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Liu XY, Wei DK, Li ZY, Lu JS, Xie XM, Yu YZ, Pang XB. Immunogenicity and immunoprotection of the functional TL-HN fragment derived from tetanus toxin. Vaccine 2023; 41:6834-6841. [PMID: 37816654 DOI: 10.1016/j.vaccine.2023.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023]
Abstract
Tetanus toxin (TeNT) is a protein toxin produced by Clostridium tetani bacteria, which causes hyperreflexia and rhabdomyolysis by spastic paralysis. Like botulinum neurotoxin, TeNT comprises a heavy chain (HC) and a light chain (LC) linked via an interchain disulfide bond, which include the following three functional domains: a receptor-binding domain (Hc), a translocation domain (HN), and a catalytic domain (LC). Herein, we produced and characterized three functional domains of TeNT and three types of TeNT-derived L-HN fragments (TL-HN, TL-GS-HN and TL-2A-HN), which contained L and HN domains but lacked the Hc domain. The immunological effects of these different functional domains or fragments of TeNT were explored in an animal model. Our investigations showed the TL-HN functional fragment provided the best immunoprotection among all the TeNT functional domains. The TL-HN fragment, as a protective antigen, induced the highest levels of neutralizing antibodies, indicating that it might contain some crucial epitopes. Further experiments revealed that the protective effect of TL-HN was superior to that of the THc, TL, or THN fragments, either individually or in combination. Therefore, the TL-HN fragment exerts an important function in immune protection against tetanus toxin, providing a good basis for the development of TeNT vaccines or antibodies, and could serve as a promising subunit vaccine to replace THc or tetanus toxoid (TT).
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Affiliation(s)
- Xu-Yang Liu
- Pharmaceutical College, Henan University, Kaifeng 475001, China; Beijing Institute of Biotechnology, Beijing 100071, China
| | - Dong-Kui Wei
- Pharmaceutical College, Henan University, Kaifeng 475001, China; Beijing Institute of Biotechnology, Beijing 100071, China
| | - Zhi-Ying Li
- Pharmaceutical College, Henan University, Kaifeng 475001, China; Beijing Institute of Biotechnology, Beijing 100071, China
| | - Jian-Sheng Lu
- Beijing Institute of Biotechnology, Beijing 100071, China
| | - Xin-Mei Xie
- Pharmaceutical College, Henan University, Kaifeng 475001, China.
| | - Yun-Zhou Yu
- Beijing Institute of Biotechnology, Beijing 100071, China.
| | - Xiao-Bin Pang
- Pharmaceutical College, Henan University, Kaifeng 475001, China.
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2
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Li Y, Chen Y, Cui J, Liu D, Zhang W, Xue C, Xiong X, Liu G, Chen H. Preparation and characterization of a neutralizing murine monoclonal antibody against tetanus toxin. J Immunol Methods 2023; 513:113427. [PMID: 36652969 DOI: 10.1016/j.jim.2023.113427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/11/2022] [Accepted: 01/11/2023] [Indexed: 01/16/2023]
Abstract
After Clostridium tetani infects the human body, it propagates under anaerobic conditions and produces tetanus neurotoxin (TeNT). TeNT can affect the central nervous system, inhibit the release of neurotransmitters, and result in respiratory failure, which are the root causes of death in tetanus patients. Identifying monoclonal antibodies (mAbs) targeting TeNT with neutralizing activity is urgently needed for the prevention and treatment of tetanus infection. In this study, through immunizing BALB/c mice with tetanus toxoid (TT), we obtained six positive hybridoma cell lines (1A7, 2C7, 3A7, 3H4, 4C1, and 4E12). Antibody isotyping showed that the antibodies are all of the IgG1/κ subclass. Ascites fluid was prepared by allogeneic ascites induction and the antibodies were purified through protein G affinity chromatography columns. Purities of the produced murine mAbs were all greater than 95%. All six antibodies bound to linear epitopes, among which 3A7 bound to the TeNT/L domain and the other five antibodies bound to the TeNT/Hc domain. Moreover, the affinity constants of these six antibodies against the antigen were all in the nanomolar range, and the affinity of 4E12 antibody reached the picomolar range. Results from toxin-neutralization assays in mice showed that 2C7 antibody delayed animal death, while 1A7, 3A7, 3H4, and 4E12 antibodies conferred partial protection. Additionally, 4C1 antibody offered complete protection, as 200 μg of 4C1 antibody fully protected against toxin challenge with 10 LD50 of TeNT and had a window period of 1 h. Antibody epitope grouping results revealed that the binding epitopes of 4C1 antibody were different from those of the other five antibodies. When 4C1 antibody was used in combination with another antibody, the neutralizing activities of antibodies were all evidently enhanced. Specifically, 4C1 combined with 3A7 antibody led to the greatest improvement in neutralizing activities, and 20 μg antibodies total (10 + 10 μg) fully protected against toxin challenge with 10 LD50. When 4E12, 3A7, and 4C1 antibodies were used in combination, 18 μg antibodies total (6 + 6 + 6 μg) completely neutralized 10 LD50 toxin. The present study derived murine mAbs with neutralizing activities and laid the foundation for follow-up therapeutic drug development for TeNT poisoning as well as establishment of TeNT detection methods.
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Affiliation(s)
- Yi Li
- Academy of Military Medical Sciences, Beijing 100080, China
| | - Yangyang Chen
- College of Pharmacy, Harbin University of Commerce, Harbin 1500076, China
| | - Jiazhen Cui
- Academy of Military Medical Sciences, Beijing 100080, China
| | - Dongqi Liu
- College of Pharmacy, Harbin University of Commerce, Harbin 1500076, China
| | - Weicai Zhang
- Academy of Military Medical Sciences, Beijing 100080, China
| | - Chong Xue
- Academy of Military Medical Sciences, Beijing 100080, China
| | - Xianghua Xiong
- Academy of Military Medical Sciences, Beijing 100080, China.
| | - Gang Liu
- Academy of Military Medical Sciences, Beijing 100080, China.
| | - Huipeng Chen
- Academy of Military Medical Sciences, Beijing 100080, China.
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Manieri TM, Takata DY, Targino RC, Quintilio W, Batalha-Carvalho JV, da Silva CML, Moro AM. Characterization of Neutralizing Human Anti-Tetanus Monoclonal Antibodies Produced by Stable Cell Lines. Pharmaceutics 2022; 14:1985. [PMID: 36297421 PMCID: PMC9611486 DOI: 10.3390/pharmaceutics14101985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 10/12/2023] Open
Abstract
Tetanus toxin (TeNT) is produced by C. tetani, a spore-forming bacillus broadly spread in the environment. Although an inexpensive and safe vaccine is available, tetanus persists because of a lack of booster shots and variable responses to vaccines due to immunocompromised status or age-decreased immune surveillance. Tetanus is most prevalent in low- and medium-income countries, where it remains a health problem. Neutralizing monoclonal antibodies (mAbs) can prevent the severity of illness and death caused by C. tetani infection. We identified a panel of mAbs that bind to TeNT, some of which were investigated in a preclinical assay, showing that a trio of mAbs that bind to different sites of TeNT can neutralize the toxin and prevent symptoms and death in mice. We also identified two mAbs that can impair the binding of TeNT to the GT1b ganglioside receptor in neurons. In this work, to generate a series of cell lines, we constructed vectors containing sequences encoding heavy and light constant regions that can receive the paired variable regions resulting from PCRs of human B cells. In this way, we generated stable cell lines for five mAbs and compared and characterized the antibody produced in large quantities, enabling the characterization experiments. We present the results regarding the cell growth and viability in a fed-batch culture, titer measurement, and specific productivity estimation. The affinity of purified mAbs was analyzed by kinetics and under steady-state conditions, as three mAbs could not dissociate from TeNT within 36,000 s. The binding of mAbs to TeNT was confirmed by ELISA and inhibition of toxin binding to GT1b. The use of the mAbs mixture confirmed the individual mAb contribution to inhibition. We also analyzed the binding of mAbs to FcγR by surface plasmon resonance (SPR) and the glycan composition. Molecular docking analyses showed the binding site of an anti-tetanus mAb.
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Affiliation(s)
- Tania Maria Manieri
- Biopharmaceuticals Laboratory, Butantan Institute, Sao Paulo 05503-900, Brazil
| | - Daniela Yumi Takata
- Biopharmaceuticals Laboratory, Butantan Institute, Sao Paulo 05503-900, Brazil
- Interunits Graduate Program in Biotechnology, University of Sao Paulo, Sao Paulo 05508-270, Brazil
| | | | - Wagner Quintilio
- Biopharmaceuticals Laboratory, Butantan Institute, Sao Paulo 05503-900, Brazil
| | - João Victor Batalha-Carvalho
- Biopharmaceuticals Laboratory, Butantan Institute, Sao Paulo 05503-900, Brazil
- Graduate Program in Immunology, University of Sao Paulo, Sao Paulo 05508-270, Brazil
| | | | - Ana Maria Moro
- Biopharmaceuticals Laboratory, Butantan Institute, Sao Paulo 05503-900, Brazil
- Center for Research and Development in Immunobiologicals (CeRDI), Butantan Institute, Sao Paulo 05503-900, Brazil
- National Institute for Science and Technology (INCT/iii), University of Sao Paulo, Sao Paulo 05403-900, Brazil
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Tetanus Toxin Fragment C: Structure, Drug Discovery Research and Production. Pharmaceuticals (Basel) 2022; 15:ph15060756. [PMID: 35745675 PMCID: PMC9227095 DOI: 10.3390/ph15060756] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 12/05/2022] Open
Abstract
Tetanus toxoid (TTd) plays an important role in the pharmaceutical world, especially in vaccines. The toxoid is obtained after formaldehyde treatment of the tetanus toxin. In parallel, current emphasis in the drug discovery field is put on producing well-defined and safer drugs, explaining the interest in finding new alternative proteins. The tetanus toxin fragment C (TTFC) has been extensively studied both as a neuroprotective agent for central nervous system disorders owing to its neuronal properties and as a carrier protein in vaccines. Indeed, it is derived from a part of the tetanus toxin and, as such, retains its immunogenic properties without being toxic. Moreover, this fragment has been well characterized, and its entire structure is known. Here, we propose a systematic review of TTFC by providing information about its structural features, its properties and its methods of production. We also describe the large uses of TTFC in the field of drug discovery. TTFC can therefore be considered as an attractive alternative to TTd and remarkably offers a wide range of uses, including as a carrier, delivery vector, conjugate, booster, inducer, and neuroprotector.
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Ghotloo S, Golsaz-Shirazi F, Amiri MM, Jeddi-Tehrani M, Shokri F. Neutralization of tetanus toxin by a novel chimeric monoclonal antibody. Toxicon 2021; 201:27-36. [PMID: 34411590 DOI: 10.1016/j.toxicon.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/10/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Tetanus is a life-threatening disease characterized by muscle spasm caused by neurotoxin of Clostridium tetani. Given the current passive immunotherapy of tetanus with human anti-toxin polyclonal antibodies (PAbs) and the limitations of such preparations, neutralizing monoclonal antibodies (MAbs), especially chimeric or human antibodies with reduced immunogenicity might be considered as an alternative source. METHODS A mouse-human chimeric MAb, designated c-1F2C2, was generated and its binding specificities to various recombinant fragments of tetanus toxin, generated in E. coli, were determined. In vivo toxin neutralizing activity of c-1F2C2 was evaluated and compared with that of a commercially available human anti-toxin PAb in a mouse model. The possible mechanisms of toxin neutralizing activity of c-1F2C2 were investigated by assessing its inhibitory effects on toxin receptors binding, including GT1b ganglioside receptor and those expressed on PC12 cells. RESULTS In vivo neutralizing assay showed that c-1F2C2 was able to protect mice against tetanus toxin with an estimated potency of 7.7 IU/mg comparing with 1.9 IU/mg of the commercial human anti-toxin PAb for 10 MLD toxin and 10 IU/mg versus 1.9 IU/mg of the PAb for 2.5 MLD toxin. c-1F2C2 recognized fragment C of the toxin, which is responsible for binding of the toxin to its receptor on neuronal cells. Accordingly, the chimeric MAb partially prevented the toxin from binding to its receptors on PC12 cells (37% inhibition). CONCLUSION The chimeric MAb c-1F2C2 displayed similar structural and functional characteristics compared to its murine counterpart and might be useful for passive immunotherapy of tetanus.
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Affiliation(s)
- Somayeh Ghotloo
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Golsaz-Shirazi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Amiri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Jeddi-Tehrani
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Fazel Shokri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
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de Smit H, Ackerschott B, Tierney R, Stickings P, Harmsen MM. A novel single-domain antibody multimer that potently neutralizes tetanus neurotoxin. Vaccine X 2021; 8:100099. [PMID: 34169269 PMCID: PMC8207222 DOI: 10.1016/j.jvacx.2021.100099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 04/17/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Tetanus antitoxin, produced in animals, has been used for the prevention and treatment of tetanus for more than 100 years. The availability of antitoxins, ethical issues around production, and risks involved in the use of animal derived serum products are a concern. We therefore developed a llama derived single-domain antibody (VHH) multimer to potentially replace the conventional veterinary product. In total, 28 different tetanus neurotoxin (TeNT) binding VHHs were isolated, 14 of which were expressed in yeast for further characterization. Four VHH monomers (T2, T6, T15 and T16) binding TeNT with high affinity (KD < 1 nM), covering different antigenic domains as revealed by epitope binning, and including 3 monomers (T6, T15 and T16) that inhibited TeNT binding to neuron gangliosides, were chosen as building blocks to generate 11 VHH multimers. These multimers contained either 1 or 2 different TeNT binding VHHs fused to 1 VHH binding to either albumin (A12) or immunoglobulin (G13) to extend serum half-life in animals. Multimers consisting of 2 TeNT binding VHHs showed more than a 10-fold increase in affinity (KD of 4-23 pM) when compared to multimers containing only one TeNT binding VHH. The T6 and T16 VHHs showed synergistic in vivo TeNT neutralization and, when incorporated into a single VHH trimer (T6T16A12), they showed a very high TeNT neutralizing capacity (1,510 IU/mg).
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Affiliation(s)
- Hans de Smit
- R&D, Smivet B.V., Diemewei 4110, 6605XC Wijchen, the Netherlands
| | - Bart Ackerschott
- R&D, Smivet B.V., Diemewei 4110, 6605XC Wijchen, the Netherlands
| | - Robert Tierney
- Division of Bacteriology, National Institute for Biological Standards and Control (NIBSC), MHRA, Potters Bar, Hertfordshire EN6 3QG, UK
| | - Paul Stickings
- Division of Bacteriology, National Institute for Biological Standards and Control (NIBSC), MHRA, Potters Bar, Hertfordshire EN6 3QG, UK
| | - Michiel M. Harmsen
- Wageningen Bioveterinary Research, P.O. Box 65, 8200 AB Lelystad, the Netherlands
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Ghotloo S, Golsaz-Shirazi F, Amiri MM, Jeddi-Tehrani M, Shokri F. Epitope Mapping of Tetanus Toxin by Monoclonal Antibodies: Implication for Immunotherapy and Vaccine Design. Neurotox Res 2019; 37:239-249. [PMID: 31410686 DOI: 10.1007/s12640-019-00096-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 07/27/2019] [Accepted: 08/02/2019] [Indexed: 01/05/2023]
Abstract
Tetanus as a life-threatening disease is characterized by muscle spasm. The disease is caused by the neurotoxin of Clostridium tetani. Active form of tetanus neurotoxin is composed of the light chain (fragment A) and the heavy chain. Fragment A is a zinc metalloprotease, which cleaves the neuronal soluble N-ethylmaleimide-sensitive attachment receptor (SNARE) protein, leading to the blockade of inhibitory neurotransmitter release and subsequent generalized muscular spasm. Two functional domains of the heavy chain are fragment C, which is required for neuronal cell binding of the toxin and subsequent endocytosis into the vesicles, and fragment B, which is important for fragment A translocation across the vesicular membrane into the neuronal cytosol. Currently, polyclonal immunoglobulins against tetanus neurotoxin obtained from human plasma of hyper-immunized donors are utilized for passive immunotherapy of tetanus; however, these preparations have many disadvantages including high lot-to-lot heterogeneity, possibility of transmitting microbial agents, and the adverse reactions to the other proteins in the plasma. Neutralizing anti-tetanus neurotoxin monoclonal antibodies (MAbs) lack these drawbacks and could be considered as a suitable alternative for passive immunotherapy of tetanus. In this review, we provide an overview of the literature discussing epitope mapping of the published neutralizing MAbs against tetanus toxin.
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Affiliation(s)
- Somayeh Ghotloo
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Laboratory Medicine, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Forough Golsaz-Shirazi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Amiri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Jeddi-Tehrani
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Fazel Shokri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
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Aliprandini E, Takata DY, Lepique A, Kalil J, Boscardin SB, Moro AM. An oligoclonal combination of human monoclonal antibodies able to neutralize tetanus toxin in vivo. Toxicon X 2019; 2:100006. [PMID: 32550563 PMCID: PMC7285915 DOI: 10.1016/j.toxcx.2019.100006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/27/2018] [Accepted: 01/10/2019] [Indexed: 12/01/2022] Open
Abstract
The use of antibody-based therapy to treat a variety of diseases and conditions is well documented. The use of antibodies as an antidote to treat tetanus infections was one of the first examples of immunotherapy and remains the standard of care for cases involving potential infections. Plasma-derived immunoglobulins obtained from human or horse pose risks of infection from undetectable emergent viruses or may cause anaphylaxis. Further, there is a lack of consistency between lots. In the search for new formulations, we obtained a series of clonally related human monoclonal antibodies (mAbs) derived from B cells sorted from donors that presented anti-tetanus neutralizing titers. Donors were revaccinated prior to blood collection. Different strategies were used for single-cell sorting, since it was challenging to identify cells at a very low frequency: memory B cell sorting using fluorescent-labeled tetanus toxoid and toxin as baits, and plasmablast sorting done shortly after revaccination. Screening of the recombinant mAbs with the whole tetanus toxin allowed us to select candidates with therapeutic potential, since mAbs to different domains can contribute additively to the neutralizing effect. Because of selective binding to different domains, we tested mAbs individually, or in mixtures of two or three, in the neutralizing in vivo assay specified by Pharmacopeia for the determination of polyclonal hyperimmune sera potency. An oligoclonal mixture of three human mAbs completely neutralized the toxin injected in the animals, signaling an important step for clinical mAb development.
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Affiliation(s)
- Eduardo Aliprandini
- Laboratory of Biopharmaceuticals in Animal Cells, Instituto Butantan, São Paulo, Brazil.,Interunits Graduate Program in Biotechnology, University of São Paulo, Brazil
| | - Daniela Yumi Takata
- Laboratory of Biopharmaceuticals in Animal Cells, Instituto Butantan, São Paulo, Brazil.,Interunits Graduate Program in Biotechnology, University of São Paulo, Brazil
| | - Ana Lepique
- Dept of Immunology, Biomedical Sciences Institute, University of São Paulo, Brazil
| | - Jorge Kalil
- Laboratory of Immunology, School of Medicine, University of São Paulo, São Paulo, Brazil.,Institute for Investigation in Immunology, iii - INCT (National Institute of Science and Technology), São Paulo, Brazil
| | - Silvia Beatriz Boscardin
- Dept of Parasitology, Biomedical Sciences Institute, University of São Paulo, Brazil.,Institute for Investigation in Immunology, iii - INCT (National Institute of Science and Technology), São Paulo, Brazil
| | - Ana Maria Moro
- Laboratory of Biopharmaceuticals in Animal Cells, Instituto Butantan, São Paulo, Brazil.,Institute for Investigation in Immunology, iii - INCT (National Institute of Science and Technology), São Paulo, Brazil
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Yousefi M, Younesi V, Bayat AA, Jadidi-Niaragh F, Abbasi E, Razavi A, Khosravi-Eghbal R, Asgarian-Omran H, Shokri F. Comparative human and mouse antibody responses against tetanus toxin at clonal level. J Immunotoxicol 2015; 13:243-8. [DOI: 10.3109/1547691x.2015.1046572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mehdi Yousefi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran,
| | - Vahid Younesi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
| | - Ali Ahmad Bayat
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, and
| | - Farhad Jadidi-Niaragh
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
| | - Ebrahim Abbasi
- Department of Bacterial Vaccines, Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Alireza Razavi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
| | - Roya Khosravi-Eghbal
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
| | - Hossein Asgarian-Omran
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
| | - Fazel Shokri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, and
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