Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19.
Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19.
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DOI：
10.1182/blood.2020008423
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发表时间：
2020-11-12
期刊：
影响因子：
20.3
通讯作者：
Lacombe K
中科院分区：
文献类型：
--
作者：
Hueso T;Pouderoux C;Péré H;Beaumont AL;Raillon LA;Ader F;Chatenoud L;Eshagh D;Szwebel TA;Martinot M;Camou F;Crickx E;Michel M;Mahevas M;Boutboul D;Azoulay E;Joseph A;Hermine O;Rouzaud C;Faguer S;Petua P;Pommeret F;Clerc S;Planquette B;Merabet F;London J;Zeller V;Ghez D;Veyer D;Ouedrani A;Gallian P;Pacanowski J;Mékinian A;Garnier M;Pirenne F;Tiberghien P;Lacombe K
抗CD 20单克隆抗体广泛用于治疗血液恶性肿瘤或自身免疫性疾病，但可能导致继发性体液缺乏。在COVID-19感染的情况下，这可能会阻止引发特异性SARS-CoV-2抗体反应。我们报告了一系列连续的17名患者，他们患有严重的B细胞淋巴细胞减少症和持续的COVID-19症状，免疫球蛋白G（IgG）-IgM SARS-CoV-2血清学阴性，通过数字聚合酶链反应测量的RNA血症阳性，接受了4个单位的COVID-19恢复期血浆治疗。在输血后48小时内，除1例患者外，所有患者的临床症状均有所改善。炎症综合征在一周内减轻。只有1名因严重COVID-19疾病需要机械通气的患者死于细菌性肺炎。在所有9例接受评估的患者中，SARS-CoV-2 RNA血症均降至敏感性阈值以下。在3例患者中，在恢复期血浆输注前使用T细胞酶联免疫斑点试验分析病毒特异性T细胞应答。所有人都表现出维持SARS-CoV-2的T细胞反应，对其他冠状病毒的交叉反应较差。未报告不良事件。在无法对SARS-CoV-2产生特异性体液应答的患者的持续COVID-19症状的背景下，含有抗SARS-CoV-2抗体的恢复期血浆似乎是一种非常有前途的方法。作为概念证明，COVID-19恢复期血浆代表了一种用于B细胞耗竭的COVID-19长期患者的有趣方法。COVID-19恢复期血浆诱导1周内体温和炎症参数下降，与氧脱机相关。
Anti-CD20 monoclonal antibodies are widely used for the treatment of hematological malignancies or autoimmune disease but may be responsible for a secondary humoral deficiency. In the context of COVID-19 infection, this may prevent the elicitation of a specific SARS-CoV-2 antibody response. We report a series of 17 consecutive patients with profound B-cell lymphopenia and prolonged COVID-19 symptoms, negative immunoglobulin G (IgG)-IgM SARS-CoV-2 serology, and positive RNAemia measured by digital polymerase chain reaction who were treated with 4 units of COVID-19 convalescent plasma. Within 48 hours of transfusion, all but 1 patient experienced an improvement of clinical symptoms. The inflammatory syndrome abated within a week. Only 1 patient who needed mechanical ventilation for severe COVID-19 disease died of bacterial pneumonia. SARS-CoV-2 RNAemia decreased to below the sensitivity threshold in all 9 evaluated patients. In 3 patients, virus-specific T-cell responses were analyzed using T-cell enzyme-linked immunospot assay before convalescent plasma transfusion. All showed a maintained SARS-CoV-2 T-cell response and poor cross-response to other coronaviruses. No adverse event was reported. Convalescent plasma with anti–SARS-CoV-2 antibodies appears to be a very promising approach in the context of protracted COVID-19 symptoms in patients unable to mount a specific humoral response to SARS-CoV-2. As a proof of concept, COVID-19 convalescent plasma represents an interesting approach in B-cell–depleted patients with protracted COVID-19. COVID-19 convalescent plasma induces a decrease in temperature and inflammatory parameters within 1 week associated with oxygen weaning.
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影响因子：
82.9
作者：
Robilotti EV;Babady NE;Mead PA;Rolling T;Perez-Johnston R;Bernardes M;Bogler Y;Caldararo M;Figueroa CJ;Glickman MS;Joanow A;Kaltsas A;Lee YJ;Lucca A;Mariano A;Morjaria S;Nawar T;Papanicolaou GA;Predmore J;Redelman-Sidi G;Schmidt E;Seo SK;Sepkowitz K;Shah MK;Wolchok JD;Hohl TM;Taur Y;Kamboj M
通讯作者：
Kamboj M
影响因子：
11.2
作者：
Hawker, Kathleen;O'Connor, Paul;Smith, Craig H.
通讯作者：
Smith, Craig H.
影响因子：
120.7
作者：
Li, Ling;Zhang, Wei;Liu, Zhong
通讯作者：
Liu, Zhong
影响因子：
20.3
作者：
Woyach, Jennifer A.;Smucker, Kelly;Byrd, John C.
通讯作者：
Byrd, John C.
DOI：
10.1056/nejmoa0706383
发表时间：
2008-02-14
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hauser, Stephen L;Waubant, Emmanuelle;Smith, Craig H
通讯作者：
Smith, Craig H