Interference of immune globulin with measles and rubella immunization.
ABSTRACT Passively acquired antibody may interfere with the active antibody response to live viral vaccines such as measles and rubella. To evaluate the duration of this inhibitory effect, we measured the measles and rubella antibody responses of Apache children immunized with measles, mumps, and rubella vaccine at varying intervals after administration of an immune globulin termed bacterial polysaccharide immune globulin (BPIG). This specific immune globulin contained measles and rubella antibody titers similar to those in standard intramuscularly and intravenously administered immune globulins. Antibody responses to measles vaccine were inhibited for up to 5 months after a BPIG dose of 80 mg IgG per kilogram of body weight, but responses to rubella vaccine were inhibited for only 2 months. Most children who had a decreased measles antibody response to primary measles, mumps, and rubella immunization given 1 1/2 to 4 months after BPIG administration responded to a booster immunization given 6 months after their last BPIG dose. We conclude that high doses of immune globulin (> 10 mg/kg) may inhibit the antibody response to measles for more than 3 months. We propose that the interval between administration of immune globulin and measles and rubella immunization be adjusted on the basis of the dose of immune globulin.
- SourceAvailable from: Julien Lescar
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- "These approaches are inherently biased by the native humoral immune response, and as such, may be limited in accessing epitopes that elicit no or little humoral response but may yet be functionally important target epitopes. Moreover, antibody therapy to immunodominant regions has the potential to cause immune interference, such as by masking important epitopes for eliciting a memory protective response (Siber et al., 1993; Siegrist et al., 1998; Zhang et al., 2007). "
ABSTRACT: Dengue is the most common vector-borne viral disease, causing nearly 400 million infections yearly. Currently there are no approved therapies. Antibody epitopes that elicit weak humoral responses may not be accessible by conventional B cell panning methods. To demonstrate an alternative strategy to generating a therapeutic antibody, we employed a non-immunodominant, but functionally relevant, epitope in domain III of the E protein, and engineered by structure-guided methods an antibody directed to it. The resulting antibody, Ab513, exhibits high-affinity binding to, and broadly neutralizes, multiple genotypes within all four serotypes. To assess therapeutic relevance of Ab513, activity against important human clinical features of dengue was investigated. Ab513 mitigates thrombocytopenia in a humanized mouse model, resolves vascular leakage, reduces viremia to nearly undetectable levels, and protects mice in a maternal transfer model of lethal antibody-mediated enhancement. The results demonstrate that Ab513 may reduce the public health burden from dengue. Copyright © 2015 Elsevier Inc. All rights reserved.Cell 07/2015; 162(3). DOI:10.1016/j.cell.2015.06.057 · 32.24 Impact Factor
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ABSTRACT: This was the hot topic of workshops at this year's PPAG Annual Meeting. The workshop was well attended with strong audience participation. Amy Parham, Pharm.D., guided us through the benefits and limitations associated with using either standard concentrations or rule of six for preparation of continuous drips. The JCAHO national patient safety goal to "standardize and limit the number of drug concentrations available in the organization" has been successfully accomplished by some institutions however those currently not in compliance do have an option. Institutions not using standard drips may submit a Request for Review of an Alternative Approach to JCAHO no later than 60 days prior to their survey. Other suggestions for institutions not using standard drips include using computerized calculations to verify preparation by the rule of six and have pharmacy prepare all parenteral products.