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Biomedical subjects

C V Prowse

Publications and source records attributed to C V Prowse.

At least 37 records · Page 2Linked to original sources
PubMed1995

No detectable alterations in immunogenicity following terminal severe dry-heat treatment of high-purity factor VIII (Liberate) and factor IX (HP9) concentrates.

We used monoclonal antibody ELISAs, antigen molecular size distribution, competition ELISA and neonatal mouse immune tolerance methods to detect potential neoantigen formation and increased immunogenicity following severe dry-heat treatment of high-purity factor VIII (Liberate) and factor IX concentrates. To provide positive controls, concentrates were heated in solution (70 degrees C for 2 h) to produce denaturation on purpose. The competition ELISA applied to factor IX proved particularly useful for quantifying differences between the positive control and the dry-heated/unheated concentrates. None of the test systems employed by us indicated any detectable neoantigen formation or any alteration in immunogenicity following terminal severe dry-heat treatment of the high-purity concentrates, and this finding is supported by clinical experience so far.

Antigens↗
PubMed1995

In vivo recovery of factor VIII following transfusion: a survey of recent data and publications to assess the influence of standards used for potency assignment. On behalf of the Subcommittee on Factor VIII and IX of the Scientific and Standardization Committee of the ISTH.

In the therapy of factor VIII deficiency, experience has taught the value of achieving a target level of plasma coagulation factor VIII. There is a consensus that an empirical value of 2 iu/dl/iu/kg may be used to estimate recovery, and hence plasma levels, of factor VIII. This may be influenced by the methods used to assign label potency to the products and for assessment of patient post-infusion plasmas. To assess a possible influence of the standard used to assign product potency on in vivo recovery, a survey was undertaken of recent in vivo recovery studies. Analysis of submitted data, in combination with published studies over the last ten years, revealed a significant influence of the standard used to assign potency to products on the measured in vivo recovery. Furthermore, from limited data the potency determined in post-infusion patient plasmas was found not to be influenced by the use of one-stage or chromogenic assay methods.

Blood Component Transfusion↗
PubMed1992

Development, optimization and use of an enzyme linked immunosorbent assay (ELISA) to measure factor VIII antigen utilizing monoclonal antibodies.

An enzyme linked immunosorbent assay (ELISA) has been developed to measure VIII:Ag in plasma and concentrates. The assay utilizes two commercially available monoclonal antibodies to VIII:Ag and provides an alternative to the established immunoradiometric assay (IRMA). It has the advantage of not requiring the use of radioactive material and human antibodies. The assay sensitivity is 0.006 u/ml and the interassay coefficient of variation is 6.3%. Forty-eight samples with VIII:Ag levels ranging from 0.006 to 1.5 u/ml were assayed by both ELISA and IRMA. The coefficient of correlation between the two assays was 0.89. In addition to measuring human VIII:Ag, it is also possible to detect antigen in several animal plasma and sera.

Antibodies, Monoclonal↗
PubMed1991

Comparison of high purity factor IX concentrates and a prothrombin complex concentrate in a canine model of thrombogenicity.

A non-stasis canine model of thrombogenicity has been used to evaluate batches of high purity factor IX concentrates from 4 manufacturers and a conventional prothrombin complex concentrate (PCC). Platelets, activated partial thromboplastin time (APTT), fibrinogen, fibrin(ogen) degradation products and fibrinopeptide A (FPA) were monitored before and after infusion of concentrate. Changes in FPA were found to be the most sensitive and reproducible indicator of thrombogenicity after infusion of batches of the PCC at doses of between 60 and 180 IU/kg, with a dose related delayed increase in FPA occurring. Total FPA generated after 100-120 IU/kg of 3 batches of PCC over the 3 h time course was 9-12 times that generated after albumin infusion. In contrast the amounts of FPA generated after 200 IU/kg of the 4 high purity factor IX products were in all cases similar to albumin infusion. It was noted that some batches of high purity concentrates had short NAPTTs indicating that current in vitro tests for potential thrombogenicity may be misleading in predicting the effects of these concentrates in vivo.

Animals↗
PubMed1991

Use of factor VII-deficient beagles bred by artificial insemination to evaluate mechanisms of thrombosis associated with prothrombin complex concentrates.

Artificial insemination with frozen semen was used to breed beagles homozygous for a deficiency in clotting factor VII, with plasma concentrations of 2-3% of normal adult beagle pooled plasma. The factor VII-deficient beagles were used to determine if factor VII activity has a role in the thrombogenic activity of prothrombin complex concentrates (PCCs) containing factors II, IX and X by evaluating changes in selected indicators of thrombogenicity. No differences were seen between the responsiveness of the factor VII-deficient and normal beagles, indicating that the thrombogenic activities of PCCs are mediated via effects on the intrinsic clotting system.

Animals↗
PubMed1991

A clinical trial of red-cell concentrate prepared from blood collected in half-strength citrate anticoagulant.

Earlier studies have indicated that plasma from blood donations drawn into half-strength citrate anticoagulant (0.5 CPD-A2) may give improved yields of factor VIII:C after fractionation. It has also been shown previously that cellular components from blood donations drawn into 0.5 CPD-A2 have satisfactory in-vitro and in-vivo properties. The present study examines the clinical use of red cell concentrate (RCC) from 0.5 CPD-A2 blood donations. Forty-nine patients who were undergoing elective orthopaedic surgery and who required blood transfusion received 0.5 CPD-A2 RCC. A transfused control group of 107 patients received standard CPD-A1 RCC for their transfusion requirements. Patients in the two transfused groups had similar haemoglobin responses to transfusion. All patients experienced a moderate pyrexia following the operation. Both study groups showed similar responses to serum lactate dehydrogenase levels in the 2 weeks following surgery, and in postoperative peripheral blood platelet counts. Serious postoperative complications arose in both groups. In the 0.5 CPD-A2 group two patients had pulmonary emboli (one fatal) and one patient had a non-fatal myocardial infarction. Three patients had pulmonary emboli in the CPD-A1 transfused group. These incidences of major adverse events were within the expected range of these complications in patients who were undergoing major joint replacement surgery and did not differ significantly between the study groups. This study indicates that red cell concentrate prepared in half-strength citrate anticoagulant is comparable to that prepared in CPD-A1 for patients undergoing orthopaedic surgery.

Adenine↗
PubMed1989

Importance of a quality assurance scheme for factor VIII assays in quality monitoring of human plasma destined for fractionation into factor VIII concentrate.

A national quality assurance scheme has been established to monitor the validity of factor VIII assays performed by the various laboratories of the Scottish National Blood Transfusion Service engaged in collection and processing of donor plasma destined for fractionation. The results over the first 3-year period show that comparable assay values can be obtained by participating centres using a common standard, despite differences in equipment, methods or substrate chosen for the one-stage assay. The results also showed that chromogenic factor VIII assays correlated well with the one-stage method. Random factor VIII assays performed on plasma, harvested and frozen within 18 h from collection, were analysed to validate recently proposed Scottish specifications which stipulate that 70% of plasma donations destined for fractionation should contain at least 0.7 IU/ml. Plasma harvested and frozen between 8 and 18 h from collection did not meet the specified level in any of the regional centres. This nationally specified level was also not met by plasma harvested and frozen within 8 h from collection in spite of being achieved individually by three regional centres. Assays performed on large plasma pools at the Fractionation Centre suggested loss of some factor VIII during storage, transportation and thawing of plasma prior to bulk processing.

Blood Banks↗
PubMed1988

The interaction of von Willebrand factor (vWf) with collagen: investigation of vWf-binding sites in the collagen molecule.

Following fragmentation of the collagen molecule, we have examined the ability of the isolated fragments to bind vWf. In view of the importance of collagen tertiary and quaternary structure for binding, fragments were first renatured to restore triple-helical conformation and then polymerized. Results indicate the presence of specific vWf-binding sites in both the alpha 1(I)- and alpha 2(I)-chains of type I collagen. Cleavage of the alpha 1(I)-chain with cyanogen bromide suggests the presence of at least four (conceivably several more) binding sites implying a wide distribution of sites along the length of the collagen type I molecule. Collagen type III appears to possess a similar wide distribution of sites. Chemical modification of specific amino acid residues indicates that interaction involves arginyl residues in collagen and carboxyl groups in vWf. Although interaction between fibronectin and collagen fibres also involves collagen arginyl residues and carboxyl groups in fibronectin (authors' unpublished results), fibronectin does not compete with vWf in the binding to collagen fibres.

Amino Acids↗
PubMed1988

Fibrinolytic and haemostatic responses to desamino-D-arginine vasopressin (DDAVP) administered by intravenous and subcutaneous routes in healthy subjects.

DDAVP was administered at 0.4 microgram kg-1 intravenous (i.v.) and subcutaneous (s.c.) routes to 6 healthy subjects in a double blind crossover study. Both study treatments were well tolerated. Flushing occurred after both treatments but was more prominent after i.v. than after s.c. DDAVP. Mild transient local discomfort at the s.c. injection site occurred in 5 of 6 subjects. The mean peak factor VIII (FVIII) response was 369% and 247% of baseline after i.v. and s.c. DDAVP respectively and the maximum increase in FVIII occurred earlier with the i.v. route. Changes in FVIII antigen (FVIII:Ag) and von Willebrand factor antigen (vWF:Ag) were also monitored. Tissue-type plasminogen activator (t-PA) activity measured by a chromogenic assay employing soluble fibrin had a median peak value of 2.9 IU ml-1 at 20 min after i.v. and of 1.9 IU ml-1 at 60 min after s.c. DDAVP. t-PA antigen was also measured so that the specific activity of circulating t-PA could be determined. Preinjection median values of 14,650 and 13,700 IU mg-1 increased to peak median values of 236,200 IU mg-1 at 20 min after i.v. and 202,400 IU mg-1 at 60 min after s.c. DDAVP. Plasminogen activator inhibitor (PAI) activity fell following DDAVP and became undetectable in some subjects during the sampling period. The ratio of maximum fibrinolytic response was similar to the ratio of maximum haemostatic responses obtained by two routes of injection. Our results indicate that s.c. DDAVP might successfully replace i.v. DDAVP in several applications such as confirmation of haemostatic or fibrinolytic responsiveness in patient groups; for obtaining FVIII enriched plasma; as well as its obvious potential usefulness in home treatment of haemophilia A and von Willebrand's disease.

Adult↗
PubMed1988

A fatal transfusion reaction associated with blood contaminated with Pseudomonas fluorescens.

A fatal transfusion reaction due to contamination of platelet-depleted whole blood with Pseudomonas fluorescens is reported. Routine sterility testing on blood products and environmental microbiological monitoring suggested no source for the contaminating organism, as has been the case for the majority of reported incidents of this type. The value of routine sterility testing in the prevention and investigation of such incidents is discussed.

Aged↗
PubMed1988

Studies on the stability of VIII:C during the manufacture of a factor VIII concentrate for clinical use.

The stability of VIII:C was investigated by monitoring samples taken at different points from a routine process for the manufacture of factor VIII concentrate and by examining the stabilising influence of a number of product formulations. Loss of VIII:C over process-finishing procedures (formulation, 0.22 micron filtration, dispensing) was associated with a citrate-induced inactivation which could be prevented by controlling the ionised calcium concentration of the solution. These results were obtained using a one-stage clotting assay but were not observed using a two-stage assay. No evidence for activation was found in vitro (e.g. by FPA generation and VIII:C stability) and the yield increase suggested by the one-stage assay was supported by results from a controlled clinical evaluation.

Antigens↗
PubMed1988

Artificial factor VIII deficient plasma: preparation using monoclonal antibodies and its use in one stage coagulation assays.

Monoclonal antibodies to factor VIII antigen (VIII:Ag) and von Willebrand factor (vWf:Ag) were immobilised on Sephacryl S-1000 and tested for their ability to deplete normal human citrated plasma of factor VIII. A combination of two antibodies to VIII:Ag and one antibody to vWf:Ag was required to produce plasma containing less than 0.01 IU/ml. Its performance in the one stage coagulation assay of VIII:C was equivalent to that of congenital VIII deficient plasma for the assay of normal and haemophilic plasma and factor VIII concentrates. Storage of freeze dried aliquots of this product at -20 degrees C, +4 degrees C, and 37 degrees C showed that it could be used as a substrate for at least six months when stored at temperatures +4 degrees C and below.

Antibodies, Monoclonal↗