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Chang-Rabley E, van Zelm MC, Ricotta EE, Edwards ESJ. An Overview of the Strategies to Boost SARS-CoV-2-Specific Immunity in People with Inborn Errors of Immunity. Vaccines (Basel) 2024; 12:675. [PMID: 38932404 PMCID: PMC11209597 DOI: 10.3390/vaccines12060675] [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: 05/03/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
The SARS-CoV-2 pandemic has heightened concerns about immunological protection, especially for individuals with inborn errors of immunity (IEI). While COVID-19 vaccines elicit strong immune responses in healthy individuals, their effectiveness in IEI patients remains unclear, particularly against new viral variants and vaccine formulations. This uncertainty has led to anxiety, prolonged self-isolation, and repeated vaccinations with uncertain benefits among IEI patients. Despite some level of immune response from vaccination, the definition of protective immunity in IEI individuals is still unknown. Given their susceptibility to severe COVID-19, strategies such as immunoglobulin replacement therapy (IgRT) and monoclonal antibodies have been employed to provide passive immunity, and protection against both current and emerging variants. This review examines the efficacy of COVID-19 vaccines and antibody-based therapies in IEI patients, their capacity to recognize viral variants, and the necessary advances required for the ongoing protection of people with IEIs.
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Affiliation(s)
- Emma Chang-Rabley
- The Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Menno C. van Zelm
- Allergy and Clinical Immunology Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
- The Jeffrey Modell Diagnostic and Research Centre for Primary Immunodeficiencies in Melbourne, Melbourne, VIC 3000, Australia
- Department of Immunology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Emily E. Ricotta
- The Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
- Department of Preventive Medicine and Biostatistics, Uniform Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Emily S. J. Edwards
- Allergy and Clinical Immunology Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
- The Jeffrey Modell Diagnostic and Research Centre for Primary Immunodeficiencies in Melbourne, Melbourne, VIC 3000, Australia
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2
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Zimmerman O, Altman Doss AM, Ying B, Liang CY, Mackin SR, Davis-Adams HG, Adams LJ, VanBlargan LA, Chen RE, Scheaffer SM, Desai P, Raju S, Mantia TL, O’Shaughnessy CC, Monroy JM, Wedner HJ, Rigell CJ, Kau AL, Dy TB, Ren Z, Turner JS, O’Halloran JA, Presti RM, Kendall PL, Fremont DH, Ellebedy AH, Diamond MS. Immunoglobulin replacement products protect against SARS-CoV-2 infection in vivo despite poor neutralizing activity. JCI Insight 2024; 9:e176359. [PMID: 38175703 PMCID: PMC10967375 DOI: 10.1172/jci.insight.176359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Immunoglobulin (IG) replacement products are used routinely in patients with immune deficiency and other immune dysregulation disorders who have poor responses to vaccination and require passive immunity conferred by commercial antibody products. The binding, neutralizing, and protective activity of intravenously administered IG against SARS-CoV-2 emerging variants remains unknown. Here, we tested 198 different IG products manufactured from December 2019 to August 2022. We show that prepandemic IG had no appreciable cross-reactivity or neutralizing activity against SARS-CoV-2. Anti-spike antibody titers and neutralizing activity against SARS-CoV-2 WA1/2020 D614G increased gradually after the pandemic started and reached levels comparable to vaccinated healthy donors 18 months after the diagnosis of the first COVID-19 case in the United States in January 2020. The average time between production to infusion of IG products was 8 months, which resulted in poor neutralization of the variant strain circulating at the time of infusion. Despite limited neutralizing activity, IG prophylaxis with clinically relevant dosing protected susceptible K18-hACE2-transgenic mice against clinical disease, lung infection, and lung inflammation caused by the XBB.1.5 Omicron variant. Moreover, following IG prophylaxis, levels of XBB.1.5 infection in the lung were higher in FcγR-KO mice than in WT mice. Thus, IG replacement products with poor neutralizing activity against evolving SARS-CoV-2 variants likely confer protection to patients with immune deficiency disorders through Fc effector function mechanisms.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Andrew L. Kau
- Department of Medicine, and
- Department of Molecular Microbiology
- Center for Women’s Infectious Disease Research
| | | | | | | | | | - Rachel M. Presti
- Department of Medicine, and
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, and
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | | | - Ali H. Ellebedy
- Department of Pathology and Immunology
- Department of Molecular Microbiology
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, and
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael S. Diamond
- Department of Medicine, and
- Department of Pathology and Immunology
- Department of Molecular Microbiology
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, and
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, Missouri, USA
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3
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Aggarwal A, Akerman A, Milogiannakis V, Silva MR, Walker G, Stella AO, Kindinger A, Angelovich T, Waring E, Amatayakul-Chantler S, Roth N, Manni S, Hauser T, Barnes T, Condylios A, Yeang M, Wong M, Jean T, Foster CSP, Christ D, Hoppe AC, Munier ML, Darley D, Churchill M, Stark DJ, Matthews G, Rawlinson WD, Kelleher AD, Turville SG. SARS-CoV-2 Omicron BA.5: Evolving tropism and evasion of potent humoral responses and resistance to clinical immunotherapeutics relative to viral variants of concern. EBioMedicine 2022; 84:104270. [PMID: 36130476 DOI: 10.1101/2021.12.14.21267772] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/09/2022] [Accepted: 09/02/2022] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Genetically distinct viral variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been recorded since January 2020. The introduction of global vaccine programs has contributed to lower COVID-19 hospitalisation and mortality rates, particularly in developed countries. In late 2021, Omicron BA.1 emerged, with substantially altered genetic differences and clinical effects from other variants of concern. Shortly after dominating global spread in early 2022, BA.1 was supplanted by the genetically distinct Omicron lineage BA.2. A sub-lineage of BA.2, designated BA.5, presently has an outgrowth advantage over BA.2 and other BA.2 sub-lineages. Here we study the neutralisation of Omicron BA.1, BA.2 and BA.5 and pre-Omicron variants using a range of vaccine and convalescent sera and therapeutic monoclonal antibodies using a live virus neutralisation assay. Using primary nasopharyngeal swabs, we also tested the relative fitness of BA.5 compared to pre-Omicron and Omicron viral lineages in their ability to use the ACE2-TMPRSS2 pathway. METHODS Using low passage clinical isolates of Clade A.2.2, Beta, Delta, BA.1, BA.2 and BA.5, we determined humoral neutralisation in vitro in vaccinated and convalescent cohorts, using concentrated human IgG pooled from thousands of plasma donors, and licensed monoclonal antibody therapies. We then determined infectivity to particle ratios in primary nasopharyngeal samples and expanded low passage isolates in a genetically engineered ACE2/TMPRSS2 cell line in the presence and absence of the TMPRSS2 inhibitor Nafamostat. FINDINGS Peak responses to 3 doses of BNT162b2 vaccine were associated with a 9-fold reduction in neutralisation for Omicron lineages BA.1, BA.2 and BA.5. Concentrated pooled human IgG from convalescent and vaccinated donors and BNT162b2 vaccination with BA.1 breakthrough infections were associated with greater breadth of neutralisation, although the potency was still reduced 7-fold across all Omicron lineages. Testing of clinical grade antibodies revealed a 14.3-fold reduction using Evusheld and 16.8-fold reduction using Sotrovimab for the BA.5. Whilst the infectivity of BA.1 and BA.2 was attenuated in ACE2/TMPRSS2 entry, BA.5 was observed to be equivalent to that of an early 2020 circulating clade and had greater sensitivity to the TMPRSS2 inhibitor Nafamostat. INTERPRETATION Observations support all Omicron variants to significantly escape neutralising antibodies across a range of vaccination and/or convalescent responses. Potency of therapeutic monoclonal antibodies is also reduced and differs across Omicron lineages. The key difference of BA.5 from other Omicron sub-variants is the reversion in tropism back to using the well-known ACE2-TMPRSS2 pathway, utilised efficiently by pre-Omicron lineages. Monitoring if these changes influence transmission and/or disease severity will be key for ongoing tracking and management of Omicron waves globally. FUNDING This work was primarily supported by Australian Medical Foundation research grants MRF2005760 (ST, GM & WDR), MRF2001684 (ADK and ST) and Medical Research Future Fund Antiviral Development Call grant (WDR), Medical Research Future Fund COVID-19 grant (MRFF2001684, ADK & SGT) and the New South Wales Health COVID-19 Research Grants Round 2 (SGT).
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Affiliation(s)
- Anupriya Aggarwal
- The Kirby Institute, University of New South Wales, New South Wales, Australia
| | - Anouschka Akerman
- The Kirby Institute, University of New South Wales, New South Wales, Australia
| | | | - Mariana Ruiz Silva
- The Kirby Institute, University of New South Wales, New South Wales, Australia
| | - Gregory Walker
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, Australia
| | | | - Andrea Kindinger
- The Kirby Institute, University of New South Wales, New South Wales, Australia
| | - Thomas Angelovich
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Emily Waring
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | | | - Nathan Roth
- Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
| | - Sandro Manni
- Department of Bioanalytical Sciences, Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
| | - Thomas Hauser
- Department of Bioanalytical Sciences, Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
| | - Thomas Barnes
- Department of Bioanalytical Sciences, Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
| | - Anna Condylios
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, Australia
| | - Malinna Yeang
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, Australia
| | - Maureen Wong
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, Australia
| | - Tyra Jean
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, Australia
| | - Charles S P Foster
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, Australia
| | - Daniel Christ
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | | | - Mee Ling Munier
- The Kirby Institute, University of New South Wales, New South Wales, Australia
| | - David Darley
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Melissa Churchill
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Damien J Stark
- Molecular Diagnostic Medicine Laboratory, Sydpath, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Gail Matthews
- The Kirby Institute, University of New South Wales, New South Wales, Australia; St Vincent's Hospital, Sydney, New South Wales, Australia
| | - William D Rawlinson
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, Australia
| | - Anthony D Kelleher
- The Kirby Institute, University of New South Wales, New South Wales, Australia; St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Stuart G Turville
- The Kirby Institute, University of New South Wales, New South Wales, Australia.
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4
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Farcet MR, Schwaiger J, Karbiener M, Kreil TR. Function matters: Coronavirus cross-binding antibodies do not cross-neutralize. Front Med (Lausanne) 2022; 9:924426. [PMID: 35983096 PMCID: PMC9378960 DOI: 10.3389/fmed.2022.924426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background During the current pandemic, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) neutralization capacity of the immunoglobulin (IG) supply has changed from undetectable for lots manufactured from plasma collected before the pandemic, to now highly potent. Objective As antibodies induced by exposure to or vaccination against coronaviruses were shown to be cross-coronavirus reactive, it was of interest to understand whether SARS-CoV-2 neutralizing antibodies would result in increased functional IG potency also against seasonal coronaviruses. Methods IG lots from US plasma collected before SARS-CoV-2 emerged and collected during the pandemic were analyzed by live virus neutralization assay for SARS-CoV-2 and seasonal human coronaviruses (HCoVs) NL63 and OC43 neutralizing antibody content. Results Pre-pandemic IG showed no SARS-CoV-2 neutralizing antibody titers. However, IG lots produced from plasma of post-coronavirus disease 2019 (COVID-19) individuals exhibited robust anti-SARS-CoV-2 potency (1,267 IU/ml) which further increased ~4-fold in pandemic IG lots reaching a mean titer of 5,122 IU/ml. Nonetheless, neutralizing antibody potencies to the HCoVs NL63 and OC43 remained stable over this period, i.e., have not increased correspondingly. Conclusion The present results show that cross-coronavirus-reactive antibodies are not cross-neutralizing, i.e., SARS-CoV-2 antibodies do not neutralize seasonal coronaviruses NL63 and OC43.
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Affiliation(s)
| | | | | | - Thomas R. Kreil
- Global Pathogen Safety, Takeda Manufacturing Austria AG, Vienna, Austria
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5
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Mizrahi RA, Lin WY, Gras A, Niedecken AR, Wagner EK, Keating SM, Ikon N, Manickam VA, Asensio MA, Leong J, Medina-Cucurella AV, Benzie E, Carter KP, Chiang Y, Edgar RC, Leong R, Lim YW, Simons JF, Spindler MJ, Stadtmiller K, Wayham N, Büscher D, Terencio JV, Germanio CD, Chamow SM, Olson C, Pino PA, Park JG, Hicks A, Ye C, Garcia-Vilanova A, Martinez-Sobrido L, Torrelles JB, Johnson DS, Adler AS. GMP Manufacturing and IND-Enabling Studies of a Recombinant Hyperimmune Globulin Targeting SARS-CoV-2. Pathogens 2022; 11:806. [PMID: 35890050 PMCID: PMC9320065 DOI: 10.3390/pathogens11070806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Conventionally, hyperimmune globulin drugs manufactured from pooled immunoglobulins from vaccinated or convalescent donors have been used in treating infections where no treatment is available. This is especially important where multi-epitope neutralization is required to prevent the development of immune-evading viral mutants that can emerge upon treatment with monoclonal antibodies. Using microfluidics, flow sorting, and a targeted integration cell line, a first-in-class recombinant hyperimmune globulin therapeutic against SARS-CoV-2 (GIGA-2050) was generated. Using processes similar to conventional monoclonal antibody manufacturing, GIGA-2050, comprising 12,500 antibodies, was scaled-up for clinical manufacturing and multiple development/tox lots were assessed for consistency. Antibody sequence diversity, cell growth, productivity, and product quality were assessed across different manufacturing sites and production scales. GIGA-2050 was purified and tested for good laboratory procedures (GLP) toxicology, pharmacokinetics, and in vivo efficacy against natural SARS-CoV-2 infection in mice. The GIGA-2050 master cell bank was highly stable, producing material at consistent yield and product quality up to >70 generations. Good manufacturing practices (GMP) and development batches of GIGA-2050 showed consistent product quality, impurity clearance, potency, and protection in an in vivo efficacy model. Nonhuman primate toxicology and pharmacokinetics studies suggest that GIGA-2050 is safe and has a half-life similar to other recombinant human IgG1 antibodies. These results supported a successful investigational new drug application for GIGA-2050. This study demonstrates that a new class of drugs, recombinant hyperimmune globulins, can be manufactured consistently at the clinical scale and presents a new approach to treating infectious diseases that targets multiple epitopes of a virus.
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Affiliation(s)
- Rena A. Mizrahi
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Wendy Y. Lin
- Alira Health, Inc., Framingham, MA 01702, USA; (W.Y.L.); (S.M.C.); (C.O.)
| | - Ashley Gras
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Ariel R. Niedecken
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Ellen K. Wagner
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Sheila M. Keating
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Nikita Ikon
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Vishal A. Manickam
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Michael A. Asensio
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Jackson Leong
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Angelica V. Medina-Cucurella
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Emily Benzie
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Kyle P. Carter
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Yao Chiang
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Robert C. Edgar
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Renee Leong
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Yoong Wearn Lim
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Jan Fredrik Simons
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Matthew J. Spindler
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Kacy Stadtmiller
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Nicholas Wayham
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Dirk Büscher
- Grifols S.A., 08174 Sant Cugat del Vallès, Spain; (D.B.); (J.V.T.)
| | | | | | - Steven M. Chamow
- Alira Health, Inc., Framingham, MA 01702, USA; (W.Y.L.); (S.M.C.); (C.O.)
| | - Charles Olson
- Alira Health, Inc., Framingham, MA 01702, USA; (W.Y.L.); (S.M.C.); (C.O.)
| | - Paula A. Pino
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (P.A.P.); (A.H.); (A.G.-V.); (L.M.-S.); (J.B.T.)
| | - Jun-Gyu Park
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (J.-G.P.); (C.Y.)
| | - Amberlee Hicks
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (P.A.P.); (A.H.); (A.G.-V.); (L.M.-S.); (J.B.T.)
| | - Chengjin Ye
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (J.-G.P.); (C.Y.)
| | - Andreu Garcia-Vilanova
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (P.A.P.); (A.H.); (A.G.-V.); (L.M.-S.); (J.B.T.)
| | - Luis Martinez-Sobrido
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (P.A.P.); (A.H.); (A.G.-V.); (L.M.-S.); (J.B.T.)
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (J.-G.P.); (C.Y.)
| | - Jordi B. Torrelles
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (P.A.P.); (A.H.); (A.G.-V.); (L.M.-S.); (J.B.T.)
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (J.-G.P.); (C.Y.)
| | - David S. Johnson
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
| | - Adam S. Adler
- GigaGen, Inc., South San Francisco, CA 94080, USA; (R.A.M.); (A.G.); (A.R.N.); (E.K.W.); (S.M.K.); (N.I.); (V.A.M.); (M.A.A.); (J.L.); (A.V.M.-C.); (E.B.); (K.P.C.); (Y.C.); (R.C.E.); (R.L.); (Y.W.L.); (J.F.S.); (M.J.S.); (K.S.); (N.W.); (D.S.J.)
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6
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Durkee-Shock JR, Keller MD. Immunizing the Imperfect Immune System: COVID-19 Vaccination in Patients with Inborn Errors of Immunity. Ann Allergy Asthma Immunol 2022; 129:562-571.e1. [PMID: 35718282 PMCID: PMC9212748 DOI: 10.1016/j.anai.2022.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
Abstract
Objective To update clinicians on current evidence regarding the immunogenicity and safety of coronavirus disease 2019 (COVID-19) vaccines in patients with inborn errors of immunity (IEI). Data Sources Peer-reviewed, published studies in PubMed, clinical trials listed on ClinicalTrials.gov, and professional organization and governmental guidelines. Study Selections Literature searches on PubMed and ClinicalTrials.gov were performed using a combination of the following keywords: primary immunodeficiency, COVID-19, SARS-CoV-2, and vaccination. Results A total of 26 studies met the criteria and were included in this review. Overall, antibody responses to COVID-19 vaccination were found in 72% of study subjects, with stronger responses observed after messenger RNA vaccination. Neutralizing antibodies were detected in patients with IEI, though consistently at lower levels than healthy controls. Risk factors for poor antibody responses included diagnosis of common variable immunodeficiency, presence of autoimmune comorbidities, and use of rituximab. T cell responses were detectable in most patients with IEI, with poorer responses often found in patients with common variable immunodeficiency. Safety of COVID-19 vaccines in patients with IEI was acceptable with high rates of reactogenicity but very few serious adverse events, including in patients with immune dysregulation. Conclusion COVID-19 vaccines are safe in patients with IEI and seem to be immunogenic in most individuals, with stronger responses found after messenger RNA vaccinations.
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Affiliation(s)
- Jessica R Durkee-Shock
- Laboratory of Infectious Diseases, National Institute for Allergy and Infectious Diseases, Bethesda, Maryland
| | - Michael D Keller
- Division of Allergy & Immunology and Center for Cancer and Immunology Research, Children's National Hospital, Washington, District of Columbia; Department of Pediatrics and GW Cancer Center, George Washington University, Washington, District of Columbia.
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7
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Aggarwal A, Stella AO, Walker G, Akerman A, Esneau C, Milogiannakis V, Burnett DL, McAllery S, Silva MR, Lu Y, Foster CSP, Brilot F, Pillay A, Van Hal S, Mathivanan V, Fichter C, Kindinger A, Hoppe AC, Munier ML, Amatayakul-Chantler S, Roth N, Coppola G, Symonds GP, Schofield P, Jackson J, Lenthall H, Henry JY, Mazigi O, Jäck HM, Davenport MP, Darley DR, Matthews GV, Khoury DS, Cromer D, Goodnow CC, Christ D, Robosa R, Starck DJ, Bartlett NW, Rawlinson WD, Kelleher AD, Turville SG. Platform for isolation and characterization of SARS-CoV-2 variants enables rapid characterization of Omicron in Australia. Nat Microbiol 2022; 7:896-908. [PMID: 35637329 PMCID: PMC9159941 DOI: 10.1038/s41564-022-01135-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/26/2022] [Indexed: 01/31/2023]
Abstract
Genetically distinct variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged since the start of the COVID-19 pandemic. Over this period, we developed a rapid platform (R-20) for viral isolation and characterization using primary remnant diagnostic swabs. This, combined with quarantine testing and genomics surveillance, enabled the rapid isolation and characterization of all major SARS-CoV-2 variants circulating in Australia in 2021. Our platform facilitated viral variant isolation, rapid resolution of variant fitness using nasopharyngeal swabs and ranking of evasion of neutralizing antibodies. In late 2021, variant of concern Omicron (B1.1.529) emerged. Using our platform, we detected and characterized SARS-CoV-2 VOC Omicron. We show that Omicron effectively evades neutralization antibodies and has a different entry route that is TMPRSS2-independent. Our low-cost platform is available to all and can detect all variants of SARS-CoV-2 studied so far, with the main limitation being that our platform still requires appropriate biocontainment.
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Affiliation(s)
- Anupriya Aggarwal
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Alberto Ospina Stella
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Gregory Walker
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - Anouschka Akerman
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Camille Esneau
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Vanessa Milogiannakis
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Deborah L Burnett
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Samantha McAllery
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Mariana Ruiz Silva
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Yonghui Lu
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - Charles S P Foster
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - Fabienne Brilot
- Brain Autoimmunity Group, Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, School of Medical Sciences, Sydney University of Sydney, Sydney Institute for Infectious Diseases, Sydney, New South Wales, Australia
| | - Aleha Pillay
- Brain Autoimmunity Group, Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, School of Medical Sciences, Sydney University of Sydney, Sydney Institute for Infectious Diseases, Sydney, New South Wales, Australia
| | | | - Vennila Mathivanan
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Christina Fichter
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrea Kindinger
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Carey Hoppe
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Mee Ling Munier
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Supavadee Amatayakul-Chantler
- Department of Bioanalytical Sciences, Plasma Product Development, Research and Development, CSL Behring, Broadmeadows, Melbourne, Victoria, Australia
| | - Nathan Roth
- Department of Bioanalytical Sciences, Plasma Product Development, Research and Development, CSL Behring AG, Bern, Switzerland
| | - Germano Coppola
- Department of Bioanalytical Sciences, Plasma Product Development, Research and Development, CSL Behring, Broadmeadows, Melbourne, Victoria, Australia
| | | | - Peter Schofield
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Jennifer Jackson
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Helen Lenthall
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Jake Y Henry
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Ohan Mazigi
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | | | - Miles P Davenport
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - David R Darley
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Gail V Matthews
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - David S Khoury
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Deborah Cromer
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Daniel Christ
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Roselle Robosa
- Molecular Diagnostic Medicine Laboratory, Sydpath, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Damien J Starck
- Molecular Diagnostic Medicine Laboratory, Sydpath, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Nathan W Bartlett
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - William D Rawlinson
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Anthony D Kelleher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Stuart G Turville
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
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8
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Burnouf T, Gathof B, Bloch EM, Bazin R, de Angelis V, Patidar GK, Rastvorceva RMG, Oreh A, Goel R, Rahimi-Levene N, Hindawi S, Al-Riyami AZ, So-Osman C. Production and Quality Assurance of Human Polyclonal Hyperimmune Immunoglobulins against SARS-CoV-2. Transfus Med Rev 2022; 36:125-132. [PMID: 35879213 PMCID: PMC9183240 DOI: 10.1016/j.tmrv.2022.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Thierry Burnouf
- College of Biomedical Engineering, Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan; International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.
| | - Birgit Gathof
- Department of Transfusion Medicine, University Hospital of Cologne, Köln, Germany.
| | - Evan M Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Renée Bazin
- Héma-Québec, Medical Affairs and Innovation, Québec, Canada
| | | | - Gopal Kumar Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rada M Grubovic Rastvorceva
- Institute for Transfusion Medicine of RNM, Skopje, North Macedonia; Faculty of Medical Sciences, University Goce Delcev, Štip, North Macedonia
| | - Adaeze Oreh
- Department of Planning, Research and Statistics, National Blood Service Commission, Federal Ministry of Health, Abuja, Nigeria
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine and ImpactLife Blood Center, Springfield, IL, USA
| | | | - Salwa Hindawi
- Haematology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arwa Z Al-Riyami
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Cynthia So-Osman
- Department of Haematology, Erasmus Medical Centre, Rotterdam, The Netherlands; Unit Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
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9
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Bergman P, Wullimann D, Gao Y, Wahren Borgström E, Norlin AC, Lind Enoksson S, Aleman S, Ljunggren HG, Buggert M, Smith CIE. Elevated CD21 low B Cell Frequency Is a Marker of Poor Immunity to Pfizer-BioNTech BNT162b2 mRNA Vaccine Against SARS-CoV-2 in Patients with Common Variable Immunodeficiency. J Clin Immunol 2022; 42:716-727. [PMID: 35290571 PMCID: PMC8922070 DOI: 10.1007/s10875-022-01244-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/24/2022] [Indexed: 12/18/2022]
Abstract
PURPOSE Limited data is available on the effect of COVID-19 vaccination in immunocompromised individuals. Here, we provide the results from vaccinating a single-center cohort of patients with common variable immunodeficiency (CVID). METHODS In a prospective, open-label clinical trial, 50 patients with CVID and 90 age-matched healthy controls (HC) were analyzed for SARS-CoV-2 spike antibody (Ab) production after one or two doses of the Pfizer-BioNTech BNT162b2 mRNA vaccine. Additionally, in selected patients, SARS-CoV-2 spike-specific T-cells were assessed. RESULTS A potent vaccine-induced anti-spike-specific IgG Ab response was observed in all the HC. In contrast, only 68.3% of the CVID patients seroconverted, with median titers of specific Ab being 83-fold lower than in HC. In fact, only 4/46 patients (8.6%) of patients who were seronegative at baseline reached the threshold for an optimal response (250 U/mL). Using the EUROclass definition, patients with either a reduced proportion, but not absolute counts, of switched memory B-cells or having an increased frequency of CD21low B-cells generally generated poor vaccine responses. Overall, CVID-patients had reduced spike-specific IFN-γ positive CD4+ T cell responses 2 weeks after the second dose, compared to HC. The total CD4 and CD4 central memory cell counts correlated with humoral immunity to the vaccine. CONCLUSIONS CVID patients with low frequency of switched memory B-cells or an increased frequency of CD21low B-cells according to the EUROclass definition demonstrated poor responses to Pfizer-BioNTech BNT162b2 mRNA vaccination. Cellular immune responses were significantly affected, affirming that the defect in CVID is not limited to humoral immunity.
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Affiliation(s)
- Peter Bergman
- Department of Infectious Diseases, Immunodeficiency Unit, Karolinska University Hospital, Stockholm, Sweden.
- Department of Laboratory Medicine, Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden.
| | - David Wullimann
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yu Gao
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emilie Wahren Borgström
- Department of Infectious Diseases, Immunodeficiency Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Anna-Carin Norlin
- Department of Infectious Diseases, Immunodeficiency Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Lind Enoksson
- Department of Clinical immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Investigation and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Soo Aleman
- Department of Infectious Diseases, Immunodeficiency Unit, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Infectious Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Hans-Gustaf Ljunggren
- Department of Infectious Diseases, Immunodeficiency Unit, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Buggert
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C I Edvard Smith
- Department of Infectious Diseases, Immunodeficiency Unit, Karolinska University Hospital, Stockholm, Sweden
- Department of Laboratory Medicine, Biomolecular and Cellular Medicine, Karolinska Institutet, Stockholm, Sweden
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10
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Focosi D, Franchini M. Passive immunotherapies for COVID-19: The subtle line between standard and hyperimmune immunoglobulins is getting invisible. Rev Med Virol 2022; 32:e2341. [PMID: 35275607 DOI: 10.1002/rmv.2341] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy
| | - Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantua, Italy
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