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Vaccine Apr 2013With the effective control of infectious diseases in many parts of the world, chronic, non-communicable diseases have become the major cause of death and disability.... (Review)
Review
With the effective control of infectious diseases in many parts of the world, chronic, non-communicable diseases have become the major cause of death and disability. Monoclonal antibodies (mAbs) have become an important class of drugs for the treatment of such diseases. Nevertheless, mAbs suffer from major shortcomings in a chronic setting: most notably, generation of anti-antibodies and high cost of goods. Here, we discuss a novel approach to treat chronic diseases based on active rather than passive immunization and contrast the 2 treatment modalities to highlight their respective advantages and disadvantages.
Topics: Antibodies, Monoclonal; Chronic Disease; Humans; Immunization, Passive; Immunotherapy, Active; Patient Compliance; Treatment Failure
PubMed: 23415932
DOI: 10.1016/j.vaccine.2013.02.001 -
Emerging Infectious Diseases Mar 2022To assess whether high-dose coronavirus disease (COVID-19) convalescent plasma (CCP) transfusion may benefit patients with severe COVID-19, we conducted a multicenter... (Randomized Controlled Trial)
Randomized Controlled Trial
To assess whether high-dose coronavirus disease (COVID-19) convalescent plasma (CCP) transfusion may benefit patients with severe COVID-19, we conducted a multicenter randomized trial in Brazil. Patients with severe COVID-19 who were within 10 days of initial symptom onset were eligible. Patients in the CCP group received 3 daily doses of CCP (600 mL/d) in addition to standard treatment; control patients received standard treatment only. Primary outcomes were death rates at days 30 and 60 of study randomization. Secondary outcomes were ventilator-free days and hospital-free days. We enrolled 107 patients: 36 CCP and 71 control. At day 30, death rates were 22% for CCP and 25% for the control group; at day 60, rates were 31% for CCP and 35% for control. Needs for invasive mechanical ventilation and durations of hospital stay were similar between groups. We conclude that high-dose CCP transfused within 10 days of symptom onset provided no benefit for patients with severe COVID-19.
Topics: COVID-19; Humans; Immunization, Passive; Plasma; SARS-CoV-2; Treatment Outcome; COVID-19 Serotherapy
PubMed: 35081022
DOI: 10.3201/eid2803.212299 -
Biologie Aujourd'hui 2010Rabies is a fatal disease transmitted by infected animals by bite, scratch, licking on broken skin or contamination of mucosis by saliva. The regimen of post-exposure... (Review)
Review
Rabies is a fatal disease transmitted by infected animals by bite, scratch, licking on broken skin or contamination of mucosis by saliva. The regimen of post-exposure prophylaxis for people not previously vaccinated, that is currently recommended by WHO, consists of a combination of wound cleaning, active immunization and passive immunization when the exposure is of category 3. Most of the products available on the market, in particular human rabies immunoglobulins, highly purified equine rabies immunoglobulins and the derived F(ab')(2) fragments, are now characterized by high potency and safety. Although the interest of passive anti-rabies immunization was first demonstrated in the first half of the 20th century, there is still an inadequate supply of these products to the target populations mostly in developing countries. Therefore, it is urgent to set-up training and information actions for healthcare personnel on the need to use passive immunotherapy and the lack of adverse effects of the related products. For the future, we hope that a scale up of production and a lower price will improve the accessibility to these products. The development of new products based on monoclonal antibodies and molecular biology, and which may be cheaper, is promising.
Topics: Animals; Developing Countries; History, 19th Century; History, 20th Century; History, 21st Century; Horse Diseases; Horses; Humans; Immune Tolerance; Immunization, Passive; Rabies; Rabies Vaccines; Rabies virus
PubMed: 20950578
DOI: 10.1051/jbio/2009049 -
Expert Review of Neurotherapeutics Apr 2006
Topics: Brain Neoplasms; Humans; Immunization, Passive
PubMed: 16623643
DOI: 10.1586/14737175.6.4.447 -
Emerging Infectious Diseases May 2022
Topics: Antibodies, Neutralizing; Antibodies, Viral; COVID-19; Humans; Immunization, Passive; SARS-CoV-2; COVID-19 Serotherapy
PubMed: 35447061
DOI: 10.3201/eid2805.220363 -
Microbiology Spectrum Apr 2015Antibodies and passive antibody therapy in the treatment of infectious diseases is the story of a treatment concept which dates back more than 120 years, to the 1890s,... (Review)
Review
Antibodies and passive antibody therapy in the treatment of infectious diseases is the story of a treatment concept which dates back more than 120 years, to the 1890s, when the use of serum from immunized animals provided the first effective treatment options against infections with Clostridium tetani and Corynebacterium diphtheriae. However, after the discovery of penicillin by Fleming in 1928, and the subsequent introduction of the much cheaper and safer antibiotics in the 1930s, serum therapy was largely abandoned. However, the broad and general use of antibiotics in human and veterinary medicine has resulted in the development of multi-resistant strains of bacteria with limited to no response to existing treatments and the need for alternative treatment options. The combined specificity and flexibility of antibody-based treatments makes them very valuable tools for designing specific antibody treatments to infectious agents. These attributes have already caused a revolution in new antibody-based treatments in oncology and inflammatory diseases, with many approved products. However, only one monoclonal antibody, palivizumab, for the prevention and treatment of respiratory syncytial virus, is approved for infectious diseases. The high cost of monoclonal antibody therapies, the need for parallel development of diagnostics, and the relatively small markets are major barriers for their development in the presence of cheap antibiotics. It is time to take a new and revised look into the future to find appropriate niches in infectious diseases where new antibody-based treatments or combinations with existing antibiotics, could prove their value and serve as stepping stones for broader acceptance of the potential for and value of these treatments.
Topics: Animals; Antibodies; Communicable Diseases; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Immunization, Passive
PubMed: 26104697
DOI: 10.1128/microbiolspec.AID-0026-2014 -
Southern Medical Journal May 2023Current evidence favors plasma to be effective against coronavirus disease 2019 (COVID-19) in critically ill patients in the early stages of infection. We investigated... (Review)
Review
OBJECTIVES
Current evidence favors plasma to be effective against coronavirus disease 2019 (COVID-19) in critically ill patients in the early stages of infection. We investigated the safety and efficacy of convalescent plasma in specifically late-stage (designated as after 2 weeks of hospital admission) severe COVID-19 infection. We also conducted a literature review on the late-stage use of plasma in COVID-19.
METHODS
This case series examined eight COVID-19 patients admitted to the intensive care unit (ICU) who met criteria for severe or life-threatening complications. Each patient received one dose (200 mL) of plasma. Clinical information was gathered in intervals of 1 day pretransfusion and 1 hour, 3 days, and 7 days posttransfusion. The primary outcome was effectiveness of plasma transfusion, measured by clinical improvement, laboratory parameters, and all-cause mortality.
RESULTS
Eight ICU patients received plasma late in the course of COVID-19 infection, on average at 16.13 days postadmission. On the day before transfusion, the averaged initial Sequential Organ Failure Assessment (SOFA) score, PaO:FiO ratio, Glasgow Coma Scale (GCS), and lymphocyte count were 6.5, 228.03, 8.63, and 1.19, respectively. Three days after plasma treatment, the group averages for the SOFA score (4.86), PaO:FiO ratio (302.73), GCS (9.29), and lymphocyte count (1.75) improved. Although the mean GCS improved to 10.14 by posttransfusion day 7, the other means marginally worsened with an SOFA score of 5.43, a PaO:FiO ratio of 280.44, and a lymphocyte count of 1.71. Clinical improvement was noted in six patients who were discharged from the ICU.
CONCLUSIONS
This case series provides evidence that convalescent plasma may be safe and effective in late-stage, severe COVID-19 infection. Results showed clinical improvement posttransfusion as well as decreased all-cause mortality in comparison to pretransfusion predicted mortality. Randomized controlled trials are needed to conclusively determine benefits, dosage, and timing of treatment.
Topics: Humans; COVID-19; SARS-CoV-2; Blood Component Transfusion; Plasma; COVID-19 Serotherapy; Immunization, Passive
PubMed: 37137479
DOI: 10.14423/SMJ.0000000000001546 -
Nature Reviews. Clinical Oncology Nov 2014Immunoconjugates are specific, highly effective, minimally toxic anticancer therapies that are beginning to show promise in the clinic. Immunoconjugates consist of three... (Review)
Review
Immunoconjugates are specific, highly effective, minimally toxic anticancer therapies that are beginning to show promise in the clinic. Immunoconjugates consist of three separate components: an antibody that binds to a cancer cell antigen with high specificity, an effector molecule that has a high capacity to kill the cancer cell, and a linker that will ensure the effector does not separate from the antibody during transit and will reliably release the effector to the cancer cell or tumour stroma. The high affinity antibody-antigen interaction allows specific and selective delivery of a range of effectors, including pharmacologic agents, radioisotopes, and toxins, to cancer cells. Some anticancer molecules are not well tolerated when administered systemically owing to unacceptable toxicity to the host. However, this limitation can be overcome through the linking of such cytotoxins to specific antibodies, which mask the toxic effects of the drug until it reaches its target. Conversely, many unconjugated antibodies are highly specific for a cancer target, but have low therapeutic potential and can be repurposed as delivery vehicles for highly potent effectors. In this Review, we summarize the successes and shortcomings of immunoconjugates, and discuss the future potential for the development of these therapies.
Topics: Animals; Clinical Trials as Topic; Drug Delivery Systems; Humans; Immunization, Passive; Immunoconjugates; Immunotherapy; Molecular Targeted Therapy; Neoplasms; Protein Engineering
PubMed: 25265912
DOI: 10.1038/nrclinonc.2014.159 -
JAMA Apr 2022
Topics: Antibodies, Viral; Humans; Immunization, Passive; Immunologic Factors; Infant; Respiratory Syncytial Virus Infections; Respiratory Syncytial Virus, Human
PubMed: 35471514
DOI: 10.1001/jama.2022.6208 -
The New England Journal of Medicine Feb 2021
Topics: Aged; COVID-19; Coronavirus Infections; Humans; Immunization, Passive; Plasma; SARS-CoV-2; COVID-19 Serotherapy
PubMed: 33440086
DOI: 10.1056/NEJMe2035678