Antibodies to SARS-CoV-2 in immunoglobulin products and their capacity to augment immunity in immunodeficient patients

2022 AIFA Primary Immunodeficiency Clinical Research Grant (supported by CSL Behring)

Dr Emily Edwards, Monash University

The team includes researchers from Alfred Health, Monash University and the Burnet Institute, with collaboration from the patient organisation AusPIPs and the Australian Red Cross Lifeblood.

Other investigators: Prof Menno Van Zelm and Prof Robin O'Hehir (Monash University and Alfred Health), Dr Samar Ojaimi (Monash Health), Dr Julian Bosco (Alfred Health), Prof Heidi Drummer (Burnet Insitute), Prof Mark Hogarth ( Burnet Institute, Uni of Melbourne, Monash University), Dr James Daly (Australian Red Cross Lifeblood), Ms Jackie Murphy (AusPIPs)

This project will measure the levels and protective capacity of SARS-CoV-2 antibodies in Australian immunoglobulin product, and in primary immunodeficiency patient plasma after COVID-19 vaccination.

Dr Emily Edwards

The COVID-19 pandemic has been experienced by 100s of millions of people globally. People with an impaired immune system, including primary immunodeficiency (PID), are at increased risk of severe COVID-19 disease. For these individuals, it is unclear how successful vaccination is in protecting against severe disease.

Many patients receive immunoglobulin (Ig) product to replace the antibodies they lack, in order to reduce the number and severity of infections. This is possible because Ig product contains a mixture of antibodies from plasma donations from >1000 donors, ensuring product contains antibodies directed against the wide range of pathogens circulating in the population. Ideally, products contain antibodies against SARS-CoV-2, the virus that causes COVID-19.

Whilst we know these antibodies are present in Ig products from internationally donated plasma, this information is not available for product generated from Australian plasma donations. As many patients rely on products derived from Australian plasma, this information is important especially considering the current high COVID-19 infection rates in Australia. Additionally, evidence that immunodeficient patients respond to COVID-19 vaccination is limited.

Usually, it is impossible to measure the vaccination responses of Ig product recipients. This is because product contains antibodies to routine vaccines, administered to the public, and donor and recipient antibodies are indistinguishable from one another. Therefore, it is likely that when PID patients received COVID-19 vaccination the levels of SARS-COV-2 antibodies were absent or low due to low infection and vaccination rates in Australia.

The study measures the levels and protective capacity of SARS-CoV-2 antibodies in Australian Ig product, and in PID patient plasma after COVID-19 vaccination. This provides the unique opportunity to measure patient responses to COVID-19 vaccination, before antibodies to this vaccine were present in product. The team will also compare patient antibody levels to healthy individuals to determine whether patients’ responses to vaccination are impaired.

 

AIFA PID Clinical Research Grant of $30,000 (supported by CSL Behring)