Interference of immune globulin with measles and rubella immunization
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.
[Show abstract] [Hide abstract] 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.1Comment 4Citations
- "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). Utilizing panning of B cells derived from infected patients or challenged mice, a range of DENV-neutralizing antibodies have been identified, including those with reactivity to multiple serotypes (Beltramello et al., 2010; Brien et al., 2010; de Alwis et al., 2011; Lai et al., 2013; Smith et al., 2013 ). "
[Show abstract] [Hide abstract] ABSTRACT: Therapeutic antibodies include polyclonal immunoglobulins isolated from regular or high-titered human plasma, sera from immunized animals, and monoclonal antibodies. This array of therapeutic antibodies is used for the prevention and treatment of many infectious diseases, antibody immunodeficiencies, autoimmune and inflammatory diseases, neurological disorders, and cancers. Polyclonal human immunoglobulins are available for intramuscular injection (IGIM), intravenous infusion (IGIV) and subcutaneous infusion (SCIG). We review these products and detail the therapeutic use of polyclonal human antibodies in the treatment of antibody immunodeficiencies, including their occasional local side effects (tenderness, sterile abscesses), minor systemic side effects (chills, muscle aches, malaise, headaches) and major side effects (aseptic meningitis, nephropathy, thrombosis).0Comments 21Citations
- "Immune globulin injections (or infusions) may inhibit antibody responses to live virus vaccines such as measles or varicella. Siber and associatesrecommend an interval of 3 months between IGIV or IGIM therapy and administration of live virus vaccines after IG doses less than 40 mg/kg, 6 months after doses of 40e80 mg/kg, 8 months after doses of 80e 400 mg/kg, and 12 months after large doses (1e2 g/kg). Late side effects after IGIM injections are uncommon; however, fibrosis of the buttocks or localized subcutaneous atrophy may develop at the site of repeated injections in some patients, possibly related to foreign substance recurrent reactions . "
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