N. The immune system as a target for therapy of SARS-CoV-2: A systematic review of the current immunotherapies for COVID-19. Life Sci 2020; 258:118185. [PMID: 32750438 PMCID: PMC7395832 DOI: 10.1016/j.lfs.2020.118185] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 12/21/2022]
Abstract
AIMS The immune response is essential for the control and resolution of viral infections. Following the outbreak of novel coronavirus disease (COVID-19), several immunotherapies were applied to modulate the immune responses of the affected patients. In this review, we aimed to describe the role of the immune system in response to COVID-19. We also provide a systematic review to collate and describe all published reports of the using immunotherapies, including convalescent plasma therapy, monoclonal antibodies, cytokine therapy, mesenchymal stem cell therapy, and intravenous immunoglobulin and their important outcomes in COVID-19 patients. MATERIAL AND METHODS A thorough search strategy was applied to identify published research trials in PubMed, Scopus, Medline, and EMBASE from Dec 1, 2019, to May 4, 2020, for studies reporting clinical outcomes of COVID-19 patients treated with immunotherapies along with other standard cares. KEY FINDINGS From an initial screen of 80 identified studies, 24 studies provided clinical outcome data on the use of immunotherapies for the treatment of COVID-19 patients, including convalescent plasma therapy (33 patients), monoclonal antibodies (55 patients), interferon (31 patients), mesenchymal stem cell therapy (8 patient), and immunoglobulin (63 patients). Except for nine severe patients who died after treatment, most patients were recovered from COVID-19 with improved clinical symptoms and laboratory assessment. SIGNIFICANCE Based on the available evidence, it seems that treatment with immunotherapy along with other standard cares could be an effective and safe approach to modulate the immune system and improvement of clinical outcomes.
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Affiliation(s)
- Amir Hossein Mansourabadi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mona Sadeghalvad
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran,Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran,Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid-Reza Mohammadi-Motlagh
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nima Rezaei
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
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16
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Phanthong S, Densumite J, Seesuay W, Thanongsaksrikul J, Teimoori S, Sookrung N, Poovorawan Y, Onvimala N, Guntapong R, Pattanapanyasat K, Chaicumpa W. Human Antibodies to VP4 Inhibit Replication of Enteroviruses Across Subgenotypes and Serotypes, and Enhance Host Innate Immunity. Front Microbiol 2020; 11:562768. [PMID: 33101238 PMCID: PMC7545151 DOI: 10.3389/fmicb.2020.562768] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a highly contagious disease that usually affects infants and young children (<5 years). HFMD outbreaks occur frequently in the Asia-Pacific region, and these outbreaks are associated with enormous healthcare and socioeconomic burden. There is currently no specific antiviral agent to treat HFMD and/or the severe complications that are frequently associated with the enterovirus of serotype EV71. Therefore, the development of a broadly effective and safe anti-enterovirus agent is an existential necessity. In this study, human single-chain antibodies (HuscFvs) specific to the EV71-internal capsid protein (VP4) were generated using phage display technology. VP4 specific-HuscFvs were linked to cell penetrating peptides to make them cell penetrable HuscFvs (transbodies), and readily accessible to the intracellular target. The transbodies, as well as the original HuscFvs that were tested, entered the enterovirus-infected cells, bound to intracellular VP4, and inhibited replication of EV71 across subgenotypes A, B, and C, and coxsackieviruses CVA16 and CVA6. The antibodies also enhanced the antiviral response of the virus-infected cells. Computerized simulation, indirect and competitive ELISAs, and experiments on cells infected with EV71 particles to which the VP4 and VP1-N-terminus were surface-exposed (i.e., A-particles that don’t require receptor binding for infection) indicated that the VP4 specific-antibodies inhibit virus replication by interfering with the VP4-N-terminus, which is important for membrane pore formation and virus genome release leading to less production of virus proteins, less infectious virions, and restoration of host innate immunity. The antibodies may inhibit polyprotein/intermediate protein processing and cause sterically strained configurations of the capsid pentamers, which impairs virus morphogenesis. These antibodies should be further investigated for application as a safe and broadly effective HFMD therapy.
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Affiliation(s)
- Siratcha Phanthong
- Graduate Program in Immunology, Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Department of Parasitology, Faculty of Medicine Siriraj Hospital, Center of Research Excellence in Therapeutic Proteins and Antibody Engineering, Mahidol University, Bangkok, Thailand
| | - Jaslan Densumite
- Graduate Program in Immunology, Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Department of Parasitology, Faculty of Medicine Siriraj Hospital, Center of Research Excellence in Therapeutic Proteins and Antibody Engineering, Mahidol University, Bangkok, Thailand
| | - Watee Seesuay
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Center of Research Excellence in Therapeutic Proteins and Antibody Engineering, Mahidol University, Bangkok, Thailand
| | - Jeeraphong Thanongsaksrikul
- Graduate Program in Biomedical Science, Faculty of Allied Health Sciences, Thammasat University, Bangkok, Thailand
| | - Salma Teimoori
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Center of Research Excellence in Therapeutic Proteins and Antibody Engineering, Mahidol University, Bangkok, Thailand
| | - Nitat Sookrung
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Center of Research Excellence in Therapeutic Proteins and Antibody Engineering, Mahidol University, Bangkok, Thailand.,Biomedical Research Incubator Unit, Department of Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yong Poovorawan
- Department of Pediatrics, Faculty of Medicine, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
| | - Napa Onvimala
- Department of Medical Science, Ministry of Public Health, National Institute of Health, Nonthaburi, Thailand
| | - Ratigorn Guntapong
- Department of Medical Science, Ministry of Public Health, National Institute of Health, Nonthaburi, Thailand
| | - Kovit Pattanapanyasat
- Biomedical Research Incubator Unit, Department of Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanpen Chaicumpa
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Center of Research Excellence in Therapeutic Proteins and Antibody Engineering, Mahidol University, Bangkok, Thailand
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17
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Gupta A, Karki R, Dandu HR, Dhama K, Bhatt ML, Saxena SK. COVID-19: benefits and risks of passive immunotherapeutics. Hum Vaccin Immunother 2020; 16:2963-2972. [PMID: 32962524 PMCID: PMC7544960 DOI: 10.1080/21645515.2020.1808410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Passive immunotherapeutics (PITs), including convalescent plasma, serum, or hyperimmune immunoglobulin, have been of clinical importance during sudden outbreaks since the early twentieth century for the treatment of viral diseases such as severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS) and swine flu (H1N1). With the recent SARS-CoV-2 pandemic, wherein effective antivirals and vaccines are still lacking, an interest in convalescent plasma therapy as a lifesaving option has resurfaced due to its capacity for antigenic neutralization and reducing viremia. This review summarizes convalescent blood products (CBPs) in terms of current technologies and the shortcomings related to the collection, manufacture, pathogen inactivation, and banking of CBPs, with a specific focus on their plausible applications, benefits, and risks in the COVID-19 pandemic.
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Affiliation(s)
- Ankur Gupta
- Ceutica & Chemie Healthcare Pvt. Ltd ., Bangalore, India
| | - Rashmi Karki
- Ceutica & Chemie Healthcare Pvt. Ltd ., Bangalore, India
| | - Himanshu R Dandu
- Department of Internal Medicine, King George's Medical University , Lucknow, India
| | - Kuldeep Dhama
- Division of Pathology, Indian Veterinary Research Institute (IVRI) , Bareilly, India
| | - Madan Lb Bhatt
- Department of Centre for Advanced Research (CFAR), Faculty of Medicine, King George's Medical University (KGMU) , Lucknow, India
| | - Shailendra K Saxena
- Department of Centre for Advanced Research (CFAR), Faculty of Medicine, King George's Medical University (KGMU) , Lucknow, India
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18
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Ali MJ, Hanif M, Haider MA, Ahmed MU, Sundas FNU, Hirani A, Khan IA, Anis K, Karim AH. Treatment Options for COVID-19: A Review. Front Med (Lausanne) 2020; 7:480. [PMID: 32850922 PMCID: PMC7412857 DOI: 10.3389/fmed.2020.00480] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/15/2020] [Indexed: 12/17/2022] Open
Abstract
Background: The recent COVID-19 pandemic sweeping the globe has caused great concern worldwide. Due to the limited evidence available on the dynamics of the virus and effective treatment options available, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a huge impact in terms of morbidity and mortality. The economic impact is still to be assessed. Aims: The purpose of this article is to review the evidence for the multiple treatment options available, to consider the future of this global pandemic, and to identify some potential options that could revolutionize the treatment of COVID-19. Moreover, this article underscores the sheer importance of repurposing some of the available antiviral and antimicrobial agents that have long been in use so as to have an effective and expeditious response to this widespread pandemic and the need to conduct a multicenter global randomized controlled trial to find an effective single antiviral agent or a cocktail of available antimicrobial agents. Method: We thoroughly searched and reviewed various case reports, retrospective analyses, and in vitro studies published in PubMed, EMBASE, and Google Scholar regarding the treatment options used for SARS-CoV, MERS-CoV, and SARS-CoV-2 since its outbreak in an attempt to highlight treatments with the most promising results. Conclusion: We are currently facing one of the worst pandemics in history. Although SARS-CoV-2 is associated with a lower mortality rate than are SARS-CoV and MERS-CoV, its higher infectivity is making it a far more serious threat. Unfortunately, no vaccine against SARS-CoV-2 or effective drug regimen for COVID-19 currently exists. Drug repurposing of available antiviral agents may provide a respite; moreover, a cocktail of antiviral agents may be helpful in treating this disease. Here, we have highlighted a few available antimicrobial agents that could be very effective in treating COVID-19; indeed, a number of trials are underway to detect and confirm the efficacy of these agents.
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Affiliation(s)
- Mukarram Jamat Ali
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Hanif
- Department of Medicine, Khyber Medical College, Peshawar, Pakistan
| | | | | | - FNU Sundas
- Department of Medicine, Khyber Medical College, Peshawar, Pakistan
| | - Arham Hirani
- Department of Medicine, Ziauddin University, Karachi, Pakistan
| | - Izhan Ali Khan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Khurram Anis
- Department of Gastroenterology, Pakistan Kidney and Liver Institute, Lahore, Pakistan
| | - Amin H. Karim
- Department of Cardiology, Baylor College of Medicine, Houston, TX, United States
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19
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Bonam SR, Kaveri SV, Sakuntabhai A, Gilardin L, Bayry J. Adjunct Immunotherapies for the Management of Severely Ill COVID-19 Patients. Cell Rep Med 2020; 1:100016. [PMID: 32562483 PMCID: PMC7190525 DOI: 10.1016/j.xcrm.2020.100016] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has infected millions, with more than 275,000 fatal cases as of May 8, 2020. Currently, there are no specific COVID-19 therapies. Most patients depend on mechanical ventilation. Current COVID-19 data clearly highlight that cytokine storm and activated immune cell migration to the lungs characterize the early immune response to COVID-19 that causes severe lung damage and development of acute respiratory distress syndrome. In view of uncertainty associated with immunosuppressive treatments, such as corticosteroids and their possible secondary effects, including risks of secondary infections, we suggest immunotherapies as an adjunct therapy in severe COVID-19 cases. Such immunotherapies based on inflammatory cytokine neutralization, immunomodulation, and passive viral neutralization not only reduce inflammation, inflammation-associated lung damage, or viral load but could also prevent intensive care unit hospitalization and dependency on mechanical ventilation, both of which are limited resources.
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Affiliation(s)
- Srinivasa Reddy Bonam
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Université de Paris, Paris 75006, France
| | - Srini V. Kaveri
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Université de Paris, Paris 75006, France
| | - Anavaj Sakuntabhai
- Unité de Génétique Fonctionnelle des Maladies Infectieuses, Institut Pasteur, CNRS UMR2000 Génomique Évolutive, Modélisation et Santé, Institut Pasteur, Paris 75015, France
| | | | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Université de Paris, Paris 75006, France
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20
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Shi H, Zhou C, He P, Huang S, Duan Y, Wang X, Lin K, Zhou C, Zhang X, Zha Y. Successful treatment with plasma exchange followed by intravenous immunoglobulin in a critically ill patient with COVID-19. Int J Antimicrob Agents 2020; 56:105974. [PMID: 32298745 PMCID: PMC7194512 DOI: 10.1016/j.ijantimicag.2020.105974] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 01/17/2023]
Abstract
Many severe COVID-19 patients require intensive care or even mechanical ventilation for those with respiratory failure. Clinical course of a COVID-19 patient with persistent diarrhoea, acute respiratory failure and shock 1 day after admission. The patient was undoubtedly classified into the severe type of COVID-19. Patient recovered promptly after plasma exchange (PE) followed by IVIg, without mechanical ventilation or intensive care. Timely initiation of PE followed by IVIg in severe COVID-19 patients may improve poor clinical outcomes of these patients.
Here we report a case of a laboratory-confirmed 2019 novel coronavirus (2019-nCoV)-infected patient with COVID-19 (coronavirus disease 2019) who developed respiratory failure and shock accompanied by persistent diarrhoea despite conventional therapeutic interventions. The patient avoided mechanical ventilation and showed an immediate clinical and radiological improvement following treatment with intensive plasma exchange (PE) followed by intravenous immunoglobulin (IVIG). Successful therapeutic strategies in this case suggest that timely initiation of PE treatment followed by IVIG in critically ill patients with COVID-19 may prevent the disease from worsening and help to reduce the requirement for mechanical ventilation and intensive supportive care. Moreover, it may improve poor clinical outcomes of these patients.
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Affiliation(s)
- Hua Shi
- Department of Nephrology, The People's Hospital of Guizhou Province, 550002, Guiyang, Guizhou, China; Department of Infectious Diseases, People's Hospital of Tongren, 554300, Tongren, Guizhou, China
| | - Chaomin Zhou
- Department of Nephrology, The People's Hospital of Guizhou Province, 550002, Guiyang, Guizhou, China
| | - Pinghong He
- Department of Nephrology, The People's Hospital of Guizhou Province, 550002, Guiyang, Guizhou, China
| | - Sheng Huang
- Department of Infectious Diseases, People's Hospital of Tongren, 554300, Tongren, Guizhou, China
| | - Youjun Duan
- Department of Infectious Diseases, People's Hospital of Tongren, 554300, Tongren, Guizhou, China
| | - Xuesheng Wang
- Department of Infectious Diseases, People's Hospital of Tongren, 554300, Tongren, Guizhou, China
| | - Kexiong Lin
- Department of Infectious Diseases, People's Hospital of Tongren, 554300, Tongren, Guizhou, China
| | - Chao Zhou
- Department of Infectious Diseases, People's Hospital of Tongren, 554300, Tongren, Guizhou, China
| | - Xiangyan Zhang
- Department of Respiratory Medicine, The People's Hospital of Guizhou Province, 550002, Guiyang, Guizhou, China
| | - Yan Zha
- Department of Nephrology, The People's Hospital of Guizhou Province, 550002, Guiyang, Guizhou, China.
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21
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Jawhara S. Could Intravenous Immunoglobulin Collected from Recovered Coronavirus Patients Protect against COVID-19 and Strengthen the Immune System of New Patients? Int J Mol Sci 2020; 21:E2272. [PMID: 32218340 PMCID: PMC7178250 DOI: 10.3390/ijms21072272] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023] Open
Abstract
The emergence of the novel coronavirus in Wuhan, China, which causes severe respiratory tract infections in humans (COVID-19), has become a global health concern. Most coronaviruses infect animals but can evolve into strains that cross the species barrier and infect humans. At the present, there is no single specific vaccine or efficient antiviral therapy against COVID-19. Recently, we showed that intravenous immunoglobulin (IVIg) treatment reduces inflammation of intestinal epithelial cells and eliminates overgrowth of the opportunistic human fungal pathogen Candida albicans in the murine gut. Immunotherapy with IVIg could be employed to neutralize COVID-19. However, the efficacy of IVIg would be better if the immune IgG antibodies were collected from patients who have recovered from COVID-19 in the same city, or the surrounding area, in order to increase the chance of neutralizing the virus. These immune IgG antibodies will be specific against COVID-19 by boosting the immune response in newly infected patients. Different procedures may be used to remove or inactivate any possible pathogens from the plasma of recovered coronavirus patient derived immune IgG, including solvent/detergent, 60 °C heat-treatment, and nanofiltration. Overall, immunotherapy with immune IgG antibodies combined with antiviral drugs may be an alternative treatment against COVID-19 until stronger options such as vaccines are available.
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Affiliation(s)
- Samir Jawhara
- CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, INSERM U1285, F-59000 Lille, France
- University of Lille, F-59000 Lille, France
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22
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Could Intravenous Immunoglobulin Collected from Recovered Coronavirus Patients Protect against COVID-19 and Strengthen the Immune System of New Patients? Int J Mol Sci 2020. [PMID: 32218340 DOI: 10.3390/ijms21072272.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The emergence of the novel coronavirus in Wuhan, China, which causes severe respiratory tract infections in humans (COVID-19), has become a global health concern. Most coronaviruses infect animals but can evolve into strains that cross the species barrier and infect humans. At the present, there is no single specific vaccine or efficient antiviral therapy against COVID-19. Recently, we showed that intravenous immunoglobulin (IVIg) treatment reduces inflammation of intestinal epithelial cells and eliminates overgrowth of the opportunistic human fungal pathogen Candida albicans in the murine gut. Immunotherapy with IVIg could be employed to neutralize COVID-19. However, the efficacy of IVIg would be better if the immune IgG antibodies were collected from patients who have recovered from COVID-19 in the same city, or the surrounding area, in order to increase the chance of neutralizing the virus. These immune IgG antibodies will be specific against COVID-19 by boosting the immune response in newly infected patients. Different procedures may be used to remove or inactivate any possible pathogens from the plasma of recovered coronavirus patient derived immune IgG, including solvent/detergent, 60 °C heat-treatment, and nanofiltration. Overall, immunotherapy with immune IgG antibodies combined with antiviral drugs may be an alternative treatment against COVID-19 until stronger options such as vaccines are available.
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23
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Karnam A, Stephen-Victor E, Das M, Magy L, Vallat JM, Bolgert F, Simon-Loriere E, Kaveri SV, Sakuntabhai A, Bayry J. Does intravenous immunoglobulin therapy in Guillain-Barré syndrome patients interfere with serological Zika detection? Autoimmun Rev 2019; 18:632-633. [PMID: 30959213 DOI: 10.1016/j.autrev.2019.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Anupama Karnam
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Paris F-75006, France
| | - Emmanuel Stephen-Victor
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Paris F-75006, France
| | - Mrinmoy Das
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Paris F-75006, France
| | - Laurent Magy
- Centre de Référence 'Neuropathies Périphériques Rares' et Service de Neurologie, Hôpital Universitaire Limoges, F-87042 Limoges, France
| | - Jean-Michel Vallat
- Centre de Référence 'Neuropathies Périphériques Rares' et Service de Neurologie, Hôpital Universitaire Limoges, F-87042 Limoges, France
| | - Francis Bolgert
- Réanimation Neurologique, Neurologie 1, Hôpital de la Pitié-Salpêtrière, Paris F-75651, France
| | | | - Srini V Kaveri
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Paris F-75006, France; Université Paris Descartes, Sorbonne Paris Cité, Paris F-75006, France
| | - Anavaj Sakuntabhai
- Unité de Génétique Fonctionnelle des Maladies Infectieuses, Institut Pasteur, Paris F-75015, France; CNRS UMR2000 Génomique Évolutive, Modélisation et Santé, Institut Pasteur, Paris F-75015, France
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe - Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Paris F-75006, France; Université Paris Descartes, Sorbonne Paris Cité, Paris F-75006, France.
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Charlet R, Sendid B, Kaveri SV, Poulain D, Bayry J, Jawhara S. Intravenous Immunoglobulin Therapy Eliminates Candida albicans and Maintains Intestinal Homeostasis in a Murine Model of Dextran Sulfate Sodium-Induced Colitis. Int J Mol Sci 2019; 20:ijms20061473. [PMID: 30909599 PMCID: PMC6471409 DOI: 10.3390/ijms20061473] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/19/2019] [Accepted: 03/21/2019] [Indexed: 12/21/2022] Open
Abstract
Intravenous immunoglobulin (IVIg) therapy has diverse anti-inflammatory and immunomodulatory effects and has been employed successfully in autoimmune and inflammatory diseases. The role of IVIg therapy in the modulation of intestinal inflammation and fungal elimination has not been yet investigated. We studied IVIg therapy in a murine model of dextran sulfate sodium (DSS)-induced colitis. Mice received a single oral inoculum of Candidaalbicans and were exposed to DSS treatment for 2 weeks to induce colitis. All mice received daily IVIg therapy starting on day 1 for 7 days. IVIg therapy not only prevented a loss of body weight caused by the development of colitis but also reduced the severity of intestinal inflammation, as determined by clinical and histological scores. IVIg treatment significantly reduced the Escherichiacoli,Enterococcusfaecalis, and C.albicans populations in mice. The beneficial effects of IVIg were associated with the suppression of inflammatory cytokine interleukin (IL)-6 and enhancement of IL-10 in the gut. IVIg therapy also led to an increased expression of peroxisome proliferator-activated receptor gamma (PPARγ), while toll-like receptor 4 (TLR-4) expression was reduced. IVIg treatment reduces intestinal inflammation in mice and eliminates C.albicans overgrowth from the gut in association with down-regulation of pro-inflammatory mediators combined with up-regulation of anti-inflammatory cytokines.
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Affiliation(s)
- Rogatien Charlet
- Inserm, U995/Team2, Université Lille, 1 place Verdun, F-59000 Lille, France.
- University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.
- CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France.
| | - Boualem Sendid
- Inserm, U995/Team2, Université Lille, 1 place Verdun, F-59000 Lille, France.
- University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.
- CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France.
| | - Srini V Kaveri
- Inserm Centre de Recherche des Cordeliers, Equipe-Immunopathologie et Immuno-intervention Thérapeutique, Sorbonne Universités, Université Paris Descartes, Sorbonne Paris Cité, F-75006 Paris, France.
| | - Daniel Poulain
- Inserm, U995/Team2, Université Lille, 1 place Verdun, F-59000 Lille, France.
- University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.
- CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France.
| | - Jagadeesh Bayry
- Inserm Centre de Recherche des Cordeliers, Equipe-Immunopathologie et Immuno-intervention Thérapeutique, Sorbonne Universités, Université Paris Descartes, Sorbonne Paris Cité, F-75006 Paris, France.
| | - Samir Jawhara
- Inserm, U995/Team2, Université Lille, 1 place Verdun, F-59000 Lille, France.
- University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.
- CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France.
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Humbert L, Cornu M, Proust-Lemoine E, Bayry J, Wemeau JL, Vantyghem MC, Sendid B. Chronic Mucocutaneous Candidiasis in Autoimmune Polyendocrine Syndrome Type 1. Front Immunol 2018; 9:2570. [PMID: 30510552 PMCID: PMC6254185 DOI: 10.3389/fimmu.2018.02570] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/18/2018] [Indexed: 11/13/2022] Open
Abstract
Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) is an autosomal recessive disease caused by mutations in the autoimmune regulator (AIRE) gene, characterized by the clinical triad of chronic mucocutaneous candidiasis (CMC), hypoparathyroidism, and adrenal insufficiency. CMC can be complicated by systemic candidiasis or oral squamous cell carcinoma (SCC), and may lead to death. The role of chronic Candida infection in the etiopathogenesis of oral SCC is unclear. Long-term use of fluconazole has led to the emergence of Candida albicans strains with decreased susceptibility to azoles. CMC is associated with an impaired Th17 cell response; however, it remains unclear whether decreased serum IL-17 and IL-22 levels are related to a defect in cytokine production or to neutralizing autoantibodies resulting from mutations in the AIRE gene.
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Affiliation(s)
- Linda Humbert
- Department of Endocrinology and Metabolism, CHU Lille, Lille, France
| | - Marjorie Cornu
- Department Parasitology-Mycology, CHU, Lille, France
- Inserm, U995-LIRIC, Fungal Associated Invasive & Inflammatory Diseases, Lille, France
| | | | - Jagadeesh Bayry
- Inserm, Center de Recherche des Cordeliers, Sorbonne Université, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-Louis Wemeau
- Department of Endocrinology and Metabolism, CHU Lille, Lille, France
| | - Marie-Christine Vantyghem
- Department of Endocrinology and Metabolism, CHU Lille, Lille, France
- UMR 1190, Translational Research in Diabetes Inserm, Lille, France
- European Genomic Institute for Diabetes, Univ Lille, Lille, France
| | - Boualem Sendid
- Department Parasitology-Mycology, CHU, Lille, France
- Inserm, U995-LIRIC, Fungal Associated Invasive & Inflammatory Diseases, Lille, France
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Bergmann M, Llewellyn JR, Hartmann K. [Diagnosis of leptospirosis in dogs]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2017; 45:170-177. [PMID: 28513759 DOI: 10.15654/tpk-170039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/15/2017] [Indexed: 12/29/2022]
Abstract
Rapid confirmation of the diagnosis leptospirosis is important in order to apply appropriate treatment; in addition, infected dogs are a zoonotic risk. Culture and isolation of living leptospires from blood, urine, or tissues is considered the reference standard of diagnosis. However, sensitivity are low, and leptospires require weeks to months to grow. Therefore, diagnosis of leptospirosis is most commonly based on antibody testing or the detection of Leptospira spp. DNA by PCR. Microscopic agglutination test (MAT) is currently still the recommended confirmatory test for canine leptospirosis, despite its numerous limitations (e. g., negative results in early infection, positive results due to vaccine-associated antibodies). ELISA can differentiate between IgG and IgM antibodies and thus, discriminate current infections from previous vaccination or exposure. Point-of-care tests and in-house-PCR tests have recently been developed for use in private practice allowing easy and immediate diagnosis. However, only few data on sensitivity and specificity of these tests exist so far. A reliable diagnosis can only be established in case of a positive PCR result or a fourfold titre increase in MAT.
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Affiliation(s)
- Michèle Bergmann
- Michèle Bergmann, Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
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Al-Ahmad M, Maher A, Nurkic J. Health-related quality of life in patients with common variable immunodeficiency switching from intravenous to subcutaneous immunoglobulin therapy. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2017. [DOI: 10.4103/ejim.ejim_2_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wahid B, Ali A, Idrees M, Rafique S. Immunotherapeutic strategies for sexually transmitted viral infections: HIV, HSV and HPV. Cell Immunol 2016; 310:1-13. [PMID: 27514252 PMCID: PMC7124316 DOI: 10.1016/j.cellimm.2016.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/22/2016] [Accepted: 08/02/2016] [Indexed: 12/24/2022]
Abstract
More than 1 million sexually transmitted infections (STIs) are acquired each day globally. Etiotropic drugs cannot effectively control infectious diseases therefore, there is a dire need to explore alternative strategies especially those based on the regulation of immune system. The review discusses all rational approaches to develop better understanding towards immunotherapeutic strategies based on modulation of immune system in an attempt to curb the elevating risk of infectious diseases such as HIV, HPV and HSV because of their high prevalence. Development of monoclonal antibodies, vaccines and several other immune based treatments are promising alternative strategies that are offering new opportunities to eradicate pathogens.
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Affiliation(s)
- Braira Wahid
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Amjad Ali
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Muhammad Idrees
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan; Vice Chancellor Hazara University Mansehra, Pakistan.
| | - Shazia Rafique
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
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29
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Bergmann M, Friedl Y, Hartmann K. [Passive immunization in dogs and cats]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:287-92. [PMID: 27410719 DOI: 10.15654/tpk-160189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/12/2016] [Indexed: 11/13/2022]
Abstract
Antibodies play an important role in the defense against infectious diseases. Passive immunization provides immediate protection through transfer of exogenous antibodies to a recipient. It is mainly used for prophylaxis in dogs and cats that failed to receive maternal antibodies through the colostrum or when there is an acute risk to acquire infectious diseases. Only a small number of placebo-controlled studies have been published regarding the therapeutic use of passive immunization in small animals. While positive effects were reported in cats with acute virus infections of the upper respiratory tract and in dogs with distemper, no statistically significant influence could be demonstrated in the treatment of canine parvovirosis. Prospective, double-blinded, and placebo-controlled studies using adequate numbers of patients are warranted for a definitive statement regarding the therapeutic and prophylactic use of passive immunization in dogs and cats.
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Affiliation(s)
- Michèle Bergmann
- Michèle Bergmann, Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
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Abstract
Catastrophic antiphospholipid syndrome is a rapidly progressive life-threatening disease that causes multiple organ thromboses and dysfunction in the presence of antiphospholipid antibodies. A high index of clinical suspicion and careful investigation are required to make an early diagnosis so that treatment with anticoagulation and corticosteroids can be initiated; plasma exchange and/or intravenous immunoglobulins can be added if the life-threatening condition persists. Despite aggressive treatment and intensive care unit management, patients with catastrophic antiphospholipid syndrome have a 48% mortality rate, primarily attributable to cardiopulmonary failure. This article reviews the current information on the etiopathogenesis, clinical manifestations, diagnosis, management, and prognosis of catastrophic antiphospholipid syndrome.
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Affiliation(s)
- Setu K Vora
- Pulmonary Physicians of Norwich, Norwich, Connecticut, USA
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Lee EJ, Cha GW, Ju YR, Han MG, Lee WJ, Jeong YE. Prevalence of Neutralizing Antibodies to Japanese Encephalitis Virus among High-Risk Age Groups in South Korea, 2010. PLoS One 2016; 11:e0147841. [PMID: 26807709 PMCID: PMC4725746 DOI: 10.1371/journal.pone.0147841] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 01/08/2016] [Indexed: 11/30/2022] Open
Abstract
After an extensive vaccination policy, Japanese encephalitis (JE) was nearly eliminated since the mid-1980s in South Korea. Vaccination in children shifted the affected age of JE patients from children to adults. However, an abrupt increase in JE cases occurred in 2010, and this trend has continued. The present study aimed to investigate the prevalence of neutralizing antibodies to the JE virus (JEV) among high-risk age groups (≥40 years) in South Korea. A plaque reduction neutralization test was conducted to evaluate the prevalence of neutralizing antibodies to JEV in 945 subjects within four age groups (30–39, 40–49, 50–59, and 60–69 years) in 10 provinces. Of the 945 enrolled subjects, 927 (98.1%) exhibited antibodies against JEV. No significant differences were found in the prevalence of neutralizing antibodies according to sex, age, or occupation. However, there were significant differences in the plaque reduction rate according to age and occupation; oldest age group had a higher reduction rate, and subjects who were employed in agriculture or forestry also had a higher value than the other occupations. We also found that three provinces (Gangwon, Jeonnam, and Gyeongnam) had a relatively lower plaque reduction rate than the other locations. In addition, enzyme-linked immunosorbent assays were conducted to determine recent viral infections and 12 (2.2%) subjects were found to have been recently infected by the virus. In conclusion, the present study clearly indicated that the prevalence of neutralizing antibodies has been maintained at very high levels among adult age groups owing to vaccination or natural infections, or both. In the future, serosurveillance should be conducted periodically using more representative samples to better understand the population-level immunity to JE in South Korea.
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Affiliation(s)
- Eun Ju Lee
- Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Korea
- Japanese Encephalitis Regional Reference Laboratory for the WHO Western Pacific Region, Cheongju-si, Chungcheongbuk-do, Korea
| | - Go-Woon Cha
- Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Korea
- Japanese Encephalitis Regional Reference Laboratory for the WHO Western Pacific Region, Cheongju-si, Chungcheongbuk-do, Korea
| | - Young Ran Ju
- Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Korea
- Japanese Encephalitis Regional Reference Laboratory for the WHO Western Pacific Region, Cheongju-si, Chungcheongbuk-do, Korea
| | - Myung Guk Han
- Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Korea
- Japanese Encephalitis Regional Reference Laboratory for the WHO Western Pacific Region, Cheongju-si, Chungcheongbuk-do, Korea
| | - Won-Ja Lee
- Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Korea
- Japanese Encephalitis Regional Reference Laboratory for the WHO Western Pacific Region, Cheongju-si, Chungcheongbuk-do, Korea
| | - Young Eui Jeong
- Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Korea
- Japanese Encephalitis Regional Reference Laboratory for the WHO Western Pacific Region, Cheongju-si, Chungcheongbuk-do, Korea
- Department of Biomedical Sciences, Graduate School of Hallym University, Chuncheon-si, Gangwon-do, Korea
- * E-mail:
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Ng Q, He F, Kwang J. Recent Progress towards Novel EV71 Anti-Therapeutics and Vaccines. Viruses 2015; 7:6441-57. [PMID: 26670245 PMCID: PMC4690872 DOI: 10.3390/v7122949] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 12/14/2022] Open
Abstract
Enterovirus 71 (EV71) is a group of viruses that belongs to the Picornaviridae family, which also includes viruses such as polioviruses. EV71, together with coxsackieviruses, is widely known for its association with Hand Foot Mouth Disease (HFMD), which generally affects children age five and below. Besides HFMD, EV71 can also trigger more severe and life-threatening neurological conditions such as encephalitis. Considering the lack of a vaccine and antiviral drug against EV71, together with the increasing spread of these viruses, the development of such drugs and vaccines becomes the top priority in protecting our younger generations. This article, hence, reviews some of the recent progress in the formulations of anti-therapeutics and vaccine generation for EV71, covering (i) inactivated vaccines; (ii) baculovirus-expressed vaccines against EV71; (iii) human intravenous immunoglobulin (IVIg) treatment; and (iv) the use of monoclonal antibody therapy as a prevention and treatment for EV71 infections.
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MESH Headings
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Viral/therapeutic use
- Antiviral Agents/isolation & purification
- Antiviral Agents/pharmacology
- Drug Discovery/methods
- Drug Discovery/trends
- Enterovirus A, Human/drug effects
- Enterovirus A, Human/immunology
- Hand, Foot and Mouth Disease/drug therapy
- Hand, Foot and Mouth Disease/prevention & control
- Humans
- Immunoglobulins, Intravenous/therapeutic use
- Vaccines, Inactivated/immunology
- Vaccines, Inactivated/isolation & purification
- Vaccines, Subunit/immunology
- Vaccines, Subunit/isolation & purification
- Viral Vaccines/immunology
- Viral Vaccines/isolation & purification
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Affiliation(s)
- Qingyong Ng
- Animal Health Biotechnology, Temasek Life Sciences Laboratory, 1 Research Link, National University of Singapore, 117604 Singapore.
| | - Fang He
- Animal Health Biotechnology, Temasek Life Sciences Laboratory, 1 Research Link, National University of Singapore, 117604 Singapore.
- College of Animal Sciences, Zhejiang University, Yuhangtang Road 866, Hangzhou 310013, China.
| | - Jimmy Kwang
- Animal Health Biotechnology, Temasek Life Sciences Laboratory, 1 Research Link, National University of Singapore, 117604 Singapore.
- Department of Microbiology Faculty of Medicine, National University of Singapore, 117604 Singapore.
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Chea S, Cheng YB, Chokephaibulkit K, Chotpitayasunondh T, Rogier van Doorn H, Hafy Z, Kawichai S, Liu CC, Nam NT, Ooi MH, Wolbers M, Zeng M. Workshop on use of intravenous immunoglobulin in hand, foot and mouth disease in Southeast Asia. Emerg Infect Dis 2015; 21:e140992. [PMID: 25531166 PMCID: PMC4285270 DOI: 10.3201/eid2101.140992] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The South East Asia Infectious Disease Clinical Research Network convened subject matter experts at a workshop to make consensus recommendations for study design of a clinical trial for use of intravenous immunoglobulin (IVIg) in severe hand, foot and mouth disease (HFMD). HFMD is a highly contagious emerging infection among children in the region, a small proportion of whom develop neurologic and cardiopulmonary complications with high case-fatality rates. The use of IVIg for treatment of severe disease is widespread and a part of local, national, and international guidelines, but no clinical evidence warrants the use of this drug, which is expensive and has potentially serious side effects. During a 2-day workshop in March 2014, a group of HFMD experts reviewed the current evidence related to use of IVIg in HFMD and discussed potential study design, feasibility, inclusion and exclusion criteria, sample size, primary and secondary endpoints, and subsidiary studies for a randomized, placebo-controlled trial.
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Sánchez-Ramón S, Valor L. [Therapy with intravenous gammaglobulins in systemic inflammatory autoimmune diseases: new indications?]. Med Clin (Barc) 2014; 143:130-3. [PMID: 24480286 DOI: 10.1016/j.medcli.2013.11.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 11/14/2013] [Accepted: 11/21/2013] [Indexed: 11/15/2022]
Affiliation(s)
| | - Lara Valor
- Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, España
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35
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Zhu Z, Dimitrov AS, Chakraborti S, Dimitrova D, Xiao X, Broder CC, Dimitrov DS. Development of human monoclonal antibodies against diseases caused by emerging and biodefense-related viruses. Expert Rev Anti Infect Ther 2014; 4:57-66. [PMID: 16441209 DOI: 10.1586/14787210.4.1.57] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Polyclonal antibodies have a century-old history of being effective against some viruses; recently, monoclonal antibodies (mAbs) have also shown success. The humanized mAb Synagis (palivizumab), which is still the only mAb against a viral disease approved by the US FDA, has been widely used as a prophylactic measure against respiratory syncytial virus infections in neonates and immunocompromised individuals. The first fully human mAbs against two other paramyxoviruses, Hendra and Nipah virus, which can cause high (up to 75%) mortality, were recently developed; one of them, m101, showed exceptional potency against infectious virus. In an amazing pace of research, several potent human mAbs targeting the severe acute respiratory syndrome coronavirus S glycoprotein that can affect infections in animal models have been developed months after the virus was identified in 2003. A potent humanized mAb with therapeutic potential was recently developed against the West Nile virus. The progress in developing neutralizing human mAbs against Ebola, Crimean-Congo hemorrhagic fever, vaccinia and other emerging and biodefense-related viruses is slow. A major problem in the development of effective therapeutic agents against viruses, including therapeutic antibodies, is the viruses' heterogeneity and mutability. A related problem is the low binding affinity of crossreactive antibodies able to neutralize a variety of primary isolates. Combinations of mAbs or mAbs with other drugs, and/or the identification of potent new mAbs and their derivatives that target highly conserved viral structures, which are critical for virus entry into cells, are some of the possible solutions to these problems, and will continue to be a major focus of antiviral research.
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Affiliation(s)
- Zhongyu Zhu
- Protein Interactions Group, CCRNP, BRP, SAIC-Frederick, Inc., NCI-Frederick, NIH Bldg 469, Rm 139, PO Box B, MD 21702-1201, USA.
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Gupta N, LeGoff J, Chamat S, Mercier-Delarue S, Touzelet O, Power UF, Kazatchkine MD, Simon F, Lacroix-Desmazes S, Bayry J, Kaveri SV. Affinity-purified respiratory syncytial virus antibodies from intravenous immunoglobulin exert potent antibody-dependent cellular cytotoxicity. PLoS One 2013; 8:e69390. [PMID: 23894466 PMCID: PMC3716625 DOI: 10.1371/journal.pone.0069390] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 06/14/2013] [Indexed: 11/25/2022] Open
Abstract
Mixed infections are one of the major therapeutic challenges, as the current strategies have had limited success. One of the most common and widespread conditions of mixed infection is respiratory syncytial virus-mediated pathology of the respiratory tract in children. There is a dire need for the development of novel therapeutic approaches during mixed infections. Therapeutic intravenous immunoglobulin preparations, obtained from plasma pools of healthy donors have been used in immune deficiencies. This study was thus designed to characterize the functional efficacy of RSV-specific antibodies in IVIg. To explore the functional ability of these affinity-purified RSV-specific antibodies, the antibody-dependent and complement dependent cytotoxicity was determined using peripheral cells of healthy donors. This study demonstrates the existence of highly potent RSV-specific antibodies in IVIg preparations and provides the basis for the use of IVIg as broad-spectrum protective shield to RSV-infected children during mixed infections.
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Affiliation(s)
- Nimesh Gupta
- Institut National de la Santé et de la Recherche Médicale, Unité 872, Paris, France
- Centre de recherche des Cordeliers, Equipe 16-Immunopathology and Therapeutic immunointervention, Paris, France
- Université Pierre et Marie Curie, Université Paris Descartes, UMR S 872, Paris, France
| | - Jerome LeGoff
- University Paris Diderot, Pres Sorbone Paris Cité, Paris, France
- Microbiology laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, France
| | - Soulaima Chamat
- Laboratory of Immunology, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | | | - Olivier Touzelet
- Centre for Infection and Immunity, School of Medicine, Dentistry, and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Ultan F. Power
- Centre for Infection and Immunity, School of Medicine, Dentistry, and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Michel D. Kazatchkine
- United Nation Secretary General Special Envoy on HIV/AIDS in Eastern Europe and Central Asia, Geneva, Switzerland
| | - Francois Simon
- University Paris Diderot, Pres Sorbone Paris Cité, Paris, France
- Microbiology laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, France
| | - Sebastien Lacroix-Desmazes
- Institut National de la Santé et de la Recherche Médicale, Unité 872, Paris, France
- Centre de recherche des Cordeliers, Equipe 16-Immunopathology and Therapeutic immunointervention, Paris, France
- Université Pierre et Marie Curie, Université Paris Descartes, UMR S 872, Paris, France
- International Associated Laboratory, Institut National de la Santé et de la Recherche Médicale-France and Indian council of Medical Research, Mumbai, India
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale, Unité 872, Paris, France
- Centre de recherche des Cordeliers, Equipe 16-Immunopathology and Therapeutic immunointervention, Paris, France
- Université Pierre et Marie Curie, Université Paris Descartes, UMR S 872, Paris, France
- International Associated Laboratory, Institut National de la Santé et de la Recherche Médicale-France and Indian council of Medical Research, Mumbai, India
| | - Srinivas V. Kaveri
- Institut National de la Santé et de la Recherche Médicale, Unité 872, Paris, France
- Centre de recherche des Cordeliers, Equipe 16-Immunopathology and Therapeutic immunointervention, Paris, France
- Université Pierre et Marie Curie, Université Paris Descartes, UMR S 872, Paris, France
- International Associated Laboratory, Institut National de la Santé et de la Recherche Médicale-France and Indian council of Medical Research, Mumbai, India
- * E-mail:
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Human IgG subclasses against enterovirus Type 71: neutralization versus antibody dependent enhancement of infection. PLoS One 2013; 8:e64024. [PMID: 23700449 PMCID: PMC3659118 DOI: 10.1371/journal.pone.0064024] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 04/08/2013] [Indexed: 12/02/2022] Open
Abstract
The emerging human enterovirus 71 (EV71) represents a growing threat to public health, and no vaccine or specific antiviral is currently available. Human intravenous immunoglobulin (IVIG) is clinical used in treating severe EV71 infections. However, the discovery of antibody dependent enhancement (ADE) of EV71 infection illustrates the complex roles of antibody in controlling EV71 infection. In this study, to identify the distinct role of each IgG subclass on neutralization and enhancement of EV71 infection, different lots of pharmaceutical IVIG preparations manufactured from Chinese donors were used for IgG subclass fractionation by pH gradient elution with the protein A-conjugated affinity column. The neutralization and ADE capacities on EV71 infection of each purified IgG subclass were then assayed, respectively. The neutralizing activity of human IVIG is mainly mediated by IgG1 subclass and to less extent by IgG2 subclass. Interestingly, IgG3 fraction did not have neutralizing activity but enhanced EV71 infection in vitro. These results revealed the different roles of human IgG subclasses on EV71 infection, which is of critical importance for the rational design of immunotherapy and vaccines against severe EV71 diseases.
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38
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Foroughipour M, Jabbari Azad F, Farid hosseini R, Shirdel A, Khalighi AR, Yousefzadeh H, Sadri H, Moghiman T, Hekmatkhah H. Outcome of Intravenous Immunoglobulin-Transmitted HTLV-I, Hepatitis B, Hepatitis C, and HIV infections. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2013; 16:221-4. [PMID: 24470866 PMCID: PMC3881258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 11/08/2012] [Indexed: 10/29/2022]
Abstract
OBJECTIVE(S) Since each unit of Intravenous Immunoglobulin (IVIG) is obtained from different blood donors, blood-borne viral diseases is of high importance. We aimed at investigating the prevalence of various viral infections: Human T-cell Lymphotropic Virus Type 1 (HTLV-I), Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV) among patients referred for IVIG therapy section in Mashhad University of Medical Sciences, Mashhad, Iran. MATERIALS AND METHODS A prospective study was conducted on 130 IVIG recipients admitted to different wards of our Medical Centre: Immunology, Hematology, and Neurology, in 2010. After filling the informed consent form, a 5 cc blood sample was initially taken from each patient. Viral infections including HTLV-I Ab, HIV-Ab, HBsAg, HBc-Ab, and HBV-Ab were assessed using the ELISA technique before and after six three months treatment. RESULTS Test results for HTLV-I Ab, HBsAg, HBc Ab, HIV Ab, and HCV Ab were negative in all cases before IVIG therapy. After receiving IVIG, two female cases with CIDP showed positive results for HBV Ab (0.8%) and HBS Ag (0.8%) with ELISA and only one patient confirmed with PCR. There was not any significant relation between HBV Ag (P=0.14) and HBC Ab with type of disorder (P=0.66). CONCLUSION This study showed that HTLV-I viral replication and the other investigated viral transmissions do not occur in plasma; therefore, the IVIG products are safe.
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Affiliation(s)
- Mohsen Foroughipour
- Neurology Department, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farahzad Jabbari Azad
- Allergy Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author: Farahzad Jabbari Azad, Allergy Research Centre, School of Medicine, MUMS, Mashhad, Iran. Tel:+98-511-8012770; E-mail:
| | - Reza Farid hosseini
- Immunology Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Shirdel
- Internal Medicine Department, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Reza Khalighi
- Internal Medicine Department, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadis Yousefzadeh
- Student Research Assembly of Mashhad University of Medical Sciences, Mashhad, Iran
| | - Homa Sadri
- Allergy Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Moghiman
- Preventive Cardiovascular Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Hekmatkhah
- Preventive Cardiovascular Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
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Wozniak MA, Itzhaki RF. Intravenous immunoglobulin reduces β amyloid and abnormal tau formation caused by herpes simplex virus type 1. J Neuroimmunol 2013; 257:7-12. [PMID: 23385080 DOI: 10.1016/j.jneuroim.2013.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 01/07/2013] [Accepted: 01/10/2013] [Indexed: 11/27/2022]
Abstract
Intravenous immunoglobulin (IVIG) treatment of Alzheimer's disease (AD) has been encouraging. Its mechanism of action might be via anti-β-amyloid (Aβ) antibodies which facilitate Aβ clearance. However, IVIG's benefits might result from its antiviral activity, particularly against herpes simplex virus type 1 (HSV1), a virus implicated in AD. We investigated IVIG's effect on HSV1, specifically on the accumulation of Aβ and abnormally phosphorylated tau which it causes. We show that IVIG is effective at reducing the accumulation of these abnormal molecules and that it acts synergistically with the antiviral acyclovir, suggesting that their combined use would be beneficial for treating AD.
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Affiliation(s)
- Matthew A Wozniak
- Faculty of Life Sciences, The University of Manchester, Manchester, M13 9PT, UK
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40
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Stiehm ER, Keller MA. Passive immunization. Vaccines (Basel) 2013. [DOI: 10.1016/b978-1-4557-0090-5.00001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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41
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Ramos-Medina R, Corbí AL, Sánchez-Ramón S. [Intravenous immunoglobulin: immunomodulatory key of the immune system]. Med Clin (Barc) 2012; 139:112-7. [PMID: 22285062 DOI: 10.1016/j.medcli.2011.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 11/12/2011] [Accepted: 11/17/2011] [Indexed: 12/30/2022]
Abstract
The mechanisms of action of intravenous immunoglobulins (IVIG) are complex and mostly reproduce those of the natural immunoglobulin G (IgG) in our organism. The therapeutic doses used range from substitutive (200-400mg/kg of body weight) in immunodeficiencies to high doses (1-2g/kg of body weight) in autoimmune or inflammatory diseases. The paradoxical pro- or anti-inflammatory effects of IVIG are based on the modulation of the expression of activating versus inhibitory Fc receptors, the type and stage of maturation of the target cell. This huge diversity of actions may explain the extensive and varied range of clinical applications of IVIG nowadays (immunodeficiencies, autoimmune diseases, degenerative diseases such as Alzheimer's, and cancer). On the other hand, biological therapies with monoclonal antibodies mostly consist of IgG molecules with unique antigen specificity, and currently represent a therapeutic field expanding in various pathologies including cancer and diseases of immunological basis. The effects of IgG are added to their specific effects on molecules target.
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Affiliation(s)
- Rocío Ramos-Medina
- Unidad de Inmunología Clínica, Departamento de Inmunología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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42
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Kaveri SV, Silverman GJ, Bayry J. Natural IgM in immune equilibrium and harnessing their therapeutic potential. THE JOURNAL OF IMMUNOLOGY 2012; 188:939-45. [PMID: 22262757 DOI: 10.4049/jimmunol.1102107] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Natural IgM Abs are the constitutively secreted products of B1 cells (CD5(+) in mice and CD20(+)CD27(+)CD43(+)CD70(-) in humans) that have important and diverse roles in health and disease. Whereas the role of natural IgM as the first line of defense for protection against invading microbes has been extensively investigated, more recent reports have highlighted their potential roles in the maintenance of tissue homeostasis via clearance of apoptotic and altered cells through complement-dependent mechanisms, inhibition of inflammation, removal of misfolded proteins, and regulation of pathogenic autoreactive IgG Abs and autoantibody-producing B cells. These observations have provided the theoretical underpinnings for efforts that currently seek to harness the untapped therapeutic potential of natural IgM either by boosting in vivo natural IgM production or via therapeutic infusions of monoclonal and polyclonal IgM preparations.
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43
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Casulli S, Topçu S, Fattoum L, von Gunten S, Simon HU, Teillaud JL, Bayry J, Kaveri SV, Elbim C. A differential concentration-dependent effect of IVIg on neutrophil functions: relevance for anti-microbial and anti-inflammatory mechanisms. PLoS One 2011; 6:e26469. [PMID: 22065996 PMCID: PMC3204983 DOI: 10.1371/journal.pone.0026469] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 09/27/2011] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Polymorphonuclear neutrophils (PMN) play a key role in host defences against invading microorganisms but can also potentiate detrimental inflammatory reactions in case of excessive or misdirected responses. Intravenous immunoglobulins (IVIg) are used to treat patients with immune deficiencies and, at higher doses, in autoimmune, allergic and systemic inflammatory disorders. METHODOLOGY/PRINCIPAL FINDINGS We used flow cytometry to examine the effects of IVIg on PMN functions and survival, using whole-blood conditions in order to avoid artifacts due to isolation procedures. IVIg at low concentrations induced PMN activation, as reflected by decreased L-selectin and increased CD11b expression at the PMN surface, oxidative burst enhancement, and prolonged cell survival. In contrast, IVIg at higher concentrations inhibited LPS-induced CD11b degranulation and oxidative burst priming, and counteracted LPS-induced PMN lifespan prolongation. CONCLUSIONS/SIGNIFICANCE IVIg appears to have differential, concentration-dependent effects on PMN, possibly supporting the use of IVIg as either an anti-microbial or an anti-inflammatory agent.
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Affiliation(s)
- Sarah Casulli
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, UMR S 872, Paris, F-75006 France and Université Paris Descartes, UMR S 872, Paris, F-75006 France; INSERM, U872, Paris, F-75006, France
| | - Selma Topçu
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, UMR S 872, Paris, F-75006 France and Université Paris Descartes, UMR S 872, Paris, F-75006 France; INSERM, U872, Paris, F-75006, France
| | - Lakhdar Fattoum
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, UMR S 872, Paris, F-75006 France and Université Paris Descartes, UMR S 872, Paris, F-75006 France; INSERM, U872, Paris, F-75006, France
| | | | - Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Jean-Luc Teillaud
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, UMR S 872, Paris, F-75006 France and Université Paris Descartes, UMR S 872, Paris, F-75006 France; INSERM, U872, Paris, F-75006, France
| | - Jagadeesh Bayry
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, UMR S 872, Paris, F-75006 France and Université Paris Descartes, UMR S 872, Paris, F-75006 France; INSERM, U872, Paris, F-75006, France
| | - Srini V. Kaveri
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, UMR S 872, Paris, F-75006 France and Université Paris Descartes, UMR S 872, Paris, F-75006 France; INSERM, U872, Paris, F-75006, France
- * E-mail: (SVK); (CE)
| | - Carole Elbim
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, UMR S 872, Paris, F-75006 France and Université Paris Descartes, UMR S 872, Paris, F-75006 France; INSERM, U872, Paris, F-75006, France
- * E-mail: (SVK); (CE)
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Wymann S, Zuercher AW, Schaub A, Bolli R, Stadler BM, Miescher SM. Monomeric and dimeric IgG fractions show differential reactivity against pathogen-derived antigens. Scand J Immunol 2011; 74:31-41. [PMID: 21338382 DOI: 10.1111/j.1365-3083.2011.02537.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Polyvalent Ig preparations, derived from the pooled plasma of thousands of healthy donors, contain a complex mix of both 'acquired' and natural antibodies directed against pathogens as well as foreign and self/auto antigens (Ag). Depending on their formulation, donor pool size, etc., liquid Ig preparations contain monomeric and dimeric IgG. The dimeric IgG fraction is thought to represent mainly idiotype-antiidiotype Ab pairs. Treatment of all IgG fractions at pH 4 effectively monomerizes the IgG dimers resulting in separated idiotype-antiidiotype Ab pairs and thus in a comparable F(ab')(2) binding site availability of the different IgG fractions. Previously, we identified an increased anti-self-reactivity within the monomerized dimer fraction. This study addressed if, among the different IgG fractions, an analogous preferential reactivity was evident in the response against different pathogen-derived protein and carbohydrate antigens. Therefore, we assessed the activity of total unseparated IgG, the monomeric and dimeric IgG fractions against antigenic structures of bacterial and viral antigens/virulence factors. All fractions showed similar reactivity to protein antigens except for exotoxin A of Pseudomonas aeruginosa, where the dimeric fraction, especially when monomerized, showed a marked increase in reactivity. This suggests that the production of antiidiotypic IgG antibodies contributes to controlling the immune response to certain categories of pathogens. In contrast, the monomeric IgG fractions showed increased reactivity towards pathogen-associated polysaccharides, classically regarded as T-independent antigens. Taken together, the differential reactivity of the IgG fractions seems to indicate a preferential segregation of antibody reactivities according to the nature of the antigen.
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Affiliation(s)
- S Wymann
- CSL Behring AG, Wankdorfstrasse 10, Bern, Switzerland.
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45
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Cao RY, Han JF, Jiang T, Tian X, Yu M, Deng YQ, Qin ED, Qin CF. In vitro and in vivo characterization of a new enterovirus type 71-specific human intravenous immunoglobulin manufactured from selected plasma donors. J Clin Virol 2011; 51:246-9. [DOI: 10.1016/j.jcv.2011.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 04/13/2011] [Accepted: 05/03/2011] [Indexed: 10/18/2022]
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46
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Kaveri SV, Maddur MS, Hegde P, Lacroix-Desmazes S, Bayry J. Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy. Clin Exp Immunol 2011; 164 Suppl 2:2-5. [PMID: 21466545 DOI: 10.1111/j.1365-2249.2011.04387.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Intravenous immunoglobulin (IVIG) is a therapeutic compound prepared from pools of plasma obtained from several thousand healthy blood donors. For more than 20 years, IVIG has been used in the treatment of a wide range of primary and secondary immunodeficiencies. IVIG now represents a standard therapeutic option for most antibody deficiencies. Routinely, IVIG is used in patients with X-linked agammaglobulinaemia (XLA), common variable immunodeficiency (CVID), X-linked hyper-IgM, severe combined immunodeficiency, Wiskott-Aldrich syndrome, and selective IgG class deficiency. In addition, IVIG is used extensively in the treatment of a wide variety of autoimmune disorders. IVIG is administered at distinct doses in the two clinical settings: whereas immunodeficient patients are treated with replacement levels of IVIG, patients with autoimmune and inflammatory diseases are administered with very high doses of IVIG. Several lines of experimental evidence gathered in the recent years suggest that the therapeutic beneficial effect of IVIG in immunodeficiencies reflects an active role for IVIG, rather than a mere passive transfer of antibodies.
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Affiliation(s)
- S V Kaveri
- Institut National de la Santé et de la Recherche Médicale Unité 872, Paris, France.
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47
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Bayry J, Fournier EM, Maddur MS, Vani J, Wootla B, Sibéril S, Dimitrov JD, Lacroix-Desmazes S, Berdah M, Crabol Y, Oksenhendler E, Lévy Y, Mouthon L, Sautès-Fridman C, Hermine O, Kaveri SV. Intravenous immunoglobulin induces proliferation and immunoglobulin synthesis from B cells of patients with common variable immunodeficiency: a mechanism underlying the beneficial effect of IVIg in primary immunodeficiencies. J Autoimmun 2010; 36:9-15. [PMID: 20970960 DOI: 10.1016/j.jaut.2010.09.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 09/20/2010] [Accepted: 09/23/2010] [Indexed: 12/28/2022]
Abstract
Common variable immunodeficiency (CVID) is associated with low serum immunoglobulin concentrations and an increased susceptibility to infections and autoimmune diseases. The treatment of choice for CVID patients is replacement intravenous immunoglobulin (IVIg) therapy. IVIg has been beneficial in preventing or alleviating the severity of infections and autoimmune and inflammatory process in majority of CVID patients. Although the mechanisms of action of IVIg given as 'therapeutic high dose' in patients with autoimmune diseases are well studied, the underlying mechanisms of beneficial effects of IVIg in primary immunodeficiencies are not completely understood. Therefore we investigated the effect of 'replacement dose' of IVIg by probing its action on B cells from CVID patients. We demonstrate that IVIg at low doses induces proliferation and immunoglobulin synthesis from B cells of CVID patients. Interestingly, B cell stimulation by IVIg is not associated with induction of B cell effector cytokine IFN-γ and of transcription factor T-bet. Together, our results indicate that in some CVID patients, IVIg rectifies the defective signaling of B cells normally provided by T cells and delivers T-independent signaling for B cells to proliferate. IVIg 'replacement therapy' in primary immunodeficiencies is therefore not a merepassive transfer of antibodies to prevent exclusively the recurrent infections; rather it has an active role in regulating autoimmune and inflammatory responses through modulating B cell functions and thus imposing dynamic equilibrium of the immune system.
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Affiliation(s)
- Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale Unité 872, F-75006 Paris, France.
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49
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Olivieri BP, Vasconcellos R, Nóbrega A, Minoprio P, Kaveri SV, Araújo-Jorge TC. Intravenous immunoglobulin increases survival time in the acute phase of experimental Chagas disease. Parasite Immunol 2010; 32:464-9. [PMID: 20500678 DOI: 10.1111/j.1365-3024.2010.01212.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chagas disease induced by Trypanosoma cruzi (Tc) infection is an important cause of mortality and morbidity affecting the cardiovascular system for which presently available therapies are insufficient and largely inadequate. Intravenous immunoglobulin (IVIg) is a therapeutic preparation containing normal polyspecific IgG obtained from plasma pools of several thousand healthy donors and is used in several autoimmune, inflammatory and infectious diseases. In the study of heart from mice chronically infected with Tc, we observed that IVIg restores type 1 atrioventricular block or bradycardia. In the present study, we investigated the effects of IVIg in acute Tc infection. Intravenous immunoglobulin administration after the first week of infection was associated with an increase in survival time. Taken together, results observed in the chronic and in the acute phase associate IVIg treatment with a favourable outcome in T. cruzi infection.
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Affiliation(s)
- B P Olivieri
- Laboratory of Innovations in Therapy, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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50
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Hagemann S, Faude A, Rabenstein M, Balzer-Geldsetzer M, Nölker C, Bacher M, Dodel R. Reducing sample complexity of polyclonal human autoantibodies by chromatofocusing. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:2249-54. [PMID: 20655814 DOI: 10.1016/j.jchromb.2010.06.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 06/20/2010] [Accepted: 06/26/2010] [Indexed: 11/29/2022]
Abstract
Chromatofocusing was performed in order to separate a polyclonal antigen-specific mixture of human immunoglobulins (IgGs) that would then allow for further analyses of as few different IgGs as possible. Because polyclonal IgGs only differ by amino acid sequence and possible post-translational modifications but not by molecular weight, we chose chromatofocusing for protein separation by different isoelectric points. We isolated antigen-specific IgGs from commercially available intravenous immunoglobulins (IVIG) using a combination of affinity- and size exclusion-chromatography and in order to reduce the complexity of the starting material IVIG was then replaced by single-donor plasmapheresis material. Using two-dimensional gel electrophoresis (2-DE), we observed a clear decrease in the number of different light and heavy chains in the chromatofocusing peak as compared to the starting material. In parallel, we monitored slight problems with the selected peak in isoelectric focusing as the first dimension of 2-DE, displayed in by the less proper focusing of the spots. When we tested whether IgGs were binding to their specific antigen after chromatofocusing, we were able to show that they were still in native conformation. In conclusion, we showed that chromatofocusing can be used as a first step in the analysis of mixtures of very similar proteins, e.g. polyclonal IgG preparations, in order to minimize the amount of different proteins in separated fractions in a reproducible way.
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Affiliation(s)
- Sascha Hagemann
- Department of Neurology, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35037 Marburg, Germany
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