title: A new manufacturing process to remove thrombogenic factors (II, VII, IX, X, and XI) from intravenous immunoglobulin gamma preparations.
abstract: Coagulation factors (II, VII, IX, X, and particularly XIa) remaining in high concentrations in intravenous immunoglobulin (IVIG) preparations can form thrombi, causing thromboembolic events, and in serious cases, result in death. Therefore, manufacturers of biological products must investigate the ability of their production processes to remove procoagulant activities. Previously, we were able to remove coagulation factors II, VII, IX, and X from our IVIG preparation through ethanol precipitation, but factor XIa, which plays an important role in thrombosis, remained in the intermediate products. Here, we used a chromatographic process using a new resin that binds with high capacity to IgG and removes procoagulant activities. The procoagulant activities were reduced to low levels as determined by the thrombin generation assay: <1.56 mIU/mL, chromogenic FXIa assay: <0.16 mIU/mL, non-activated partial thromboplastin time (NaPTT): >250 s, FXI/FXIa ELISA: <0.31 ng/mL. Even after spiking with FXIa at a concentration 32.5 times higher than the concentration in normal specimens, the procoagulant activities were below the detection limit (<0.31 ng/mL). These results demonstrate the ability of our manufacturing process to remove procoagulant activities to below the detection limit (except by NaPTT), suggesting a reduced risk of thromboembolic events that maybe potentially caused by our IVIG preparation.
authors.affiliation: Green Cross Corp., Ihyeon-ro 30 beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea.
authors.forename: Dong Hwarn
authors.initials: DH
authors.lastname: Park
authors.affiliation: Green Cross Corp., Ihyeon-ro 30 beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea.
authors.forename: Gil Bu
authors.initials: GB
authors.lastname: Kang
authors.affiliation: Green Cross Corp., Ihyeon-ro 30 beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea.
authors.forename: Dae Eun
authors.initials: DE
authors.lastname: Kang
authors.affiliation: Green Cross Corp., Ihyeon-ro 30 beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea.
authors.forename: Jeung Woon
authors.initials: JW
authors.lastname: Hong
authors.affiliation: Research Center for Epigenome Regulation, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea.
authors.forename: Min Gyu
authors.initials: MG
authors.lastname: Lee
authors.affiliation: Green Cross Corp., Ihyeon-ro 30 beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea. Electronic address: kimky@greencross.com.
authors.forename: Ki Yong
authors.initials: KY
authors.lastname: Kim
authors.affiliation: Research Center for Epigenome Regulation, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea. Electronic address: jhhan551@skku.edu.
authors.forename: Jeung Whan
authors.initials: JW
authors.lastname: Han
mesh_terms: D001779:Blood Coagulation Factors / Q000737:chemistry*; D006801:Humans; D007074:Immunoglobulin G / Q000737:chemistry* / Q000302:isolation & purification*; D016756:Immunoglobulins, Intravenous / Q000737:chemistry* / Q000302:isolation & purification*; D013923:Thromboembolism / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D001779:Blood Coagulation Factors; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous
keywords: Coagulation factor XIa; Intravenous immunoglobulin G; Procoagulant activity; Thromboembolic events