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Immunology and Allergy Clinics of North... Nov 2008The benefit of immunoglobulin (IG) replacement in primary antibody deficiencies is unquestionable. Many of these congenital disorders present early in life and this... (Review)
Review
The benefit of immunoglobulin (IG) replacement in primary antibody deficiencies is unquestionable. Many of these congenital disorders present early in life and this therapy is often first implemented in the young. This article focuses on the indications of IG replacement in children, with an emphasis on the specific diagnostic problems encountered in this population. Also presented is an overview of the practical aspects of IG administration in the pediatric setting, including the recognition and management of adverse reactions. Finally, the advent of subcutaneous IG, a therapeutic IG modality with the potential to have a great impact on the quality of life of children with antibody deficiencies and their families, is discussed.
Topics: Child; Drug Dosage Calculations; HIV Infections; Humans; Immunization, Passive; Immunocompromised Host; Immunologic Deficiency Syndromes; Infant, Newborn; Infusion Pumps; Injections, Subcutaneous; Sepsis
PubMed: 18940577
DOI: 10.1016/j.iac.2008.07.001 -
Archives of Disease in Childhood Jul 2010The cost-effectiveness of passive immunisation against respiratory syncytial virus (RSV) in the Netherlands was studied by assessing incremental costs to prevent one...
AIM
The cost-effectiveness of passive immunisation against respiratory syncytial virus (RSV) in the Netherlands was studied by assessing incremental costs to prevent one hospitalisation in high-risk children using a novel individualised monthly approach.
METHODS
Cost-effectiveness analysis was performed by combining estimates of individual hospitalisation costs and monthly hospitalisation risks, with immunisation costs, parental costs and efficacy of passive immunisation for a reference case with the highest hospitalisation risks and costs of hospitalisation during the RSV season (male, gestational age < or =28 weeks, birth weight < or =2500 g, having bronchopulmonary dysplasia (BPD), aged 0 months at the beginning of the season (October)). Various sensitivity analyses and a cost-neutrality analysis were performed.
RESULTS
Cost-effectiveness of passive immunisation varied widely by child characteristics and seasonal month. For the reference case it was most cost effective in December at euro13,190 per hospitalisation averted. Cost-effectiveness was most sensitive to changes in hospitalisation risk. For the reference case, cost neutrality was reached in December, if acquisition costs of passive immunisation decreased from euro 930 to euro 375, monthly hospitalisation risk increased from 7.6% to 17%, or hospitalisation costs increased from euro 10 250 to euro 23 250 per hospitalisation. Even if passive immunisation prevented all hospitalisations, costs per hospitalisation averted in December would still exceed euro 2645.
CONCLUSIONS
Although cost-effectiveness of passive immunisation varied strongly by child characteristics and seasonal month, incremental costs per hospitalisation averted were always high. A restrictive immunisation policy only immunising children with BPD in high-risk months is therefore recommended. The costs of passive immunisation would have to be considerably reduced to achieve cost-effectiveness.
Topics: Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antiviral Agents; Cost of Illness; Cost-Benefit Analysis; Drug Costs; Female; Health Services Research; Hospital Costs; Hospitalization; Humans; Immunization, Passive; Infant; Infant, Newborn; Male; Netherlands; Palivizumab; Respiratory Syncytial Virus Infections; Seasons; Sensitivity and Specificity
PubMed: 20504841
DOI: 10.1136/adc.2008.155556 -
MBio Oct 2023Post-COVID conditions (PCCs) are persistent new patient symptoms occurring after acute COVID-19 infection and are an increasingly appreciated dimension of the COVID-19...
Post-COVID conditions (PCCs) are persistent new patient symptoms occurring after acute COVID-19 infection and are an increasingly appreciated dimension of the COVID-19 pandemic. The factors that cause PCCs are not well understood. In recent work, Gebo et al. identify a connection between acute IL-6 levels, early COVID-19 convalescent plasma (CP) administration, and later PCCs in subjects from a randomized controlled trial of acutely ill subjects enrolled in 2020 to 2021 (K. A. Gebo, S. L. Heath, Y. Fukuta, X. Zhu, et al., mBio e00618-23, 2023, https://doi.org/10.1128/mbio.00618-23). These results may be viewed as part of an emerging picture linking the intensity of inflammatory responses during acute infection to later PCCs.
Topics: Humans; COVID-19; Post-Acute COVID-19 Syndrome; Pandemics; COVID-19 Serotherapy; Inflammation; Antibodies; Immunization, Passive
PubMed: 37750708
DOI: 10.1128/mbio.01489-23 -
The American Journal of Bioethics : AJOB Sep 2020
Topics: COVID-19; Coronavirus Infections; Humans; Immunization, Passive; Individuality; Pandemics; Pneumonia, Viral; COVID-19 Serotherapy
PubMed: 32840449
DOI: 10.1080/15265161.2020.1798673 -
Veterinary Immunology and... Nov 1992In the present experiments the efficacy of murine and bovine monoclonal antibodies for passive immunization in cattle was compared. The in vivo immunoneutralization of... (Comparative Study)
Comparative Study
In the present experiments the efficacy of murine and bovine monoclonal antibodies for passive immunization in cattle was compared. The in vivo immunoneutralization of pregnant mare serum gonadotrophin (PMSG) by murine and bovine antibodies after repeated administration was chosen as a model for this study. Results indicate that repeated injections of murine monoclonal antibodies against PMSG (mMCA) alone did not, or only to a small extent, elicit an anti-mouse immune response. The simultaneous administration of mMCA and PMSG resulted in relatively high levels of anti-mouse antibodies after the second injection, leading to a decrease in neutralizing activity of mMCA. The results suggest that the neutralizing activity of mMCA is inhibited more by anti-idiotypic than by anti-isotypic antibodies against mMCA. In vivo, the bovine monoclonal antibody against PMSG (bMCA) only partially neutralizes PMSG. After repeated administration of bMCA, either alone or in combination with PMSG, no anti-bMCA antibodies could be detected in our assay system. In addition, no change in plasma levels of bMCA and PMSG compared with levels after the first injection was observed. Although it has to be confirmed by further experiments whether our findings can be generalized, the present results suggest that for repeated passive immunization in cattle homologous antibodies are to be preferred above heterologous antibodies.
Topics: Animals; Antibodies, Monoclonal; Cattle; Cross Reactions; Female; Gonadotropins, Equine; Immunization, Passive; Mice; Neutralization Tests
PubMed: 1455683
DOI: 10.1016/0165-2427(92)90169-q -
MMW Fortschritte Der Medizin Jun 2021
Review
Topics: Aged; COVID-19; Humans; Immunization, Passive; SARS-CoV-2; Secondary Prevention; COVID-19 Serotherapy
PubMed: 34086221
DOI: 10.1007/s15006-021-0068-4 -
Equine Veterinary Journal Nov 1988
Review
Topics: Animals; Animals, Newborn; Horses; Immunity, Maternally-Acquired; Immunization, Passive
PubMed: 3063519
DOI: 10.1111/j.2042-3306.1988.tb01556.x -
Clinical Microbiology Reviews Sep 2020Convalescent plasma (CP) therapy has been used since the early 1900s to treat emerging infectious diseases; its efficacy was later associated with the evidence that... (Review)
Review
Convalescent plasma (CP) therapy has been used since the early 1900s to treat emerging infectious diseases; its efficacy was later associated with the evidence that polyclonal neutralizing antibodies can reduce the duration of viremia. Recent large outbreaks of viral diseases for which effective antivirals or vaccines are still lacking has renewed the interest in CP as a life-saving treatment. The ongoing COVID-19 pandemic has led to the scaling up of CP therapy to unprecedented levels. Compared with historical usage, pathogen reduction technologies have now added an extra layer of safety to the use of CP, and new manufacturing approaches are being explored. This review summarizes historical settings of application, with a focus on betacoronaviruses, and surveys current approaches for donor selection and CP collection, pooling technologies, pathogen inactivation systems, and banking of CP. We additionally list the ongoing registered clinical trials for CP throughout the world and discuss the trial results published thus far.
Topics: Antibodies, Neutralizing; Biological Specimen Banks; COVID-19; Coronavirus Infections; Donor Selection; Enzyme-Linked Immunosorbent Assay; Humans; Immunization, Passive; Neutralization Tests; Pandemics; Pneumonia, Viral; Severe Acute Respiratory Syndrome; COVID-19 Serotherapy
PubMed: 32792417
DOI: 10.1128/CMR.00072-20 -
Poultry Science Apr 2005In 1967, the success of vaccination programs, combined with the seemingly unstoppable triumph of antibiotics, prompted the US Surgeon General to declare that "it was... (Review)
Review
In 1967, the success of vaccination programs, combined with the seemingly unstoppable triumph of antibiotics, prompted the US Surgeon General to declare that "it was time to close the books on infectious diseases." We now know that the prediction was overly optimistic and that the fight against infectious diseases is here to stay. During the last 20 yr, infectious diseases have indeed made a staggering comeback for a variety of reasons, including resistance against existing antibiotics. As a consequence, several alternatives to antibiotics are currently being considered or reconsidered. Passive immunization (i.e., the administration of more or less pathogen-specific antibodies to the patient) prior to or after exposure to the disease-causing agent is one of those alternative strategies that was almost entirely abandoned with the introduction of chemical antibiotics but that is now gaining interest again. This review will discuss the early successes and limitations of passive immunization, formerly referred to as "serum therapy," the current use of antibody administration for prophylaxis or treatment of infectious diseases in agriculture, and, finally, recent developments in the field of antibody engineering and "molecular farming" of antibodies in various expression systems. Especially the potential of producing therapeutic antibodies in crops that are routine dietary components of farm animals, such as corn and soy beans, seems to hold promise for future application in the fight against infectious diseases.
Topics: Animal Diseases; Animal Feed; Animals; Anti-Bacterial Agents; Antibodies; Immunization, Passive; Plantibodies
PubMed: 15844826
DOI: 10.1093/ps/84.4.660 -
BMJ (Clinical Research Ed.) Nov 1992Passive immunisation has been used in clinical practice since the end of last century, mainly for prophylaxis. Success of early treatments was marred by anaphylactic... (Review)
Review
Passive immunisation has been used in clinical practice since the end of last century, mainly for prophylaxis. Success of early treatments was marred by anaphylactic reactions and serum sickness because antibodies or antitoxins were not raised in humans. Recombination of gene segments during antibody synthesis means that specific antibodies for numerous antigens can be produced from a limited gene pool. Killer lymphocytes, phagocytes, and complement then bind to the constant region of the antibody facilitating elimination of the pathogen. Development of a method of obtaining large quantities of antibodies against a specific antigen (monoclonal antibodies) offers the possibility of initiating host defence mechanisms against any unwanted antigen, though some problems still remain in preventing the body from attacking the monoclonal antibody.
Topics: Antibodies; Antibodies, Monoclonal; Antibody Diversity; Antibody Formation; Binding Sites, Antibody; History, 20th Century; Humans; Immunization; Immunization, Passive
PubMed: 1477573
DOI: 10.1136/bmj.305.6864.1269