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Williamson KM, Faddy H, Nicholson S, Stambos V, Hoad V, Butler M, Housen T, Merritt T, Durrheim DN. A Cross-Sectional Study of Measles-Specific Antibody Levels in Australian Blood Donors-Implications for Measles Post-Elimination Countries. Vaccines (Basel) 2024; 12:818. [PMID: 39066455 PMCID: PMC11281562 DOI: 10.3390/vaccines12070818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/11/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
Passive immunisation with normal human immunoglobulin (NHIG) is recommended as post-exposure prophylaxis (PEP) for higher-risk measles contacts where vaccination is contraindicated. However, the concentration of measles-specific antibodies in NHIG depends on antibody levels within pooled donor plasma. There are concerns that measles immunity in the Australian population may be declining over time and that blood donors' levels will progressively decrease, impacting levels required to produce effective NHIG for measles PEP. A cross-sectional study of Australian plasmapheresis donors was performed using an age-stratified, random sample of recovered serum specimens, collected between October and November 2019 (n = 1199). Measles-specific IgG antibodies were quantified by ELISA (Enzygnost anti-measles virus IgG, Siemens), and negative and equivocal specimens (n = 149) also underwent plaque reduction neutralisation testing (PRNT). Mean antibody levels (optical density values) progressively decreased from older to younger birth cohorts, from 2.09 [±0.09, 95% CI] to 0.58 [±0.04, 95% CI] in donors born in 1940-1959 and 1990-2001, respectively (p < 0.0001). This study shows that mean measles-specific IgG levels are significantly lower in younger Australian donors. While current NHIG selection policies target older donors, as younger birth cohorts become an increasingly larger proportion of contributing donors, measles-specific antibody concentrations of NHIG will progressively reduce. We therefore recommend monitoring measles-specific antibody levels in future donors and NHIG products in Australia and other countries that eliminated measles before the birth of their youngest blood donors.
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Affiliation(s)
- Kirsten M. Williamson
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287, Australia; (M.B.); (T.M.); (D.N.D.)
- National Centre for Epidemiology and Population Health, Australian National University, 62 Mills Road, Acton, ACT 2601, Australia;
| | - Helen Faddy
- Australian Red Cross Lifeblood, P.O. Box 354, South Melbourne, VIC 3205, Australia; (H.F.); (V.H.)
- School of Health, University of the Sunshine Coast, P.O. Box 200, Petrie, QLD 4502, Australia
| | - Suellen Nicholson
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; (S.N.); (V.S.)
- Department of Infectious Diseases, University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Vicki Stambos
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; (S.N.); (V.S.)
| | - Veronica Hoad
- Australian Red Cross Lifeblood, P.O. Box 354, South Melbourne, VIC 3205, Australia; (H.F.); (V.H.)
| | - Michelle Butler
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287, Australia; (M.B.); (T.M.); (D.N.D.)
| | - Tambri Housen
- National Centre for Epidemiology and Population Health, Australian National University, 62 Mills Road, Acton, ACT 2601, Australia;
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Tony Merritt
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287, Australia; (M.B.); (T.M.); (D.N.D.)
| | - David N. Durrheim
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287, Australia; (M.B.); (T.M.); (D.N.D.)
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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Stinca S, Barnes TW, Vogel P, Meyers W, Schulte-Pelkum J, Filchtinski D, Steller L, Hauser T, Manni S, Gardiner DF, Popik S, Roth NJ, Schuetz P. Modelling the concentration of anti-SARS-CoV-2 immunoglobulin G in intravenous immunoglobulin product batches. PLoS One 2021; 16:e0259731. [PMID: 34843493 PMCID: PMC8629175 DOI: 10.1371/journal.pone.0259731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background Plasma-derived intravenous immunoglobulin (IVIg) products contain a dynamic spectrum of immunoglobulin (Ig) G reactivities reflective of the donor population from which they are derived. We sought to model the concentration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG which could be expected in future plasma pool and final-product batches of CSL Behring’s immunoglobulin product Privigen. Study design and methods Data was extracted from accessible databases, including the incidence of coronavirus disease 2019 and SARS-CoV-2 vaccination status, antibody titre in convalescent and vaccinated groups and antibody half-life. Together, these parameters were used to create an integrated mathematical model that could be used to predict anti-SARS-CoV-2 antibody levels in future IVIg preparations. Results We predict that anti-SARS-CoV-2 IgG concentration will peak in batches produced in mid-October 2021, containing levels in the vicinity of 190-fold that of the mean convalescent (unvaccinated) plasma concentration. An elevated concentration (approximately 35-fold convalescent plasma) is anticipated to be retained in batches produced well into 2022. Measurement of several Privigen batches using the Phadia™ EliA™ SARS-CoV-2-Sp1 IgG binding assay confirmed the early phase of this model. Conclusion The work presented in this paper may have important implications for physicians and patients who use Privigen for indicated diseases.
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Affiliation(s)
- Sara Stinca
- Department of Bioanalytical Sciences, Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
| | - Thomas W. Barnes
- Department of Bioanalytical Sciences, Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
| | - Peter Vogel
- Global Digital Core, Plasma Product Development, Research & Development, CSL Behring Innovation GmbH, Marburg, Germany
| | - Wilfried Meyers
- Global Digital Core, Plasma Product Development, Research & Development, CSL Behring Innovation GmbH, Marburg, Germany
| | | | - Daniel Filchtinski
- Assay Design, Thermo Fisher Scientific ImmunoDiagnostics Phadia GmbH, Freiburg, Germany
| | - Laura Steller
- Assay Design, Thermo Fisher Scientific ImmunoDiagnostics Phadia GmbH, Freiburg, Germany
| | - Thomas Hauser
- Department of Bioanalytical Sciences, 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
| | - David F. Gardiner
- Immunology, CSL Behring, King of Prussia, Pennsylvania, United States of America
| | - Sharon Popik
- Immunology, CSL Behring, King of Prussia, Pennsylvania, United States of America
| | - Nathan J. Roth
- Department of Bioanalytical Sciences, Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
| | - Patrick Schuetz
- Department of Bioanalytical Sciences, Plasma Product Development, Research & Development, CSL Behring AG, Bern, Switzerland
- * E-mail:
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Measles virus neutralizing antibodies in immunoglobulin lots produced from plasma collected in Europe or the United States. Vaccine 2019; 37:3151-3153. [PMID: 31060953 DOI: 10.1016/j.vaccine.2019.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 02/01/2023]
Abstract
Vaccination against measles has reduced disease, although measles virus antibody (MVAb) levels are lower after vaccination than natural infection. Immunoglobulin (IG) preparations thus contain decreasing MVAb titers. US IG lot release requires a minimum titer of MVAb, yet equivalent information is not available for other geographies. Using a measles virus neutralization assay, IG fractionated from US or EU plasma is shown to contain similar levels of MVAb always above US regulatory requirements, supportive of equivalent protection against MV infection. Thus, the dosage for post-exposure prophylaxis in the EU could be aligned with the US FDA's treatment recommendations.
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