Keywords
1. Measles vaccination
2. Immunoglobulin
3. Neutralization assays
4. Post-exposure prophylaxis
5. Measles virus antibodies
Introduction
Vaccination remains one of the most powerful tools in the fight against infectious diseases. The measles virus (MV), a pathogen responsible for countless deaths and complications over the centuries, has been largely contained through the widespread use of the measles vaccine. Yet despite this success, challenges remain in ensuring that individuals are protected against the virus through both vaccination and other measures, such as immunoglobulin (IG) therapies.
A recent study titled “Measles virus neutralizing antibodies in immunoglobulin lots produced from plasma collected in Europe or the United States” provides profound insights into the potency of IG produced on different sides of the Atlantic. Published in the journal “Vaccine,” the research uncovers the equality of measles virus antibody (MVAb) levels in IG produced from plasma collected in Europe and the United States. This finding is significant, as it suggests the potential for harmonizing the dosage recommendations for post-exposure prophylaxis between these regions.
DOI: 10.1016/j.vaccine.2019.04.022
The Study and Its Findings
The study conducted by Maria R. Farcet and colleagues at Baxter AG aimed to determine the levels of measles virus neutralizing antibodies in IG lots produced from plasma collected in Europe or the United States. Given the recent decline in MVAb levels in the population following the widespread use of vaccination—which produces lower antibody concentrations than natural infection—assessing the potency of IG preparations has become critically important.
Using a standardized measles virus neutralization assay, the researchers tested IG lots and found that they consistently contained MVAb levels above the minimum regulatory requirements set forth by the United States. Notably, no significant difference was observed between the IG lots produced from plasma of either region, indicating that both offer equivalent protection against MV infection.
Implications of the Research
The implications of this research are significant for public health policies and protocols. With the confirmation that European IG lots contain similar MVAb levels to their American counterparts, there is a strong argument for the European Union to align its post-exposure prophylaxis recommendations with those of the US Food and Drug Administration (FDA). This could standardize treatment and potentially improve outcomes for individuals exposed to the measles virus.
Challenges and Considerations
While the study’s outcomes are promising, they also highlight the continuous need to monitor MVAb levels in IG lots as vaccination practices evolve. With fewer people experiencing natural measles infection due to successful vaccination programs, the source of high-titer MVAb becomes more limited. Furthermore, the production and regulatory oversight of IG therapies vary across geographies, emphasizing the need for harmonized testing and release criteria to ensure consistent product quality and efficacy.
Importance of Post-Exposure Prophylaxis
For those who are exposed to the measles virus, especially individuals who are immunocompromised or otherwise unable to receive the vaccine, post-exposure prophylaxis with IG can be life-saving. The study’s findings bolster the case for post-exposure prophylaxis as a crucial intervention, not just by equating the protective titers in IG lots but also by potentially simplifying and aligning treatment protocols.
Future Directions
The researchers call for continued surveillance of MVAb levels in immunoglobulin products and suggest the need for the development of more sensitive assays to quantify these antibodies accurately. They also note the potential for adjustments to the production processes to ensure a consistent and adequate supply of high-quality IG lots.
Global Public Health Impact
As the world becomes increasingly interconnected and the threat of measles outbreaks persists, the availability and effectiveness of IG treatments play a pivotal role in global health security. The study underscores the importance of international collaboration in maintaining a robust arsenal against vaccine-preventable diseases.
Conclusion
This research represents an important step in reinforcing the global fight against measles. By demonstrating that immunoglobulin lots from Europe and the United States have equivalent levels of measles virus neutralizing antibodies, it provides a scientific foundation for aligning post-exposure prophylaxis protocols and enhancing patient care. While the fight against measles continues, studies like this ensure that the medical community remains equipped with the best tools to protect vulnerable populations.
References
1. Farcet, M. R., Karbiener, M., Rabel, P. O., Schirmer, A., Ilk, R., & Kreil, T. R. (2019). Measles virus neutralizing antibodies in immunoglobulin lots produced from plasma collected in Europe or the United States. Vaccine, 37(24), 3151–3153. https://doi.org/10.1016/j.vaccine.2019.04.022
2. World Health Organization (WHO). (n.d.). Measles. Retrieved from https://www.who.int/news-room/fact-sheets/detail/measles
3. Centers for Disease Control and Prevention (CDC). (n.d.). Measles (Rubeola). Retrieved from https://www.cdc.gov/measles/index.html
4. Public Health England (PHE). (n.d.). Immunoglobulin Handbook. Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/816288/Immunoglobulin_Handbook.pdf
5. U.S. Food and Drug Administration (FDA). (n.d.). Vaccines Licensed for Use in the United States. Retrieved from https://www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states
DOI: 10.1016/j.vaccine.2019.04.022
The protection against measles afforded by immunoglobulin therapies is a testament to the advances in medical science and the enduring importance of vaccination programs. This study’s insights promote not only enhanced patient care through effective post-exposure prophylaxis but also underscore the critical need for global collaboration in the fight against infectious diseases.