Enterovirus antibody titers after IVIG replacement in agammaglobulinemic children

Fifteen-minute consultation: enterovirus meningitis and encephalitis—when can we stop the antibiotics?

“…Human immunoglobulin has antibodies against some EV serotypes that may help reduce the risk of EV infection;40 however, immunoglobulin should not be routinely used to prevent EV infections. Vaccines for serotypes that have been associated with large outbreaks, for example, EV-71, are available in some countries, for example, China 41.…”

Pleconaril—an advance in the treatment of enteroviral infection in immuno-compromised patients

“…This is probably due to partial neutralisation of the virus by antibodies in pooled immunoglobulin; these products are now made from pooled plasma taken from at least 10,000 healthy donors, so it is likely that most batches will contain some specific antibody to a variety of enteroviruses (Galama et al, 2000). This may explain the rarity of CEMA in UK patients over the past decade, with no reports of the 'dermatomyositic' features.…”

Cardiac cushions modulate action potential phenotype during heart development

“…While no specific therapy for echovirus infection is available, current clinical treatment regimen still include pleconaril [Abzug, 2004; American Academy of Pediatrics, 2006; Desmond et al, 2006]. Also, as antibodies are known to play an important role in the defense against enteroviral infections [Abzug et al, 1995], treatment of echovirus infection with intravenous immunoglobulin (IVIG) preparations has been suggested as beneficial [Mease et al, 1981; Nagington, 1982; Nagington et al, 1983; Erlendsson et al, 1985; Johnston and Overall, 1989; Abzug et al, 1995; Galama et al, 2000]. IVIG is a therapeutic preparation that contains the pooled antibodies from thousands of healthy plasma donors.…”

“…Two different plasma collection practices are utilized, where “Recovered” plasma is collected from whole blood donations and “Source” plasma is obtained from donors by apheresis. Previous work has shown that administration of IVIG with high echovirus antibody content improves clinical outcome [Mease et al, 1981; Nagington, 1982; Nagington et al, 1983; Erlendsson et al, 1985; McKinney et al, 1987; Johnston and Overall, 1989; Abzug et al, 1995; Galama et al, 1997, 2000] or protect those at risk of infection, especially during the echovirus season from June to October [CDC, 2006]. Although some of these studies have reported echovirus antibody titers for IVIG preparations and corresponding clinical efficacy, the specific results obtained are of limited value for current clinical use, since none of the products analyzed are available anymore [Abzug et al, 1995].…”

“…Throughout the last decades E 9, E 11, and E 30 were reported most frequently in the general US [CDC, 2006] and EU [Ortner et al, 2009; RKI, 2010] populations, whereas E 13 has been circulating in the EU for some time but has only recently been associated with disease in the US [Mullins et al, 2004]. Previous efforts to link echovirus occurrence in the general population with echovirus antibody content of IVIG were not successful [Galama et al, 2000]. Other studies that investigated IVIG antibody specificities for different pathogens in IVIG lots suggested that antibody content varies according to plasma donor age [Modrof et al, 2008], vaccination status [Audet et al, 2006; Farcet et al, 2010], and virus epidemiology [Planitzer et al, 2007].…”