Methylene blue (MB) treated plasma has been in clinical use for 18 years. The current THERAFLEX MB-Plasma has a number of improved features compared with the original Springe methodology. This overview embodies: the biochemical characteristics of MB, the mechanism of the technology, toxicology, pathogen reduction capacity, current position in clinical setting and status within Europe. The THERAFLEX MB (TMB) procedure is a robust, well standardised system lending itself to transfusion setting and meets the current guidelines. The pathogen kill power of the TMB system, like the other available technologies, is not limitless, probably in order of 6 log for most enveloped viruses and considerably less for non-enveloped ones. It does not induce either new antigen or grossly reducing the function and life span of active principle in fresh frozen plasma (FFP). The removal of the residual MB at the end of the process has the beneficial effect of reducing potential toxic impacts. Clinical haemovigilance data, so far, indicate that cell-free MB plasma is effective in all therapeutic setting requiring FFP, besides inconsistent thrombotic thrombocytopenia purpura data, without serious side-effects or toxicity. The current system is in continuous improvement e.g. regarding virus reduction range, illumination device, software used, and process integration in the blood bank setting.
Bo vine colostrum as a bi o logic in clin i cal med i cine: A re view-Part II Ab stract. The value of bo vine colostrum as a bi o logic in med i cine is doc u mented in clin i cal tri als and sup ported by rel a tively large databases con tain ing case re ports and an ec dotal find ings. The main ac tions in clude an an ti bac te rial ef fect and mod u la tion of the im mune re sponse. The abil ity of bo vine colos trum con cen trates (BCC are polyvalent bo vine colostrum con cen trates pro duced from the colos trums of sev eral 100 cows) to neu tral ize lipopolysaccharides, i.e. endo tox ins aris ing from Gram-neg a tive bac te rial pathogens and to in hibit enterogenic endotoxemia in an i mal mod els as shown in the last re view to have its coun ter part in pa tient ther apy. Clin ical tri als with BCC pro vide ev i dence that oral ap pli ca tion re duces the in flux of LPS from the gut and this ap pears to be a ma jor mech anism un der ly ing its ther a peu tic ef fect in patients at risk for Gram-neg a tive sep tic shock; data from two well-con trolled clin i cal stud ies with a to tal of 100 sur gi cal pa tients have shown that the in hi bi tion of in tes ti nal LPS absorp tion mea sured af ter the ap pli ca tion of BCC not only re duced the LPS lev els in the pe riph eral blood but also in flam ma tory param e ters like IL-6 and CRP were found to be di min ished. The usual daily dose of the com mer cially avail able BCC prep a ra tion, Lactobin ® (LC1) is 10-20 g daily, but higher doses can be used in the ma jor ity of pa tients be cause of the low in ci dence of in tol er ance prob lems. In chronic di ar rhea in volv ing severe forms of sec ond ary immunodeficiencies, pa tients re ceiv ing LC1 were disease-free for about 4 weeks but the re sponse may be lower in pa tients with AIDS. BCC is ef fec tive in in fants with hem or rhagic di ar rhea caused by in fec tions with enterohemorrhagic E. coli and re duces the like li hood of the disease pro gress ing to a hemolytic uremic syndrome. The safety of newer BCC prod ucts ob tained from BSE-free re gions seems now be yond con ten tion. In the case of LC1, which was used as a com mer cial di etary food stuff in Ger many un til 1992 and tested in three Phase 1 and 5 clin i cal stud ies (two tri als in pa tients with sec ond ary immunodeficiencies, one in sur gi cal pa tients with gas tro in tes ti nal dis orders, one in pa tients un der go ing open heart sur gery and one in pe di at ric pa tients with EHEC in fec tions), there were no cases of BSE-as so ci ated dis ease such as the new variant of Creutz feldt-Jakob dis ease. Side ef fects of clin i cal rel e vance are lim ited to pos si ble in tol er ance to lac tose and sen si tiv ity to milk pro teins as these are also pres ent in many com monly used food stuffs. Im por tant syn ergis tic ac tions with con ven tional drug ther apies have been ob served with BCC in clud ing a re duc tion in LPS plasma lev els in pa tients with Gram-neg a tive bac te rial in fec tions treated with bac te ri cidal an ti bi ot ics...
Human bocavirus (HBoV) was recently detected in samples from children and infants with infections of the respiratory tract. Here we analyze the prevalence of IgG and IgM antibodies against HBoV virus-like VP2 particles in healthy adult blood donors and children using a newly established standardized enzyme-linked immunosorbent assay. Virus-specific IgG antibodies were frequently detected in infants with active viremia and respiratory illness (10/24, 42%) and in young children without detectable HBoV genomes in their blood (27/52, 52%). In sera obtained from healthy adults, ubiquitous VP2-specific antibodies were found in 280/299 (94%) cases. HBoV-specific IgM antibodies were detected in 10/24 (42%) of sera samples obtained from HBoV DNA-positive children, and in 6/24 (25%) the sera displayed equivocal responses. In contrast, VP2-specific IgM was not detectable in samples obtained from 52 children without detectable amounts of HBoV genomes in their blood. Only 2/299 sera samples from healthy adult blood donors were found to be IgM-positive (1%), and equivocal IgM responses were observed in 9/299 (3%) individuals. In conclusion, a high IgG seroprevalence of HBoV in the adult population was observed, whereas the presence of virus-specific IgM was associated with viremia. These data show that ELISA test systems for the detection of HBoV-specific antibodies are a valuable tool for serological diagnosis of this new emerging pathogen.
Human bocavirus was recently described as a novel member of the Parvoviridae to infect humans. Based on accumulating clinical and epidemiological data the virus is currently being associated with respiratory infections in young children and infants and is furthermore discussed as causative agent of gastrointestinal illness.
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