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Sun P, Jiang P, Liu Q, Zhang R, Wang Z, Cao H, Ye X, Ji S, Han J, Lu K, He X, Fan J, Cao D, Zhang Y, Yin Y, Chen Y, Zhao X, Ye S, Su N, Du X, Ma L, Li C. Parvovirus B19 DNA and antibodies in Chinese plasma donors, plasma pools and plasma derivatives. PeerJ 2023; 11:e15698. [PMID: 37554334 PMCID: PMC10405795 DOI: 10.7717/peerj.15698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/14/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Human parvovirus B19 (B19V) is a common contaminant found in plasma pools and plasma derivatives. Previous studies were mainly focused on limited aspects, further assessment of prevalence of B19V DNA and antibodies in plasma donors, the contamination of B19V in pooled plasma and plasma derivatives should be performed in China. STUDY DESIGN AND METHODS Individual plasma donors' samples from four provinces and pooled plasma from four Chinese blood product manufacturers were collected and screened using B19V DNA diagnostic kits between October 2018 and May 2020. The positive samples were investigated for the seroprevalence of B19V antibodies and subjected to sequence analysis and alignment for phylogenetic studies. Moreover, 11 plasma donors who were B19V DNA-positive at their first testing were also followed during the later donation period. Additionally, 400 plasma pools and 20 batches of plasma derivatives produced by pooled plasma with a viral load of B19V DNA exceeding 104IU/mL were also collected and tested for B19V DNA and antibodies. OBJECTIVES To comprehensively and systematically determine the frequency and viral load of B19V DNA in plasma donors, pooled plasma, and plasma derivatives from four Chinese blood product manufacturers. RESULTS A total of 17,187 plasma donors were analyzed and 44 (0.26%) specimens were found positive for B19V DNA. The quantitative DNA levels ranged from 1.01 × 101 to 5.09 × 1012 IU/mL. Forty-four DNA-positive specimens were also investigated for the seroprevalence of B19V antibodies, 75.0% and 2.3% of which were seropositive for B19V IgG and IgM antibodies, respectively. The phylogenic analyses showed that the prevalent genotypes in the four provinces' plasma donors belonged to B19V Genotype 1. Eleven individual plasma donors who were B19V DNA-positive at the first donation were then followed for a period, and in general, the DNA levels of B19V gradually decreased. Moreover, 64.8% (259/400) of the pooled plasma was contaminated by B19V, with concentrations of 1.05 × 100-3.36 × 109IU/mL. Approximately 72.6% of the DNA-positive plasma pools were only moderately contaminated (<104 IU/mL), while 27.4% contained >104 IU/mL. Twenty batches of plasma derivatives produced by pooled plasma with a viral load of B19V DNA exceeding 104IU/mL were also tested. B19V was detected in 5/5 PCC samples and 5/5 factor VIII samples but was not found in the intravenous immune globulin and albumin samples. CONCLUSION The contamination of B19V in pooled plasma and plasma-derived clotting factor concentrates is serious. Whether B19V nucleic acid testing (NAT) screening of plasma and plasma derivatives is launched in China, blood product manufacturers should spontaneously perform B19V NAT screening in plasma donors and mini-pool plasma. These measures can ensure that samples with high titer B19V DNA are discarded in order to prevent and control this transfusion transmitted virus.
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Affiliation(s)
- Pan Sun
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Peng Jiang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Qing Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Rong Zhang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Zongkui Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Haijun Cao
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | | | - Shangzhi Ji
- Beijing Wantai Biological Pharmacy, Beijing, China
| | - Jinle Han
- Beijing Wantai Biological Pharmacy, Beijing, China
| | - Kuilin Lu
- Chengdu Rongsheng Pharmaceutical Co., Ltd., Chengdu, China
| | - Xuexin He
- Chengdu Rongsheng Pharmaceutical Co., Ltd., Chengdu, China
| | - Jiajin Fan
- Shandong Taibang Biological Products Co., Ltd., Taian, China
| | - Dawei Cao
- Shandong Taibang Biological Products Co., Ltd., Taian, China
| | - Yu Zhang
- Hualan Biological Products Co., Ltd., Xinxiang, China
| | - Yongsheng Yin
- Hualan Biological Products Co., Ltd., Xinxiang, China
| | - Yunhua Chen
- Guizhou Taibang Biological Products Co., Ltd, Guiyang, China
| | - Xuemei Zhao
- Guizhou Taibang Biological Products Co., Ltd, Guiyang, China
| | - Shengliang Ye
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Na Su
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xi Du
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Li Ma
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Changqing Li
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
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Kalkan AK, Palaz F, Sofija S, Elmousa N, Ledezma Y, Cachat E, Rios-Solis L. Improving recombinant protein production in CHO cells using the CRISPR-Cas system. Biotechnol Adv 2023; 64:108115. [PMID: 36758652 DOI: 10.1016/j.biotechadv.2023.108115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/28/2022] [Accepted: 02/03/2023] [Indexed: 02/10/2023]
Abstract
Chinese hamster ovary (CHO) cells are among the most widely used mammalian cell lines in the biopharmaceutical industry. Therefore, it is not surprising that significant efforts have been made around the engineering of CHO cells using genetic engineering methods such as the CRISPR-Cas system. In this review, we summarize key recent studies that have used different CRISPR-Cas systems such as Cas9, Cas13 or dCas9 fused with effector domains to improve recombinant protein (r-protein) production in CHO cells. Here, every relevant stage of production was considered, underscoring the advantages and limitations of these systems, as well as discussing their bottlenecks and probable solutions. A special emphasis was given on how these systems could disrupt and/or regulate genes related to glycan composition, which has relevant effects over r-protein properties and in vivo activity. Furthermore, the related promising future applications of CRISPR to achieve a tunable, reversible, or highly stable editing of CHO cells are discussed. Overall, the studies covered in this review show that despite the complexity of mammalian cells, the synthetic biology community has developed many mature strategies to improve r-protein production using CHO cells. In this regard, CRISPR-Cas technology clearly provides efficient and flexible genetic manipulation and allows for the generation of more productive CHO cell lines, leading to more cost-efficient production of biopharmaceuticals, however, there is still a need for many emerging techniques in CRISPR to be reported in CHO cells; therefore, more research in these cells is needed to realize the full potential of this technology.
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Affiliation(s)
- Ali Kerem Kalkan
- Department of Bioengineering and Imperial College Centre for Synthetic Biology, Imperial College London, London, UK; Environmental Engineering Department, Gebze Technical University, Turkey
| | - Fahreddin Palaz
- Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey
| | - Semeniuk Sofija
- Centre for Engineering Biology, University of Edinburgh, Edinburgh EH9 3BF, UK; Institute of Quantitative Biology, Biochemistry and Biotechnology, School of Biological Sciences University of Edinburgh, Edinburgh EH9 3BF, UK
| | - Nada Elmousa
- Institute for Bioengineering, School of Engineering, University of Edinburgh, Edinburgh EH9 3DW, UK
| | - Yuri Ledezma
- Institute for Bioengineering, School of Engineering, University of Edinburgh, Edinburgh EH9 3DW, UK; Biology Department, Faculty of Pure and Natural Sciences, Universidad Mayor de San Andrés, Bolivia
| | - Elise Cachat
- Centre for Engineering Biology, University of Edinburgh, Edinburgh EH9 3BF, UK; Institute of Quantitative Biology, Biochemistry and Biotechnology, School of Biological Sciences University of Edinburgh, Edinburgh EH9 3BF, UK; UK Centre for Mammalian Synthetic Biology, University of Edinburgh, Edinburgh EH8 9YL, UK
| | - Leonardo Rios-Solis
- Centre for Engineering Biology, University of Edinburgh, Edinburgh EH9 3BF, UK; Institute for Bioengineering, School of Engineering, University of Edinburgh, Edinburgh EH9 3DW, UK; School of Natural and Environmental Sciences, Molecular Biology and Biotechnology Division, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK.
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Abdelrahman D, Al-Sadeq DW, Smatti MK, Taleb SA, AbuOdeh RO, Al-Absi ES, Al-Thani AA, Coyle PV, Al-Dewik N, Qahtani AAA, Yassine HM, Nasrallah GK. Prevalence and Phylogenetic Analysis of Parvovirus (B19V) among Blood Donors with Different Nationalities Residing in Qatar. Viruses 2021; 13:v13040540. [PMID: 33805034 PMCID: PMC8063948 DOI: 10.3390/v13040540] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 12/16/2022] Open
Abstract
Human parvovirus (B19V) is the causative agent of erythema infectiosum in children and is linked to a wide range of clinical manifestations. Studies related to B19V prevalence in the Middle East and North Africa (MENA) region and other parts of Asia are very scarce. The objectives of this study were to estimate the seroprevalence (anti-B19V IgM and IgG), the viremia rate (B19V DNA), and the circulating genotypes of B19V among blood donors in Qatar. Methods: Donors’ blood samples (n = 5026) from different nationalities, mainly from the MENA region and South East Asia, were collected from 2014–2016. Samples were tested for the B19V DNA using RT-PCR. Furthermore, 1000 selected samples were tested to determine the seroprevalence of B19V antibodies using enzyme-linked immunosorbent assay (ELISA). Genotyping was performed on 65 DNA positive samples by sequencing of nested PCR fragments (NS1-VP1u region, 927 nt). Results: Only 1.4% (70/5026) of the samples had detectible B19V DNA in their blood. B19V DNA prevalence statistically decreased with age (p = 0.03). Anti-B19V IgG was detected in 60.3% (561/930) of the tested samples, while only 2.1% (20/930) were IgM-positive and 1.2% (11/930) were both IgM- and IgG-positive. B19V genotyping showed a predominance of Genotype 1 (100%). Sequence analysis of the NS1-VP1u region revealed 139 mutation sites, some of which were amino acid substitutions. Conclusion: Our results indicated a relatively high seroprevalence of B19V in Qatar. Most importantly, B19 DNA was detected among Qatari and non-Qatari blood donors. Therefore, blood banks in Qatar might need to consider screening for B19V, especially when transfusion is intended for high-risk populations, including immunocompromised patients.
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Affiliation(s)
| | - Duaa W. Al-Sadeq
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; (D.W.A.-S.); (M.K.S.); (E.S.A.-A.); (A.A.A.-T.); (H.M.Y.)
- College of Medicine, Member of QU Health, Qatar University, Doha, Qatar
| | - Maria K. Smatti
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; (D.W.A.-S.); (M.K.S.); (E.S.A.-A.); (A.A.A.-T.); (H.M.Y.)
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar;
| | - Sara A. Taleb
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar;
| | - Raed O AbuOdeh
- Medical Laboratory Sciences Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates;
| | - Enas S. Al-Absi
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; (D.W.A.-S.); (M.K.S.); (E.S.A.-A.); (A.A.A.-T.); (H.M.Y.)
| | - Asmaa A. Al-Thani
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; (D.W.A.-S.); (M.K.S.); (E.S.A.-A.); (A.A.A.-T.); (H.M.Y.)
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Peter. V. Coyle
- Division of Virology, Department of Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, Qatar;
| | - Nader Al-Dewik
- Department of Pediatrics, Clinical and Metabolic Genetics, Hamad Medical Corporation, Doha, Qatar;
| | - Ahmed A. Al Qahtani
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia;
- Department of Microbiology and Immunology, Alfaisal University School of Medicine, Riyadh 11533, Saudi Arabia
| | - Hadi M. Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; (D.W.A.-S.); (M.K.S.); (E.S.A.-A.); (A.A.A.-T.); (H.M.Y.)
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Gheyath K. Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; (D.W.A.-S.); (M.K.S.); (E.S.A.-A.); (A.A.A.-T.); (H.M.Y.)
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
- Correspondence:
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Schieve LA, Byams VR, Dupervil B, Oakley MA, Miller CH, Soucie JM, Abe K, Bean CJ, Hooper WC. Evaluation of CDC's Hemophilia Surveillance Program - Universal Data Collection (1998-2011) and Community Counts (2011-2019), United States. MMWR. SURVEILLANCE SUMMARIES : MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES 2020; 69:1-18. [PMID: 32881847 PMCID: PMC8797870 DOI: 10.15585/mmwr.ss6905a1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Problem/Condition Hemophilia is an X-linked genetic disorder that primarily affects males and results in deficiencies in blood-clotting proteins. Hemophilia A is a deficiency in factor VIII, and hemophilia B is a deficiency in factor IX. Approximately one in 5,000 males are born with hemophilia, and hemophilia A is about four times as common as hemophilia B. Both disorders are characterized by spontaneous internal bleeding and excessive bleeding after injuries or surgery. Hemophilia can lead to repeated bleeding into the joints and associated chronic joint disease, neurologic damage, damage to other organ systems, and death. Although no precise national U.S. prevalence estimates for hemophilia exist because of the difficulty identifying cases among persons who receive care from various types of health care providers, two previous state-based studies estimated hemophilia prevalence at 13.4 and 19.4 per 100,000 males. In addition, these studies showed that 67% and 82% of persons with hemophilia received care in a federally funded hemophilia treatment center (HTC), and 86% and 94% of those with the most severe cases of hemophilia (i.e., those with the lowest levels of clotting factor activity in the circulating blood) received care in a federally funded HTC. As of January 2020, the United States had 144 HTCs. Period Covered 1998–2019. Description of the System Surveillance for hemophilia, which is a complex, chronic condition, is challenging because of its low prevalence, the difficulty in ascertaining cases uniformly, and the challenges in routinely characterizing and tracking associated health complications. Over time, two systems involving many stakeholders have been used to conduct ongoing hemophilia surveillance. During 1998–2011, CDC and the HTCs collaborated to establish the Universal Data Collection (UDC) surveillance system. The purposes of the UDC surveillance system were to monitor human immunodeficiency virus (HIV) and bloodborne viral hepatitis in persons with hemophilia, thereby tracking blood safety, and to track the prevalence of and trends in complications associated with hemophilia. HTC staff collected clinical data and blood specimens from UDC participants and submitted them to CDC. CDC tested specimens for viral hepatitis and HIV. In 2011, the UDC surveillance system was replaced by a new hemophilia surveillance system called Community Counts. CDC and the HTCs established Community Counts to expand laboratory testing and the collection of clinical data to better identify and track emerging health issues in persons with hemophilia. Results This report is the first comprehensive summary of CDC’s hemophilia surveillance program, which comprises both UDC and Community Counts. Data generated from these surveillance systems have been used in the development of public health and clinical guidelines and practices to improve the safety of U.S. blood products and either prevent hemophilia-related complications or identify complications early. Several factors have played a role in the effectiveness of the UDC and Community Counts systems, including 1) a stable data collection design that was developed and is continually reviewed in close partnership with HTC regional leaders and providers to ensure surveillance activities are focused on maximizing the scientific and clinical impact; 2) flexibility to respond to emerging health priorities through periodic updates to data collection elements and special studies; 3) high data quality for many clinical indicators and state-of-the-art laboratory testing methods for hemophilia treatment product inhibitors (developed and refined in part based on CDC research); 4) timely data and specimen collection and submission, laboratory specimen testing, analysis, and reporting; and 5) the largest and most representative sample of persons with hemophilia in the United States and one of the largest and most comprehensive data collection systems on hemophilia worldwide. Interpretation CDC has successfully developed, implemented, and maintained a surveillance system for hemophilia. The program can serve as an example of how to conduct surveillance for a complex chronic disease by involving stakeholders, improving and building new infrastructure, expanding data collection (e.g., new diagnostic assays), providing testing guidance, establishing a registry with specimen collection, and integrating laboratory findings in clinical practice for the individual patient. Public Health Action Hemophilia is associated with substantial lifelong morbidity, excess premature deaths, and extensive health care needs throughout life. Through monitoring data from Community Counts, CDC will continue to characterize the benefits and adverse events associated with existing or new hemophilia treatment products, thereby contributing to maximizing the health and longevity of persons with hemophilia.
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Affiliation(s)
- Laura A Schieve
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Vanessa R Byams
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Brandi Dupervil
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Meredith A Oakley
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Connie H Miller
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - J Michael Soucie
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Karon Abe
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Christopher J Bean
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - W Craig Hooper
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
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Impact of Blood Transfusion on the Prevalence of HHpgV-1, HPgV-1, and B19V Among Iranian HCV-infected Patients With Hemophilia. J Pediatr Hematol Oncol 2020; 42:e213-e218. [PMID: 31972722 DOI: 10.1097/mph.0000000000001717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Blood-derived products from patient with hemophilia treated by factor VIII concentrates are potential sources of transfusion-transmitted infections, including human immunodeficiency virus, hepatitis, human pegivirus-1 (HPgV-1), B19 virus, and also human hepegivirus-1 (HHpgV-1). In the current study, we investigated the impact of blood transfusion on the prevalence of HHpgV-1, HPgV-1, and B19 virus in plasma of Iranian patient with hemophilia after direct-acting antiviral treatment of hepatitis C virus (HCV) infections for the first time. MATERIALS AND METHODS A total of 170 patients with hemophilia who received direct-acting antivirals were enrolled in this study. Among them, 92 patients had a history of blood transfusion. The presence of HHpgV-1, HPgV-1, and B19 virus was detected by nested polymerase chain reaction analysis using the conserved primers. The plasmids harboring 5'-UTR and NS3 were used as positive controls for HPgV-1 and HHpgV-1, respectively. RESULTS Our data identified 3 individuals with HHpgV-1 viremia (1.76%), 11 individuals with HPgV-1 viremia (6.47%), and 33 individuals with B19 viremia (19.4%). All patients were negative for hepatitis B virus, human immunodeficiency virus, and HCV infections. These findings indicated lower transmissibility or higher rates of virus clearance for HHpgV-1, HPgV-1, and B19 virus as compared with other bloodborne human flaviviruses such as HCV. However, the prevalence of B19 virus was significantly higher than the other 2 viruses. CONCLUSION In general, these findings showed that the history of blood transfusion could increase the risk of viral transmission of bloodborne viruses among patient with hemophilia.
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Peyvandi F, Kouides P, Turecek PL, Dow E, Berntorp E. Evolution of replacement therapy for von Willebrand disease: From plasma fraction to recombinant von Willebrand factor. Blood Rev 2019; 38:100572. [DOI: 10.1016/j.blre.2019.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/27/2019] [Accepted: 04/02/2019] [Indexed: 01/19/2023]
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Kelishadi M, Hashemi P, Ashrafi G, Behnampour N, Tabarraei A. Presence of GB Virus C in Whole-Blood Derivatives: A Pilot Study. MEDICAL LABORATORY JOURNAL 2019. [DOI: 10.29252/mlj.13.5.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Adan-Kubo J, Tsujikawa M, Takahashi K, Hongo-Hirasaki T, Sakai K. Microscopic visualization of virus removal by dedicated filters used in biopharmaceutical processing: Impact of membrane structure and localization of captured virus particles. Biotechnol Prog 2019; 35:e2875. [PMID: 31228338 PMCID: PMC7003479 DOI: 10.1002/btpr.2875] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/26/2019] [Accepted: 06/04/2019] [Indexed: 11/23/2022]
Abstract
Virus filtration with nanometer size exclusion membranes (“nanofiltration”) is effective for removing infectious agents from biopharmaceuticals. While the virus removal capability of virus removal filters is typically evaluated based on calculation of logarithmic reduction value (LRV) of virus infectivity, knowledge of the exact mechanism(s) of virus retention remains limited. Here, human parvovirus B19 (B19V), a small virus (18–26 nm), was spiked into therapeutic plasma protein solutions and filtered through Planova™ 15N and 20N filters in scaled‐down manufacturing processes. Observation of the gross structure of the Planova hollow fiber membranes by transmission electron microscopy (TEM) revealed Planova filter microporous membranes to have a rough inner, a dense middle and a rough outer layer. Of these three layers, the dense middle layer was clearly identified as the most functionally critical for effective capture of B19V. Planova filtration of protein solution containing B19V resulted in a distribution peak in the dense middle layer with an LRV >4, demonstrating effectiveness of the filtration step. This is the first report to simultaneously analyze the gross structure of a virus removal filter and visualize virus entrapment during a filtration process conducted under actual manufacturing conditions. The methodologies developed in this study demonstrate that the virus removal capability of the filtration process can be linked to the gross physical filter structure, contributing to better understanding of virus trapping mechanisms and helping the development of more reliable and robust virus filtration processes in the manufacture of biologicals.
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Affiliation(s)
- Jun Adan-Kubo
- Central Research Laboratory, Japanese Blood Products Organization, Kobe, Hyogo Prefecture, Japan
| | - Muneo Tsujikawa
- Central Research Laboratory, Japanese Blood Products Organization, Kobe, Hyogo Prefecture, Japan
| | - Kadue Takahashi
- Central Research Laboratory, Japanese Blood Products Organization, Kobe, Hyogo Prefecture, Japan
| | - Tomoko Hongo-Hirasaki
- Technology Development Department, Bioprocess Division, Asahi Kasei Medical Co. Ltd., Nobeoka, Miyazaki Prefecture, Japan
| | - Kaoru Sakai
- Central Research Laboratory, Japanese Blood Products Organization, Kobe, Hyogo Prefecture, Japan
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Amann T, Hansen AH, Kol S, Hansen HG, Arnsdorf J, Nallapareddy S, Voldborg B, Lee GM, Andersen MR, Kildegaard HF. Glyco-engineered CHO cell lines producing alpha-1-antitrypsin and C1 esterase inhibitor with fully humanized N-glycosylation profiles. Metab Eng 2018; 52:143-152. [PMID: 30513349 DOI: 10.1016/j.ymben.2018.11.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/30/2018] [Accepted: 11/30/2018] [Indexed: 01/22/2023]
Abstract
Recombinant Chinese hamster ovary (CHO) cells are able to provide biopharmaceuticals that are essentially free of human viruses and have N-glycosylation profiles similar, but not identical, to humans. Due to differences in N-glycan moieties, two members of the serpin superfamily, alpha-1-antitrypsin (A1AT) and plasma protease C1 inhibitor (C1INH), are currently derived from human plasma for treating A1AT and C1INH deficiency. Deriving therapeutic proteins from human plasma is generally a cost-intensive process and also harbors a risk of transmitting infectious particles. Recombinantly produced A1AT and C1INH (rhA1AT, rhC1INH) decorated with humanized N-glycans are therefore of clinical and commercial interest. Here, we present engineered CHO cell lines producing rhA1AT or rhC1INH with fully humanized N-glycosylation profiles. This was achieved by combining CRISPR/Cas9-mediated disruption of 10 gene targets with overexpression of human ST6GAL1. We were able to show that the N-linked glyco-structures of rhA1AT and rhC1INH are homogeneous and similar to the structures obtained from plasma-derived A1AT and C1INH, marketed as Prolastin®-C and Cinryze®, respectively. rhA1AT and rhC1INH produced in our glyco-engineered cell line showed no detectable differences to their plasma-purified counterparts on SDS-PAGE and had similar enzymatic in vitro activity. The work presented here shows the potential of expanding the glyco-engineering toolbox for CHO cells to produce a wider variety of glycoproteins with fully humanized N-glycan profiles. We envision replacing plasma-derived A1AT and C1INH with recombinant versions and thereby decreasing our dependence on human donor blood, a limited and possibly unsafe protein source for patients.
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Affiliation(s)
- Thomas Amann
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anders Holmgaard Hansen
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark.
| | - Stefan Kol
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Henning Gram Hansen
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Johnny Arnsdorf
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Saranya Nallapareddy
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Bjørn Voldborg
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Gyun Min Lee
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark; Department of Biological Sciences, KAIST, Daejeon, Republic of Korea
| | - Mikael Rørdam Andersen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Helene Faustrup Kildegaard
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark.
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Factors affecting the quality, safety and marketing approval of clotting factor concentrates for haemophilia. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2018; 16:525-534. [PMID: 30201084 DOI: 10.2450/2018.0150-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/22/2018] [Indexed: 12/27/2022]
Abstract
Selecting therapeutic products for the treatment of haemophilia follows the process of obtaining market approval of products submitted to the scrutiny of a regulatory agency. In well-resourced countries, key decisions on whether a product is sufficiently safe and of high quality are made by highly expert and well-resourced agencies, such as the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). In countries lacking such agencies, well-informed decisions can still be made through an appreciation of the key issues affecting the quality, safety and efficacy of haemophilia products. A number of well-established principles may then be applied in order to make a choice. In this review, reflecting principles outlined by the World Federation of Hemophilia, we outline the key features in determining the acceptability of therapeutic products for haemophilia in order to ensure an optimal choice in all the environments providing haemophilia care.
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11
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The current and future role of plasma-derived clotting factor concentrate in the treatment of haemophilia A. Transfus Apher Sci 2018; 57:502-506. [DOI: 10.1016/j.transci.2018.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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12
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Juhl D, Hennig H. Parvovirus B19: What Is the Relevance in Transfusion Medicine? Front Med (Lausanne) 2018; 5:4. [PMID: 29450198 PMCID: PMC5799219 DOI: 10.3389/fmed.2018.00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/09/2018] [Indexed: 01/17/2023] Open
Abstract
Parvovirus B19 (B19V) has been discovered in 1975. The association with a disease was unclear in the first time after the discovery of B19V, but meanwhile, the usually droplet transmitted B19V is known as the infectious agent of the “fifth disease,” a rather harmless children’s illness. But B19V infects erythrocyte progenitor cells and thus, acute B19V infection in patients with a high erythrocyte turnover may lead to a life-threatening aplastic crisis, and acutely infected pregnant women can transmit B19V to their unborn child, resulting in a hydrops fetalis and fetal death. However, in many adults, B19V infection goes unnoticed and thus many blood donors donate blood despite the infection. The B19V infection does not impair the blood cell counts in healthy blood donors, but after the acute infection with extremely high DNA concentrations exceeding 1010 IU B19V DNA/ml plasma is resolved, B19V DNA persists in the plasma of blood donors at low levels for several years. That way, many consecutive donations that contain B19V DNA can be taken from a single donor, but the majority of blood products from donors with detectable B19V DNA seem not to be infectious for the recipients from several reasons: first, many recipients had undergone a B19V infection in the past and have formed protective antibodies. Second, B19V DNA concentration in the blood product is often too low to infect the recipient. Third, after the acute infection, the presence of B19V DNA in the donor is accompanied by presumably neutralizing antibodies which are protective also for the recipient of his blood products. Thus, transfusion-transmitted (TT-) B19V infections are very rarely reported. Moreover, in most blood donors, B19V DNA concentration is below 1,000 IU/ml plasma, and no TT-B19V infections have been found by such low-viremic donations. Cutoff for an assay for B19V DNA blood donor screening should, therefore, be approximately 1,000 IU/ml plasma, if a general screening of blood donors for single donation blood components is considered at all: for the overwhelming majority of transfusion recipients, B19V infection is not relevant as well as for the blood donors. B19V DNA screening of vulnerable patients after transfusion seems to be a more reasonable approach than general blood donor screening.
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Affiliation(s)
- David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Holger Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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Javanmard D, Ziaee M, Ghaffari H, Namaei MH, Tavakoli A, Mollaei H, Moghoofei M, Mortazavi HS, Monavari SH. Human parvovirus B19 and parvovirus 4 among Iranian patients with hemophilia. Blood Res 2017; 52:311-315. [PMID: 29333409 PMCID: PMC5762743 DOI: 10.5045/br.2017.52.4.311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/15/2017] [Accepted: 06/14/2017] [Indexed: 01/26/2023] Open
Abstract
Background Human parvovirus B19 (B19V) is one of the smallest DNA viruses and shows great resistance to most disinfectants. Therefore, it is one of the common contaminant pathogens present in blood and plasma products. Parvovirus 4 (PARV4) is a newly identified parvovirus, which is also prevalent in parenteral transmission. In this study, we aimed to evaluate the prevalence of B19V and PARV4 DNA among patients with hemophilia in Birjand County in eastern Iran. Methods This was a cross-sectional epidemiological study comprising nearly all people with hemophilia in this region. Whole blood samples were taken after patient registration and sent for plasma isolation. After nucleic acid extraction, B19V was detected with real-time polymerase chain reaction, PARV4 DNA was then detected using sensitive semi-nested PCR. Results In total, there were 86 patients with hemophilia, with mean age 28.5±1.5 years. Of these, 90.7% were men and 9.3% women; 84.9% had hemophilia A and 7.0% had hemophilia B. We found 11 patients (12.8%) were positive for B19V DNA and 8 were positive (9.3%) for PARV4 DNA. The prevalence of B19V was higher in middle-aged groups rather than younger people, whereas PARV4 infection was more common in younger patients (P <0.05). Conclusion There was a high prevalence of B19V and PARV4 infection in this high-risk group of patients with hemophilia. Due to the clinical significance of the B19 virus, imposing more precautionary measures for serum and blood products is recommended.
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Affiliation(s)
- Davod Javanmard
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masood Ziaee
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hadi Ghaffari
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hasan Namaei
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Tavakoli
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mollaei
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Moghoofei
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Helya Sadat Mortazavi
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Abstract
INTRODUCTION Hemophilia A is the most frequent inherited bleeding disorder and most challenging coagulation disorder. To combat this, a number of new improved rFVIII/IX concentrates have recently been approved. Some of them are derived from protein fusion biotechnology or pegylation to extend their half-life (HL). However, prophylaxis has become a standard of care to prevent arthropathy in hemophiliacs though the need of frequent venipunctures is a major obstacle to primary prophylaxis. The new Extended Half-Life (EHL) rFIX concentrates allow increased intervals, while the improved HL of new rFVIII was moderate. rFVIII Simoctocog alfa is produced in Human Embryonic Kidney (HEK) cells and the post-translational modifications performed by HEK cells are very similar to those occurring in the native FVIII. Areas covered: Herein, the author provides a review of simoctocog alfa with its contents including information on simoctocog alfa's manufacturing, clinical trials, safety and tolerability. They also give their expert opinion and future perspectives on this therapy. Expert opinion: An important advantage of simoctocog alfa is the possibility to omit at least 30% of venipunctures with prophylaxis. Consequently, the standard three times weekly bolus administrations may be reduced to twice weekly, meaning approximately 50 fewer venipunctures per year. This may be particularly helpful to children.
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Affiliation(s)
- Massimo Morfini
- a Italian Association of Haemophilia Centres - AICE , Firenze , Italy
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15
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van Vulpen LFD, Saccullo G, Iorio A, Makris M. The current state of adverse event reporting in hemophilia. Expert Rev Hematol 2016; 10:161-168. [PMID: 28013565 DOI: 10.1080/17474086.2017.1272410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Replacement of the missing clotting factor is the mainstay of hemophilia treatment. Whilst historically many hemophilia patients were infected with blood-borne viruses transmitted via plasma-derived products, nowadays the formation of alloantibodies against the missing clotting factor is the main adverse event of treatment. Areas covered: This paper provides an overview of the current national and international adverse event reporting systems, what these surveillance schemes taught us about side effects of the products presently in use, and elaborates on how to adapt these systems to the challenges we face with the changing treatment landscape. Expert commentary: Treatment of inherited bleeding disorders was accompanied by severe complications in the past, resulting in major morbidity and mortality. Current products are much safer, but still require monitoring via efficient safety surveillance systems. Adverse events are reported in national and international systems. With many new products entering the market, as well as non-factor replacement therapies, new safety issues may arise. It is important to identify potential adverse events early by making surveillance systems suitable to pick up unknown or unexpected effects, and to recognize and communicate patterns of adverse events rapidly.
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Affiliation(s)
- Lize F D van Vulpen
- a Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital , Sheffield , UK.,b Van Creveldkliniek, University Medical Center Utrecht , Utrecht , The Netherlands
| | - Giorgia Saccullo
- a Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital , Sheffield , UK
| | - Alfonso Iorio
- c Department of Clinical Epidemiology and Biostatistics , McMaster University , Hamilton , ON , Canada
| | - Michael Makris
- a Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital , Sheffield , UK.,d Department of Infection , Immunity and Cardiovascular Disease, University of Sheffield , Sheffield , UK
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16
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Morfini M. Pharmacokinetic drug evaluation of albutrepenonacog alfa (CSL654) for the treatment of hemophilia. Expert Opin Drug Metab Toxicol 2016; 12:1359-1365. [DOI: 10.1080/17425255.2016.1240168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Massimo Morfini
- Italian Association Haemophilia Centres – AICE, Firenze, Italy
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17
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Abstract
INTRODUCTION Replacement therapy with clotting factor concentrates is the most appropriate and effective way to treat bleedings of Hemophilia A&B to prevent chronic arthropathy. Unfortunately, the short half-life (HL) of FVIII/IX concentrates obliges the patients to receive frequent infusions, a big concern for children. The development of inhibitors in about 30-45% of hemophilia A and in 3-5% of hemophilia B patient is the major adverse event of replacement therapy. AREAS COVERED In the last few years, new rFIX have been developed with HL. New rFVIII concentrates are displaying small increase of PK characteristics. The new bio-engineering methods allowed the production of molecules fused with Fc fragment of IgG or Albumin or linked to PEG. A new approach to improve hemostasis is represented by Mab against TFPI and small RNA interfering with Antithrombin synthesis. Another innovative drug seems to be the new bi-specific antibody which mimics FVIII function in linking FXa and FX to tenase production. EXPERT OPINION The emerging drugs for hemophilia treatment seem to be very promising. The extended half-life will improve the adherence of patients to therapy. Accurate post-marketing surveillance studies will be necessary to check the efficacy, safety and immunogenicity of these new molecules.
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Affiliation(s)
- Massimo Morfini
- a Past President of Italian Association of Haemophilia Centres , Firenze , Italy
| | - Ezio Zanon
- b Internal Medicine Department, University of Padua Medical School , Padua , Italy
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Franchini M, Mannucci PM. The safety of pharmacologic options for the treatment of persons with hemophilia. Expert Opin Drug Saf 2016; 15:1391-400. [DOI: 10.1080/14740338.2016.1208747] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
| | - Pier Mannuccio Mannucci
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
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Shen H, Zhang W, Wang H, Shao S. Identification of recombination in the NS1 and VPs genes of parvovirus B19. J Med Virol 2016; 88:1457-61. [DOI: 10.1002/jmv.24471] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Hongxing Shen
- Medical College; Jiangsu University; Zhenjiang P.R. China
| | - Wen Zhang
- Medical College; Jiangsu University; Zhenjiang P.R. China
| | - Hua Wang
- Medical College; Jiangsu University; Zhenjiang P.R. China
| | - Shihe Shao
- Medical College; Jiangsu University; Zhenjiang P.R. China
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20
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Wu MA, Zanichelli A, Mansi M, Cicardi M. Current treatment options for hereditary angioedema due to C1 inhibitor deficiency. Expert Opin Pharmacother 2015; 17:27-40. [DOI: 10.1517/14656566.2016.1104300] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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21
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Abstract
The evolution of care in hemophilia is a remarkable story. Over the last 60 years, advances in protein purification, protein chemistry, donor screening, viral inactivation, gene sequencing, gene cloning, and recombinant protein production have dramatically enhanced the treatment and lives of patients with hemophilia. Recent efforts have produced enhanced half-life (EHL) clotting factors to better support prophylaxis and decrease the frequency of infusions. Medical needs remain in the areas of alternate modes of administration to decrease the need for venous access, better treatment, and prophylaxis for patients who form antibodies to clotting factors, and ultimately a cure of the underlying genetic defect. In this brief review, the authors summarize data on EHL clotting factors, introduce agents whose mode of action is not clotting factor replacement, and list current gene therapy efforts.
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Affiliation(s)
- Marcus E Carr
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA ; Worldwide Research and Development, Pfizer, Inc., Cambridge, MA, USA
| | - Bartholomew J Tortella
- Drexel University College of Medicine, Philadelphia, PA, USA ; Global Innovative Pharma, Pfizer, Inc., Collegeville, PA, USA
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22
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Hemostatic efficacy, safety, and pharmacokinetics of a recombinant von Willebrand factor in severe von Willebrand disease. Blood 2015; 126:2038-46. [PMID: 26239086 DOI: 10.1182/blood-2015-02-629873] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 06/25/2015] [Indexed: 01/09/2023] Open
Abstract
This phase 3 trial evaluated the safety and hemostatic efficacy of a recombinant von Willebrand factor (rVWF) for treatment of bleeds in severe von Willebrand disease (VWD). rVWF was initially administered together with recombinant factor VIII (rFVIII) and subsequently alone, as long as hemostatic factor VIII activity (FVIII : C) levels were maintained. Pharmacokinetics (PK) were evaluated in a randomized cross-over design (rVWF vs rVWF:rFVIII at 50 IU VWF:ristocetin cofactor activity [RCo]/kg). Bleed control for all treated bleeds (N = 192 bleeds in 22 subjects) was rated good or excellent (96.9% excellent; 119 of 122 minor, 59 of 61 moderate, and 6 of 7 major bleeds) on a 4-point scale (4 = none to 1 = excellent). A single infusion was effective in 81.8% of bleeds. Treatment success, defined as the number of subjects with a mean efficacy rating of <2.5, was 100%. The PK profile of rVWF was not influenced by rFVIII (mean VWF:RCo terminal half-life: 21.9 hours for rVWF and 19.6 hours for rVWF:rFVIII). FVIII : C levels increased rapidly after rVWF alone, with hemostatic levels achieved within 6 hours and sustained through 72 hours after infusion. Eight adverse events (AEs; 6 nonserious AEs in 4 subjects and 2 serious AEs [chest discomfort and increased heart rate, without cardiac symptomatology] concurrently in 1 subject) were associated with rVWF. There were no thrombotic events or severe allergic reactions. No VWF or FVIII inhibitors, anti-VWF binding antibodies, or antibodies against host cell proteins were detected. These results show that rVWF was safe and effective in treating bleeds in VWD patients and stabilizes endogenous FVIII : C, which may eliminate the need for rFVIII after the first infusion. This trial was registered at www.clinicaltrials.gov as #NCT01410227.
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23
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Principles of treatment and update of recommendations for the management of haemophilia and congenital bleeding disorders in Italy. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 12:575-98. [PMID: 25350962 DOI: 10.2450/2014.0223-14] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Toppinen M, Norja P, Aaltonen LM, Wessberg S, Hedman L, Söderlund-Venermo M, Hedman K. A new quantitative PCR for human parvovirus B19 genotypes. J Virol Methods 2015; 218:40-5. [DOI: 10.1016/j.jviromet.2015.03.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/27/2015] [Accepted: 03/09/2015] [Indexed: 11/29/2022]
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Astermark J, Dolan G, Hilberg T, Jiménez-Yuste V, Laffan M, Lassila R, Lobet S, Martinoli C, Perno CF. Managing haemophilia for life: 4th Haemophilia Global Summit. Haemophilia 2015; 20 Suppl 5:1-20. [PMID: 24924596 DOI: 10.1111/hae.12468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The 4th Haemophilia Global Summit was held in Potsdam, Germany, in September 2013 and brought together an international faculty of haemophilia experts and delegates from multidisciplinary backgrounds. The programme was designed by an independent Scientific Steering Committee of haemophilia experts and explored global perspectives in haemophilia care, discussing practical approaches to the optimal management of haemophilia now and in the future. The topics outlined in this supplement were selected by the Scientific Steering Committee for their relevance and potential to influence haemophilia care globally. In this supplement from the meeting, Jan Astermark reviews current understanding of risk factors for the development of inhibitory antibodies and discusses whether this risk can be modulated and minimized. Factors key to the improvement of joint health in people with haemophilia are explored, with Carlo Martinoli and Víctor Jiménez-Yuste discussing the utility of ultrasound for the early detection of haemophilic arthropathy. Other aspects of care necessary for the prevention and management of joint disease in people with haemophilia are outlined by Thomas Hilberg and Sébastian Lobet, who highlight the therapeutic benefits of physiotherapy and sports therapy. Riitta Lassila and Carlo-Federico Perno describe current knowledge surrounding the risk of transmission of infectious agents via clotting factor concentrates. Finally, different types of extended half-life technology are evaluated by Mike Laffan, with a focus on the practicalities and challenges associated with these products.
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Affiliation(s)
- J Astermark
- Department of Hematology and Vascular Disorders, Skåne University Hospital, Malmö/Lund, Sweden
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Abstract
Hemophilia A and hemophilia B are X chromosome-linked congenital bleeding disorders caused by a deficiency or absence of activity of coagulation factor VIII (hemophilia A) or factor IX (hemophilia B), which are graded in different degrees of severity (mild, moderate, severe). Depending on the severity patients may experience spontaneous bleeding episodes or will develop excessive bleeding in the context of injuries or surgery. Hemophilia should not be a contraindication for an invasive procedure; however, a number of conditions are required to provide successful surgery and an uncomplicated and safe postoperative course. This review provides an overview of hemophilia and the key biochemical laboratory and clinical aspects as well as possible specific and non-specific treatment options and addresses the special needs for the perioperative care of these patients.
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Affiliation(s)
- S Lison
- Klinik für Anaesthesiologie, Abteilung für Transfusionsmedizin, Zelltherapeutika und Hämostaseologie, Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland,
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Di Minno G, Canaro M, Ironside JW, Navarro D, Perno CF, Tiede A, Gürtler L. Pathogen safety of long-term treatments for bleeding disorders: still relevant to current practice. Haematologica 2014; 98:1495-8. [PMID: 24091928 DOI: 10.3324/haematol.2013.084145] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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28
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P1PK, GLOB, and FORS Blood Group Systems and GLOB Collection: Biochemical and Clinical Aspects. Do We Understand It All Yet? Transfus Med Rev 2014; 28:126-36. [DOI: 10.1016/j.tmrv.2014.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/15/2014] [Accepted: 04/17/2014] [Indexed: 01/09/2023]
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Abstract
The development of a new recombinant factor VIII was designed and implemented to answer a number of unmet needs of patients affected by hemophilia A. Turoctocog alfa is bioengineered in a specific Chinese hamster ovary clone to present translational and posttranslational characteristics (sulphation, glycosylation) biosimilar to natural circulating forms of FVIII, with the aim to devoid any minimal change which may impact immunogenicity and antigenicity of recombinant protein. Both producer cell line and media are maintained free of any animal or human plasma derivative. Downstream processes of purification are performed by five steps (immunoaffinity chromatography, ion-exchange chromatography, virus inactivation by means of solvent-detergent treatment and nanofiltration, and to end with gel filtration), to provide the best possible margin of safety from known and unknown infectious agents. Large clinical trials seem to confirm the expectations placed in Turoctocog alfa in terms of high quality and safety of recombinant FVIII toward the goal of overcoming actual and future challenges of hemophilia therapy.
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Affiliation(s)
- Massimo Morfini
- Previous Director of Haemophilia Center, University Hospital of Florence, Via dello Statuto n.1-50129 Florence, Italy
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30
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Skinner MW, Soucie JM, McLaughlin K. The national haemophilia program standards, evaluation and oversight systems in the United States of America. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2014; 12 Suppl 3:e542-e548. [PMID: 24922285 PMCID: PMC4044795 DOI: 10.2450/2014.0019-14s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Mark W. Skinner
- National Hemophilia Foundation, Washington, DC, United States of America
| | - J. Michael Soucie
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, GA, United States of America
| | - Kathryn McLaughlin
- Genetic Services Branch, Division of Children with Special Health Care Needs, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Washington, DC, United States of America
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Franchini M, Coppola A, Rocino A, Zanon E, Morfini M. Perceived challenges and attitudes to regimen and product selection from Italian haemophilia treaters: the 2013 AICE survey. Haemophilia 2014; 20:e128-35. [DOI: 10.1111/hae.12334] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2013] [Indexed: 12/23/2022]
Affiliation(s)
- M. Franchini
- Department of Transfusion Medicine and Haematology; Carlo Poma Hospital; Mantova Italy
| | - A. Coppola
- Regional Reference Centre for Coagulation Disorders; Federico II University Hospital; Naples Italy
| | - A. Rocino
- Haemophilia and Thrombosis Centre; San Giovanni Bosco Hospital; Naples Italy
| | - E. Zanon
- Haemophilia Centre; Department of Cardiologic, Thoracic and Vascular Sciences; University of Padua Medical School; Padua Italy
| | - M. Morfini
- Agency for Haemophilia; Department of Emergency and Reception; Azienda Ospedaliero-Universitaria Careggi; Firenze Italy
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DeJongh J, Frieling J, Lowry S, Drenth HJ. Pharmacokinetics of recombinant human antithrombin in delivery and surgery patients with hereditary antithrombin deficiency. Clin Appl Thromb Hemost 2013; 20:355-64. [PMID: 24335249 DOI: 10.1177/1076029613516188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Population pharmacokinetic (PK) analyses were conducted to refine dosing recommendations for recombinant human anti-thrombin therapy in surgery and delivery patients with hereditary antithrombin deficiency (HD). Single-dose PK data from patients with HD and nonlinear mixed-effects modeling were used to devise a dosing regimen to target antithrombin (AT) activity levels between 80% and 120% of normal. External validation with data from a phase 3 trial confirmed the correctness of a covariate-free model for surgery patients, but dosing adjustment was necessary for delivery patients. After different covariates were tested, the model was updated to incorporate the influential covariate, delivery. Simulations were used to develop a therapeutic drug-monitoring scenario that results in steady state AT activity levels within the target range as quickly as practically feasible. Data from a second clinical trial provided additional external validation and confirmed the accuracy of the dosing model for both groups of patients.
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