Reconvalescent Plasma Therapy for Ebola Virus Infection

 

Lakshmi K.*, Aishwarya J.R., Chitralekha S., Illamani V.

Department of Microbiology, Sree Balaji Medical College and Hospital, (Bharath University), Chennai, India

*Corresponding Author E-mail: laksh45@gmail.com

 

ABSTRACT:

Ebola viral infections are one of the dangerous reemerging viral infections which are becoming a global threat nowadays. Unfortunately only symptomatic treatment is available for the Ebola viral disease. Currently, there is no specific antiviral treatment exist for Ebola viral disease. Antiviral drugs and vaccines are currently under clinical trials. This short communication throws light into the use of reconvalescent plasma therapy in cases of Ebola viral outbreaks.

 

KEYWORDS: Reconvalescent Plasma Therapy, Ebola viral infections.

 

INTRODUCTION:

Ebola viral disease has become a global threat. But the major drawback is the minimal and merely symptomatic treatment options available. Vaccines are still under development. Some data from animal studies suggested that blood or plasma transfusion from the affected patients recovered from the disease, can be used a good treatment option because their blood would contain antibodies to the Ebola virus [1]. But this has raised many controversies and doubts regarding the possibility of viral transmission by this approach.

 

Among the whole blood and plasma transfusion, plasma transfusion is suggested to be better[2]. The donor can donate only once per quarter and appropriate matching of ABO for whole blood transfusion. Added to it, the whole blood cannot be treated by the virus inactivation methods which makes the infections like HIV and West Nile virus(WNV) detection complicated.

 

On the other hand, plasma transfusion would overcome the various problems associated with the use of whole blood. Plasma transfusion needs the check of only blood type compatibility. Also, the donor can donate upto 50 times per year or twice weekly for plasma collection by plasmapheresis[2]. Amount of plasma collected per donation can even be upto many millilitres of plasma. Installation of automated plasmapheresis capacity machines has been on the increase. This method also helps in collection of more volume of antibody containing material than the whole blood collection. This may help in multiple treatment of cases.

 

Screening the general population in the affected areas by antibody testing will be of more help to identify the persons of asymptomatic infection and who is in seroconversion phase. These persons could be effective plasma donors and would also be healthy donors. But how far the Ebola virus antibodies present in their blood gives protection is a question, which would require intense research studies. After plasma collection from donor, the plasma could be virus inactivated by methods which would increase the virus safety margin of plasma units, like S59 + UVA Intercept or riboflavin + UV Mirasol treatment or by a solvent/detergent (SD) treatment[3]. Among these, the preferred method is the SD method due its unique robustness in inactivating all the lipid enveloped viruses. The other two methods have found to show a limited virus inactivation capacity for lipid enveloped viruses. But still, SD treatment of plasma for Ebola virus remains a great challenge. Another method could be testing of plasma in SD treated integral disposable processing bags[4].

 

Hyperimmune intravenous immunoglobulin preparations fractionated from Reconvalescent plasma could be offered as a good treatment option in a current situation like this where a good vaccine for the emerging Ebola viral disease is still under trial phase.

 

REFERENCES:

1.        Dye JM, Herbert AS, Kuehne AI, Barth JF, Muhammad MA, Zak SE, Postexposure antibody prophylaxis protects nonhuman primates from filovirus disease. Proc Natl Acad Sci U S A. 2012;109:50349

2.        Kreil TR. Treatment of Ebola virus infection with antibodies from reconvalescent donors. Emerg Infect Dis. 2015 Mar [date cited]. http://dx.doi.org/10.3201/eid2103.141838

3.        Liumbruno GM, Franchini M. Solvent/detergent plasma: pharmaceutical characteristics and clinical experience. J Thromb Thrombolysis. 2014. Epub 2014 May 21

4.        El-Ekiaby M, Sayed MA, Caron C, Burnouf S, El-Sharkawy N, Goubran H, Solvent-detergent filtered (SD-F) fresh frozen plasma and cryoprecipitate minipools prepared in a newly designed integral disposable processing bag system.Transfus Med. 2010;20:4861..

 

 

Received on 20.08.2015 Modified on 13.09.2015

Accepted on 16.09.2015 RJPT All right reserved

Research J. Pharm. and Tech. 8(11): Nov., 2015; Page 1603-1604

DOI: 10.5958/0974-360X.2015.00286.3