Immunoadsorption as a method of antibody donation during the COVID-19 pandemic

Jannik Rothenburg; Silke Rink-Baron; Lisa Müller; Philipp Niklas Ostermann; Johannes C Fischer; Derik Hermsen; Johannes Stegbauer; Anja Moldenhauer

doi:10.1111/vox.13647

Immunoadsorption as a method of antibody donation during the COVID-19 pandemic

Vox Sang. 2024 May 13. doi: 10.1111/vox.13647. Online ahead of print.

Authors

Jannik Rothenburg^{1

2}, Silke Rink-Baron³, Lisa Müller⁴, Philipp Niklas Ostermann⁴, Johannes C Fischer¹, Derik Hermsen⁵, Johannes Stegbauer⁶, Anja Moldenhauer^{1

7}

Affiliations

¹ Institute for Transplant Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
² Cytiva, Dreieich, Germany.
³ Miltenyi Biotec, Bergisch Gladbach, Germany.
⁴ Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
⁵ Central Institute of Laboratory Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
⁶ Department of Nephrology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
⁷ Saarland University, Homburg, Germany.

PMID: 38740559
DOI: 10.1111/vox.13647

Abstract

Background and objectives: Initial therapeutic efforts to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) included the use of plasma from convalescent donors containing anti-SARS-CoV-2 antibodies. High-neutralizing antibody titres are required for therapeutic efficacy. This study aims to show that immunoadsorption followed by tangential flow filtration can be used to obtain antibody concentrates with high-neutralizing capacities.

Materials and methods: Eligible donors (n = 10, five males and three females) underwent immunoadsorption using adsorber columns specific for human antibodies. Glycine-washed out eluates of 1.5 L volume were further concentrated by tangential flow filtration using 30 kDa ultrafiltration membranes. The same membranes were applied for diafiltrations to exchange residual glycine for 0.9% normal saline.

Results: Antibody concentrates were obtained within 8 h from the start of donation and had, 4.58 ± 1.95, 3.28 ± 1.28 and 2.02 ± 0.92 times higher total IgG, IgA and IgM concentrations, 3.29 ± 1.62 and 3.74 ± 0.6 times higher SARS-CoV-2 N and S antibody concentrations and 3.85 ± 1.71 times higher SARS-CoV-2 S-specific IgG concentrations compared to the donors' peripheral blood. The specific SARS-CoV-2 virus neutralization capacities increased in all but one concentrate. All antibody concentrates (50-70 mL final volume) passed microbiological tests, were free of hazardous glycine levels and could be stored at -80°C and 4°C for 1 year with 20 ± 3% antibody loss.

Conclusion: Immunoadsorption followed by tangential flow filtration is a feasible procedure to collect IgG, IgA and IgM as well as SARS-CoV-2 N- and S-specific antibody concentrates of low volume, free of albumin and coagulation factors. Whether these concentrates can be used as passive immunisation in infected patients remains to be elucidated.

Keywords: COVID‐19 convalescence; antibody donation; immunoadsorption; virus neutralization.