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Ubiquitous convalescent plasma: An artificial universal plasma for COVID-19 patients
Mahla Sattarzadeh Bardsiri1, Seyedeh Mehrnaz Kouhbananinejad2, Reza Vahidi3
1Student Research Committee, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran; Cell Therapy and Regenerative Medicine Comprehensive Center, Kerman University of Medical Sciences, Kerman, Iran; Department of Hematology and Laboratory Sciences, Faculty of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran.
Insights
A novel red blood cell (RBC)-mediated adsorption technique effectively reduces natural ABO antibodies in plasma. This method enables the creation of universal convalescent plasma for COVID-19 patients, overcoming donor limitations and ABO incompatibility issues.
Area of Science:
- Immunology
- Transfusion Medicine
- Virology
Background:
- The COVID-19 pandemic, caused by a novel RNA virus, presents a high mortality rate with no definitive treatment.
- Convalescent plasma transfusion from recovered patients offers a potential therapeutic approach by providing specific antibodies.
- Limitations such as donor scarcity and ABO incompatibility hinder the widespread use of convalescent plasma therapy.
Purpose of the Study:
- To evaluate a red blood cell (RBC)-mediated adsorption technique for reducing natural ABO antibodies in plasma.
- To develop a method for producing universal plasma suitable for COVID-19 patients of any blood group.
Main Methods:
- An experimental study was conducted involving 168 plasma samples.
- Plasma samples were incubated with varying percentages of RBCs at room temperature (RT) and 4°C for 60 minutes.
- Pre- and post-incubation antibody titers were determined to assess the reduction efficacy.
Main Results:
- Both RBC concentration and incubation temperature significantly decreased antibody titers (P < 0.001).
- Incubation at 4°C demonstrated a greater reduction in antibody titer compared to RT.
- Optimal conditions for reducing antibody titer across all blood groups were identified as 4°C with 2% RBC concentration.
Conclusions:
- The developed RBC-mediated adsorption procedure effectively reduces ABO antibodies to non-immunogenic levels.
- This technique yields "Ubiquitous Convalescent Plasma," a universal plasma product for COVID-19 treatment.
- The procedure is simple, feasible, and efficacious, addressing limitations of traditional convalescent plasma therapy.
Objectives And Background:
In December 2019, the first case of COVID-19 was reported in Wuhan, China. Its causative virus, is a novel strain of RNA viruses with high mortality rate. There is no definitive treatment, but among available approaches the use of recovered patients' plasma containing specific antibodies can enhance the immune response against coronavirus. However, the dearth of eligible donors and also ABO incompatibility in plasma transfusion, have limited this therapeutic method. Therefore, it is highly desirable to introduce a simple procedure that allows efficient reduction or even removal of natural ABO antibodies. Accordingly, we aimed to evaluate a RBC-mediated adsorption technique that reduces the titer of the mentioned antibodies in plasma.
Methods/Materials:
This experimental study was conducted in Kerman University of Medical Sciences, Kerman, Iran. The pre- and post-incubation antibody titers of 168 plasma samples were determined. For incubation, each plasma sample was exposed (60 min) to different percentages of RBCs at room temperature or 4 °C.
Results:
The results evidenced that both the concentration of RBCs and temperature had significant decreasing effects on antibody titer (P < 0.001) and all concentrations significantly reduced titer. Compared to RT, 4 °C further reduced the antibody titer. Overall, the best incubation condition for reducing antibody titer in all blood groups was 4 °C and 2% RBCs concentration.
Conclusion:
The presented adsorption procedure is able to produce universal plasma (we call it Ubiquitous Convalescent Plasma) with a non-immunogenic level of ABO mismatch antibodies which can be used for COVID-19 patients with any type of blood group with desirable simplicity, feasibility, and efficacy.
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