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Open AccessResearch article

Using high titer West Nile intravenous immunoglobulin from selected Israeli donors for treatment of West Nile virus infection

David Ben-Nathan1,2 email, Orly Gershoni-Yahalom1 email, Itzchak Samina2 email, Yevgeny Khinich2 email, Israel Nur3 email, Orgad Laub3 email, Ahuva Gottreich4 email, Michael Simanov2 email, Angel Porgador1 email, Bracha Rager-Zisman1 email and Nadav Orr3 email

The Shraga Segal Dept. of Microbiology and Immunology, Ben Gurion University, Beer Sheva, Israel

Kimron Veterinary Institute, Department of Virology, Beit Dagan, Israel

OMRIX Biopharmaceuticals, Weizmann Science Park, Ness-Ziona, Israel

MDA National Blood Services, Tel Hashomer, Kiryat Ono, Israel

author email corresponding author email

BMC Infectious Diseases 2009, 9:18doi:10.1186/1471-2334-9-18

Published: 17 February 2009

Abstract

Background

West Nile Virus (WNV) is endemic in Israel and a significant level of antibodies is present in the population due to natural exposure. Anecdotal cases suggested that the presence of anti-WNV antibodies in intravenous immunoglobulin (IVIG) from Israeli donors (IVIG-IL) assisted the recovery of patients with severe WNV infection.

Methods

To enhance the therapeutic efficacy of IVIG-IL against WNV infection, OMRIX Biopharmaceuticals, Israel, have developed a strategy for selection of plasma units from a 10% fraction of Israeli blood donors with anti-WNV antibodies. Positive units were processed into pharmaceutical grade WNV IVIG (WNIG). Following inoculation with WNV, mice received i.p. injections of different doses (0.01–8 mg/mouse) of IVIG-IL or WNIG, according to the specific experimental protocol.

Results

WNIG was about 10 times more potent (per gr of IgG) than was regular IVIG-IL when tested by ELISA and neutralization assays. In a mouse lethal WNV infection model, prophylactic treatment with WNIG was at least 5–10-fold more potent as compared to treatment with IVIG-IL. Treatment with WNIG during active encephalitis, three or four days following WNV infection, had a significant protective effect. WNIG was also very effective in protecting immunosuppressed mice. Indeed, treatment of dexamethasone-immunosuppressed mice with 0.2 or 1.0 mg WNIG 4 h after virus infection, led to 100% survival.

Conclusion

IVIG produced from selected plasma donated in WNV endemic regions can be used to produce WNV IVIG with superior activity for therapeutic and prophylactic measures.


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