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Human Vaccines & Immunotherapeutics Apr 2022Passive immunization with polyclonal hyper immunoglobulin (HIG) therapy represents a proven strategy by transferring immunoglobulins to patients to confer immediate... (Review)
Review
Passive immunization with polyclonal hyper immunoglobulin (HIG) therapy represents a proven strategy by transferring immunoglobulins to patients to confer immediate protection against a range of pathogens including infectious agents and toxins. Distinct from active immunization, the protection is passive and the immunoglobulins will clear from the system; therefore, administration of an effective dose must be maintained for prophylaxis or treatment until a natural adaptive immune response is mounted or the pathogen/agent is cleared. The current review provides an overview of this technology, key considerations to address different pathogens, and suggested improvements. The review will reflect on key learnings from development of HIGs in the response to public health threats due to Zika, influenza, and severe acute respiratory syndrome coronavirus 2.
Topics: Antibodies; COVID-19; Humans; Immunization, Passive; Immunoglobulins; SARS-CoV-2; Zika Virus; Zika Virus Infection
PubMed: 34010089
DOI: 10.1080/21645515.2021.1886560 -
European Journal of Pharmacology Apr 2023Pharmacological treatments available for substance use disorder (SUD) focus on pharmacodynamics, agonizing or antagonizing the drug of abuse (DOA) on receptor level.... (Review)
Review
BACKGROUND AND OBJECTIVES
Pharmacological treatments available for substance use disorder (SUD) focus on pharmacodynamics, agonizing or antagonizing the drug of abuse (DOA) on receptor level. Drawbacks of this approach include the reliance on long-term patient compliance, on-target off-site effects, perpetuation of addiction and unavailability for many DOAs. Newer, pharmacokinetic approaches are needed that restrict DOA's access to the brain or disrupt DOA-instated brain changes maintaining addiction. Biotechnology might be able to provide the right biopharmaceutical tools to deliver a fine-tuned solution with less side effects compared to currently available treatments.
METHODS
This review examines the available literature on biopharmaceuticals developed to treat SUD.
RESULTS
Active and passive immunization, metabolic enhancers that augment DOA metabolism and clearance, as well as genetic/epigenetic modulation are promising next generation SUD treatments. Active immunization relies on production of antidrug antibodies by means of vaccination, while passive immunization constitutes of exogenous administration of such antibodies. Metabolic enhancers include drug-specific metabolizing enzymes that can be administered or secreted by modified skin grafts, as well as catalytic antibodies that hasten DOA metabolism. Nanotechnological advances can also allow for brain delivery of siRNAs, mRNAs or DNA in order to modulate central, common in all addictions, genetic or epigenetic targets attenuating drug seeking behavior and reversing drug-induced brain changes.
CONCLUSIONS
and Scientific Significance: Biopharmaceuticals can in the future complement or even replace traditional pharmacodynamics approaches in SUD treatment. While passive and active immunization biopharmaceuticals have entered human clinical trials, metabolic enhancers and genetic approaches are at the preclinical level.
Topics: Humans; Biological Products; Substance-Related Disorders; Antibodies; Immunization, Passive; Behavior, Addictive; Illicit Drugs
PubMed: 36775113
DOI: 10.1016/j.ejphar.2023.175587 -
Journal of Medical Economics 2023In the US, RSV imposes significant burdens on infants, households, and the health system. Yet the only licensed immunization is accessible to only certain risk groups...
In the US, RSV imposes significant burdens on infants, households, and the health system. Yet the only licensed immunization is accessible to only certain risk groups comprising 2% of the infant population, leaving the remaining 98% unprotected. An effective immunization for all infants is a significant public health priority. One possible solution is the FDA-approved monoclonal antibody nirsevimab, which recent evidence suggests is safe and effective in preventing RSV in all infants, and which is currently being considered for inclusion in the pediatric immunization schedule and the federal Vaccines for Children (VFC) program. But the question arises whether immunization products like nirsevimab ought to be eligible for the VFC, which nominally and traditionally centers on vaccines providing immunity. Addressing this is urgent because VFC inclusion will be decided on imminently. I argue there are strong policy grounds, i.e., reasons grounded in the ultimate health system goals of maximizing population health or social welfare subject to resource constraints, not to exclude passive immunization from VFC eligibility. Active and passive immunizations both provide adaptive immunity and can therefore produce qualitatively similar effects on risks of infection, disease, and transmission; on disease severity and duration; and on health, welfare, and health resource use. The distinction between active and passive immunization does not intrinsically matter since what matters for the attainment of health system goals is the extent of immunity conferred, not whether immunity is active or passive. Nor can passivity be considered a useful proxy for conferring a lesser extent of immunity, since no such proxy is needed (existing valuation methods can cope with variations in product attributes), and it is a poor proxy (passive immunizations can be better for individuals with impaired immune systems and can have comparable effectiveness durations and economic value as vaccines).
Topics: Infant; Child; Humans; Antibodies, Monoclonal; Respiratory Syncytial Virus Infections; Immunization; Vaccination; Immunization, Passive
PubMed: 37498791
DOI: 10.1080/13696998.2023.2242169 -
British Journal of Pharmacology Sep 2021The coronavirus disease 2019 (COVID-19) pandemic stimulated both the scientific community and healthcare companies to undertake an unprecedented effort with the aim of... (Review)
Review
Coronavirus disease 2019 and the revival of passive immunization: Antibody therapy for inhibiting severe acute respiratory syndrome coronavirus 2 and preventing host cell infection: IUPHAR review: 31.
The coronavirus disease 2019 (COVID-19) pandemic stimulated both the scientific community and healthcare companies to undertake an unprecedented effort with the aim of understanding the molecular mechanisms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and developing effective therapeutic solutions. The peculiar immune response triggered by this virus, which seems to last only few months, led to a search for alternatives such as passive immunization in addition to conventional vaccinations. Convalescent sera, monoclonal antibodies selected from the most potent neutralizing binders induced by the virus infection, recombinant human single-domain antibodies, and binders of variable scaffold and different origin have been tested alone or in combination exploiting monovalent, multivalent and multispecific formats. In this review, we analyse the state of the research in this field and present a summary of the ongoing projects finalized to identify suitable molecules for therapies based on passive immunization.
Topics: Antibodies, Neutralizing; Antibodies, Viral; COVID-19; Humans; Immunization, Passive; SARS-CoV-2; COVID-19 Serotherapy
PubMed: 33401333
DOI: 10.1111/bph.15359 -
The European Respiratory Journal Feb 2022https://bit.ly/3DGyz6t
https://bit.ly/3DGyz6t
Topics: Antibodies, Viral; COVID-19; Humans; Immunization, Passive; SARS-CoV-2; COVID-19 Serotherapy
PubMed: 34531275
DOI: 10.1183/13993003.02076-2021 -
Transfusion Medicine (Oxford, England) Feb 2023The COVID-19 pandemic severely tested the resilience of the US blood supply with wild fluctuations in blood donation and utilisation rates as community donation... (Review)
Review
The COVID-19 pandemic severely tested the resilience of the US blood supply with wild fluctuations in blood donation and utilisation rates as community donation opportunities ebbed and hospitals post-poned elective surgery. Key stakeholders in transfusion services, blood centres, supply chains and manufacturers reviewed their experiences during the SARS-CoV-2 pandemic as well as available literature to describe successes, opportunities for improvement and lessons learned. The blood community found itself in uncharted territory responding to restriction of its access to donors (approximately 20% decrease) and some supplies; environmental adjustments to address staff and donor concerns about coronavirus transmission; and the development of a new product (COVID-19 convalescent plasma [CCP]). In assuring that the needs of the patients were paramount, the donation process was safe, that clinicians had access to CCP, and vendor relationships aligned, the blood banking community relearned its primary focus: improving patient outcomes.
Topics: Humans; United States; COVID-19; SARS-CoV-2; Pandemics; COVID-19 Serotherapy; Blood Donors; Immunization, Passive
PubMed: 35918741
DOI: 10.1111/tme.12896 -
Current Opinion in Pulmonary Medicine May 2021Coronavirus disease 2019 (COVID-19) is an acute multisystem disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Investigations are ongoing in... (Review)
Review
PURPOSE OF REVIEW
Coronavirus disease 2019 (COVID-19) is an acute multisystem disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Investigations are ongoing in the search for effective therapeutics, with clinical approaches evolving based upon such evidence.
RECENT FINDINGS
The antiviral agent, remdesivir, and the immunomodulator, dexamethasone, are the first therapeutics for which there is evidence of efficacy from randomized trials. Subgroup analyses suggest remdesivir is beneficial in hospitalized patients whose severity of illness falls at the lower end of the spectrum, while dexamethasone is more beneficial in hospitalized patients whose severity of illness falls at the higher end of the spectrum. We recommend that inpatients who require supplemental oxygen but are not mechanically ventilated receive both remdesivir and dexamethasone, and inpatients who require mechanical ventilation receive dexamethasone monotherapy. Additional evidence regarding anti-SARS-CoV-2 antibodies, convalescent plasma, and a variety of antiinterleukin therapies is forthcoming.
SUMMARY
The body of evidence related to COVID-19 therapeutics continues to evolve and, as a result, management is likely to change with time. As new evidence is generated and published, the optimal approach to managing patients with COVID-19 should be reconsidered.
Topics: Adenosine Monophosphate; Alanine; Antiviral Agents; COVID-19; Dexamethasone; Humans; Immunization, Passive; Immunologic Factors; Patient Selection; Respiration, Artificial; SARS-CoV-2; COVID-19 Serotherapy
PubMed: 33606409
DOI: 10.1097/MCP.0000000000000766 -
Journal of Biological Regulators and... 2021Infection with SARS-CoV2 leads to COVID-19, the severity of which derives from the host’s immune response, especially the release of a storm of pro-inflammatory...
Infection with SARS-CoV2 leads to COVID-19, the severity of which derives from the host’s immune response, especially the release of a storm of pro-inflammatory cytokines. This coronavirus infects by first binding to the ectoenzyme Angiotensin Converting Enzyme 2 (ACE2), a serine protease acting as the receptor, while another serine protease is necessary for priming the viral spike “S” protein required for entering the cells. Repurposing existing drugs for potential anti-coronavirus activity have failed. As a result, there were intense efforts to rapidly produce ways of providing prophylactic active immunization (vaccines) or abortive passive (convalescent plasma or monoclonal antibodies) neutralizing antibodies. The availability of vaccines for COVID-19 have been largely successful, but many questions still remain unanswered. In spite of the original enthusiasm, clinical studies using convalescent serum or monoclonal antibodies have shown limited benefit. Moreover, the emergence of Long-COVID syndrome in most infected patients necessitates the development of treatment approaches that may prevent viral entry by blocking both serine proteases involved, as with a liposomal blend of the natural flavonoids luteolin and quercetin.
Topics: Antibodies, Viral; COVID-19; COVID-19 Vaccines; Humans; Immunization, Passive; Peptidyl-Dipeptidase A; RNA, Viral; SARS-CoV-2; Spike Glycoprotein, Coronavirus; COVID-19 Serotherapy
PubMed: 33896155
DOI: 10.23812/Theo_edit -
The New England Journal of Medicine Aug 2020
Topics: Betacoronavirus; Biomedical Research; COVID-19; COVID-19 Vaccines; Coronavirus Infections; Humans; Immunization, Passive; Pandemics; Pneumonia, Viral; SARS-CoV-2; United States; Viral Vaccines; COVID-19 Serotherapy
PubMed: 32846078
DOI: 10.1056/NEJMe2028547 -
European Journal of Medical Research May 2020The rapid spread of the corona virus pandemic is an existential problem for many people in numerous countries. So far, there is no effective vaccine protection or proven... (Review)
Review
The rapid spread of the corona virus pandemic is an existential problem for many people in numerous countries. So far, there is no effective vaccine protection or proven therapy available against the SARS-CoV-2 virus. In this review, we describe the role of passive immunization in times of the corona virus. Passive immunization could be a bridging technology to improve the immune defense of critically ill patients until better approaches with effective medications are available.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Immunization, Passive; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32404189
DOI: 10.1186/s40001-020-00414-5