Biochemical rationale for transfusion of high titre COVID-19 convalescent plasma.

Biochemical rationale for transfusion of high titre COVID-19 convalescent plasma.

Publication date: Oct 09, 2024

We aimed to model binding of donor antibodies to virus that infects COVID-19 patients following transfusion of convalescent plasma (CCP). An immunosorbent assay was developed to determine apparent affinity (K). Antibody binding to virus was modelled using antibody concentration and estimations of viral load. Assay and model were validated using reference antibodies and clinical data of monoclonal antibody therapy. A single K or two resolvable K were found for IgG in 11% or 89% of CCP donations, respectively. For IgA this was 50%-50%. Median IgG K was 0. 8nM and 3. 6nM for IgA, ranging from 0. 1-14. 7nM and 0. 2-156. 0nM respectively. The median concentration of IgG was 44. 0nM (range 8. 4-269. 0nM) and significantly higher than IgA at 2. 0nM (range 0. 4-11. 4nM). The model suggested that a double CCP transfusion (i. e. 500 mL) allows for > 80% binding of antibody to virus provided K was  150nM. In our cohort from the pre-vaccination era, 4% of donations fulfilled these criteria. Low and mid-range viral loads are found early post exposure, suggesting that convalescent plasma will be most effective then. This study provides a biochemical rationale for selecting high affinity and high antibody concentration CCP transfused early in the disease course.

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Concepts Keywords
150nm Adult
Antibodies Affinity
Therapy Antibodies, Viral
Viral Antibodies, Viral
Blood Donors
Convalescent plasma
COVID-19
COVID-19
COVID-19 Serotherapy
Female
Humans
Immunization, Passive
Immunoglobulin A
Immunoglobulin A
Immunoglobulin G
Immunoglobulin G
Male
Middle Aged
SARS-CoV-2
SARS-CoV-2
Transfusion
Viral Load

Semantics

Type Source Name
disease MESH COVID-19
disease IDO assay
disease MESH viral load
disease IDO disease course
disease MESH emergency
drug DRUGBANK Spinosad
disease MESH infection
disease IDO blood
drug DRUGBANK Coenzyme M
disease IDO algorithm
disease MESH clinical relevance
disease IDO intervention
drug DRUGBANK Methionine
drug DRUGBANK Proline
disease IDO production
disease MESH pneumonia
drug DRUGBANK Rasagiline
drug DRUGBANK Medical air
disease MESH death
disease IDO cell
disease IDO host
disease IDO bacteria
disease MESH immunocompromised patients
pathway REACTOME Reproduction

Original Article

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