Improvement of the Preparation of Factor VIII Concentrates

1975 ◽  
Author(s):  
C. Vermeer ◽  
B.A.M. Soute ◽  
H. G. J. Brummelhuis
Keyword(s):  
Factor Viii ◽  
Protein Concentration ◽  
Optimal Recovery ◽  
Freezing And Thawing ◽  
Membrane Filters ◽  
Peg 4000 ◽  
In Series ◽  
Factor Viii Concentrates ◽  
Thawing Rate ◽  
Filter Aids

The effect of some variables on the yield of factor VIII procoagulant activity during the preparation of factor VIII concentrates was investigated. The results may be summarized as follows:- The pH of the anticoagulant solution, which results in an optimal recovery of factor VIII in plasma varies with the time, during which the blood or plasma has to be stored before the plasma is frozen. The temperature during the storage of blood and plasma should be higher than 10° C.- A high freezing and thawing rate of the plasma results in a high recovery of factor VIII and less contaminating proteins and lipids in the cryoprecipitate.- After centrifugation and dissolving of the precipitate, the preparation may be lyophilized. An appreciable loss of activity is found when the temperature during this process exceeds 20° C.- From the cryoprecipitate factor VIII can be further purified by precipitation with PEG 4000. The fraction between 2½% at 20° C and 6% at 0° C was used. Within certain limits this precipitation is independent on the protein concentration, pH, time, and ionic strength. Mandelate (0.3% w/v) prevents irreversible precipitation of fibrinogen during all operations.- Sterilization of the dissolved precipitate was achieved by filtration through membrane filters (0.3 μ) on which the filter aids Celite 535 and Hyflo supercel were layered.- PEG precipitation and sterilization induce a 20% loss.- The clinical use of the product was assayed in series of infusions in hemophiliacs.

An Improved Method of Making Factor VIII Concentrates

1979 ◽  
Author(s):  
G. Rock ◽  
D.S. Palmer ◽  
E.S. Tackaberry ◽  
M. Wickerhauser
Keyword(s):  
Factor Viii ◽  
Present Method ◽  
Batch Preparation ◽  
Improved Method ◽  
Factor Viii Activity ◽  
Peg 4000 ◽  
Plasma Factor ◽  
Factor Viii Concentrates ◽  
The Cost ◽  
Plasma Activity

The yields from batch preparation of Factor VIII concentrates can be substantially improved by collecting the blood into heparin rather than into CPD as anticoagulant. The resultant cryoprecipitate contains 78 ± 9% of the original plasma activity if 20 mls of supernatant per litre of starting plasma are left with the cryoprecipitate to maintain heparin levels. This cryoprecipitate was further purified by solubilization at 37°C for 5 minutes using 40 cc of saline per litre of starting plasma. This preparation was adjusted to pH 6.3 and 4.5% PEG 4000. Then, after removal of the precipitate by centrifugaron, the 4.5% PEG supernatant is adjusted to pH 6.0 and 11% PEG. The 11% PEG precipitate obtained after centrifugation is resolubilized in 1/100th the original plasma volume with buffer (0.1 M glycine, 20 mM citrate, 0.15 H saline) containing 1 unit of heparin per ml. Experiments using plasma pools containing 1-15 donor units gave yields ranging from 390-490 plasma Factor VIII equivalents per litre of the starting plasma. The final product retains an average of 90% of the initial Factor VIII activity after 24 hours at 22°C. It is believed that the present method could substantially reduce the cost of producing Factor VIII concentrates.

Automation of Two-Stage Factor VIII Assay

1978 ◽  
Vol 39 (02) ◽  
pp. 455-465 ◽  
Author(s):  
Yvonne Stirling ◽  
D J Howarth ◽  
Marguerite Vickers ◽  
W R S North ◽  
T W Meade
Keyword(s):  
Factor Viii ◽  
Optical Density ◽  
Electric Circuit ◽  
Clotting Time ◽  
Two Stage ◽  
Laboratory Error ◽  
Premature Closure ◽  
Factor Viii Concentrates ◽  
Experimental Findings ◽  
Automated Methods

SummaryTwo automated methods for two-stage factor VIII assays have been compared with one another, and evaluated in practice. The Depex method records the clotting time when an electric circuit is completed by the formation of a fibrin thread across a hook-type electrode; the Electra method is based on an optical density technique of clot detection. The two methods gave comparable results for measured levels of factor VIII when haemophilic or “normal” plasmas were assayed. Results from the two methods in practice also suggest that both are valid at low and “normal” factor VIII levels. The Electra method is also probably suitable for assays of concentrates; however, the Depex method appears to give falsely high values in these circumstances, and experimental findings suggest that the reason may be that increased viscosity due to the high fibrinogen levels in factor VIII concentrates causes premature closure of the circuit between the two ends of the Depex electrode. The main advantage of the Depex method is that, provided 3 or 4 machines are available, a given number of assays can be completed more quickly than on Electra. The main advantages of Electra are that it is probably subject to less laboratory error than Depex, and that it is suitable for assaying concentrates as well as haemophilic and “normal” plasmas.

The Recovery of Factor VIII from Fresh-Frozen, Indated and Outdated Human Plasma

1976 ◽  
Vol 36 (01) ◽  
pp. 071-077 ◽  
Author(s):  
Daniel E. Whitman ◽  
Mary Ellen Switzer ◽  
Patrick A. McKee
Keyword(s):  
Factor Viii ◽  
Polyacrylamide Gel Electrophoresis ◽  
Sodium Dodecyl ◽  
The United States ◽  
Fresh Frozen Plasma ◽  
Red Cross ◽  
Random Samples ◽  
Fresh Frozen ◽  
Factor Viii Concentrates ◽  
Frozen Plasma

SummaryThe availability of factor VIII concentrates is frequently a limitation in the management of classical hemophilia. Such concentrates are prepared from fresh or fresh-frozen plasma. A significant volume of plasma in the United States becomes “indated”, i. e., in contact with red blood cells for 24 hours at 4°, and is therefore not used to prepare factor VIII concentrates. To evaluate this possible resource, partially purified factor VIII was prepared from random samples of fresh-frozen, indated and outdated plasma. The yield of factor VIII protein and procoagulant activity from indated plasma was about the same as that from fresh-frozen plasma. The yield from outdated plasma was substantially less. After further purification, factor VIII from the three sources gave a single subunit band when reduced and analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. These results indicate that the approximately 287,000 liters of indated plasma processed annually by the American National Red Cross (ANRC) could be used to prepare factor VIII concentrates of good quality. This resource alone could quadruple the supply of factor VIII available for therapy.

Factor VIII-Related Activities in Normal, Haemophilic and von Willebrand’s Disease Platelet Fractions

1978 ◽  
Vol 40 (02) ◽  
pp. 288-301 ◽  
Author(s):  
P Meucci ◽  
I R Peake ◽  
A L Bloom
Keyword(s):  
Factor Viii ◽  
Electrophoretic Mobility ◽  
Concanavalin A ◽  
Freezing And Thawing ◽  
Von Willebrand's Disease ◽  
Factor Viii Related Antigen ◽  
Von Willebrand’S Disease ◽  
Normal Plasma ◽  
Significant Difference ◽  
Ristocetin Cofactor

SummaryFactor VIII-related activities have been studied in platelet fractions in order to try to reconcile the conflicting findings of other workers, and to extend the studies. In platelets from 16 normal subjects procoagulant factor VIII was not detected. The amount of factor VIII-related antigen (FVIIIR: AG) in the cytosol per mg of protein was about twice that in the membrane fraction and about ten times that in the debris fraction. There was no significant difference between the amount of FVIIIR: AG and ristocetin cofactor (RistCof) activity in each fraction. The findings in haemophilic platelets were similar. In von Willebrand’s disease (vWd) one serverely affected patient had no detectable factor VIII related activities in any platelet fraction. In 5 patients with intermediate vWd results were normal. In a further 5, with more prolonged bleeding times, no FVIIIR: RistCof was detected in platelets, despite a normal amount of FVIIIR: AG in the cytosol and debris. The electrophoretic mobility of cytosol FVIIIR: AG was increased in all normals and patients, while that in the membrane and debris fractions had normal mobility. Cytosol FVIIIR: AG eluted later than normal FVIIIR: AG on gel filtration on Sepharose 2B, and also showed reduced antibody binding in an immunoradiometric assay. Precipitation of FVIIIR: AG by concanavalin A was incomplete in all platelet fractions from normals, and even more reduced in vWd platelet fractions. The results suggest the possibility of two types of platelet FVIIIR: AG.A factor VIII-related antigen was shown to be associated with normal washed platelets by immunofluorescence techniques (Bloom et al. 1973). Since then, several studies have been reported on the localisation of factor VIII related antigen (FVIIIR: AG), factor VIII procoagulant activity (FVIII: C) and factor VIII related ristocetin cofactor activity (FVIIIR: RistCof) within the platelets. Initially, Howard et al. (1974) indicated that FVIIIR: AG was firmly bound to the platelet membrane, and noted that in lysed platelets the level of FVIIIR: AG as measured by electroimmunodiffusion was higher than that in whole platelet suspensions. However, further studies by Nachman and Jaffe (1975) showed that FVIIIR: AG was also present to a considerable extent in the granules, and they detected none in the platelet cytosol. Bouma and colleagues (1975) were, however, able to find FVIIIR: AG and FVIIIR: RistCof in the cytosol upon freezing and thawing platelets. This FVIIIR: AG had an electrophoretic mobility comparable to that of normal plasma. They also noted that platelets which were air dried apparently had a granular FVIIIR:AG localisation by immunfluorescence; however, intact platelets in suspension did not stain by this method.Recently Ruggeri et al. (1977) and Sultan et al. (1977) have also found FVIIIR: AG in the cytosol, and the former authors reported it to have increased electrophoretic mobility when compared to normal plasma FVIIIR:AG. Results concerning the localisation of FVIIIR: AG in normal platelets have thus been conflicting. Similarly, in the few reports available concerning platelet FVIIIR: AG in von Willibrand’s disease variable results have also been obtained (Ruggeri et al. 1977, Howard et al. 1974, Shearn et al. 1974 and Bouma et al. 1975).In this study we report on the localisation of factor VIII-related activities in normal, haemophilic and von Willebrand’s disease platelets using available standard techniques as well as precipitation of FVIIIR: AG with the plant lectin concanavalin A, a procedure which has been shown to detect abnormal forms of FVIIIR:AG in certain types of von Willebrand’s disease (Peake and Bloom 1977).

A Survey of the Effectiveness of Prothrombin Complex Concentrates in Controlling Hemorrhage in Patients with Hemophilia and Anti-Factor VIII Antibodies

1980 ◽  
Vol 44 (01) ◽  
pp. 039-042 ◽  
Author(s):  
Philip M Blatt ◽  
Doris Ménaché ◽  
Harold R Roberts
Keyword(s):  
Factor Viii ◽  
Ad Hoc ◽  
Hemophilia A ◽  
Working Party ◽  
International Committee ◽  
Factor Ix ◽  
Prothrombin Complex Concentrates ◽  
Factor Viii Concentrates

SummaryThe treatment of patients with hemophilia A and anti-Factor VIII antibodies is difficult. Between July 1977 and June 1978, a survey was carried out by an ad hoc working party of the subcommittee on Factor IX concentrates of the International Committee on Thrombosis and Hemostasis to assess the effectiveness of Prothrombin Complex Concentrates in controlling hemorrhage in these patients. The results are presented in this paper and, although subjective, support the view that these concentrates are not as effective in patients with inhibitors as Factor VIII concentrates are in patients without inhibitors.

A Higher than Expected Incidence of Factor VIII Inhibitors in Multitransfused Haemophilia A Patients Treated with an Intermediate Purity Pasteurized Factor VIII Concentrate

1993 ◽  
Vol 69 (02) ◽  
pp. 115-118 ◽  
Author(s):  
Kathelijne Peerlinck ◽  
Jef Arnout ◽  
Jean Guy Gilles ◽  
Jean-Marie Saint-Remy ◽  
Jos Vermylen
Keyword(s):  
Factor Viii ◽  
Randomized Trials ◽  
Specific Factor ◽  
Factor Viii Inhibitor ◽  
Haemophilia A ◽  
Viral Inactivation ◽  
Gradual Decline ◽  
Inhibitor Level ◽  
Factor Viii Concentrates ◽  
Viii Inhibitor

SummaryIn May 1990, 218 patients with haemophilia A regularly attending the Leuven Haemophilia Center were randomly assigned to a group receiving either of two newly introduced factor VIII concentrates: factor VIII-P, an intermediate purity pasteurized concentrate, or factor VIII-SD, a high purity concentrate treated with solvent-detergent for viral inactivation.Patients were followed from May 1990 until October 1991. Between August 1991 and October 1991 a clinically important factor VIII inhibitor was detected in five out of the 109 patients receiving factor VIII-P while none of the 109 patients receiving factor VIII-SD developed such antibodies. All patients acquiring an inhibitor had previously been clinically tolerant to transfused factor VIII with 200 to more than 1,000 days of exposure to factor VIII prior to May 1990. Patients with inhibitors were transfused daily with 30 U factor VIII-SD per kg body weight, which was associated with a gradual decline of the inhibitor level. In all patients the antibodies were relatively slow-acting and predominantly directed towards the light chain of factor VIII.This study demonstrates a higher than expected incidence of factor VIII inhibitors associated with the use of a specific factor VIII concentrate in multitransfused haemophilia A patients. It indicates the usefulness of evaluating newly introduced concentrates in prospective, randomized trials.

Circulating Anticoagulant (Antifactor VIII) Treated with Immunosuppressive Drugs

1969 ◽  
Vol 21 (02) ◽  
pp. 249-258 ◽  
Author(s):  
L. A Sherman ◽  
M. A Goldstein ◽  
H. S Sise
Keyword(s):  
Factor Viii ◽  
Conventional Therapy ◽  
Immunosuppressive Drugs ◽  
The Other ◽  
Not Given ◽  
Factor Viii Concentrates ◽  
Short Courses

SummaryThree cases have been presented who had a circulating antifactor VIII anticoagulant developing spontaneously in non-hemophilic subjects. Following two short courses of azathioprine in one case there were transient incomplete remissions of a degree not seen in the previous 4 months of observation. In the other two cases complete remissions were observed within three weeks of beginning administration of 6-mercaptopurine. In one of these, a brief relapse was retreated successfully. In 4 other cases not given these drugs and in cases reported in the literature, such a rapid remission was not seen to occur spontaneously and happened only infrequently in cases given corticosteroids. On the basis of this experience, we suggest that in the treatment of antifactor VIII, if the disorder shows no improvement with conventional therapy (blood, factor VIII concentrates, and corticosteroids), a trial with immunosuppressive drugs is warranted.

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