Preservation of neutralizing antibody function in COVID‐19 convalescent plasma treated using a riboflavin and ultraviolet light‐based pathogen reduction technology

• Published in: Vox Sanguinis 2021-11, Vol.116 (10), p.1076-1083
• Main Authors: Yonemura, Susan, Hartson, Lindsay, Dutt, Taru S., Henao‐Tamayo, Marcela, Goodrich, Raymond, Marschner, Susanne
• Format: Article
• Language: English
• Subjects: Antibodies; antibody – function; Binding; blood safety; Coagulation; Coagulation factors; Coronaviruses; COVID-19; Disease control; Enzyme-linked immunosorbent assay; Epitopes; Health risks; Health services; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Neutralization; Neutralizing; Original Paper; Original Papers; pathogen inactivation; Pathogens; plasma; Proteins; Respiratory diseases; Retention; Riboflavin; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Spike protein; Statistical analysis; Statistical methods; Technology; Transfusion; transfusion therapy; Ultraviolet radiation; Viral diseases
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1111/vox.13108

Background and objectives Convalescent plasma (CP) has been embraced as a safe therapeutic option for coronavirus disease 2019 (COVID‐19), while other treatments are developed. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is not transmissible by transfusion, but bloodborne pathogens remain a risk in regions with high endemic prevalence of disease. Pathogen reduction can mitigate this risk; thus, the objective of this study was to evaluate the effect of riboflavin and ultraviolet light (R + UV) pathogen reduction technology on the functional properties of COVID‐19 CP (CCP). Materials and methods COVID‐19 convalescent plasma units (n = 6) from recovered COVID‐19 research donors were treated with R + UV. Pre‐ and post‐treatment samples were tested for coagulation factor and immunoglobulin retention. Antibody binding to spike protein receptor‐binding domain (RBD), S1 and S2 epitopes of SARS‐CoV‐2 was assessed by ELISA. Neutralizing antibody (nAb) function was assessed by pseudovirus reporter viral particle neutralization (RVPN) assay and plaque reduction neutralization test (PRNT). Results Mean retention of coagulation factors was ≥70%, while retention of immunoglobulins was 100%. Starting nAb titres were low, but PRNT50 titres did not differ between pre‐ and post‐treatment samples. No statistically significant differences were detected in levels of IgG (P ≥ 0·3665) and IgM (P ≥ 0·1208) antibodies to RBD, S1 and S2 proteins before and after treatment. Conclusion R + UV PRT effects on coagulation factors were similar to previous reports, but no significant effects were observed on immunoglobulin concentration and antibody function. SARS‐CoV‐2 nAb function in CCP is conserved following R + UV PRT treatment.