Key result
European-sourced IgG therapy correlates with detectable TBE antibodies, unlike North-American donor products.
Why the study?
There is no agreement on an optimal vaccination schedule for plasma donors, and regional differences in tick-borne encephalitis vaccination rates may affect specific antibody titers in immunoglobulin products for PAD patients.
Does the geographic origin of plasma donors affect specific IgG titers against tick-borne encephalitis in patients with primary antibody deficiency receiving immunoglobulin substitution therapy?
Observational (n=110)
Does the geographic origin of plasma donors affect specific IgG titers against tick-borne encephalitis in patients with primary antibody deficiency receiving immunoglobulin substitution therapy?
The geographic origin of plasma donors significantly impacts the presence of specific antibodies against tick-borne encephalitis in immunoglobulin preparations, suggesting regional plasma donation may better address local infection profiles.
North American donor Ig products lacked detectable TBE IgG; leaves open whether donor geography affects clinical protection in antibody deficiency.
Immunoglobulin (Ig) replacement therapy is effective in reducing infections in patients with primary antibody deficiency (PAD). Diversity of specific antibodies is achieved by pooling plasma from over 1000 donors usually of a given geographic region. However, there is no agreement with regard to an optimal vaccination schedule for plasma donors. Especially for tick-borne encephalitis (TBE), regional vaccination rates differ widely among populations due to the epidemiology of the disease. We analyzed specific antibody titers against TBE in comparison to total IgG levels in 162 serum samples collected from 110 PAD patients substituted with polyvalent intravenous IgG or subcutaneous IgG. Some patients received different IgG products over time leading to a total number of 122 different patient-IgG product combinations. Positive TBE-specific IgG levels were detected in 35 cases when measured by standard ELISA and could be confirmed by demonstration of neutralizing antibodies in 31 cases. The detection of specific antibody levels correlated with the geographic origin of the IgG preparations. No titers were detectable in patients substituted with IgG products from North-American donors, whereas variable degrees of anti-TBE titers were observed in patients receiving products from different European countries. We suggest considering the patients' personal risk for TBE when selecting an appropriate Ig preparation. These data support regional plasma donation in order to address the diverse local infection profile.
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Goldacker et al. (2015) conducted an observational in Primary antibody deficiency (PAD) (n=110). Geographic origin of plasma donors for immunoglobulin replacement therapy vs. North American vs European vs Mixed origin was evaluated on Positive TBE-specific IgG levels (>150 U/ml). Positive TBE-specific IgG levels were detected in 35 of 122 patient-product combinations and strongly correlated with the geographic origin of the IgG preparations, with no titers detectable from North-American donors.
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