Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study
Hand, foot, and mouth disease (HFMD) is highly prevalent in East and Southeast Asia. It particularly affects children under five years of age. The most common causative agents are coxsackieviruses A6 and A16, and enterovirus A71 (EV71). The clinical presentation is usually mild and self-limited, but...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/10/5/625 |
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| author | Chonnamet Techasaensiri Artit Wongsa Thanyawee Puthanakit Kulkanya Chokephaibulkit Tawee Chotpitayasunondh Ubonwon Charoonruangrit Somjai Sombatnimitsakul Pilaipan Puthavathana Hatairat Lerdsamran Prasert Auewarakul Boonrat Tassaneetrithep |
| author_facet | Chonnamet Techasaensiri Artit Wongsa Thanyawee Puthanakit Kulkanya Chokephaibulkit Tawee Chotpitayasunondh Ubonwon Charoonruangrit Somjai Sombatnimitsakul Pilaipan Puthavathana Hatairat Lerdsamran Prasert Auewarakul Boonrat Tassaneetrithep |
| author_sort | Chonnamet Techasaensiri |
| collection | DOAJ |
| description | Hand, foot, and mouth disease (HFMD) is highly prevalent in East and Southeast Asia. It particularly affects children under five years of age. The most common causative agents are coxsackieviruses A6 and A16, and enterovirus A71 (EV71). The clinical presentation is usually mild and self-limited, but, in some cases, severe and fatal complications develop. To date, no specific therapy or worldwide vaccine is available. In general, viral infection invokes both antibody and cell-mediated immune responses. Passive immunity transfer can ameliorate the severe symptoms of diseases such as COVID-19, influenza, MERS, and SARS. Hyperimmune plasma (HIP) from healthy donors with high anti-EV71 neutralizing titer were used to transfuse confirmed EV71-infected children with neurological involvement (n = 6). It resulted in recovery within three days, with no neurological sequelae apparent upon examination 14 days later. Following HIP treatment, plasma chemokines were decreased, whereas anti-inflammatory and pro-inflammatory cytokines gradually increased. Interestingly, IL-6 and G-CSF levels in cerebrospinal fluid declined sharply within three days. These findings indicate that HIP has therapeutic potential for HFMD with neurological complications. However, given the small number of patients who have been treated, a larger cohort study should be undertaken. Successful outcomes would stimulate the development of anti-EV71 monoclonal antibody therapy. |
| first_indexed | 2024-03-10T11:16:26Z |
| format | Article |
| id | doaj.art-acf9b168a475479a8a2904c037a41f31 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-10T11:16:26Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-acf9b168a475479a8a2904c037a41f312023-11-21T20:26:16ZengMDPI AGPathogens2076-08172021-05-0110562510.3390/pathogens10050625Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot StudyChonnamet Techasaensiri0Artit Wongsa1Thanyawee Puthanakit2Kulkanya Chokephaibulkit3Tawee Chotpitayasunondh4Ubonwon Charoonruangrit5Somjai Sombatnimitsakul6Pilaipan Puthavathana7Hatairat Lerdsamran8Prasert Auewarakul9Boonrat Tassaneetrithep10Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandCenter of Research Excellence in Immunoregulation, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandDepartment of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandDepartment of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandDepartment of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok 10400, ThailandNational Blood Bank Center, Thai Red Cross, Bangkok 10330, ThailandNational Blood Bank Center, Thai Red Cross, Bangkok 10330, ThailandCenter for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakon Pathom 73170, ThailandCenter for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakon Pathom 73170, ThailandDepartment of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandCenter of Research Excellence in Immunoregulation, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandHand, foot, and mouth disease (HFMD) is highly prevalent in East and Southeast Asia. It particularly affects children under five years of age. The most common causative agents are coxsackieviruses A6 and A16, and enterovirus A71 (EV71). The clinical presentation is usually mild and self-limited, but, in some cases, severe and fatal complications develop. To date, no specific therapy or worldwide vaccine is available. In general, viral infection invokes both antibody and cell-mediated immune responses. Passive immunity transfer can ameliorate the severe symptoms of diseases such as COVID-19, influenza, MERS, and SARS. Hyperimmune plasma (HIP) from healthy donors with high anti-EV71 neutralizing titer were used to transfuse confirmed EV71-infected children with neurological involvement (n = 6). It resulted in recovery within three days, with no neurological sequelae apparent upon examination 14 days later. Following HIP treatment, plasma chemokines were decreased, whereas anti-inflammatory and pro-inflammatory cytokines gradually increased. Interestingly, IL-6 and G-CSF levels in cerebrospinal fluid declined sharply within three days. These findings indicate that HIP has therapeutic potential for HFMD with neurological complications. However, given the small number of patients who have been treated, a larger cohort study should be undertaken. Successful outcomes would stimulate the development of anti-EV71 monoclonal antibody therapy.https://www.mdpi.com/2076-0817/10/5/625EV71hand, foot, and mouth diseasehyperimmune plasma treatmentneurological complication |
| spellingShingle | Chonnamet Techasaensiri Artit Wongsa Thanyawee Puthanakit Kulkanya Chokephaibulkit Tawee Chotpitayasunondh Ubonwon Charoonruangrit Somjai Sombatnimitsakul Pilaipan Puthavathana Hatairat Lerdsamran Prasert Auewarakul Boonrat Tassaneetrithep Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study Pathogens EV71 hand, foot, and mouth disease hyperimmune plasma treatment neurological complication |
| title | Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study |
| title_full | Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study |
| title_fullStr | Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study |
| title_full_unstemmed | Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study |
| title_short | Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study |
| title_sort | response of severe ev71 infected patients to hyperimmune plasma treatment a pilot study |
| topic | EV71 hand, foot, and mouth disease hyperimmune plasma treatment neurological complication |
| url | https://www.mdpi.com/2076-0817/10/5/625 |
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