Persistence of Rabies Antibody 5 Years after Postexposure Prophylaxis with Vero Cell Antirabies Vaccine and Antibody Response to a Single Booster Dose

ABSTRACTThis study was done to investigate the antibody response to a Vero cell antirabies vaccine, the persistence of antibody for 5 years, and the effect of a booster dose after this interval. From August 2005 to February 2011, a total of 195 patients were enrolled into our study due to an animal bite. The Essen intramuscular (i.m.) regimen, which is recommended by the WHO for modern vaccines used in postexposure treatment, was adopted in this study. Blood samples were obtained on day 0, day 7, day 14, day 45, year 1, year 2, year 3, year 4, year 5, and year 5 plus 14 days. Immunogenicity was evaluated by the titration of neutralizing antibodies with a rapid fluorescent focus inhibition test (RFFIT). Seroconversion was expressed as the seroconversion rate (SCR). A secondary quantitative evaluation criterion, other than the seroconversion level, was the geometric mean titer (GMT). Of the 195 enrolled patients, 168 (86.4%) of them completed the whole study. No serious adverse reactions to the vaccine were reported during vaccination, the 5-year follow-up period, or revaccination. On day 14, the rabies antibody GMT value was 8.87 IU/ml in the vaccinees. During the next 5 years, the SCR in the ChengDa vaccine group gradually decreased to 34.0% at year 5, down from 90.5% at year 1. There was a significant booster effect: the GMT was 15.22 IU/ml on year 5 plus 14 days. Our findings demonstrate that the ChengDa rabies vaccine offers an alternative with a high degree of efficacy and yet limited side effects and ensures that the exposed patient will be on the safe side of the risk of rabies by the 14th day. Moreover, when followed by a booster dose 5 years later, it could boost the immunity. A further booster is effective in inducing a good neutralizing antibody response even after an interval of 5 years.

Download Full-text

LB11. A Single Dose of the MVA-BN Smallpox Vaccine Induces an Early Protective Antibody Response Similar to a Traditional Replicating Vaccine and Is Suitable for Emergency Scenarios

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz415.2494 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S997-S998

Author(s):

Jane Maclennan ◽

Heinz Weidenthaler ◽

Phillip Pittman ◽

Darja Schmidt ◽

Paul Chaplin

Keyword(s):

Single Dose ◽

Antibody Response ◽

Neutralizing Antibodies ◽

Geometric Mean ◽

Spontaneous Mutation ◽

Neutralizing Antibody ◽

Smallpox Vaccine ◽

Group 2 ◽

Emergency Scenarios ◽

Group 1

Abstract Background Smallpox remains a high-priority threat due to its potential for re-emergence through events including bioterrorism and spontaneous mutation. While traditional replicating smallpox vaccines such as ACAM2000 are associated with serious side effects, the non-replicating MVA BN smallpox vaccine was developed as a safer alternative. Methods This phase 3 non-inferiority study compared indicators of efficacy between the MVA-BN smallpox vaccine and ACAM2000. The co-primary endpoints were (1) to compare vaccine-induced serum neutralizing antibodies (geometric mean titer [GMT]) at predefined Peak Visits, as measured by plaque reduction neutralization tests (PRNT) and (2) to assess the attenuation of ACAM2000-induced takes after MVA-BN administration by measuring maximum lesion area (MLA). Early neutralizing antibody GMTs at Day 14, a timepoint considered protective for traditional replicating smallpox vaccines, were also compared following single doses of either vaccine. Results A total of 440 subjects were evenly randomized to receive either 2 doses of MVA-BN followed by 1 dose of ACAM2000 at 4 week intervals (Group 1) or a single dose of ACAM2000 (Group 2). Peak neutralizing antibody GMTs were significantly higher following 2 MVA-BN doses (153.5) compared with ACAM2000 (79.3), with a ratio of 1.935 (95% CI: 1.562, 2.397). At Day 14, neutralizing antibody GMTs were equal following a single dose of either MVA BN or ACAM2000 (16.2, ratio of 0.997, 95% CI: 0.738, 1.348), with similar seroconversion rates (90.8% vs. 91.8%, respectively). The median MLA induced by ACAM2000 was significantly reduced when subjects received prior MVA-BN in Group 1 (0 mm2) compared with Group 2 (76.0 mm2), suggesting protection against orthopoxvirus. MVA BN was well tolerated, demonstrating a better safety profile than ACAM2000. Conclusion Two doses of MVA-BN induce significantly higher peak neutralizing antibody responses compared with ACAM2000. A single dose induces an early neutralizing antibody response equal to ACAM2000 at Day 14, demonstrating the suitability of MVA BN in both pre- and post-outbreak scenarios. This study was partly funded by BARDA under contract HHSO100200700034C. Disclosures Jane Maclennan, BSc MRPharmS, Bavarian Nordic (Employee), Bavarian Nordic (Employee, Shareholder), Heinz Weidenthaler, MD, Bavarian Nordic (Employee, Shareholder), Phillip Pittman, MD, Bavarian Nordic (Scientific Research Study Investigator), Darja Schmidt, PhD, Bavarian Nordic (Employee, Shareholder), Paul Chaplin, PhD, Bavarian Nordic (Board Member, Employee, Shareholder), Bavarian Nordic (Employee, Shareholder).

Download Full-text

Immunogenicity in sheep of Uruguayan commercial vaccines against bovine alphaherpesvirus 1, 5 and bovine pestiviruses

Ciência Rural ◽

10.1590/0103-8478cr20190465 ◽

2020 ◽

Vol 50 (4) ◽

Author(s):

Ingryd Merchioratto ◽

Alana de Almeida Aurélio ◽

Janice Machado Villela ◽

Nicole Vieira Stone ◽

Isac Junior Roman ◽

...

Keyword(s):

Antibody Response ◽

Neutralizing Antibodies ◽

Geometric Mean ◽

Neutralizing Antibody ◽

Serological Response ◽

Serum Samples ◽

Post Vaccination ◽

Immunological Responses ◽

Antibody Titers ◽

Low Levels

ABSTRACT: The serological responses induced by four commercial inactivated Uruguayan vaccines against bovine alphaherpesviruses (BoHV)-1 and -5 and bovine pestiviruses (BVDV-1, BVDV-2, and HoBiPeV) were evaluated in sheep. Thirty-seven sheep were immunized twice (day 0 and 25) and their serum samples were tested at different intervals (days 0, 25, 40, 60, and 90) post-vaccination (PV). Among the four vaccines tested, only one (G4) could induce the production of moderate neutralizing antibody titers against BoHV-1 and -5 and BVDV-1 and -2. The G3 vaccine showed a neutralizing serological response against the bovine alphaherpesviruses only. The G1 and G2 vaccines produced extremely low levels of antibodies in a few vaccinated animals only (geometric mean titers (GMT) 2.2). Similar levels of immunological responses were induced by the G4 vaccine against BoHV-1 and -5, and titers of neutralizing antibodies induced in approximately 70% of the animals are known to confer protection (GMT > 8). For bovine pestiviruses, the vaccine stimulated response of G4 against BVDV-2 was higher compared to that against BVDV-1, and extremely low for HoBiPeV. The peak of neutralizing antibodies to BoHV-1 and BVDV-1 was observed on days 40 and 60 PV, respectively. Thereafter, a remarkably decrease in neutralizing antibody response was observed at day 90 PV. These results demonstrated that tested commercial Uruguayan vaccines did not induce a serological response of adequate magnitude and duration. Thus, it is important to periodically review formulations and compositions of commercial vaccines against bovine alphaherpesviruses and pestiviruses.

Download Full-text

SARS-CoV-2 Neutralizing Antibody has Better Diagnostic Sensitivity than IgM and IgG

10.21203/rs.3.rs-562694/v1 ◽

2021 ◽

Author(s):

Shujuan Cui ◽

Meiyu Wang ◽

Jianhui Nie ◽

Chenyan Zhao ◽

Lingyu Shen ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Neutralizing Antibodies ◽

Seroconversion Rate ◽

Geometric Mean ◽

Neutralizing Antibody ◽

Epidemiological Survey ◽

Diagnostic Sensitivity ◽

Clinical Indicators ◽

Duration Of Infection

Abstract COVID-19 has spread worldwide. However, SARS-CoV-2 serological markers, which usually important indicators of disease progression, remains to be studied. To determine serological patterns during infection and their corresponding influencing factors, we conducted a cohort study including 115 patients with COVID-19 from 41 hospitals. The study included measuring IgM, IgG, and neutralizing antibodies (NAb) in serum, conducting epidemiological survey of the subjects, and retrieving clinical indicators from electronic medical records. We found NAb had the highest seroconversion rate (79.61%), followed by IgG (60.42%), and IgM (26.56%). Seroconversion rate peaked 20–40 d post-infection with NAb reaching 100%. The Geometric mean of NAb ID50 is 201 (30 to 6271). The NAb titer was positively correlated with duration of infection (p = 0), IgM (p = 0.016), and IgG (p = 0). Compared with IgM or IgG, NAb has better diagnostic sensitivity and serological patterns are valuable for clinical diagnosis and disease monitoring.

Download Full-text

Neutralizing Antibody Response to Pseudotype SARS-CoV-2 Differs between mRNA-1273 and BNT162b2 COVID-19 Vaccines and by History of SARS-CoV-2 Infection

10.1101/2021.10.20.21265171 ◽

2021 ◽

Author(s):

Harmony L. Tyner ◽

Mark G. Thompson ◽

Jefferey L. Burgess ◽

Lauren Grant ◽

Manjusha Gaglani ◽

...

Keyword(s):

Antibody Response ◽

Messenger Rna ◽

Neutralizing Antibodies ◽

Geometric Mean ◽

Vaccine Dose ◽

Neutralizing Antibody ◽

Frontline Workers ◽

History Of ◽

Antibody Titers ◽

Polymerase Chain

Background: Data on the development of neutralizing antibodies against SARS-CoV-2 after SARS-CoV-2 infection and after vaccination with messenger RNA (mRNA) COVID-19 vaccines are limited. Methods: From a prospective cohort of 3,975 adult essential and frontline workers tested weekly from August, 2020 to March, 2021 for SARS-CoV-2 infection by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) assay irrespective of symptoms, 497 participants had sera drawn after infection (170), vaccination (327), and after both infection and vaccination (50 from the infection population). Serum was collected after infection and each vaccine dose. Serum-neutralizing antibody titers against USA-WA1/2020-spike pseudotype virus were determined by the 50% inhibitory dilution. Geometric mean titers (GMTs) and corresponding fold increases were calculated using t-tests and linear mixed effects models. Results: Among 170 unvaccinated participants with SARS-CoV-2 infection, 158 (93%) developed neutralizing antibodies (nAb) with a GMT of 1,003 (95% CI=766-1,315). Among 139 previously uninfected participants, 138 (99%) developed nAb after mRNA vaccine dose-2 with a GMT of 3,257 (95% CI = 2,596-4,052). GMT was higher among those receiving mRNA-1273 vaccine (GMT =4,698, 95%CI= 3,186-6,926) compared to BNT162b2 vaccine (GMT=2,309, 95%CI=1,825-2,919). Among 32 participants with prior SARS-CoV-2 infection, GMT was 21,655 (95%CI=14,766-31,756) after mRNA vaccine dose-1, without further increase after dose-2. Conclusions: A single dose of mRNA vaccine after SARS-CoV-2 infection resulted in the highest observed nAb response. Two doses of mRNA vaccine in previously uninfected participants resulted in higher nAb to SARS-CoV-2 than after one dose of vaccine or SARS-CoV-2 infection alone. Neutralizing antibody response also differed by mRNA vaccine product.

Download Full-text

IMMUNOGENICITY AND SAFETY OF INACTIVATED SARS-COV-2 VACCINE (VERO CELL), BBIBP-CORV (SINOPHARM); AN OBSERVATIONAL STUDY FROM PAKISTAN

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v6i6.7034 ◽

2021 ◽

Vol 71 (6) ◽

pp. 2024-28

Author(s):

Muhammad Farooq ◽

Muhammad Fayyaz Malik ◽

Ashfaq Hussain ◽

Majid Latif ◽

Muhammad Usman Rathore ◽

...

Keyword(s):

Vero Cell ◽

Neutralizing Antibodies ◽

Adverse Reactions ◽

Seroconversion Rate ◽

Vaccine Dose ◽

Neutralizing Antibody ◽

Cross Sectional Study ◽

Military Hospital ◽

Cross Sectional ◽

Antibody Titers

Objective: To ascertain the immunogenicity and short-term safety of inactivated SARS-CoV-2 Vaccine (Vero Cell), BBIBPCorV (Sinopharm) in our setup. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital Sialkot Pakistan, from Feb to Apr 2021. Methodology: A total of 227 health care workers (HCWs) between 18 to 59 years of age were included in the study. Two doses of Inactivated SARS-CoV-2 Vaccine (Vero Cell), BBIBP-CorV were administered to all individuals 21 days apart and they were monitored for any vaccine-related adverse reactions for 7 days after each dose. Neutralizing antibodies (NAbs) in study subjects were detected in three samples i.e. before 1st dose of vaccine, 21 days after 1st dose and 14 days after 2nd dose by Elecsys Anti- SARS-CoV-2 S (Roche Diagnostics). Results: Mean age of individuals in the study was 36.70 ± 18.08 years and most individuals were in the 31-45 years age group. Fatigue and drowsiness were the most common adverse effects experienced by study subjects after 1st and 2nd dose of the vaccine followed by malaise and headache. Only 42 (39%) individuals developed positive neutralizing antibody titers in a sample taken 21 days after 1st dose while all individuals except one (99%) developed positive neutralizing antibody titers in a sample taken 2 weeks after 2nd vaccine dose. Conclusion: Inactivated SARS-CoV-2 Vaccine (Vero Cell), BBIBP-CorV is safe and well-tolerated with very few adverse reactions. Immunogenicity was well achieved as the seroconversion rate was 99% two weeks after 2nd dose of the vaccine.

Download Full-text

SARS-CoV-2 RBD trimer protein adjuvanted with Alum-3M-052 protects from SARS-CoV-2 infection and immune pathology in the lung

Nature Communications ◽

10.1038/s41467-021-23942-y ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Nanda Kishore Routhu ◽

Narayanaiah Cheedarla ◽

Venkata Satish Bollimpelli ◽

Sailaja Gangadhara ◽

Venkata Viswanadh Edara ◽

...

Keyword(s):

Antibody Response ◽

Antibody Titer ◽

Neutralizing Antibodies ◽

Rhesus Macaques ◽

Neutralizing Antibody ◽

Significant Loss ◽

Lung Pathology ◽

Live Virus ◽

Suitable Candidate ◽

Immune Pathology

AbstractThere is a great need for the development of vaccines that induce potent and long-lasting protective immunity against SARS-CoV-2. Multimeric display of the antigen combined with potent adjuvant can enhance the potency and longevity of the antibody response. The receptor binding domain (RBD) of the spike protein is a primary target of neutralizing antibodies. Here, we developed a trimeric form of the RBD and show that it induces a potent neutralizing antibody response against live virus with diverse effector functions and provides protection against SARS-CoV-2 challenge in mice and rhesus macaques. The trimeric form induces higher neutralizing antibody titer compared to monomer with as low as 1μg antigen dose. In mice, adjuvanting the protein with a TLR7/8 agonist formulation alum-3M-052 induces 100-fold higher neutralizing antibody titer and superior protection from infection compared to alum. SARS-CoV-2 infection causes significant loss of innate cells and pathology in the lung, and vaccination protects from changes in innate cells and lung pathology. These results demonstrate RBD trimer protein as a suitable candidate for vaccine against SARS-CoV-2.

Download Full-text

Characterization of Pre-F-GCN4t, a Modified Human Respiratory Syncytial Virus Fusion Protein Stabilized in a Noncleaved Prefusion Conformation

Journal of Virology ◽

10.1128/jvi.02437-16 ◽

2017 ◽

Vol 91 (13) ◽

Cited By ~ 18

Author(s):

Normand Blais ◽

Martin Gagné ◽

Yoshitomo Hamuro ◽

Patrick Rheault ◽

Martine Boyer ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Antibody Response ◽

Neutralizing Antibodies ◽

Neutralizing Antibody ◽

Human Respiratory Syncytial Virus ◽

Vaccine Antigen ◽

Significant Advance ◽

F Protein ◽

Syncytial Virus

ABSTRACT The human respiratory syncytial virus (hRSV) fusion (F) protein is considered a major target of the neutralizing antibody response to hRSV. This glycoprotein undergoes a major structural shift from the prefusion (pre-F) to the postfusion (post-F) state at the time of virus-host cell membrane fusion. Recent evidences suggest that the pre-F state is a superior target for neutralizing antibodies compared to the post-F state. Therefore, for vaccine purposes, we have designed and characterized a recombinant hRSV F protein, called Pre-F-GCN4t, stabilized in a pre-F conformation. To show that Pre-F-GCN4t does not switch to a post-F conformation, it was compared with a recombinant post-F molecule, called Post-F-XC. Pre-F-GCN4t was glycosylated and trimeric and displayed a conformational stability different from that of Post-F-XC, as shown by chemical denaturation. Electron microscopy analysis suggested that Pre-F-GCN4t adopts a lollipop-like structure. In contrast, Post-F-XC had a typical elongated conical shape. Hydrogen/deuterium exchange mass spectrometry demonstrated that the two molecules had common rigid folding core and dynamic regions and provided structural insight for their biophysical and biochemical properties and reactivity. Pre-F-GCN4t was shown to deplete hRSV-neutralizing antibodies from human serum more efficiently than Post-F-XC. Importantly, Pre-F-GCN4t was also shown to bind D25, a highly potent monoclonal antibody specific for the pre-F conformation. In conclusion, this construct presents several pre-F characteristics, does not switch to the post-F conformation, and presents antigenic features required for a protective neutralizing antibody response. Therefore, Pre-F-GCN4t can be considered a promising candidate vaccine antigen. IMPORTANCE Human respiratory syncytial virus (RSV) is a global leading cause of infant mortality and adult morbidity. The development of a safe and efficacious RSV vaccine remains an important goal. The RSV class I fusion (F) glycoprotein is considered one of the most promising vaccine candidates, and recent evidences suggest that the prefusion (pre-F) state is a superior target for neutralizing antibodies. Our study presents the physicochemical characterization of Pre-F-GCN4t, a molecule designed to be stabilized in the pre-F conformation. To confirm its pre-F conformation, Pre-F-GCN4t was analyzed in parallel with Post-F-XC, a molecule in the post-F conformation. Our results show that Pre-F-GCN4t presents characteristics of a stabilized pre-F conformation and support its use as an RSV vaccine antigen. Such an antigen may represent a significant advance in the development of an RSV vaccine.

Download Full-text

Duration of immunity against COVID-19 after vaccination in Indian subcontinent

10.21203/rs.3.rs-1260289/v1 ◽

2022 ◽

Author(s):

Apoorva Munigela ◽

Sasikala M ◽

Gujjarlapudi Deepika ◽

Anand V Kulkarni ◽

Krishna Vemula ◽

...

Keyword(s):

Neutralizing Antibodies ◽

Booster Dose ◽

Indian Subcontinent ◽

Neutralizing Antibody ◽

Health Concern ◽

Mortality Data ◽

Optimal Timing ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Antibody Levels

Abstract Coronavirus disease (COVID-19) continues to be a major health concern leading to substantial mortality and morbidity across the world. Vaccination is effective in reducing the severity and associated mortality. Data pertaining to the duration of immunity, antibody waning and the optimal timing of booster dose administration is limited. In this cross-sectional study, we assessed the antibody levels in healthcare workers who were fully vaccinated after obtaining Institutional ethics committee approval and informed consent. Whole blood was collected and enumeration of S1/S2 neutralizing antibody levels was carried out using LIAISON SARS-COV-2 S1/S2 IgG assay. A total of 1636 individuals who were vaccinated with Covaxin or Covishield were included. Of these, 52% were males with a median age of 29 years. Diabetes and Hypertension was noted in 2.32% (38/1636) and 2.87% (47/1636) of the individuals. Spike neutralizing antibodies were below the detectable range (<15 AU/ml) in 6.0% (98/1636) of the individuals. Decline in neutralizing antibody was seen in 30% of the individuals above 40 years of age with comorbidities (diabetes and hypertension) after 6 months. These individuals may be prioritized for a booster dose at 6 months.

Download Full-text

Cytokine Profiles and Antibody Response Associated to Choclo Orthohantavirus Infection

Frontiers in Immunology ◽

10.3389/fimmu.2021.603228 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tybbysay P. Salinas ◽

Jose L. Garrido ◽

Jacqueline R. Salazar ◽

Publio Gonzalez ◽

Nicole Zambrano ◽

...

Keyword(s):

Antibody Response ◽

Neutralizing Antibodies ◽

Neutralizing Antibody ◽

Serum Levels ◽

Mortality Rates ◽

Antibody Responses ◽

Cytokine Profiles ◽

Th2 Cytokine ◽

Igg1 Subclass ◽

Asymptomatic Individuals

BackgroundNew World Hantaviruses (NWHs) are the etiological agent underlying hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory disease with high mortality rates in humans. In Panama, infections with Choclo Orthohantavirus (CHOV) cause a much milder illness characterized by higher seroprevalence and lower mortality rates. To date, the cytokine profiles and antibody responses associated with this milder form of HCPS have not been defined. Therefore, in this study, we examined immune serological profiles associated with CHOV infections.MethodsFor this retrospective study, sera from fifteen individuals with acute CHOV-induced HCPS, were analyzed alongside sera from fifteen convalescent phase individuals and thirty-three asymptomatic, CHOV-seropositive individuals. Cytokine profiles were analyzed by multiplex immunoassay. Antibody subclasses, binding, and neutralization against CHOV-glycoprotein (CHOV-GP) were evaluated by ELISA, and flow cytometry.ResultsHigh titers of IFNγ, IL-4, IL-8, and IL-10 serum cytokines were found in the acute individuals. Elevated IL-4 serum levels were found in convalescent and asymptomatic seropositive individuals. High titers of IgG1 subclass were observed across the three cohorts analyzed. Neutralizing antibody response against CHOV-GP was detectable in few acute individuals but was strong in both convalescent and asymptomatic seropositive individuals.ConclusionA Th1/Th2 cytokine signature is characteristic during acute mild HCPS caused by CHOV infection. High expression of Th2 and IL-8 cytokines are correlated with clinical parameters in acute mild HCPS. In addition, a strong IL-4 signature is associated with different cohorts, including asymptomatic individuals. Furthermore, asymptomatic individuals presented high titers of neutralizing antibodies.

Download Full-text

Antibody titers measured by commercial assays are correlated with neutralizing antibody titers calibrated by international standards

10.1101/2021.07.16.21260618 ◽

2021 ◽

Author(s):

Yu-An Kung ◽

Chung-Guei Huang ◽

Sheng-Yu Huang ◽

Kuan-Ting Liu ◽

Peng-Nien Huang ◽

...

Keyword(s):

Neutralizing Antibodies ◽

Vaccine Development ◽

Geometric Mean ◽

Neutralizing Antibody ◽

Diagnostic Techniques ◽

International Standards ◽

World Health ◽

Serum Samples ◽

Antibody Titers ◽

Health Organization

The World Health Organization (WHO) has highlighted the importance of an international standard (IS) for SARS-CoV-2 neutralizing antibody titer detection, with the aim of calibrating different diagnostic techniques. In this study, IS was applied to calibrate neutralizing antibody titers (IU/mL) and binding antibody titers (BAU/mL) in response to SARS-CoV-2 vaccines. Serum samples were collected from participants receiving the Moderna (n = 20) and Pfizer (n = 20) vaccines at three time points: pre-vaccination, after one dose, and after two doses. We obtained geometric mean titers of 1404.16 and 928.75 IU/mL for neutralizing antibodies after two doses of the Moderna and Pfizer vaccines, respectively. These values provide an important baseline for vaccine development and the implementation of non-inferiority trials. We also compared three commercially available kits from Roche, Abbott, and MeDiPro for the detection of COVID-19 antibodies based on binding affinity to S1 and/or RBD. Our results demonstrated that antibody titers measured by commercial assays are highly correlated with neutralizing antibody titers calibrated by IS.

Download Full-text