Formulations and methods for contemporaneous stabilization of active proteins during spray drying and storage

Information

  • Patent Grant
  • 11806431
  • Patent Number
    11,806,431
  • Date Filed
    Wednesday, June 2, 2021
    3 years ago
  • Date Issued
    Tuesday, November 7, 2023
    a year ago
Abstract
A method of treatment of plasma with a physiologically compatible spray dry stable acidic substance (SDSAS) prior to or contemporaneously with spray drying of the plasma that results in greater recovery and greater long-term stabilization of the dried plasma proteins as compared to spray dried plasma that has not be subject to the formulation method of the present invention, as well as compositions related to plasma dried by the methods of the present invention.
Description
BACKGROUND

Making up about 55% of the total volume of whole blood, blood plasma is a whole blood component in which blood cells and other constituents of whole blood are suspended. Blood plasma further contains a mixture of over 700 proteins and additional substances that perform functions necessary for bodily health, including clotting, protein storage, and electrolytic balance, amongst others. When extracted from whole blood, blood plasma may be employed to replace bodily fluids, antibodies and clotting factors. Accordingly, blood plasma is extensively used in medical treatments.


To facilitate storage and transportation of blood plasma until use, plasma is typically preserved by freezing soon after its collection from a donor. Fresh-Frozen Plasma (FFP) is obtained through a series of steps involving centrifugation of whole blood to separate plasma and then freezing the collected plasma within less than 8 hours of collecting the whole blood. In the United States, the American Association of Blood Banks (AABB) standard for storing FFP is up to 12 months from collection when stored at a temperature of −18° C. or below. FFP may also be stored for up to 7 years from collection if maintained at a temperature of −65° C. or below. In Europe, FFP has a shelf life of only 3 months if stored at temperatures between −18° C. to −25° C., and for up to 36 months if stored at colder than −25° C. If thawed, European standards dictate that the plasma must be transfused immediately or stored at 1° C. to 6° C. and transfused within 24 hours. If stored longer than 24 hours, the plasma must be relabeled for other uses or discarded.


Notably, however, FFP must be kept in a temperature-controlled environment of −18° C. or colder throughout its duration of storage to prevent degradation of certain plasma proteins and maintain its efficacy, which adds to the cost and difficulty of storage and transport. Furthermore, FFP must be thawed prior to use, resulting in a delay of 30-80 minutes before it may be used after removal from cold storage.


Accordingly, there is a need to develop alternative techniques for the processing and storage of plasma.


SUMMARY

A long-standing need and challenge to the blood industry has been to provide safe, reliable and convenient blood products while preserving the efficacy and safety of those products in storage and when used in transfusion or as a source for medical treatments. The present invention provides efficacy preservation and includes the preservation of the clotting factors in the plasma in a manner that does not otherwise harm the plasma or the transfused patient. During spray drying, some blood plasma proteins degrade to some extent, due to shear stress, surface stress (e.g., air-liquid interfacial stress), exposure to extreme pH, thermal stress, dehydration stress, and other environmental stresses.


The methods and compositions of the present invention recognize that pH and associated stresses can be reduced or the effects of which can be ameliorated by the use of novel formulations of the liquid plasma prior to or contemporaneously with spray drying. Formulation of the liquid plasma by citric acid or a similar spray dry stable acidic substance (SDSAS), at novel concentrations, maintains the pH of the plasma at a non-alkaline level during the spray drying process. This results in higher recovery and better subsequent storage stability of active plasma proteins when compared to unformulated plasma. FIGS. 4 A-C show how the SDSAS of the present invention may be added (formulated) contemporaneously with the plasma in the spray drying process.


The term “recovery” is defined herein as referring to the percentage of an analyte preserved after spray drying compared with the analyte in a sample of the same native plasma (the same sample before spray drying); the analyte is analyzed on native plasma and rehydrated plasma at the same protein concentrations. The analyte can be any known plasma substance such as a protein (e.g., vWF antigen or fibrinogen) and can be measured by concentration or activity of the analyte (e.g., vWF:RCo activity).


A spray dry stable acidic substance (SDSAS) as used herein is any substance such as an acid or acidic salt or other substance that effectuates pH and is physiologically suitable for addition to the plasma being spray dried and physiologically suitable to the subjects (human or otherwise) to which the reconstituted plasma is to be administered (transfused). The SDSAS remains sufficiently stable (e.g., does not materially evaporate or chemically breakdown) during the spray drying process. The SDSAS effectuates the pH adjustment described herein which results, for example, in improved von Willebrand's factor recovery in the reconstituted plasma described herein. Specific examples known to the inventors of spray dry stable acidic substances include citric acid, lactic acid, monosodium citrate, glycine HCL and other SDSAS's described herein. Other SDSAS's may be known in the art or may be determinable by straightforward experimentation.


Accordingly, spray drying formulation, i.e., treatment of feed plasma prior to or contemporaneously with spray drying, preserves and allows recovery of active clotting factors of rehydrated plasma that has undergone the spray drying process as well as long term stability during storage after drying. As further discussed below, these improvements to certain embodiments of spray drying of blood plasma involving formulation with a SDSAS, also improve the ease and lower the cost of rehydration of the plasma product by allowing the spray dried plasma to be rehydrated with sterile water (e.g., water for injection: WFI).


The present invention contemplates a method of producing spray dried plasma with improved recovery of active plasma proteins and long term stability of plasma proteins. In an embodiment, the method provides for plasma to be dried, the plasma may be selected from citrate phosphate dextrose solution (CPD) plasma or whole blood (WB) plasma. The method further provides for a SDSAS and a spray drying system. The invention further contemplates adjusting the pH of the CPD plasma or WB plasma with the SDSAS by bringing the concentration of the acidic compound to about 0.001 to about 0.050 mmol/mL, which lowers the pH of the plasma to about 5.5 to about 6.5 or to about 7.2 to create formulated plasma.


The present invention further contemplates drying the formulated plasma with the spray drying system to create spray dried formulated plasma, said spray dried formulated plasma having a recovery of active von Willebrand factor (vWF) at least 10 to at least 20 percentage points greater than the recovery of active von Willebrand factor obtained from an otherwise identical spray dried plasma that has not undergone acid formulation with an SDSAS. The SDSAS may be selected from any known in the art, however, citric acid and lactic acid are preferred substances for use in the present invention. The physiologically compatible SDSAS is added to the plasma before spray drying and preferable shortly before spray drying or contemporaneously with spray drying. Additionally, the pH of the plasma may be determined before the addition of a SDSAS to the plasma to determine an appropriate amount of acid to add. In an embodiment, about 7.4 mM of citric acid is added to the CPD plasma or WB plasma. In an embodiment, the pH of the formulated plasma is about 5.5 to about 6.5 or to about 7.2. The present invention further contemplates that the recovery of vWF may be from about 10 to about 20 percentage points to about 40 percentage points greater than the recovery of active von Willebrand factor obtained from an otherwise identical spray dried plasma that has not undergone pretreatment with a SDSAS or about 25 percentage points to about 35 percentage points greater than the recovery of active von Willebrand factor obtained from an otherwise identical spray dried plasma that has not undergone pretreatment with a SDSAS.


The present invention contemplates reconstituting the spray dried formulated plasma of the present invention. The spray dried formulated plasma of the present invention may be reconstituted with any physiologically compatible solution. Further, the spray dried formulated plasma of the present invention may be reconstituted with sterile water (e.g., water for injection (WFI) or similar) or clean, non-sterile water and, if desired, filtered after reconstitution. It is contemplated that the reconstituted spray dried formulated plasma of the present invention has a pH of about 6.8 to about 7.8, or about 6.9 to about 7.5.


In an embodiment, a subject in need of plasma is selected and the reconstituted plasma of the present invention is administered to the subject in need of plasma. Said administration is intravenous.


In an embodiment, it is contemplated that the spray dried formulated plasma is substantially more stable when stored under refrigeration, at ambient temperature or higher temperature, e.g., 37° C., e.g., for two weeks (see, FIGS. 8 and 9) before reconstitution than the spray dried plasma produced from unformulated liquid plasma. It is further contemplated that the stability of the spray dried treated plasma is determined by measuring the activity of von Willebrand factor and/or other plasma proteins.


The present invention contemplates a reconstituted spray dried plasma product for human transfusion (administration), the reconstituted spray dried plasma product having been reconstituted with, for example, sterile water and the reconstituted spray dried plasma product having a pH of about 6.8 to about 7.6 or about 6.9 to 7.5 and comprising active von Willebrand factor of greater thin 5 percentage points as compared to the recovery of active von Willebrand factor obtained from an otherwise identical spray dried plasma that has not undergone formulation with a SDSAS; or about 5 percentage points to about 40 percentage points greater than the recovery of active von Willebrand factor obtained from an otherwise identical spray dried plasma that has not undergone pretreatment with a SDSAS. The present invention further contemplates that the active von Willebrand factor is of about 25 percentage points to about 35 percentage points greater than the recovery of active von Willebrand factor obtained from an otherwise identical spray dried plasma that has not undergone formulation with a non-volatile, physiologically compatible acid.





BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, features and advantages will be apparent from the following more particular description of the embodiments, as illustrated in the accompanying drawings in which like reference characters refer to the same parts throughout the different views. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the embodiments.



FIG. 1A is a schematic illustration of an embodiment of a spray dryer system of the present disclosure, including a spray dryer device 102 and a spray dryer assembly.



FIG. 1B is a schematic illustration of a plurality of the spray dryer systems of FIG. 1A for use with a pooled liquid source.



FIGS. 2A and 2B are schematic illustrations of the spray dryer assembly of FIG. 1A.



FIG. 3 is a schematic illustration detailing embodiments of a collection chamber of the spray dryer assembly of FIGS. 2A-2B,



FIG. 4 (A-C) are A) a schematic diagram of spray drying system and possible stress experienced by protein solution and droplet during spray drying. A) Also shows how contemporaneous dosing may be performed by feeding the SDSAS into the plasma prior to feeding the plasma into the spray dryer. B) Also shows how contemporaneous dosing may be performed by feeding the SDSAS into the feeding line after the plasma but before the spray dryer. C) Also shows how contemporaneous dosing may be performed by feeding both the plasma and the SDSAS into the spray head simultaneously,



FIG. 5 panels A-C are schematic illustrations depicting unfolding/refolding model of the vWF A2 domain and protelolysis by ADAMTS13. (A) Cartoon of the vWF A2 domain in its native folded state. (B) The first step of unfolding occurs from the C-terminal end of the vWF A2 domain, influenced by the presence of the vicinal disulphide bond (cysteines depicted by C). Initial unfolding occurs up to, or including, the central b4 sheet in which the scissile bond (YM) is contained. This unfolding intermediate step exposes the high-affinity ADAMTS13 spacer-binding site. (C) Once the stabilizing effect of the calcium-binding sit (CBS) is overcome this results in the complete unfolding of the vWF A2 domain and the positioning of the ADAMTS13 active site for nucleophilic attack of the Y105-M1606 scissile bond



FIG. 6 is a bar graph showing that formulation of plasma with citric acid stabilizes during spray drying ˜50% von Willebrand Factor:Ristocetin Cofactor (vWF:RCo) activity without any impact of other coagulation factors. This is done at time zero, time upon completion of spray drying. CP indicates Control Plasma; SpDP Indicated Spray-Dried Plasma; PreT indicates plasma formulation with SDSAS.



FIG. 7 is a bar graph showing that formulation of plasma with citric acid confers stability to vWF and all other coagulation factors during storage at 4° C.



FIG. 8 is a bar graph showing that pre-treatment of plasma with citric acid confers stability to vWF and all other coagulation factors during storage at 25° C.



FIG. 9 is a bar graph showing that formulation of plasma with citric acid confers stability to coagulation factors during storage at 37° C.



FIG. 10 is a photographic image showing that formulation of plasma with citric acid stabilizes vWF during SpD (spray drying).



FIG. 11A is a line graph showing the results activity (IU/dL) of vWF:RCo activity for CP/FFP and Fed Plasma under constant plasma feeding rate of 10 mL/min, but variable aerosol gas flow rates (0, 5, 10, 15, and 20 L/min).



FIG. 11B is a line graph showing pH for CP/FFP and the fed plasma under constant plasma feeding rate of 10 mL/min, but variable aerosol gas flow rates (0, 5, 10, 15, and 20 L/min).



FIG. 12A is a line graph showing the results activity (IU/dL) of vWF:RCo for CP/FFP and Fed Plasma at Aerosol gas flow rates of 10 mL/min; fluid=2 mL/min, 10 mL/min; fluid=4 ml/min, 10 mL/min; fluid=6 ml/min, 10 mL/min; fluid=8 ml/min, and 10 mL/min; fluid a 10 ml/min.



FIG. 12B is a bar graph showing pH for CP/FFP and Fed Plasma at Aerosol gas flow rates of 10 mL/min; fluid=2 ml/min. 10 mL/min; fluid=4 m/min. 10 mL/min; fluid=6 ml/min, 10 mL/min; fluid=8 ml/min, and 10 mL/min; fluid 10 ml/min.



FIG. 13 is a bar graph showing the effect of different SDSAS-formulations on the vW:RCo recovery and pH during spray. The pH levels prior to and post spray were shown on the top of the bar graph.



FIG. 14A-C are bar graphs showing the effect of different SDSAS-formulations on the vWF:RCo recovery and pH during spray drying. (A) citric acid, (B) lactic acid, and (C) pH. The pH levels prior to and post spray were shown on the top of the bar graph.





DETAILED DESCRIPTION

Embodiments of the present disclosure are directed to methods and compositions relating to a spray dried liquid sample. In certain embodiments, the liquid sample is plasma obtained from a blood donor. In a preferred embodiment, the blood donor is human. However, it may be understood that the disclosed embodiments may be employed to spray dry any biological mixture of solid particles and/or molecules in a continuous liquid medium, including, but not limited to, colloids, suspensions and sols (a colloidal suspension of very small particles).


Plasma


Plasma is the fluid that remains after blood has been centrifuged (for example) to remove cellular materials such as red blood cells, white blood cells and platelets. Plasma is generally yellow-colored and clear to opaque. It contains the dissolved constituents of the blood such as proteins (6-8%; e.g., serum albumins, globulins, fibrinogen, etc.), glucose, clotting factors (clotting proteins), electrolytes (Na+, Ca2+, Mg2+, HCOs, Cl, etc.), hormones, etc, Whole blood (WB) plasma is plasma isolated from whole blood with no added agents except anticoagulant(s). Citrate phosphate dextrose (CPO) plasma, as the name indicates, contains citrate, sodium phosphate and a sugar, usually dextrose, which are added as anticoagulants. The level of citrate in CPO plasma, derived from whole blood, is about 20-30 mM. Thus, the final citrate concentration in the whole blood derived CPD plasma formulated with 7.4 mM citric acid will be about 27.4-37.4 mM.


The plasma of the present invention may be dried after pooling or unit-by-unit. Pooling of multiple plasma units has some benefits. For example, any shortfall in factor recovery on an equal-volume basis can be made up by adding volume from the pool to the finished product. There are negative features as well. Making up volume from the pool to improve factor recovery is expensive. Importantly, pooled plasma must be constantly tested for pathogens as any pathogens entering the pool from, for example, a single donor, runs the risk of harming hundreds or thousands of patients if not detected. Even if detected, pathogen contamination of pooled plasma would render the whole pool valueless. Testing can be obviated by pathogen inactivation of the plasma by irradiation or chemically such as solvent detergent treatment; however, each such treatment adds cost and complexity to pooled plasma processing. In any event, pooled plasma processing is generally unsuitable to the blood centers and generally only really suitable to an industrial, mass production environment.


Conversely, unit-by-unit (unit) collection and processing is well-suited to the blood center environment and eliminates the risk of pooled plasma pathogen contamination by allowing for pre-processing testing for pathogens and tracking of the unit to ensure that each unit leaves the blood center site pathogen free. The inventors have discovered that efficient and effective preservation and recovery of clotting factors is the standard by which successful unit blood plasma processing should be measured. Such efficiency is also very helpful in the pooled plasma environment as well.


Clotting Factors


There are many blood plasma factors associated with clotting. The methods and compositions of the present invention include recovering amounts of active/undenatured fibrinogen, Factor V, Factor VII, Factor IX and vWF from rehydrated plasma that has undergone the spray drying process. Such blood plasma factors are important in patient treatment especially after trauma injuries to promote clotting of wounds. Thus, rapid administration of plasma is an important factor contributing to positive clinical outcomes. The spray dried plasma of the present invention can be readily reconstituted in a few minutes at the location of the trauma event without moving the patient and without time delay. Further, the spray dried plasma of the present invention has high levels of functional proteins that are stable for extended periods of time without refrigeration or freezing.


vWF has generally been difficult to recover and has become one indicator for preservation of all factors. The present invention includes recovering amounts of active/undenatured vWF, in an amount in rehydrated spray dried plasma that is at least about 5 percentage points or greater (e.g., about 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 60 or greater percentage points) as compared to amounts of active/undenatured vWF of rehydrated spray dried plasma that do not undergo the pre-treatment steps of the present invention. The present invention includes recovering amounts of active/undenatured vWF, in an amount in rehydrated spray dried plasma that is at about 5 percentage points to about 40 percentage points or about 10 percentage points to about 35 percentage points higher as compared to amounts of active/undenatured vWF of rehydrated spray dried plasma that do not undergo the formulation steps of the present invention. vWF activity is typically assayed with an assay called the von Willebrand factor:Ristocetin cofactor [vWF:RCo] assay, as is known to those of skill in the art. The vWF:RCo assay measures the ability of a patient's plasma to agglutinate platelets in the presence of the antibiotic Ristocetin. The rate of Ristocetin induced agglutination is related to the concentration and functional activity of the plasma von Willebrand factor. Another assay, the vWF antigen assay, measures the amount of vWF protein present in a sample.


Spray Dry Stable Acidic Substance (SDSAS)


The present invention contemplates the use of a physiologically compatible spray dry stable acidic substance (SDSAS) as a formulation agent for plasma prior to being spray dried.


While the present invention is not limited by theory. It is presumed by the inventors that the SDSAS of the present invention (e.g., citric acid, lactic acid, etc.) exerts its effects because it prevents or alleviates the rising of the pH of the plasma during the spray drying process. Non-limiting examples of suitable acids are citric acid and lactic acid. Other non-limiting examples of suitable acids are ascorbic acid, gluconic acid and glycine hydrochloride (glycine HCl). Because CO2 is lost from plasma during spray drying, the reaction generating bicarbonate and H+ from CO2 and H2O is shifted away from H+, thereby increasing the pH (i.e., Chatelier's principle). Citric acid addition (or other SDSAS of the present invention) helps offset this change. Therefore, the plasma is formulated with the SDSAS of the present invention. Because of the formulation step, vWF activity loss is reduced and/or the amount of undenatured vWF is increased, as compared to spray dried plasma not subjected to the formulations steps of the present invention.


Because the physiologically compatible SDSAS of the present invention is included in this manner, the inventors further found out that the rehydration step can be performed by water alone (e.g., WFI). Alternatively, sodium phosphate or other agents can optionally be added to the rehydration solution. Further, any other suitable rehydration fluid as can be determined by one of ordinary skill in the art may be used.


From experiments conducted by the inventors with spray drying, it has been discovered that the von Willebrand factor activity level in plasma dried by spray drying is affected, in part, by the shear forces generated during the aerosolization process (see, Examples, below) and an increase in the pH of the plasma. The present invention shows that the utilization of a step wherein the plasma is formulated with a SDSAS greatly improves the recovery and stability of active vWF over conditions wherein the SDSAS is not used as a formulation agent.


A SDSAS is a substance which does not evaporate easily at room temperature at atmospheric pressure. Typically, the boiling point of the SDSAS will be greater than about 150° C. at atmospheric pressure. Non-volatile acids that are suitable of use as the SDSAS of the present invention include phosphorus-containing acids such as, for example, ortho-phosphoric acid, pyrophosphoric acid, meta-phosphoric acid, poly phosphoric acid, alkyl- and aryl-substituted phosphonic and phosphinic acids, phosphorous acid, and the hike, and mixtures thereof. Other non-volatile acids suitable for use as the SDSAS of the present invention include, but are not limited to, ascorbic acid, citric acid, lactic acid, gluconic acid, oxalic acid, halogenated acetic adds, arene sulfonic acids, molybdic acid, phosphotungstic acid, tungstic acid, chromic acid, sulfamic acid, and the like.


SDSAS useful in the process of the invention are capable of replacing the volatile acid, i.e. CO2 that escapes from the plasma during spray drying. As indicated above, examples or suitable acids include, but are not limited to, ascorbic acid, citric acid, gluconic acid, and lactic acid.


A volatile acid as defined herein has a kPa less than about 3 and a boiling point less than about 150° C. at atmospheric pressure. Typically, the pKa of the volatile acid is within the range of about 1 to about 15. Non-limiting examples of volatile acids are hydrogen chloride, hydrogen bromide, hydrogen iodide, hydrogen fluoride, acetic acid, formic acid, hydrogen sulfide, hydrogen selenide, sulfur dioxide, fluorosulfonic acid, methane sulfonic acid, trifluoroacetic acid, trifluoromethanesulfonic acid, and the like.


A volatile strong acid can be fixed with an amino acid or like to render it non-volatile, making it easier to use. For example, volatile hydrogen chloride can be converted to glycine hydrogen chloride (glycine HCl, glycine hydrochloride). Similarly, a corrosive strong acid can be converted to an acidic salt for use in pretreating plasma prior to spray-drying. Examples include NaHSO4 and NaH2PO4: namely the acidic salts of sulfuric acid.


Non-volatile acids and acidic salts are collectively defined as and included as spray dry stable acidic substance (SDSAS's) in this invention.


in an embodiment, the SDSAS of the present invention is added to the plasma within about 30 minutes, about 20 minutes, about 15 minutes, about 10 minutes, about 5 minutes, about 1 minute or time zero (0 minutes) of spray drying the plasma. In an embodiment, the SDSAS of the present invention is added contemporaneously to the plasma as the plasma is being pumped into the spray drying apparatus. The term “contemporaneously” shall be defined herein as meaning within about 60 seconds, about 50 seconds, about 40 seconds, about 30 seconds, about 20 seconds, about 10 seconds, about 5 seconds, about 1 second and about 0 seconds.


The present inventions relate to adding SDSAS to blood plasma to be spray dried in a time period prior to spray drying short enough to obtain a formulation with the desired pH (“plasma formulation”) and to prevent denaturing or damage of certain plasma protein(s) such as von Willebrand's factor due to prolonged exposure to the low pH condition. Keeping the time delay to 30 minutes or less between formulation of the plasma with SDSAS and spray drying, as described below, results in improved recovery of plasma proteins, including von Willebrand factor, without undesirable protein damage due to prolonged exposure to the low pH condition prior to spray drying.


The time period between acid formulation and spray drying will depend on the pH/acidity of the plasma formulation created by the mixing of the SDSAS and the plasma. In an embodiment, the time period between contacting the SDSAS with the blood plasma and spray drying the plasma is in a range between about 0 seconds (e.g., at the time aeroslization occurs: time 0) and about 30 minutes. To minimize protein denaturing, the time between acid formulation of the plasma and spray drying should be kept to minimum. The actual maximum time between formulation and spray drying is determined empirically. This close-in-time formulation at time 0 is referred to herein as “contemporaneous formulation.”


There are a number of methods by which contemporaneous formulation may be carried out. As illustrated in FIG. 4A, in one embodiment a formulation station is provided in association with the spray dryer. In conjunction with the formulation station, the weight or volume of the pre-spray dried plasma is determined and an SDSAS dose measured to obtain the desired pH of the plasma formulation. The SDSAS dose may be introduced into the plasma by any convenient method including by injection through a port on the plasma bag. A formulation station may be manually, semi-automatically or automatically operated. Naturally, the timing of the dosing must be controlled carefully as described above. Timing control may be manual, semi-automatic or automatic.


In another embodiment as shown in FIG. 4B, an appropriate dose of SDSAS is introduced into the plasma flow channel of the spray dryer prior to the spray drying head. SDSAS introduction is controlled manually, semi-automatically or automatically to result in the desired plasma formulation.


In a further embodiment shown in FIG. 4C, an appropriate dose of SDSAS is introduced into the spray drying chamber sufficiently close to the spray drying nozzle so that the SDSAS and plasma are mixed together to form a plasma formulation before spray drying occurs in the spray drying chamber connected to the spray drying head. SDSAS introduction is controlled manually, semi-automatically or automatically to result in the desired plasma formulation.


Protein Stability


Proteins potentially undergo physical degradation (e.g., unfolding, aggregation, insoluble particulate formation) by a number of mechanisms. Many proteins are structurally unstable in solution and are susceptible to conformational changes due to various stresses encountered during purification, processing and storage. These stresses include temperature shift, exposure to pH changes and extreme pH, shear stress, surface adsorption/interface stress, and so on. Proteins in solutions can be converted to solid formats (i.e., converted to a powder or other dry format by having the water and other volatile components of the protein solution greatly reduced or removed) for improved storage using a number of methods.


Freeze drying (also known as lyophilization) is the most common processing method for removing moisture from biopharmaceuticals, and can increase the stability, temperature tolerance, and shelf life of these products. It is a process wherein a suspension, colloid or solid is frozen and then “dried” under a vacuum by sublimation (phase transition). In this process, proteins can suffer from cold denaturation, interface stress [adsorption at the water/ice-interface], exposure to increasing alkaline pH (CO2 loss), and dehydration stress. Freeze drying is well established within the industry. However, it requires expensive equipment that takes up a great deal of space within a production facility. Freeze drying also can take days to complete, and manufacturers that need a powdered product must incorporate a granulation step to the process. In an environment where budgets are tightening, and where time and facility space are at a premium, freeze drying might be a difficult option for some companies. Because of the space needed, drying plasma by freeze-drying technology is limited to plasma manufacturers, and cannot be implemented in blood centers.


Because of the difficulties inherent with freeze drying of plasma with regard to time, space and cost, the present invention is directed towards an improved spray drying process for plasma that overcomes the known difficulties related to the spray drying of plasma.


In the spray-drying process, the viscous liquid is pumped through the feeding line to the nozzle, where the exiting fluid stream is shattered into numerous droplets under aerosol gas. The liquid droplets are met with dry gas and turned into dry particles. It is a much shorter and less expensive process than the freeze drying process, allowing it to be implemented in research labs and blood centers. However, in this process, plasma proteins can suffer from extensive shear stress, interface stress, thermal stress, dehydration stress and exposure to extreme pH (see, FIG. 4A).


Aerosolization exposes the liquid sample to shear stress and produces an extremely rapid and very large expansion of the air-liquid interface. The syngerstic effects of shear stress and air-liquid interfacial stress can cause severe detrimental effects on labile compounds such as proteins. Complex biological molecules are difficult to spray dry because they are very sensitive to high shear stress. Although some control relating to the amount of shear stress encountered can be obtained by, for example, choice of the type of atomizer used and the aerosolization pressure used, it is very challenging to apply spray drying technology to human plasma because it contains so many diverse proteins. The diverse proteins may be susceptible to different stresses and this can make it difficult determine processing conditions suitable for all of the types of proteins found in plasma. In particular, vWF, which is designed by nature to be shear sensitive for its biological functions, is the most shear-force sensitive human plasma protein. Most of the other plasma proteins remain largely intact after spray drying except vWF. As shown in the Examples section, spray-drying diminished vWF activity to below the level of detection (see, Example 1, FIG. 8).


Ionizable amino acid residues have been shown to play important roles in the binding of proteins to other molecules and in enzyme mechanisms. They also have a large influence on protein structure, stability and solubility. The types of interactions these side chains will have with their environment depend on their protonation state. Because of this, their pKa values and the factors that influence them are a subject of intense biochemical interest. Strongly altered pKa values are often seen in the active sites of enzymes, to enhance the ability of ionizable residues to act as nucleophiles, electrophiles or general bases and acids. As a consequence of the change in protonation of these residues, the stability of proteins is pH-dependent. Therefore, we rationalized that inhibition of the akalination of plasma during spray drying can potentially improve the processing and storage stabilities of many plasma proteins.


U.S. Pat. No. 8,518,452 (the '452 patent) to Bjornstrup, et al., teaches the use of citric acid as a pretreatment for lyophilized plasma.


As mentioned above, the spray drying process subjects plasma proteins to different forces than are found in the lyophilization process. First, spray drying exposes plasma proteins to high stress forces during the aerolization process as the plasma is forced through the narrow orifice exposed to high rate of air flow that is necessary to create suitably sized droplets for drying. Second, the spray drying process exposes plasma proteins to high temperatures that are necessary to force the water from the aerosolized droplets. Third, the spray drying process subjects the plasma proteins to dramatic and rapid increases in pH as a result of the rapid release of CO2 during drying. Since lyophilization does not subject plasma proteins to these forces, and especially to this unique combination of forces, one of ordinary skill in the art would not look to nor find suggestion or motivation in the lyophilization art with regard to improving the spray drying process for plasma.


Indeed, U.S. Pat. No. 7,931,919 (the '919 patent) to Bakaltcheva, et al. teaches the use of 2 mM citric acid in lyophilized plasma. However, citric acid merely acted as a pH adjuster, did not provide any benefits for improving quality of product during acquirement or storage.


The present invention provides for the high recovery rate of vWF and for storage stability of active plasma proteins; a goal that has eluded those of skill in the art of drying plasma. In fact, the '462 patent discussed above provides no teaching of either recovery or long term stability of active plasma protein function with regard to the disclosed lyophilization process. Further, any specific teaching with regard to the recovery and stability of vWF is missing from the '452 patent. vWF has been notoriously difficult to recover after the drying of plasma. This lack of teaching in the '452 patent is likely indicative of the failure of the methods disclosed in the '452 patent with regard to successfully recovering active vWF.


U.S. Pat. No. 7,297,718 (the '716 patent) to Shanbrom teaches the use of 2% by weight of citric acid and its salts to reduce bacterial growth and adjust/maintain pH in cryoprecipitates of blood and plasma for enhancing their purity and safety. The '716 patent, like the '452 patent provides no teaching of recovered plasma protein activity and stability. While the '716 patent mentions that citrate appears to stabilize labile proteins against heat denaturation, it provides no support for the statement and provides no teaching with regard to actual recovered protein activity or long term stability of recovered proteins, especially vWF.


Thus, the present inventors, in spite of the difficulties associated with the spray drying of plasma as known to those of skill in the art, have achieved a spray drying process for plasma that results in high recovery and high stability of plasma proteins, especially, but not limited to vWF, wherein the recovery of vWF is in an amount in rehydrated spray dried plasma that is at least about 5 percentage points or greater (e.g., about 5, 10, 20, 30, 40, 50, 60, 70, 80 percentage points or greater) as compared to amounts of active/undenatured vWF of rehydrated spray dried plasma that does not undergo the pretreatment steps of the present invention.


The compositions and steps of the present invention relate to the impact of the formulation of liquid plasma with a SDSAS, for example, citric acid (CA) on the recovery from the spray drying process and stability (during storage of dried and rehydrated plasma after spray drying) of vWF and other coagulation factors. This can be done by adding a SDSAS such as, for example, citric acid or lactic acid to the liquid plasma before spray drying begins or contemporaneously with the spray drying process. During the spray drying process, CO2 loss occurs which causes the pH of the plasma composition to become more alkaline (e.g., to increase) and adding SDSAS thereby maintains the plasma pH in a range to prevent significant denaturing of the dotting factors, esp. vWF. Thus, the pretreatment of plasma with citric acid, or other SDSAS, serves at least three main purposes: 1) increases in-process recovery of plasma proteins; 2) increases stability of plasma proteins during storage; and 3) allows spray dried plasma to be rehydrated with water (e.g., sterile water, WFI), eliminating the need for a specific rehydration solution.


When liquid plasma is formulated with SDSAS before it is dried, the acid resides in the dried plasma product at a level consistent to improved storage lifetime and reduced degradation of dotting factors during storage. A “level consistent to improve storage lifetime” also means, herein, at a level that results in a physiological pH upon reconstitution of the spray dried plasma. The use of the SDSAS also permits simple rehydration by low cost, readily available water for injection or, in an emergency, plain water at a physiological pH. The convenience, lowered cost and improved safety associated with direct rehydration by water is evident. Advantages include savings in being able to ship dried plasma product without the weight and bulk of rehydration fluid and savings in the cost from not having to specially formulate rehydration fluid and reduction or elimination of refrigeration or freezing during storage.


Thus, the inventors have discovered that plasma formulation by a SDSAS results in spray dried plasma that has very high recovery of plasma proteins, especially vWF, highly improved storage properties of the dried plasma and approximately neutral pH when rehydrated with water without a buffering rehydration fluid. Thus, the present invention permits spray dried plasma to be manufactured without the additional expense and complexity of pretreatment with additional stabilizers such as polyols and others known in the art. However, the use of stabilizers is not contraindicated and may be beneficial in some instances.


In a further embodiment, a new composition of matter for blood plasma spray drying is created by dosing by any means the blood plasma prior to spray drying with added citrate (i.e., citric acid) or other suitable SDSAS at an appropriate concentration, as disclosed herein.


In a further embodiment the newly dosed citrate formulated blood plasma before spray drying has a concentration of citrate of about 27.5 mM and about 40.4 mM, or of about 31.6 mM and 34.2 mM.


In a further embodiment a new spray dried blood plasma product is created by spray drying blood plasma formulated with an appropriate level of a suitable SDSAS (e.g., citric acid) prior to or contemporaneously with drying and then drying the blood plasma to the desired level of moisture. The desired level of moisture is generally between 2%-10%, 3%-8% and 4%-6%


In various embodiments, citric acid or other SDSAS is added to the plasma as a formulation. Experiments relating to the effect of citric acid or other SDSAS on protection of the activities of proteins found in plasma are explained further in the exemplification section of this specification. The concentrations at which citric acid, for example, is used are between about 1 to about 15 mM, or between about 5 mM to about 10 mM (e.g., 7.4 mM). Accordingly, plasma proteins can be preserved better when citric acid, at the indicated concentrations, is added to it prior to or contemporaneously with spray drying. The activity of vWF is provided in the exemplification because this factor is especially sensitive to denaturing and damage by spray drying (See, FIG. 6 and FIG. 7) and, thus, is a good indicator protein to show the beneficial effects of citric acid or other SDSAS with regard to recovery and stability of the spray dried plasma proteins. Examples of other physiologically compatible SDSAS are known to those of ordinary skid in the art and described herein.


Spray Dryer and the Spray Drying Process


In general, a spray dryer system (spray dryer device) is provided for spray drying a liquid sample such as blood plasma. In an embodiment, the spray dryer system of the present disclosure includes a spray dryer device and a spray dryer assembly. The spray dryer device is adapted, in an aspect, to receive flows of an aerosolizing gas, a drying gas, and plasma liquid from respective sources and coupled with the spray dryer assembly. The spray dryer device may further transmit the received aerosolizing gas, drying gas, and plasma to the spray dryer assembly. Spray drying of the plasma is performed in the spray dryer assembly under the control of the spray dryer device. Any suitable spray drying system may be used in the present invention. For exemplification, a suitable spray dryer s described below.


In certain embodiments, the spray dryer assembly includes a sterile, hermetically sealed enclosure body and a frame to which the enclosure body is attached. The frame defines first second, and third portions of the assembly, separated by respective transition zones. A drying gas inlet provided within the first portion of the assembly, adjacent to a first end of the enclosure body.


A spray drying head is further attached to the frame within the transition zone between the first and second portions of the assembly. This position also lies within the incipient flow path of the drying gas within the assembly. During spray drying, the spray drying head receives flows of an aerosolizing gas and plasma and aerosolizes the plasma with the aerosolizing gas to form an aerosolized plasma. Drying gas additionally passes through the spray drying head to mix with the aerosolized plasma within the second portion of the assembly for drying. In the second portion of the assembly, which functions as a drying chamber, contact between the aerosolized plasma and the drying gas causes moisture to move from the aerosolized plasma to the drying gas, producing dried plasma and humid drying gas.


In alternative embodiments, the aerosolizing gas may be omitted and the spray dryer assembly head may include an aerosolizer that receives and atomizes the flow of plasma. Examples of the aerosolizer may include, but are not limited to, ultrasonic atomizing transducers, ultrasonic humidified transducers, and piezo-ultrasonic atomizers. Beneficially, such a configuration eliminates the need for an aerosolizing gas, simplifying the design of the spray dryer device and assembly and lowering the cost of the spray dryer system.


The spray drying head in an embodiment is adapted to direct the flow of drying gas within the drying chamber. For example, the spray drying head includes openings separated by fins which receive the flow of drying gas from the drying gas inlet. The orientation of the fins allows the drying gas to be directed in selected flow pathways (e.g., helical). Beneficially, by controlling the flow pathway of the drying gas, the path length over which the drying gas and aerosolized blood plasma are in contact within the drying chamber is increased, reducing the time to dry the plasma.


The dried plasma and humid drying gas subsequently flow into the third portion of assembly, which houses a collection chamber. In the collection chamber, the dried plasma is isolated from the humid drying gas and collected using a filter. For example, the filter in an embodiment is open on one side to receive the flow of humid air and dried plasma and closed on the remaining sides. The humid drying gas passes through the filter and is exhausted from the spray dryer assembly.


In alternative embodiments, the filter is adapted to separate the collection chamber into two parts. The first part of the collection chamber is contiguous with the drying chamber and receives the flow of humid drying gas and dried plasma. The dried plasma is collected in this first part of the collection chamber, while the humid air passes through the filter and is exhausted from the spray dryer assembly via an exhaust in fluid communication with the second part of the spray dryer assembly.


After collecting the dried plasma, the collection chamber is separated from the spray dryer assembly and hermetically sealed. In this manner, the sealed collection chamber is used to store the dried plasma until use. The collection chamber includes a plurality of ports allowing addition of water to the collection chamber for reconstitution of the blood plasma and removal of the reconstituted blood plasma for use. The collection chamber may further be attached to a sealed vessel containing water for reconstitution.


When handling transfusion products such as blood plasma, the transfusion products must not be exposed to any contaminants during collection, storage, and transfusion. Accordingly, the spray dryer assembly, in an embodiment, is adapted for reversible coupling with the spray dryer device. For example, the spray dryer assembly is coupled to the spray dryer device at about the drying gas inlet. Beneficially, so configured, the spray dryer assembly accommodates repeated or single use. For example. In one embodiment, the spray dryer assembly and spray drying head is formed from autoclavable materials (e.g., antibacterial steels, antibacterial alloys, etc.) that are sterilized prior to each spray drying operation. In an alternative embodiment, the spray dryer head and spray drying chamber is formed from disposable materials (e.g., polymers) that are autoclaved prior to each spray drying operation and disposed of after each spray drying operation.


Reference will now be made to FIG. 1A, which schematically illustrates one embodiment of a spray dryer system 100. The system 100 includes a spray dryer device 102 configured to receive a spray dryer assembly 104. A source of plasma 112, a source of aerosolizing gas 114, and a source of drying gas 116 are further in fluid communication with the spray dryer assembly 104. During spray drying operations, a flow of the drying gas 116A is drawn within the body of the assembly 104. Concurrently, a flow of a blood plasma 112A and a flow of aerosolizing gas 114A are each drawn at selected, respective rates, to a spray drying head 104A of the assembly 104. In the spray dryer assembly 104, the flow of blood plasma 112A is aerosolized in the spray dryer head 104A and dried in a drying chamber 104B, producing a dried plasma that is collected and stored for future use in a collection chamber 104C. Waste water 122 removed from the blood plasma during the drying process is further collected for appropriate disposal.


The spray dryer device 102 further includes a spray dryer computing device 124. The spray dryer computing device 124 is adapted to monitor and control a plurality of process parameters of the spray drying operation. The spray dryer computing device 124 further includes a plurality of user interfaces. For example, one user interface may allow an operator to input data (e.g. operator information, liquid sample information, dried sample information, etc.), command functions (e.g., start, stop, etc.). Another user interface may display status information regarding components of the spray drier device (e.g., operating normally, replace, etc.) and/or spray drying process information (e.g., ready, in-process, completed, error, etc.).


The spray dryer device 102 is in further communication with a Middleware controller 160. The spray dryer device 102 records one or more parameters associated with a spray drying operation. Examples of these parameters includes, but are not limited to, bibliographic information regarding the blood plasma which is spray dried (e.g., lot number, collection date, volume, etc.), bibliographic information regarding the spray drying operation (e.g., operator, date of spray drying, serial number of the spray dryer assembly 104, volume of dried plasma, etc.), process parameters (e.g., flow rates, temperatures, etc.). Upon completion of a spray drying operation, the spray dryer device 102 communicates with the middleware controller to transmit a selected portion or all the collected information to the middleware controller 150.


For example, a spray drying system 100 may be housed in a blood bank facility. The blood back facility receives regular blood donations for storage. Liquid plasma is separated from whole blood donations, dried using the spray drying system 100 and subsequently stored until use. The middleware controller 150 comprises one or more computing devices maintained by the blood bank for tracking stored, dried blood. Beneficially, by providing a spray drying system 100 capable of relaying information regarding dried plasma to a middleware controller 160 of the blood center in which it is housed, information regarding the stored blood is then automatically conveyed to the blood center.


In an alternative embodiment, illustrated in FIG. 1B, a plurality of spray dryer systems 100A, 100B, . . . 100N can be used in combination with a pooled plasma source 112′. In general, the pooled plasma source 112′ is a bulk source of blood plasma having a volume larger than one blood unit, as known in the art (e.g., approximately 1 pint or 450 mL). Two or more of the spray dryer systems 100A, 100B . . . 100N can operate concurrently, each drawing blood for spray drying from the pooled plasma source 112′, rather than a smaller, local blood source.


The spray dryer systems 100A, 100B . . . 100N in a pooled environment can operate under the control of a computing device 124′. The computing device 124′ is similar to computing device 124 discussed above, but adapted for concurrent control of each of the spray dryer systems 100A, 100B . . . 100N. The spray dryer computing device 124′ further communicates with a remote computing device 160, as also discussed above.


The use of a pooled plasma source 112′, provides advantages over a smaller, local plasma source, such as plasma source 112. When pooled prior to drying, the pooled liquid plasma can be formulated for pathogen inactivation with UV light, a chemical, and the like. The pooled liquid plasma is dried using one or more spray drying systems 100 of the present invention and then the dried plasma can be collect in a single collection chamber or a plurality of collection chambers. If the pooled plasma is dried for human transfusion, then each collection container can be configured with an attached rehydration solution. If the pooled plasma is to be used for fractionation purposes, then it is collected in a configured without the rehydration solution. Further embodiments of a spray dryer device 102 for use with the disclosed spray dryer assembly 104 may be found in U.S. patent application Ser. No. 13/952,541, filed on Jul. 26, 2013 and entitled “Automated Spray dryer,” the entirety of which is hereby incorporated by reference.



FIGS. 2A and 2B illustrate embodiments of the spray dryer assembly 104 in greater detail. As illustrated in FIG. 2A, the spray dryer assembly 104 includes a frame 202. An enclosure or body 204 having first and second ends 208A, 208B further extends about and encloses the frame 202. Thus, the body 204 adopts the shape of the frame 202. The enclosure 204 may further include a dual layer of film sealed together about the periphery of the frame 202.


In certain embodiments, the frame 202 may define a first portion 206A, a second portion 206B, and a third portion 206C of the assembly 104. The first portion of the assembly 206A is positioned adjacent the first end 208A of the body 204. The third portion of the assembly 206C is positioned adjacent to the second end 208B of the enclosure 204. The second portion of the assembly 206B is interposed between the first and third portions of the assembly 206A, 206C.


The frame 202 further defines first and second transition zones 210A. 210B between the first, second, and third portions of the assembly 206A, 206B, 206C. For example, the first transition zone 210A may be positioned between the first and second portions of the assembly 208A. 206B and the second transition zone 210E may be positioned between the second and third portions of the assembly 206B, 206C. In certain embodiments, the frame 202 may narrow in width, as compared to the width of the surrounding assembly within the transition zones 210A, and/or 210B. The relatively narrow transition zones 210A, 210B help to direct the flow of drying gas 116A through the assembly 104.


In further embodiments, the body 204 may include a drying gas inlet 212, adjacent to the first end 208A. The drying gas inlet 212 may be adapted to couple with the spray dryer device 102 to form a hermetic and sterile connection that allows the flow of drying gas 116A to enter the assembly 104. In one embodiment, illustrated in FIG. 2A, the drying gas inlet 212 is positioned within the first portion of the assembly 206A, at about the terminus of the first end of the body 208A. In this configuration, the flow of drying gas 116A is received within the assembly 104 in a direction approximately parallel to a long axis 260 of the assembly 104.


In an alterative embodiment of the spray dryer assembly 104, illustrated in FIG. 2B, the body 204 may include a drying gas inlet 212. The position of the drying gas inlet 212′ is moved with respect to drying gas inlet 212. For example, the drying gas inlet 212′ may be positioned within the first portion of the assembly 206A and spaced a selected distance from the terminus of the first end of the enclosure 208A. In this configuration, the flow of drying gas 116A may be received within the assembly 104 in a direction that is not parallel to the long axis 250 of the assembly 104. For example, in a non-limiting embodiment, the flow of drying gas 116A is received within the assembly 104 in a direction that is approximately perpendicular to the long axis 250 of the assembly 104.


In certain embodiments the spray dryer assembly 104 may further include a removable cover 218. The cover 218 may be employed prior to coupling of the spray dryer assembly 104 with the spray drier device 102 in order to inhibit contaminants from entering the spray dryer assembly. In certain embodiments, the cover 218 may be removed immediately prior to coupling with the spray dryer device 102 or frangible and penetrated by the spray dryer device 102 during coupling with the spray dryer assembly 104.


The drying gas 116A received by the assembly 104 is urged to travel from the first portion 206A, though the second portion 206B, to the third portion 206C, where it is removed from the assembly 104. As the drying gas 116A travels within the first portion of the assembly 206A towards the second portion of the assembly 206B, the drying gas 116A passes through a first filter 220A which filters the drying gas 116A entering the assembly 104 in addition to any filtering taking place within the spray dryer device 102 between the drying gas source 116 and the drying gas inlet 212. In certain embodiments, the first filter 220A is a 0.2 micron filter having a minimum BFE (bacterial filter efficiency) of 106. The filter 220A further helps to ensure the cleanliness of the flow of drying gas 116A.


In an embodiment, during primary drying, the flow of drying gas BFE received by the spray drier assembly BFE may possess a temperature between about 50° C. and about 150° C. and a flow rate of between about 15 CFM to about 3 5 CFM. The flow of aerosolizing gas 116A can possess a flow rate of between about 5 L/min and about 20 ml/min and a temperature between about 15° C. to about 30° C. (e.g., 24° C.). The low of liquid sample 112A may possess a flow rate of between about 3 ml/min to about 20 ml/min. As the plasma is dried, the flow of the aerosolizing gas 114A, the flow of drying gas 116C, or both may direct the flow of the dried sample 232 through at least a portion of the spray dryer assembly 104 (e.g., the drying chamber, the collection chamber or both).


In an embodiment, the assembly 104 may further include a spray drying head 104A, a drying chamber 104B, and a collection chamber 104C in fluid communication with one another. The spray drying head 104A may be mounted to the frame 202 and positioned within the first transition zone 210A. So positioned, the spray drying head 104A is also positioned within the flow of drying gas 116A traveling from the first portion of the assembly 206A to the second portion of the assembly 206B. The spray drying head 104A may be further adapted to receive the flow of plasma 112A and the flow of aerosolizing gas 114A through respective feed lines 214, 216 and output aerosolized plasma 230 to the drying chamber 104B.


In further embodiments, the drying chamber 104B and collection chamber 104C may be positioned within the second and third portions of the assembly 206B, 206C, respectively. The drying chamber 104B inflates under the pressure of the flow of drying gas 116A and provides space for the aerosolized blood plasma 230 and the flow of drying gas 116A to contact one another. Within the drying chamber 104B, moisture is transferred from the aerosolized blood plasma 230 to the drying gas 116A, where the drying gas 116A becomes humid drying gas 234. The aerosolized flow of blood plasma 230 and the flow of drying gas 116A are further separated, within the drying chamber 104B, into dried plasma 232 and humid drying gas 234. In certain embodiments, the dried plasma 232 may possess a mean diameter of less than or equal to 25 μm.


The humid drying gas 234 and dried plasma 232 are further drawn into the collection chamber 104C through an inlet port 222A of the collection chamber 104C, positioned within the second transition zone 210B, connecting the collection chamber 104C and the drying chamber 104B. The collection chamber 104 includes a second filter 220B which allows through-passage of the humid drying gas 234 and inhibits through-passage of the dried plasma 232. As a result, the humid drying gas 234 passing through the filter 220B is separated from the dried plasma 232 and exhausted from the collection bag 104C through an exhaust port 222B of the collection chamber 104C that forms the second end 206B of the body 204. For example, a vacuum source (e.g., a vacuum pump) may be in fluid communication with the exhaust port 222B of the collection chamber 104C to urge the humid drying gas 234 through exhaust port b. Concurrently, the dried plasma 232 is retained in a reservoir 228 of the collection chamber 104C. The collection chamber 104C is subsequently hermetically sealed at about the inlet and exhaust ports 222A, 222B, and detached (e.g., cut) from the spray dryer assembly 104, allowing the collection chamber 104C to subsequently function as a storage vessel for the dried plasma 232 until use.


With reference to FIG. 3, the collection chamber 104C further includes a plurality of one-way valves 702A, 702B positioned at about the inlet port 222A and the exhaust port 222B, respectively. The one-way valve 702A may function to permit gas flow from the drying chamber 104B to the collection chamber 104C and inhibit gas flow from the collection chamber 104C to the drying chamber 104B. The one-way valve 702B may function to permit gas flow from the collection chamber 104C while inhibiting gas flow into the collection chamber 104C via the exhaust port 222B.


The collection chamber 104C may be further configured for use in rehydrating the dried plasma 232. For example, the collection chamber 104C may include a rehydration port 224, a plurality of spike ports 226, and a vent port 228. The rehydration port 224 may be used to communicate with a source of rehydration solution, allowing the rehydration solution to come in contact with the dried plasma 232 within the collection chamber 104C to form reconstituted plasma. The reconstituted plasma may be subsequently drawn from the collection chamber 104C through the spike ports 226.


The discussion will now turn to further embodiments of spray drying processes which include secondary plasma drying operations, as discussed in U.S. patent application Ser. No. 14/870,127, which is incorporated herein by reference. In brief, it has been recognized that high levels of residual moisture in stored, dried plasma (e.g., moisture contents above about 3% to about 10%, as compared to the moisture content of the liquid plasma) reduce the shelf life of the dried plasma. However, given the relatively low moisture content of the dried plasma collected within the collection chamber, exposure of this collected, dried plasma to elevated temperatures may result in damage to one or more the plasma proteins, rendering the dried plasma unsuitable for later reconstitution and use. Accordingly, embodiments of secondary drying operations discussed herein are designed to complement the primary spray drying processes discussed above, allowing for further reduction in the moisture content of the plasma after primary drying is completed, without significantly damaging the plasma proteins. As a result, the dried plasma stored after undergoing primary and secondary drying possesses an improved shelf life, while remaining suitable for later reconstitution and use. It has been identified that embodiments of the secondary drying processes discussed in U.S. patent application Ser. No. 14/670,127 may be employed to produce dried plasmas having less than or equal to about 3% moisture content, as compared to the liquid plasma, without significant damage to the plasma proteins, when performed at temperatures of less than or equal to about 70° C. Such secondary drying procedures are compatible with the invention of the present application.


The entire teachings of the all applications, patents and references cited herein are incorporated herein by reference. Specifically, U.S. Pat. Nos. 7.993,310, 8,489.202, 8,533.971, 8.407.912, 8,595,950, 8,801,712, 8,533,972, 8,434,242, US Patent Publication Nos. 2010/0108183, 201110142885, 2013/0000774, 201310126101, 2014/0083827, 2014/0083628, 2014/0088768, and U.S. patent application Ser. No. 14/870,127 are incorporated herein by reference and as instructive of what one of ordinary skill in the art would know and understand at the time of the present invention.


Ranges of values include all values not specifically mentioned. For example, a range of “20% or greater” includes all values from 20% to 100% including 35%, 41.6%, 67.009%, etc., even though those values are not specifically mentioned. The range of 20% to 30% shall include, for example, the values of 21.0% and 28.009%, etc., even though those values are not specifically mentioned.


The term “about,” such as “about 20%” or “about pH 7.6,” shall mean±5%, ±10% or ±20% of the value given.


EXEMPLIFICATION

Abbreviations and Nomenclature


FFP—Fresh Frozen Plasma manufactured from CPD Whole Blood; plasma not filtered. Plasma is placed in −18° C. freezer within 8 hours of collection.


CP: control plasma, referring to plasma before spray drying


CP/FFP: FFP control plasma


Batch—represents a unique spray drying run at Velico.


SpDP/FFP—Spray dried plasma manufactured from thawed FFP


SpD: spray-drying


SpDP: spray-dried plasma


Feed plasma: liquid plasma to be fed through a feeding tube to spray-drying device


Fed plasma: liquid plasma having been fed to the system without being sprayed


Sprayed plasma: fed plasma subjected to aerosolization


vWF: von Willebrand factor


vWF:RCo: vWF activity measured by vWF ristocitein assay


PreT: pretreatment or pre-treated (formulation or formulated)


CA: citric acid


PreT/CA: pre-treated (formulated) feed plasma with citric acid


RS-CA: citric acid rehydration solution (3.5 mM citric acid)


RS-CAP: citric acid rehydration solution, buffered with sodium phosphate (pH 3.5)


WFI: water for injection


SDSAS: spray dry stable acidic substance


Example 1: Enhancing In-Process (Spray-Drying) Stability of vWF Factor and Storage Stability of Multiple Plasma Proteins by Treating the Feed Plasma with Citric Acid Prior to Spray Drying

Introduction


von Willebrand factor (vWF) is a large adhesive glycoprotein with established functions in hemostasis. It serves as a carrier for factor VII and acts as a vascular damage sensor by attracting platelets to sites of vessel injury. The size of vWF is important for this latter function, with larger multimers being more hemostatically active. Functional Imbalance in multimer size can variously cause microvascular thrombosis or bleeding. The regulation of vWF multimer size and platelet-tethering function is carried out by ADAMTS13, a plasma metalloprotease that is constitutively active. It is secreted into blood and degrades large vWF multimers, decreasing their activity. Unusually, protease activity of ADAMTS13 is controlled not by natural inhibitors but by conformational changes in its substrate, which are induced when vWF is subject to elevated rheologic shear forces. This transforms vWF from a globular to an elongated protein. This conformational transformation unfolds the vWF A2 domain and reveals cryptic exosites as well as the scissile bond. To enable vWF proteolysis, ADAMTS13 makes multiple interactions that bring the protease to the substrate and position it to engage with the cleavage site as this becomes exposed by shear forces (FIG. 5). ADAMTS 13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13), also known as von Willebrand factor-cleaving protease (vWFCP), is a zinc-containing metalloprotease enzyme,


During spray drying (SpD), the plasma proteins are subject to considerable shear forces due to the spraying mechanism as the solutions are fluidized through a fine nozzle to form the droplets in contact with drying air. FIG. 4a is a schematic diagram showing the various shear forces proteins are subject to during spray drying. The process of unfurling multimeric vWF is expected to be triggered by the hydrodynamic forces of elevated shear stress during SpD in combination with air-liquid interface stress. The shear-induced structural change of vWF, when combined with other physical factors associated with SpD, such as high temperature and/or unfavorable pH as well as the air-liquid interface stress, may lead to protein denaturation (if unfolded vWF fails to refold properly post-SpD) and proteolytic degradation (unfolded vWF exposes proteolytic sites for ADMATS13), impairing the vWF activity in the spray dried plasma (SpDP), as well as other proteins.


Spray drying can be optimized to reduce the protein damage caused by shear force and temperature through mechanical engineering. However, the pH rise is inevitable during SpD due to the loss of CO2, driven by both spraying and drying sub-processes. Further, the elevated pH is particularly undesirable for SpDP during storage. SpDP contains a residual amount of water and an alkaline pH will accelerate protein degradation during storage. Therefore, it is highly desirable to maintain the physiological pH during and post SpD. This can be done by adding a non-volatile spray dry stable acidic substance (SDSAS), preferably a physiologically compatible weak acid such as citric acid or lactic acid, to the liquid plasma to counterbalance the CO2 loss by inhibiting pH rise during SpD and thereby allow SpDP to be stored at a non-alkaline pH. In summary, pretreatment or contemporaneous treatment of plasma with citric acid serves three main purposes: 1) it increases in-process stability of plasma proteins: 2) it increases stability of plasma proteins during storage; and 3) it allows SpDP to be rehydrated with water, eliminating the need for a rehydration solution.


Objectives


The object of this study is to evaluate the impact of a SDSAS formulation of plasma with citric acid on the recovery from SpD and stability during storage of SpDP of vWF and other coagulation factors in SpDP.


Study Design and Methods


Plasma samples were formulated by the addition of citric acid from a 20% stock solution prior to spray drying. Plasma samples were spray dried using a drying gas inlet temperature of 125° C., plasma fluid rate of 10 ml/min, aerosol gas rate of 20 L/min and the exhaust temperature was maintained at 55° C. The clotting factors fibrinogen, Factors V. VI, VIII and IX, von Willebrand factor (vWF), prothrombin time (PT) and activated partial prothromboblastin time (aPTT) were determined after spray drying and after storage at 37° C., room temperature and refrigeration. vWF multimer analysis was carried out at the Blood Center of Wisconsin (BCW) as follows. Plasma samples, loaded at equal vWF:Ag levels (0.2 mU), were analyzed by 0.65% LiDS-agarose gel electrophoresis and western blotting with chemiluminescent detection using the Fujifilm LAS-300 luminescent image analyzer. Densitometry was performed and area-under-the curve calculated. The percentage of low (L), intermediate (I) and high (H) molecular weight (MW) multimers (M) were calculated. Formulated SpDP samples were rehydrated with water for injection (WFI), standard SpDP samples (i.e., control samples without added pretreatment agents as listed here) were rehydrated in Citrate-Phosphate Buffer (CPB).


Results


As shown in FIG. 6, SpD resulted in a loss of coagulation factor activity between 0% and up to 20% (FV, FVII, FVIII and FIX), but had no impact on fibrinogen and vWF antigen levels. However, it lowered the vWF:RCo activity below detection, which, remarkably, increased recovery by 50% by formulation. Consistent with the excellent recoveries of the coagulation factors and fibrinogen, SpD had no adverse effect on PT. SpD slightly prolonged aPTT (comparing Bar 1 and 3 in the aPTT cluster). Citric acid formulation prolonged aPTT of the plasma even before SpD, suggesting that interference of added citric acid in the assay, likely by taking some free calcium required by multi-steps in the intrinsic pathway, collectively measured as aPTT when combined with the common pathway. However. SpD had no impact on aPTT of the formulated plasma (comparing Bar 2 and 4 in APTT cluster).


When stored refrigerated for 6 weeks, coagulation factors in the plasma samples did not lose more than 10% of their activities (FIG. 7). However, the benefits of Pre-T/CA were highlighted alter 2 weeks at 25° C. (FIG. 8) and even more so at 37° C. (FIG. 9). All characterized parameters performed better for Pre-T/CA SpDP than standard SpDP.


To gain insight into steep decline, and dramatic salvage of vWF:RCo activity by plasma formulation, vWF multimer quantifications were performed by the inventors on plasma samples pre and post-SpD, with or without pretreatment. The results are shown in FIG. 10. Positive and negative controls were also included. As rationalized in the introduction to the example. SpD took a heavy toll on vWF multimers, almost completely depleted high molecular weight vWF multimers (HMWM), which was paralleled by an increase in low molecular weight multimers (LMWM). However, Pre-T/CA greatly increased recovery of HMWM multimers, consistent with vWF:RCo data. Lane 13: Type 2B vWF Control=Type 2B von Willebrand disease. Lane 14: Healthy Control. Lane 15: CP=Control plasma. Lane 16: CP/PreT=control plasma plus citric acid. Lane 17: SpDP=reconstituted spray dried plasma. Lane 18: SpDP/PreT=reconstituted spray dried plasma power formulated with citric acid.


Conclusions


Surprisingly, SpD exerts a heavy toil on vWF multimer formation and activity. The results show that vWF is sensitive to shear stress which adversely affects its size and biological function. Shear stress enhances the proteolysis of vWF in normal plasma. Presumably, and while not limiting the present invention to theory, the synergistic effects of shear force during aerosollzation, pH change and thermal stress, causes unfolding of vWF. Formulation of plasma with a SDSAS greatly improves the recovery of shear force labile vWF, increases the stability of multiple plasma proteins during storage and simplifies rehydration. SpDP subjected to formulation showed improved profiles of PT, fibrinogen, FV, FVII, FVIII, FIX and vWF antigen (Ag) levels when stored 2 weeks and 4° ° C. and 25° C.


Example 2: Characterization of the Effect of Aerosol Flow Rate on vWF Factor

Background


The spray-drying process can be divided into feeding, spraying, and drying stages. Each sub-process can potentially cause damage to plasma proteins, especially vWF (FIG. 4). Identification of the critical step(s) to vWF degradation can aid in process development minimizing processing damage to plasma proteins. In this example, the impact of spraying on vWF recovery was evaluated.


Study Design and Methods


Thawed FFP samples were fed at 10 mL/minute under variable aerosol gas flow (0, 5, 10, 15 or 20 mL/minute) without drying gas on. These settings, allowing the plasma to be fed into the system, with or without aerosolization in the absence of heating, allowed study of the impact of plasma feeding and spray/aerosol gas flow rate in the spray-drying process. The sprayed liquid plasma samples were analyzed for pH and vWF:RCo.


Results


The results are shown in FIGS. 11A and 11B. Plasma feeding at 10 mL/min without aerosol gas flow (0 mL/min) allowed the evaluation of the impact of feeding alone on vWF recovery. Plasma feeding alone had no significant impact on either pH or vWF.


vWF still remained intact at 5 mL/min of aerosol gas flow, but the pH was sharply elevated to approximately 8.0 (FIG. 11B). However, increase of the aerosol gas low to 10 mL/min eliminated 50% vWF:RCo activity, and suffered more damage as aerosol gas flow increased to 15 and 20 mL/min (FIG. 11A). The pH remained at about 8 as the aerosol gas flow was increased from 5 to 20 mL/min, indicating near complete loss of CO2 in the plasma upon aerosolization. The lack of correlation between pH rise and vWF:RCo activity at 5 L/min suggests that transient exposure to slight alkaline pH (8.0) alone did not cause detectible damage to vWF.


Escalation of aerosol gas flow downsizes the plasma droplets, which has multiple consequences. The reduced droplet size increased exposure of plasma proteins to air/liquid interfacial stress. The combination of elevated aerosol gas flow and reduced droplet size increased speed of the droplet motion in the gas, thereby aggravating the shear stress to proteins on the droplet surface, which have already been stressed from interaction with the air/liquid interface,


Conclusion


This study firmly established the correlation between aerosolization and vWF factor deterioration.


Example 3: Characterization of the Effect of Plasma Feeding Rate on vWF

Background


Example 2 identified the spray sub-process as a major stress factor responsible for vWF degradation during spray drying. This indicates that the critical negative contribution of the combined shear and air/liquid interfacial stresses was exerted on the plasma droplets (and, consequently, on the plasma proteins) while traveling at a high rate of speed upon aerosolization. It also suggested that the impact of the combined shear and air/liquid interfacial stresses on plasma proteins upon aerosolization can be further modified by altering the droplet size. Droplet size can be modified by varying the plasma feed rate under a constant aerosol flow rate. In this example, plasma was fed into the system at different rates under constant aerosol flow rate. Larger droplets at a higher plasma feeding rate would have less air-liquid interface exposure for plasma proteins and have slower motion rate and lower shear stress for plasma proteins. Thus, the plasma proteins will sustain less stress attributed to air-liquid interface force and shear force.


Study Design and Method


Thawed FFP samples were fed at 2, 4, 6, 8 or 10 mL/min under a constant aerosol gas flow of 10 L/min without drying gas on. The sprayed liquid plasma samples were analyzed for vWF:RCo activity and pH.


Results


Consistent the observations in Example 2, at 10 L/min of aerosol gas flow, vWF:RCo activity dramatically declined after spraying between 2 and 10 mL/min of plasma input (FIG. 12). vWF:RCo recovery trended slightly higher as plasma input rate increased from 2 to 10 mL/min. pH was significantly increased under all conditions, trending lower from pH 8.3 at 2 mL/min to 7.9 at 10 mL/min as the plasma feed rate increased (FIG. 12B). The opposite trends for pH and vWF:RCo with respect to plasma feeding rate are consistent with the increase of droplet sizes as the result of the increase plasma feeding rate. This reduced the air/liquid-interface to mass ratio and, consequently, the shear and air/liquid-interface stresses as well as CO2 loss.


Conclusion


The results further established the inverse relationship between vWF recovery and spray stresses.


Example 4. The Effect of Formulation of Plasma with Different Spray Dry Stable Acidic Substance (SDSAS's) on vWF Recovery During Spray

Background


Example 1 highlighted the importance of controlling the pH of the feed plasma in reducing the detrimental effect of spray-drying on vWF, Examples 2 and 3 Identified the spray sub-process as a critical step leading to the degradation of WWF. Taken together, these data suggest that reducing the destructive effect of spray on vWF by lowering the pH of feed plasma is critical for improving the overall quality of SpDP. In this example, the impact of pretreatment on the preservation of vWF factor during spray was explored using a diverse panel of SDSAS's.


Study Design and Methods


Aliquots of thawed FFP were formulated separately with a wide range of SDSAS's including ascorbic acid, citric acid, gluconic acid, glycine hydrogen chloride (glycine-HCl), lactic acid and monosodium citrate. The amount of the treating chemical was pre-determined by titrating the unformulated SpDP rehydrated with WFI to ˜pH 7.3. Control plasmas include formulated and hyper-formulated (7.4 mM citric acid in Example 1) plasma samples.


Results


The results are shown in FIG. 13. Spraying of the naïve plasma led to a sharp rise in pH (pH 7.3 and 8.0 before and after spraying, respectively; 7.3/8.0. Bar 2) and reduced vWF:RCo activity by about 70% (30% recovery) (Bar 2). Formulation of the plasma with 7.4 mM citric acid, which lowered the pH to 6.3 in the feed plasma and resulted in a lower than the physiological pH after spraying (6,9), reduced by about 50% vWF:RCo activity during spraying (50% recovery) (Bar 3). Formulation with 7.4 mM monosodium citrate, which lowered the pH to 6.7 in the feed plasma and resulted in a physiological pH after spraying lowered vWF:RCo activity recovery by about 40% (Bar 4), which was higher than naïve plasma (Bar 2). Formulation with other SDSAS's, citric acid (4.7 mM, Bar 5), ascorbic acid (Bar 6), glycine HCl (Bar 7), gluconic acid (Bar 8) and lactic acid (Bar 9), all of which lowered the plasma pH to ˜6.7 and resulted in a physiological pH (˜7.3) after spraying, led to similar vWF:RCo activity recovery of about 40% after spray. Taken together, these results indicated that lowering the pH of feed plasma is critical for preserving vWF during spray.


Conclusion


Enhanced vWF preservation can be achieved by formulating the feed plasma with a wide array of SDSAS's—not only citric acid, but monosodium citrate, ascorbic acid, glycine HCl, gluconic acid and lactic acid, and probably many others meeting the criteria given in the present specification. However, the most important consideration in choosing the proper SDSAS is the suitability for transfusion. Other important factors include availability of USP grade formulation, tolerance for terminal sterilization and interference with standard assays, to name a few. As plasma already contains citric acid (as an anticoagulant), addition of more citric acid to bring the concentration identified in the present invention as being suitable for enhanced plasma protein recovery and stability has the advantage of not introducing a new component to serve as a pH adjuster. Further, citrate is usually rapidly metabolized by the liver. However, rapid administration of large quantiles of stored blood may cause hypocalcaemia and hypomagnesaemia when citrate binds calcium and magnesium. This can result in myocardial depression or coagulopathy. Patients most at risk are those with liver dysfunction or neonates with immature liver function having rapid large volume transfusion. Slowing or temporarily stopping the transfusion allows citrate to be metabolized. Administration of calcium chloride or calcium gluconate intravenously into another vein can be used in order to minimize citrate toxicity. Nevertheless, the elevation of citrate in SpDP can be avoided by using alternative SDSAS's such as lactic acid and glycine-HCl. Lactic acid is an important constituent in Ringers Lactate solution, which is often used for fluid resuscitation after a blood loss due to trauma, surgery, or a burn injury. GlycineHCL is referenced in the US Pharmacopeia.


Example 5: Enhanced vWF Factor Protection During Spray is Inversely Correlated with the pH Levels of the Feed Plasma

Background


Results from Example 4, evaluating different chemicals for lowering the pH of the feed plasma, confirmed the generality of the inhibition of pH rise during spay improves vWF:RCo activity recovery. However, it is still striking that vWF factor is better preserved at an acidic pH lower than the physiological pH (7.2-7.4) during the spraying process. Nevertheless, the surprising observation suggested the potential of pH manipulation for further improving vWF factor recovery. In this example, we further evaluated pH of the feed plasma with regard to vWF:RCo activity recovery after spraying. Citric acid and lactic acid were chosen for use in the study.


Study Design and Method


Aliquots of thawed FFP were formulated with different concentrations of citric acid or lactic acid from 20× stock solutions. The amount of the formulation chemicals was pre-determined ensuing a physiological or lower pH level of SpDP when rehydrated with WFI. The formulated samples were determined for pH, sprayed, and the recovered liquid samples were analyzed for pH and vWF:RCo activity.


Results


The results are shown in FIG. 14A for citric acid and FIG. 14B for lactic acid. Consistent with earlier observations, spraying alone led to a rise in pH (not shown) and vWF:RCo deterioration under all conditions. Remarkably, vWF:RCo recovery trended higher as the concentration of citric acid or lactic acid increased or pH declined. The inverse correlation between pH of the feed plasma and vWF:RCo activity recovery was clearly shown in FIG. 14C, which was generated by pooling data of both citric acid and lactic acid studies.


Conclusion


Feed plasma pH can be further exploited to increase vWF recovery in conjunction with recovery of other plasma proteins.

Claims
  • 1. A reconstituted previously dried plasma product for human transfusion made by the method of: a) combining i) plasma with ii) one or more stable acidic substances, wherein said one or more stable acidic substances is an acid or acidic salt that effectuates a pH and is physiologically suitable for addition to plasma being dried or physiologically suitable for subjects into which reconstituted plasma is transfused, to thereby create a formulated plasma so that the pH of formulated plasma is between about 5.5 and 7.2,b) drying the formulated plasma to thereby obtain a dried formulated plasma; andc) reconstituting said dried formulated plasma with sterile water or alkaline solution to thereby obtain a reconstituted dried plasma product for human transfusion.
  • 2. The reconstituted previously dried plasma product of claim 1, said reconstituted plasma has a pH of about 6.8 to about 7.6.
  • 3. The reconstituted previously dried plasma product of claim 1, wherein when combining the plasma with the one or more stable acidic substances, said pH of said plasma is adjusted with said one or more stable acidic substance up to 30 minutes before drying.
  • 4. The reconstituted previously dried plasma product of claim 1, wherein when combining the plasma with the one or more stable acidic substances, said pH of said plasma is adjusted by adding one or more stable acidic substances immediately prior to or contemporaneously with drying.
  • 5. The reconstituted previously dried plasma product of claim 1, wherein the pH of the plasma is known prior to addition of said one or more stable acidic substances and the amount of said one or more stable acidic substances to be added plasma is determined based on the known pH of said plasma.
  • 6. The reconstituted previously dried plasma product of claim 1, wherein said plasma comprises CPD (citrate phosphate dextrose solution) plasma or is WB (whole blood) plasma.
  • 7. The reconstituted previously dried plasma product of claim 1, wherein the one or more stable acidic substances is selected from the group consisting of ascorbic acid, citric acid, gluconic acid, lactic acid, glycine hydrochloride, monosodium citrate, oxalic acid, halogenated acetic acids, arene sulfonic acids, molybdic acid, phosphotungstic acid, tungstic acid, chromic acid, sulfamic acid and any combination thereof.
  • 8. The reconstituted previously dried plasma product of claim 1, wherein citric acid is added to the plasma to increase citrate concentration by 7.4 mM.
  • 9. The reconstituted previously dried plasma product of claim 8, wherein von Willebrand factor activity from reconstituted plasma is between about 10 and about 35 percentage points greater than the von Willebrand factor activity obtained from an otherwise identical dried plasma that has not undergone formulation with one or more stable acidic substances.
  • 10. The reconstituted previously dried plasma product of claim 1, wherein said formulated plasma has a pH of about 5.5 to about 6.5.
  • 11. The reconstituted previously dried plasma product of claim 1, wherein von Willebrand factor activity from reconstituted plasma is between about 5 and about 40 percentage points greater than the von Willebrand factor activity obtained from an otherwise identical dried plasma that has not undergone formulation with one or more stable acidic substances.
  • 12. The reconstituted previously dried plasma product of claim 1, wherein said dried formulated plasma is stable at ambient temperature for at least 7 days.
  • 13. The reconstituted previously dried plasma product of claim 1, further comprising measuring activity of Factors V, VII, VIII and IX or any combination thereof to determine stability of the reconstituted plasma.
  • 14. The reconstituted previously dried plasma product of claim 1, wherein the reconstituted plasma has a physiological pH.
  • 15. The reconstituted previously dried plasma product of claim 1, wherein the reconstitution solution comprises a substance selected from the group consisting of: sterile water, sodium bicarbonate, disodium phosphate, and glycine sodium hydroxide.
  • 16. A dried plasma product for human transfusion made by the method of: a) combining i) plasma with ii) one or more stable acidic substances, wherein said one or more stable acidic substances is an acid or acidic salt that effectuates a pH and is physiologically suitable for addition to plasma being dried or physiologically suitable for subjects into which reconstituted plasma is transfused, to thereby create a formulated plasma so that the pH of formulated plasma is between about 5.5 and 7.2, andb) drying the formulated plasma to thereby obtain a dried formulated plasma.
  • 17. The dried plasma product of claim 16, wherein when said formulated plasma is dried and reconstituted to obtain reconstituted plasma, said reconstituted plasma has a pH of about 6.8 to about 7.6.
  • 18. The dried plasma product of claim 16, wherein when combining the plasma with the one or more stable acidic substances, said pH of said plasma is adjusted with said one or more stable acidic substance up to 30 minutes before drying.
  • 19. The dried plasma product of claim 16, wherein when combining the plasma with the one or more stable acidic substances, said pH of said plasma is adjusted by adding one or more stable acidic substances immediately prior to or contemporaneously with drying.
  • 20. The dried plasma product of claim 16, wherein the pH of the plasma is known prior to addition of said one or more stable acidic substances and the amount of said one or more stable acidic substances to be added plasma is determined based on the known pH of said plasma.
  • 21. The dried plasma product of claim 16, wherein said plasma comprises CPD (citrate phosphate dextrose solution) plasma or is WB (whole blood) plasma.
  • 22. The dried plasma product of claim 16, wherein the one or more stable acidic substances is selected from the group consisting of ascorbic acid, citric acid, gluconic acid, lactic acid, glycine hydrochloride, monosodium citrate, oxalic acid, halogenated acetic acids, arene sulfonic acids, molybdic acid, phosphotungstic acid, tungstic acid, chromic acid, sulfamic acid and any combination thereof.
  • 23. The dried plasma product of claim 16, wherein citric acid is added to the plasma to increase citrate concentration by 7.4 mM.
  • 24. The dried plasma product of claim 16, wherein said formulated plasma has a pH of about 5.5 to about 6.5.
  • 25. The dried plasma product of claim 16, wherein when the formulated plasma is reconstituted to obtain reconstituted plasma, von Willebrand factor activity from reconstituted plasma is between about 5 and about 40 percentage points greater than the von Willebrand factor activity obtained from an otherwise identical dried plasma that has not undergone formulation with one or more stable acidic substances.
  • 26. The dried plasma product of claim 25, wherein von Willebrand factor activity from reconstituted plasma is between about 10 and about 35 percentage points greater than the von Willebrand factor activity obtained from an otherwise identical dried plasma that has not undergone formulation with one or more stable acidic substances.
  • 27. The dried plasma product of claim 16, wherein said dried formulated plasma is stable at ambient temperature for at least 7 days.
  • 28. The dried plasma product of claim 16, further comprising measuring activity of Factors V, VII, VIII and IX or any combination thereof to determine stability of the reconstituted plasma.
  • 29. A reconstituted previously spray dried plasma product for human transfusion, the reconstituted previously spray dried plasma product having been formulated with one or more spray dry stable acidic substances (SDSAS), wherein said one or more SDSAS is an acid or acidic salt that effectuates a pH and is physiologically suitable for addition to plasma being spray dried or physiologically suitable for subjects into which reconstituted plasma is transfused and having been reconstituted with sterile water, the reconstituted spray dried plasma product having a pH of about 6.8 to about 7.6.
  • 30. A spray dried plasma product for reconstitution and transfusion into a human, the spray dried plasma product having been formulated with one or more spray dry stable acidic substances (SDSAS), wherein said one or more SDSAS is an acid or acidic salt that effectuates a pH and is physiologically suitable for addition to plasma being spray dried or physiologically suitable for subjects, wherein that the pH of formulated plasma is between about 5.5 and 7.2.
RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No. 15/383,201, entitled, “Formulations And Methods For Contemporaneous Stabilization Of Active Proteins During Spray Drying And Storage” by Qiyong Peter Liu et al., filed Dec. 19, 2016, which is a continuation of U.S. application Ser. No. 14/858,539, now U.S. Pat. No. 9,545,379, entitled, “Formulations And Methods For Contemporaneous Stabilization Of Active Proteins During Spray Drying And Storage” by Qiyong Peter Liu et al., filed Sep. 18, 2015, issued Jan. 17, 2017, which claims the benefit of U.S. Provisional Application No. 62/052,689, entitled, “Spray Drier Assemblies and Methods For Automated Spray Drying” by Abdul W. Khan eta/filed Sep. 19, 2014. The entire teachings of the above application(s) are incorporated herein by reference.

GOVERNMENT SUPPORT

This invention was made with Government support under contract HHS0100201200005C awarded by the Biomedical Advanced Research and Development Authority (BARDA). The Government has certain rights in the invention.

US Referenced Citations (212)
Number Name Date Kind
2411152 Folsom Nov 1946 A
2528476 Roos et al. Oct 1950 A
2575175 Kronisch Nov 1951 A
3228838 Rinfret et al. Jan 1966 A
3230689 Hussmann Jan 1966 A
3449124 Lipner Jun 1969 A
3507278 Werding Apr 1970 A
3644128 Lipner Feb 1972 A
3654705 Smith et al. Apr 1972 A
3735792 Asizawa et al. May 1973 A
4187617 Becker, Jr. et al. Feb 1980 A
4251510 Tankersley Feb 1981 A
4347259 Suzuki et al. Aug 1982 A
4358901 Takabatake et al. Nov 1982 A
4376010 Gauvin Mar 1983 A
4378346 Tankersley Mar 1983 A
4380491 Joy Apr 1983 A
4597868 Watanabe Jul 1986 A
4600613 Yoshida Jul 1986 A
4645482 Yoshida Feb 1987 A
4705612 Shimomura et al. Nov 1987 A
4725355 Yamamoto et al. Feb 1988 A
4735832 Ichikawa et al. Apr 1988 A
4743375 Seita et al. May 1988 A
4774019 Watanabe et al. Sep 1988 A
4787154 Titus Nov 1988 A
4845132 Masuoka et al. Jul 1989 A
4861632 Caggiano Aug 1989 A
4966699 Sasaki et al. Oct 1990 A
5096537 Bergquist et al. Mar 1992 A
5139529 Seita et al. Aug 1992 A
5145706 Hagi et al. Sep 1992 A
5167763 Sakamoto Dec 1992 A
5181415 Esvan et al. Jan 1993 A
5244578 Ohnishi et al. Sep 1993 A
5252221 Van Dommelen et al. Oct 1993 A
5254248 Nakamura Oct 1993 A
5257983 Garyantes et al. Nov 1993 A
5267646 Inoue et al. Dec 1993 A
5279738 Seita et al. Jan 1994 A
5309649 Bergmann et al. May 1994 A
5372811 Yoder Dec 1994 A
5522156 Ware Jun 1996 A
5523004 Tanokura et al. Jun 1996 A
5529821 Ishikawa et al. Jun 1996 A
5547576 Onishi et al. Aug 1996 A
5562919 Doty et al. Oct 1996 A
5567238 Long, Jr Oct 1996 A
5575999 Yoder Nov 1996 A
5581903 Botich Dec 1996 A
5582794 Hagiwara et al. Dec 1996 A
5624530 Sadykhov Apr 1997 A
5647142 Andersen et al. Jul 1997 A
5610170 Inoue et al. Nov 1997 A
5727333 Folan Mar 1998 A
5924216 Takahashi Jul 1999 A
5993804 Read et al. Nov 1999 A
6004576 Weaver et al. Dec 1999 A
6060323 Jina May 2000 A
D430939 Zukor et al. Sep 2000 S
6148536 Lijima Nov 2000 A
6197289 Wirt et al. Mar 2001 B1
6284282 Maa et al. Sep 2001 B1
6299906 Bausch et al. Oct 2001 B1
6308434 Chickering, III et al. Oct 2001 B1
6308826 Merrell Oct 2001 B1
6345452 Feuilloley et al. Feb 2002 B1
6463675 Hansen et al. Oct 2002 B1
6523276 Meldrum Feb 2003 B1
6526774 Lu et al. Mar 2003 B1
6560897 Chickering, III et al. May 2003 B2
6569447 Kisic et al. May 2003 B2
6582654 Kral et al. Jun 2003 B1
6723497 Wolkers et al. Apr 2004 B2
6893412 Saito et al. May 2005 B2
7005857 Stiene et al. Feb 2006 B2
7007406 Wang et al. Mar 2006 B2
7074582 Fischer et al. Jul 2006 B2
7089681 Herbert et al. Aug 2006 B2
7094378 Goodrich, Jr. et al. Aug 2006 B1
7297716 Shanbrom Nov 2007 B2
7361306 Bole Apr 2008 B2
7399637 Wright et al. Jul 2008 B2
7419682 Campbell et al. Sep 2008 B2
7527805 Crenshaw et al. May 2009 B2
7648699 Goodrich et al. Jan 2010 B2
7931919 Bakaltcheva et al. Apr 2011 B2
7993310 Rosiello Aug 2011 B2
8322046 Wang et al. Dec 2012 B2
8398732 Turok et al. Mar 2013 B2
8407912 Hubbard et al. Apr 2013 B2
8434242 Hubbard et al. May 2013 B2
8449520 Pepper et al. May 2013 B2
8469202 Rosiello Jun 2013 B2
8518452 Bjomstrup et al. Aug 2013 B2
8533971 Hubbard et al. Sep 2013 B2
8533972 Hubbard et al. Sep 2013 B2
8595950 Hubbard et al. Dec 2013 B2
8601712 Hubbard et al. Dec 2013 B2
8968879 Inaba et al. Mar 2015 B2
9440011 Van Waeg et al. Sep 2016 B2
9545379 Liu et al. Jan 2017 B2
9561184 Khan et al. Feb 2017 B2
9561893 Root et al. Feb 2017 B2
9863699 Corbin, III et al. Jan 2018 B2
9867782 Fischer et al. Jan 2018 B2
10022478 Anzai et al. Jul 2018 B2
10251911 DaCorta et al. Apr 2019 B2
10376614 Ripper et al. Aug 2019 B2
10376809 Nielsen Aug 2019 B2
10377520 Root et al. Aug 2019 B2
10539367 Van Valkenburg Jan 2020 B2
10793327 Weimer et al. Oct 2020 B2
10843100 Khan et al. Nov 2020 B2
10960023 DaCorta et al. Mar 2021 B2
10969171 Corbin, III et al. Apr 2021 B2
11052045 Liu et al. Jul 2021 B2
11213488 Fischer et al. Jan 2022 B2
20020056206 Pace May 2002 A1
20020122803 Kisic et al. Sep 2002 A1
20020182195 Marguerre et al. Dec 2002 A1
20030037459 Chickering, II et al. Feb 2003 A1
20030099633 Campbell et al. May 2003 A1
20030103962 Campbell et al. Jun 2003 A1
20030143518 Luck et al. Jul 2003 A1
20030163931 Beyerinck Sep 2003 A1
20030180283 Batycky Sep 2003 A1
20030186004 Koslow Oct 2003 A1
20030190314 Campbell et al. Oct 2003 A1
20030209245 Poole et al. Nov 2003 A1
20040058309 Washizu Mar 2004 A1
20040086420 MacPhee May 2004 A1
20040110871 Perrut et al. Jun 2004 A1
20040146565 Strohbehn et al. Jul 2004 A1
20040175296 Opalsky et al. Sep 2004 A1
20040202660 Campbell et al. Oct 2004 A1
20040247628 Lintz et al. Dec 2004 A1
20050170068 Roodink et al. Aug 2005 A1
20050186183 DeAngelo et al. Aug 2005 A1
20050271674 Campbell et al. Dec 2005 A1
20060045907 Campbell et al. Mar 2006 A1
20060088642 Boersen et al. Apr 2006 A1
20060130768 Crenshaw et al. Jun 2006 A1
20060216687 Alves-Filho et al. Sep 2006 A1
20060222980 Makino et al. Oct 2006 A1
20070014806 Marguerre et al. Jan 2007 A1
20070084244 Rosenflanz et al. Apr 2007 A1
20070166389 Bakaltcheva Jul 2007 A1
20080058469 Abe et al. Mar 2008 A1
20080060213 Gehrmann et al. Mar 2008 A1
20080119818 Bakaltcheva May 2008 A1
20080138340 Campbell et al. Jun 2008 A1
20080145444 Merchant et al. Jun 2008 A1
20080145834 Ho Jun 2008 A1
20080213263 Campbell et al. Sep 2008 A1
20080234653 McCarthy et al. Sep 2008 A1
20080317640 Mayer Dec 2008 A1
20090092678 Marguerre et al. Apr 2009 A1
20090155410 Crenshaw et al. Apr 2009 A1
20090113753 Pepper et al. May 2009 A1
20090145783 Forker Jun 2009 A1
20090223080 McCarthy Sep 2009 A1
20100011610 Bittorf Jan 2010 A1
20100108183 Rosiello May 2010 A1
20100215667 Campbell et al. Aug 2010 A1
20100233671 Bakaltcheva Sep 2010 A1
20100273141 Bakaltcheva Oct 2010 A1
20110142885 Haley et al. Jun 2011 A1
20120027867 Fischer et al. Feb 2012 A1
20120103536 Hubbard, Jr. et al. May 2012 A1
20120167405 Hubbard, Jr. Jul 2012 A1
20120222326 Hubbard et al. Sep 2012 A1
20130000774 Rosiello Jan 2013 A1
20130048225 Hubbard et al. Feb 2013 A1
20130056158 Hubbard et al. Mar 2013 A1
20130126101 Hubbard, Jr. et al. May 2013 A1
20130129817 Consigny May 2013 A1
20130209985 Hoke Aug 2013 A1
20130243877 Haley Sep 2013 A1
20130264288 Hlavinka et al. Oct 2013 A1
20140083627 Khan et al. Mar 2014 A1
20140083628 Khan et al. Mar 2014 A1
20140088768 Haley et al. Mar 2014 A1
20140221873 Hayakawa et al. Aug 2014 A1
20140230266 Luy et al. Aug 2014 A1
20150099866 Kelleher Apr 2015 A1
20150158652 Root et al. Jun 2015 A1
20150354894 Corbin, III et al. Dec 2015 A1
20160015863 Gupta et al. Jan 2016 A1
20160082043 Khan et al. Mar 2016 A1
20160082044 Liu Mar 2016 A1
20160084572 Khan et al. Mar 2016 A1
20160113965 DaCorta et al. Apr 2016 A1
20160362307 Shiner Dec 2016 A1
20170100339 Liu et al. Apr 2017 A1
20170113824 Root et al. Apr 2017 A1
20170203871 Murto et al. Jul 2017 A1
20170259186 Khan et al. Sep 2017 A1
20180128544 Corbin et al. May 2018 A1
20180153811 Fischer et al. Jun 2018 A1
20180207654 Phua Jul 2018 A1
20180229150 Sorensen Aug 2018 A1
20190106254 Weimer et al. Apr 2019 A1
20190223671 Tomasiak Jul 2019 A1
20190241300 Root et al. Aug 2019 A1
20190298765 DaCorta et al. Oct 2019 A1
20200298137 Khan Sep 2020 A9
20210069607 Khan et al. Mar 2021 A1
20210213057 DaCorta et al. Jul 2021 A1
20210290545 Lie et al. Sep 2021 A1
20220040110 Lie et al. Feb 2022 A1
20220106357 Patatanyan Apr 2022 A1
Foreign Referenced Citations (74)
Number Date Country
2010234607 Oct 2010 AU
1182411 Feb 1985 CA
2065582 Oct 1992 CA
2 472 028 Aug 2003 CA
2757961 Oct 2010 CA
2816090 May 2012 CA
622683 Apr 1981 CH
1315139 Oct 2001 CN
102206273 Oct 2011 CN
108005711 May 2018 CN
3507278 Sep 1986 DE
0058903 Sep 1982 EP
1050220 Aug 2000 EP
2745922 Jun 2014 EP
2745923 Jun 2014 EP
2416790 May 2018 EP
3151662 Oct 2020 EP
573500 Nov 1945 GB
886533 Oct 1962 GB
964367 Jul 1964 GB
975786 Nov 1964 GB
1188168 Apr 1970 GB
2003042 Mar 1979 GB
2003042 Mar 1979 GB
1167098 Aug 2012 HK
56011903 Feb 1981 JP
63218201 Sep 1988 JP
01011618 Jan 1989 JP
03131302 Jun 1991 JP
03181301 Aug 1991 JP
5245301 Sep 1993 JP
525910 Oct 1993 JP
10182124 Jul 1998 JP
3219828 Oct 2001 JP
2002009037 Jan 2002 JP
2005191275 Jul 2005 JP
2007216158 Aug 2007 JP
6336419 Jun 2018 JP
911657 Aug 2009 KR
2022079809 Jun 2022 KR
2011010633 Jan 2012 MX
WO9615849 May 1996 WO
WO9618312 Jun 1996 WO
WO9738578 Oct 1997 WO
WO9907236 Feb 1999 WO
WO9907390 Feb 1999 WO
WO0056166 Sep 2000 WO
WO0172141 Oct 2001 WO
WO02078741 Oct 2002 WO
WO02078742 Oct 2002 WO
WO2002083157 Oct 2002 WO
WO2002092213 Nov 2002 WO
WO03030654 Apr 2003 WO
WO03030918 Apr 2003 WO
WO-03037303 May 2003 WO
WO03063607 Aug 2003 WO
WO2004075988 Sep 2004 WO
WO2004078187 Sep 2004 WO
WO2005079755 Sep 2005 WO
WO2007036227 Apr 2007 WO
WO-2008080167 Jul 2008 WO
WO2008122288 Oct 2008 WO
WO2008143769 Nov 2008 WO
WO2010111132 Sep 2010 WO
WO2010113632 Oct 2010 WO
WO2010117976 Oct 2010 WO
WO2011075614 Jun 2011 WO
WO2012058575 May 2012 WO
WO2013141050 Sep 2013 WO
WO2016036807 Mar 2016 WO
WO2016208675 Dec 2016 WO
WO2019074886 Apr 2019 WO
WO-2020065413 Apr 2020 WO
WO2020111132 Jun 2020 WO
Non-Patent Literature Citations (204)
Entry
Hamilton GJ, Van PY, Differding JA, Kremenevskiy IV, Spoerke NJ, Sambasivan C, Watters JM, Schreiber MA. “Lyophilized plasma with ascorbic acid decreases inflammation in hemorrhagic shock.” J Trauma,Aug. 2011,71(2),pp. 292-297; PMID:21825929; doi: 10.1097/TA.0b013e31821f4234. (Year: 2011).
Van PY, Hamilton GJ, Kremenevskiy IV, Sambasivan C, Spoerke NJ, Differding JA, Watters JM, Schreiber MA “Lyophilized plasma reconstituted with ascorbic acid suppresses inflammation and oxidative DNA damage”, J Trauma, Jul. 2011,71(1),pp. 20-24; PMID: 21818011; doi:10.1097/TA.0b013e3182214f44. (Year: 2011).
Cardianbct, Inc “Mirasol Pathogen Reduction Technology”, PN 306690-148, retrieved online Apr. 4, 2023 <URL: http://eurolambda.sk/shared/files/mirasol_plasma.pdf>, 2 pages. (Year: 2009).
Terumo BCT, Inc “Mirasol Pathogen Reduction Technology System”, PN 306690232, retrieved online Apr. 4, 2023 <URL: https://www.terumopenpol.com/wp-content/uploads/2019/12/306690232-1.pdf>, 7 pages. (Year: 2012).
Lea, et al. “The Reaction between Proteins and Reducing Sugars in the “Dry” State” Department of Pathology, University of Cambridge; Jun. 5, 1950; pp. 626-629.
Carpenter, et al. “Rational Design of Stable Lyophilized Protein Formulations: Theory and Practice” Kluwer Academic/Plenum Publishers; 2002; pp. 109-133.
Schmid “Spray drying of protein precipitates and Evaluation of the Nano Spray Dryer B-90” PhD Thesis; 2011; 125 pages.
Shuja, et al. “Development and Testing of Low-Volume Hyperoncotic, Hyperosmotic Spray-Dried Plasma for the treatment of Trauma-Associated Coagulopathy” The Journal of Trauma; Mar. 2011; vol. 70; No. 3; pp. 664-671.
Bakaltcheva; et al. “Freeze-dried whole plasma: Evaluating sucrose, trehalose, sorbitol, mannitol and glycine as stabilizers” Thrombosis Research; 2007; vol. 120; pp. 105-116.
Training Papers Spray Drying; Version B; www.buchi.com; 19 pages; Oct. 29, 2002.
Edwards et al., The Preparation and Use of Dried Plasma for Transfusion; British Medical journal; vol. 1, No. 4131;Mar. 9, 1940; pp. 377-381.
European Search Report, EP Application No. 14154366, dated Aug. 29, 2014, pp. 1-3.
European Search Opinion, EP Application No. 14154366, dated Aug. 29, 2014, pp. 1-3.
International Search Report and Written Opinion, PCT/US2010/049176, dated Nov. 4, 2010, pp. 1-10.
International Search Report and Written Opinion, PCT/US2011/058358, dated Jul. 4, 2012, pp. 1-9.
Answer, Affirmative Defenses, Counterclaims, Cross-Claims and Jury Demand, Entegrion, Inc. vs Velico Medical, Inc., dated Dec. 3, 2012, pp. 1-47.
Civil Action Cover Sheet; Entegrion, Inc. vs Velico Medical, Inc., dated Oct. 19, 2012, pp. 1-2.
Complaint including Exhibit A, B, and C; Entegrion, Inc. vs Velico Medical, Inc., dated Oct. 19, 2012, pp. 1-29.
Mini Spray Dryer B-290- Application Note; www.buchi.com; Mar. 30, 2008, entire document , 1 Page.
Nano Spray Dryer B-90; www.buchi.com; Jul. 18, 2011, entire document , 12 Pages.
Mini Spray Dryer System Configuration; www.buchi.com; Jan. 8, 2007, entire document , 1 Page.
Quick Operation Guide; Mini Spray Dryer B-290; www.buchi.com; Sep. 16, 2004 pp. 15-53.
Process Parameters; www.buchi.com; Nov. 21, 2008, pp. 1-2.
Mini Spray Dryer B-290; www.buchi.com; May 10, 2007, pp. 1-8.
Fischer M., et al., “Stability of African swine fever virus on spiked spray-dried porcine plasma,” Transboundary and Emerging Diseases, 68(5): 2806-2811 (2021).
International Preliminary Report on Patentability, PCT/US2011/058358, dated Apr. 30, 2013, pp. 1-7.
Blazquez, E., et al., “Biosafety steps in the manufacturing process of spray-dried plasma: a review with emphasis on the use of ultraviolet irradiation as a redundant biosafety procedure,” Porcine Health Management, 6(16): p., 78 refs. (2020). 9 Pages.
Blazquez, E., et al., “Effect of spray-drying and ultraviolet C radiation as biosafety steps for CSFV and ASFV inactivation in porcine plasma,” PLOS One, 16(4) (2021) , entire document, 11 Pages.
Entegrion's Reply To Counterclaims; Entegrion, Inc. vs Velico Medical, Inc; Dated: Jan. 14, 2013, entire document, 22 pages.
Entegrion's Motion To Dismiss Counts I, II, V, VI and XI of Velico Medical, Inc's Counterclaims and Memorandum in Support of Entegrion's Motion To Dismiss Counts I, II, V, VI, and XI of Velico Medical, Inc.'S Counterclaims; Entegrion, Inc. vs Velico Medical, Inc; Dated: Jan. 14, 2013, entire document, 3 Pages.
International Preliminary Report on Patentability, PCT/US2010/049176, dated Feb. 18, 2014, pp. 1-9.
Pusateri, Anthony E.“ Dried plasma: state of the science and recent developments” Transfusion 56: S128-S139 (Apr. 2016).
Pusateri, Anthony E.“ Comprehensive US government program for dried plasma development” Transfusion 56: S16-S23 (2016).
Popovsky, Mark A. “Spray-dried plasma: A post-traumatic blood ”bridge“ for life-saving resuscitation” Transfusion. 2021;61:S294-S300 (2021).
Flaumenhaft, Elissa J. et al., “Retention of Coagulation Factors and Storage of Freeze- Dried Plasma,” Military Med. 186 (S1):400-407 (2021).
Parr, Ashely, “Coagulation Activity of Freeze-Dried Plasma is similar to that of Fresh Frozen Plasma” (May 16, 2018), entire document, 14 Pages.
Peng, Henry T. “Ex vivo hemostatic and immune-inflammatory profiles of freeze-dried plasma” Transfusion 61: S119-S130 (2021).
Larry J. Dumont, et al., “The bioequivalence of frozen plasma prepared from whole blood held overnight at room temperature compared to fresh-frozen plasma prepared within eight hours of collection,” Transfusion 55: 480 (2015) , entire document, 9 Pages.
Blazquez, E., et al., “Combined effects of spray-drying conditions and postdrying storage time and temperature on Salmonella choleraesuis and Salmonella typhimurium survival when inoculated in liquid porcine plasma,” Letters in Applied Microbiology, 67(2): 205-211 (2018).
S. Suessner, et al., “Comparison of several complement and coagulation factor concentrations in different plasma products.” Transfusion Medicine and Hemotherapy, 41 (supplement 1) Abstract No. PBK-V02: p. 36 (2014), 3 Pages.
Cancelas, J. A., “A Phase 1, Single-Center, Partial Double-blind, Randomized, Controlled (Versus Fresh Frozen Plasma [FFP] In Cohort 3 Only) Clinical Study Of The Safety Of Ascending Doses Of Autologous Freeze Dried Plasma (FDP) In Healthy Volunteers,” Falls Church, VA: The Surgeon General, Department of the Army (2018), p. 1-128.
Polo, J., et al., “Neutralizing antibodies against porcine circovirus type 2 in liquid pooled plasma contribute to the biosafety of commercially manufactured spray-dried porcine plasma,” Journal of Animal Science, 91(5): 2192-2198 (2013).
Blazquez, E., et al., “UV-C irradiation is able to inactivate pathogens found in commercially collected porcine plasma as demonstrated by swine bioassay,” Veterinary Microbiology, 239 (2019) , entire document, 2 Pages.
Blazquez, E., et al., “Evaluation of the effectiveness of the SurePure Turbulator ultraviolet-C irradiation equipment on inactivation of different enveloped and non-enveloped viruses inoculated in commercially collected liquid animal plasma,” PLOS One, 14(2) (2019), entire document, 17 Pages.
Shen, E., et al., “Commercially produced spray-dried porcine plasma contains increased concentrations of porcine circovirus type 2 DNA but does not transmit porcine circovirus type 2 when fed to naïve pigs,” Journal of Animal Science, 89(6): 1930-1938 (2011).
Pujols, J., and Segales, J., “Survivability of porcine epidemic diarrhea virus (PEDV) in bovine plasma submitted to spray drying processing and held at different time by temperature storage conditions,” Veterinary Microbiology, 174(3/4): 427-432 (2014).
Blazquez, E., et al., “Evaluation of ultraviolet-C and spray-drying processes as two independent inactivation steps on enterotoxigenic Escherichia coli K88 and K99 strains inoculated in fresh unconcentrated porcine plasma,” Letters in Applied Microbiology, 67(5): 442-448 (2018).
Pujols, J., et al., “No transmission of hepatitis E virus in pigs fed diets containing commercial spray-dried porcine plasma: a retrospective study of samples from several swine trials,” Virology Journal, 11: p. 232 (2014), 8 Pages.
Foddai, A., et al., “Probability of introducing porcine epidemic diarrhea virus into Danish pig herds by imported spray-dried porcine plasma,” Porcine Health Management, 1: p. 18 (2015), 11 Pages.
Gerber, P. F., et al., “The spray-drying process is sufficient to inactivate infectious porcine epidemic diarrhea virus in plasma,” Veterinary Microbiology, 174(1/2): 86-92 (2014).
Patterson, A. R., et al., “Efficacy of experimentally produced spray-dried plasma on infectivity of porcine circovirus type 2,” Journal of Animal Science, 88(12: 4078-4085 (2010).
Pujols, J., et al., “Commercial spray-dried porcine plasma does not transmit porcine circovirus type 2 in weaned pigs challenged with porcine reproductive and respiratory syndrome virus,” Veterinary Journal, 190(2): 16-20 (2011).
Blazquez, E., et al., “Ultraviolet (UV-C) inactivation of Enterococcus faecium, Salmonella choleraesuis and Salmonella typhimurium in porcine plasma,” PLoS One, 12(4) (2017), 11 Pages.
Polo, J., et al., “Ultraviolet Light (UV) Inactivation of Porcine Parvovirus in Liquid Plasma and Effect of UV Irradiated Spray Dried Porcine Plasma on Performance of Weaned Pigs,” PLOS One, 10(7) (2015), 12 Pages.
Pujols, J., et al., “Lack of transmission of porcine circovirus type 2 to weanling pigs by feeding them spray-dried porcine plasma,” Veterinary Record, 163(18): 536-538 (2008).
Opriessnig, T., et al., “Porcine Epidemic Diarrhea Virus RNA Present in Commercial Spray-Dried Porcine Plasma Is Not Infectious to Naïve Pigs,” PLOS One, 9(8) (2014), 10 Pages.
Polo, J., et al., “Efficacy of spray-drying to reduce infectivity of pseudorabies and porcine reproductive and respiratory syndrome (PRRS) viruses and seroconversion in pigs fed diets containing spray-dried animal plasma,” Journal of Animal Science, 83(8): 1933-1938 (2005).
Perez-Bosque, A., et al., “Spray dried plasma as an alternative to antibiotics in piglet feeds, mode of action and biosafety,” Porcine Health Management, 2: p. 16 (2016), 10 Pages.
Moreto, M., et al., “Dietary supplementation with spray-dried porcine plasma has prebiotic effects on gut microbiota in mice,” Scientific Reports, 10(1): p. 2926 (2020), 13 Pages.
Hulst, M. M., et al., “Study on inactivation of porcine epidemic diarrhoea virus, porcine sapelovirus 1 and adenovirus in the production and storage of laboratory spray-dried porcine plasma,” Journal of Applied Microbiology, 126(6): 1931-1943 (2019).
Pasick, J., et al., “Investigation into the Role of Potentially Contaminated Feed as a Source of the First-Detected Outbreaks of Porcine Epidemic Diarrhea in Canada,” Transboundary and Emerging Diseases, 61(5): 397-410 (2014).
Duffy, M. A., et al., “Impact of dietary spray-dried bovine plasma addition on pigs infected with porcine epidemic diarrhea virus,” Translational Animal Science, 2(4): 349-357 (2018).
Cottingim, K. M., et al., “Ultraviolet irradiation of spray-dried porcine plasma does not affect the growth performance of nursery pigs when compared with nonirradiated bovine plasma,” Journal of Animal Science, 95(7): 3120-3128 (2017).
Gebhardt, J. T., et al., “Determining the impact of commercial feed additives as potential porcine epidemic diarrhea virus mitigation strategies as determined by polymerase chain reaction analysis and bioassay,” Translational Animal Science, 3(1): 28-37 (2019).
Champagne C. P., et al., “Effect of bovine colostrum, cheese whey, and spray- dried porcine plasma on the in vitro growth of probiotic bacteria and Escherichia coli,” Canadian Journal of Microbiology, 60(5): 287-295 (2014).
Perez-Bosque, A., et al., “The Anti-Inflammatory Effect of Spray-Dried Plasma Is Mediated by a Reduction in Mucosal Lymphocyte Activation and Infiltration in a Mouse Model of Intestinal Inflammation,” Nutrients, 8(10) (2016), p. 1-13.
Prabhu, B., et al., “Effects of spray-dried animal plasma on the growth performance of weaned piglets—A review,” Journal of Animal Physiology and Animal Nutrition, 105(4): 699-714 (2021).
Santos, D., et al., “Spray Drying: An Overview,” Biomaterials, (2017), p. 1-29.
USAMRMC military plasma article “Advanced Development Products,” (Second Edition). U.S. Army Medical Research and Materiel Command (2017), p. 521-529.
Govtribe, “Definitive Contract H9222216C0081”, [online], [retrieved on Mar. 20, 2020], Retrieved from https://govtribe.com/award/federal-contract-award/definitive-contract-h9222216c0081, entire document, 3 Pages.
Noorman, F. et al. “Lyophilized Plasma, an Alternative to 4 degrees C Stored Thawed Plasma for the Early Treatment of Trauma Patients with (Massive) Blood Loss in Military Theatre,” Transfusion 55A (2012), p. 1-2.
Bux, J., et al., “Quality of freeze-dried (lyophilized) quarantined single-donor plasma,” Transfusion, 53: 3203-3209 (2013).
Noorman, F., “Comparison of a single Spray dried plasma product with standard Sanquin and MBB frozen, thawed (coldstored) plasma,” (Final Report). Utrecht, Netherlands: Military Blood Bank (2021), p. 1-7.
Sailliol, A., et al., “The evolving role of lyophilized plasma in remote damage control resuscitation in the French Armed Forces Health Service,” Transfusion, 53: 65S-71S (2013).
Zaza, M., et al. “Dried Plasma,” Damage Control Resuscitation: Identification and Treatment of Life-Threatening Hemorrhage, 145-162 (2019).
Wataha, K., et al., “Spray-dried plasma and fresh frozen plasma modulate permeability and inflammation in vitro in vascular endothelial cells,” Transfusion, 53: 80S-90S (2013).
Wang, H.H., et al., “Effect of gallbladder hypomotility on cholesterol crystallization and growth in CCK-deficient mice,” Biochim Biophys Acta, 1801(2): 138-146 (2010).
Gadeela, N., et al., “The Impact of Circulating Cholesterol Crystals on Vasomotor Function. Implications for No-Reflow Phenomenon,” J Am Coll Cardiol Int, 4: 521-529 (2011).
Abela, G.S., et al., “The Effect of Ethanol on Cholesterol Crystals During Tissue Preparation for Scanning Electron Microscopy, ” J Am Coll Cardiol 1: 93 (2012), 1 Page.
Li, H., et al., “Synthesis of ß-cyclodextrin conjugated superparamagnetic iron oxide nanoparticles for selective binding and detection of cholesterol crystals,” Chem Commun, 48(28): 3385-3387 (2012).
Elizabeth, A., et al., “Growth and micro-topographical studies of gel grown cholesterol crystals,” Bull Mater Sci, 24(4): 431-434 (2001).
Kroll, M.H., et al., “Effect of Lyophilization on Results of Five Enzymatic Methods for Cholesterol,” Clin Chem, 35(7): 1523-1526 (1989).
Mughal, M.M., et al., “Symptomatic and asymptomatic carotid artery plaque,” Expert Rev Cardiovasc Ther, 9(10): 1315-1330 (2011).
Morales, J., and Gonzalez, E., “Cholesterol Crystal Embolization,” Blood Purif, 24: 431-432 (2006).
Walton, T.J., et al., “Systemic cholesterol crystal embolisation with pulmonary involvement: a fatal combination after coronary angiography,” Postgrad Med J, 78: 288-289 (2002).
Oe, K., et al., “Late Onset of Cholesterol Crystal Embolism after Thrombolysis for Cerebral Infarction,” Inter Med, 49: 833-836 (2010).
Warren, B. A., and Vales, O., “The ultrastructure of the stages of atheroembolic occlusion of renal arteries,” Br J Exp Pathol, 54(5): 469-478 (1973).
Warren B. A., Vales, O., “Electron microscopy of the sequence of events in the atheroembolic occlusion of cerebral arteries in an animal model,” Br J Exp Pathol, 56(3):205-215 (1975).
Warren, B. A., and Vales, O., “The ultrastructure of the reaction of arterial walls to cholesterol crystals in atheroembolism,” Br J Exp Pathol, 57(1), 67-77 (1976).
Steiner, T.J., et al., “Cholesterol crystal embolization in rat brain: a model for atheroembolic cerebral infarction,” Stroke, 11: 184-189 (1980).
Nozari A., et al., “Microemboli may link spreading depression, migraine aura, and patent foramen ovale,” Ann Neurol, 67(2):221-229 (2010).
Duewell, P., et al., “NLRP3 inflammasomes are required for atherogenesis and activated by cholesterol crystals,” Nature, 464,7293: 1357-1361 (2010).
Samstadt, E. O., et al., “Cholesterol crystals induce complement-dependent inflammasome activation and cytokine release,” J Immunol, 192(67): 2837-2845 (2014).
Grebe, A., and Latz, E., “Cholesterol Crystals and Inflammation,” Curr Rheumatol Rep, 15: 313 (2013), 7 Pages.
Sheedy, F., et al., “CD36 coordinates NLRP3 inflammasome activation by facilitating intracellular nucleation of soluble ligands into particulate ligands in sterile inflammation,” Nat Immunol, 14: 812-820 (2013).
Ness, M. V., et al., “Neutrophils Contain Cholesterol Crystals in Transfusion-Related Acute Lung Injury (TRALI),” Am J Clin Pathol, 140(2): 170-176 (2013).
Sheffield, W. P., et al., “Retention of hemostatic and immunological properties of frozen plasma and COVID-19 convalescent apheresis fresh-frozen plasma produced and freeze-dried in Canada,” Transfusion, 62: 418-428 (2021).
Garrigue, D., et al., “French lyophilized plasma versus fresh frozen plasma for the initial management of trauma-induced coagulopathy: a randomized open-label trial,” J Thrombosis and Haemostasis, 16:481-489 (2017).
Van, P. Y., et al., “Lyophilized Plasma Reconstituted With Ascorbic Acid Suppresses Inflammation and Oxidative DNA Damage,” J Trauma, 71(1) :20-24 (2011).
Medical Countermeasures, “BARDA continues partnership with Velico Medical for development of their FrontlineODP spray-dry plasma system to prepare for a radiological or nuclear emergency,” [online], [retrieved on Sep. 20, 2021], Retrieved from https://www.medicalcountermeasures.gov/newsroom/2021/velico-medical/ entire document, 20 Pages.
Burnouf, T., et al., “Assessment of complement activation during membrane- based plasmapheresis procedures,” J Clin Apheresis, 19: 142-147 (2004).
Ohta, R., et al., “Serum concentrations of complement anaphylatoxins and proinflammatory mediators in patients with 2009 H1N1 influenza,” Microbiology and Immunology, 55: 191-198 (2011).
“French Lyophilised Plasma (FLYP),” Ministry of Defence, Armed Forces Health Service, Jean Julliard Armed Forces Blood Transfusion Service (Technical Notice and Summary of Product Characteristics) (2013), 2 Pages.
Arun, R., “Freeze Dried Plasma Role in Emergency Resuscitation”, Tirupati, India: Sri Venkateswara Institute of Medical Sciences, https://www.istm.net.in/transmedcon2016-presentations/99.9%20Freeze %20Dried %20Plasma-Role%20in%20Emergency %20Resuscitation.pdf, downloaded on Jan. 16, 2021, entire document, 51 Pages.
Pusateri, A.E., and Weiskopf, R.B. “Dried Plasma for Trauma Resuscitation,” Trauma Induced Coagulopathy, 705-718 (2021).
Sunde, G.A., “Prehospital Plasma / TXA experience—FDP in Norwegian HEMS,” Norway: Norsk Luftambulanse (2014), p. 1-24.
Acker, J. P., et al., “Quality Assessment of Established and Emerging Blood Components for Transfusion,” Journal of Blood Transfusion, (2016), p. 1-29.
Warr, M., “Lyoplas reconstitution English,” Deutsches Rotes Kreuz, [Youtube], [retrieved on Jan. 9, 2022], Retrieved from https://www.youtube.com/watch?v=PdydStBygtk. Entire document.
Mew, I., “Reconstituting Lyoplas (Freeze dried FFP)”, [Youtube], [retrieved on Jan. 9, 2022], Retrieved from https://www.youtube.com/watch?v=RxpQDMwVK8Y. ), entire document, 9 Pages.
Cancelas, J. A., et al., “Characterization and first-in-human clinical dose- escalation safety evaluation of a next-gen human freeze-dried plasma,” Transfusion, 62: 406-417 (2021).
Terumo BCT, “Terumo BCT Awarded $1.9 Million from the United States Government to Support Development of Freeze-Dried Plasma,” [online], [retrieved on Mar. 20, 2020], Retrieved from https://www.terumobct.com/Pages/News/Press%20Releases/Terumo_BCT_Awarded_$1-9_Million_from_the_United_States_Government_to_Support_Development_of_Freeze-Dried_Plasma_aspx. , entire document, 2 pages.
Spinella, P. C., “Zero preventable deaths after traumatic injury: an achievable goal,” J Trauma Acute Care Surg, 82:S2-S8 (2017).
Davis, J. S., et al., “An analysis of prehospital deaths: who can we save?,” J Trauma Acute Care Surg, 77:213-218 (2014).
Shackelford, S. A., et al., “Association of prehospital blood product transfusion during medical evacuation of combat casualties in Afghanistan with acute and 30-day survival,” JAMA, 318:1581-1591 (2017).
Gurney, J. M., and Spinella, P. C., “Blood transfusion management in the severely bleeding military patient,” Curr Opin Anesthesiol, 31:207-214 (2018).
Moore, E. E., et al., “Plasma first in the field for postinjury hemorrhagic shock,” Shock, 41(Suppl 1):35-38 (2014).
Maegele, M., et al., “Red-blood-cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiple injury: a retrospective analysis from the trauma registry of the deutsche Gesellshaft fur Unfallchirugerie,” Vox Sang, 95:112-119 (2008).
Holcomb, J. B., et al., “Prehospital transfusion of plasma and red blood cells in trauma patients,” Prehosp Emerg Care, 19:1-9 (2015).
Holcomb, J. B., et al., “The prospective, observational, multicenter major trauma transfusion (PROMMTT) study: comparative effectiveness of a time-varying treatment with competing risks,” JAMA Surg, 148:127-136 (2013).
Holcomb, J. B., et al., “Damage control resuscitation: directly addressing the early coagulopathy of trauma,” J Trauma Acute Care Surg, 62:307-310 (2007).
Holcomb, J. B., et al., “Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial,” JAMA, 313:471-482 (2015).
Sperry, J. L., et al., “Prehospital plasma during air medical transport in trauma patients at risk for hemorrhagic shock,” N Engl J Med, 379:315-326 (2018).
Zink, K. A., et al., “A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of massive transfusion improves outcomes in a large multicenter study,” Am J Surg, 197:565-570 (2009).
Saillol, A., et al., “The evolving role of lyophilized plasma in remote damage control resuscitation in the French armed forces health service,” Transfusion, 53(Suppl 1): S129-S39 (2013).
Nuguyen, C., et al., “Use of French lyophilized plasma transfusion in severe trauma patients is associated with an early plasma transfusion and early transfusion ratio improvement,” J Trauma Acute Care Surg, 84:780-785 (2018).
Shlaifer, A., et al., “Prehospital administration of freeze-dried plasma, is it the solution for trauma casualties?,” J Trauma Acute Care Surg, 83:675-682 (2017).
Shlaifer, A., et al., “The impact of prehospital administration of freeze-dried plasma on casualty outcome,” J Trauma Acute Care Surg, 86:108-115 (2019).
Bjerkvig, C.K., et al., “”Blood failure“ time to view blood as an organ: how oxygen debt contributes to blood failure and its implications for remote damage control resuscitation,” Transfusion, 56(Suppl 2):S182-S189 (2016).
White, N. J., et al., “Hemorrhagic blood failure: oxygen debt, coagulopathy, and endothelial damage,” J Trauma Acute Care Surg, 82(6S Suppl 1): S41-S49 (2017).
Aird, W. C., “Endothelium and haemostasis,” Hamostaseologie, 35:11-16 (2015).
Esmon, C. T., “Inflammation and the activated protein C anticoagulant pathway,” Semin Thromb Hemost, 32(Suppl 1):49-60 (2006).
Tuma, M., et al., “Trauma and endothelial glycocalyx: the microcirculation helmet?,” Shock, 46:352-357 (2016).
Kozar, R. A., and Pati, S., “Syndecan-1 restitution by plasma after hemorrhagic shock,” J Trauma Acute Care Surg, 78(6 Suppl 1):S83-S86 (2015).
Rahbar, E., et al., “Endothelial glycocalyx shedding and vascular permeability in severely injured trauma patients,” J Transl Med, 13:117 (2015), entire document, 7 Pages.
Johansson, P. I., et al., “Traumatic Endotheliopathy: a prospective observational Study of 424 severely injured patients,” Ann Surg, 265:597-603 (2017).
Wu, F., et al., “miR-19b targets pulmonary endothelial syndecan-1 following hemorrhagic shock,” Sci Rep, 10:15811 (2020), 10 Pages.
Johansson, P. I., et al., “Shock induced endotheliopathy (SHINE) in acute critical illness-a unifying pathophysiologic mechanism,” Crit Care, 21:25 (2017), 7 Pages.
Spronk, H. M., et al., “New insights into modulation of thrombin formation,” Curr Atheroscler Rep, 15:363 (2013), 9 Pages.
Dunbar, N. M., and Chandler, W. L., “Thrombin generation in trauma patients,” Transfusion, 49:2652-2660 (2009).
Chandler, W. L., “Procoagulant activity in trauma patients,” Am J Clin Pathol, 134:90-96 (2010).
Cardenas, J. C., et al., “Measuring thrombin generation as a tool for predicting hemostatic potential and transfusion requirements following trauma,” J Trauma Acute Care Surg, 77:839-845 (2014).
Rourke, C., et al., “Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes,” J Thromb Haemost, 10:1342-1351 (2012).
Raza, I., et al., “The incidence and magnitude of fibrinolytic activation in trauma patients,” J Thromb Haemost, 11:307-314 (2013).
Hayakawa, M., et al., “Disseminated intravascular coagulation at an early phase of trauma is associated with consumption coagulopathy and excessive fibrinolysis both by plasmin and neutrophil elastase,” Surgery, 149:221-230 (2011).
Kaplan, A. P., and Ghebrehiwet, B., “The plasma bradykinin-forming pathways and its interrelationships with complement,” Mol Immunol, 47:2161-2169 (2010).
Omar, M. N., Mann, K. G., “Inactivation of factor Va by plasmin,” J Biol Chem, 262:9750-9755 (1987).
Marcos-Contreras, O. A., et al., “Hyperfibrinolysis increases blood-brain barrier permeability by a plasmin- and bradykinin-dependent mechanism,” Blood, 128:2423-2434 (2016).
Chapman, M. P., et al., “Overwhelming tPA release, not PAI-1 degradation, is responsible for hyperfibrinolysis in severely injured trauma patients,” J Trauma Acute Care Surg, 80:16-25 (2016).
Cardenas, J. C., et al., “Elevated tissue plasminogen activator and reduced plasminogen activator inhibitor promote hyperfibrinolysis in trauma patients,” Shock, 41:514-521 (2014).
Moore, H. B., et al., “Acute fibrinolysis shutdown after injury occurs frequently and increases mortality: a multicenter evaluation of 2,540 severely injured patients,” J Am Coll Surg, 222:347-355 (2016).
Shakur, H., et al., “Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial,” Lancet, 376:23-32 (2010).
Peng, Z., et al., “Fresh frozen plasma lessens pulmonary endothelial inflammation and hyperpermeability after hemorrhagic shock and is associated with loss of syndecan 1,” Shock, 40:195-202 (2013).
Diebel, L. N., “Microfluidics: a high-throughput system for the assessment of the endotheliopathy of trauma and the effect of timing of plasma administration on ameliorating shock-associated endothelial dysfunction,” J Trauma Acute Care Surg, 84:575-582 (2018).
Yu, Q., et al., “Identification of fibrinogen as a key anti-apoptotic factor in human fresh frozen plasma for protecting endothelial cells in vitro,” Shock, 53:646-652 (2020).
Wu, F., and Kozar, R. A., “Fibrinogen protects against barrier dysfunction through maintaining cell surface syndecan-1 in vitro,” Shock, 51:740-744 (2019).
Wu, F., et al., “Fibrinogen activates PAK1/Cofilin signaling pathway to protect endothelial barrier integrity,” Shock, 55:660-665 (2020).
Lopez, E., et al., “Antithrombin III contributes to the protective effects of fresh frozen plasma following hemorrhagic shock by preventing syndecan-1 shedding and endothelial barrier disruption,” Shock, 53:156-163 (2020).
Deng, X., et al., “Adiponectin in fresh frozen plasma contributes to restoration of vascular barrier function after hemorrhagic shock,” Shock, 45:50-54 (2016).
Rizoli, S. B., et al., “Clotting factor deficiency in early trauma-associated coagulopathy,” J Trauma, 71(5 Suppl 1):S427-S434 (2011).
Pati, S., et al., “Lyophilized plasma attenuates vascular permeability, inflammation and lung injury in hemorrhagic shock,” PLOS One, 13:e0192363 (2018) , entire document, 13 Pages.
Reineccius, G., “Flavor encapsulation, Chapter 7. Spray-drying of food flavors,” United Kingdom: Taylor and Francis, 55-66 (1989).
“Considerations for the Development of Dried Plasma Products Intended for Transfusion”, (Final Report). Food and Drug Administration (2019), entire document, 9 Pages.
Liu, Q. P., et al., “Single-donor spray-dried plasma,” Transfusion, 59:707-719 (2019).
Meledeo, M. A., et al., “Spray-dried plasma deficient in high-molecular weight multimers of von Willebrand factor retains hemostatic properties,” Transfusion, 59:714-722 (2019).
Buckley, L., and Gonzales, R., “Challenges to producing novel therapies-dried plasma for use in trauma and critical care,” Transfusion, 59:837-845 (2019).
Bercovitz, R., et al., “Microfluidic analysis of thrombus formation in reconstituted whole blood samples comparing spray-dried plasma versus fresh- frozen plasma,” Vox Sang, 116:540-546 (2020).
Spinella, P. C., et al., “All plasma products are not created equal: characterizing differences between plasma products,” J Trauma Acute Care Surg, 78:S18-S25 (2015).
Bomey, N., “Hurricane Maria halts crucial drug manufacturing in Puerto Rico, may cause shortages,” USA Today, [online], [retrieved on Oct. 20, 2017] Retrieved from https://www.usatoday.com/story/money/2017/09/22/hurricane-maria-pharmaceutical industry-puerto-rico/692752001/ (2017), entire document, 9 Pages.
Robinson, R. A., “Barda Strategic Plan 2011-2016”, Washington, D.C.: Biomedical Advanced Research and Development Authority. (2016), entire document, 20 Pages.
Pusateri A.E., “Dried Plasma Development Update,” Defense Health Agency (2015), entire document, 58 Pages.
Downes, K. A., et al., “Serial measurement of clotting factors in thawed plasma stored for 5 days,” Transfusion, 41: 570-570 (2001).
Runkel, S., et al., “The impact of whole blood processing and freezing conditions on the quality of therapeutic plasma prepared from whole blood,” Transfusion, 55: 796-804 (2015).
Kelley, D., “Update on Plasma and Cryoprecipitate Transfusion,” (Issue 1). Institute for Transfusion Medicine (2004), Entire Document, 2 Pages.
ARUP Consult, “Von Willebrand Disease Testing,” [online], [retrieved on May 12, 2015], Retrieved from https://arupconsult.com/sites/default/files/von_Willebrand_Disease_Testing_Algorithm.pdf , entire document, 1 Page.
Heger, A., et al., “Biochemical quality of the pharmaceutically licensed plasma OctaplasLG® after implementation of a novel prion protein (PrPSc) removal technology and reduction of the solvent/detergent (S/D) process time,” Vox Sanguinis, 97: 219-225 (2009).
Pusateri, A. E., et al., “Use of Dried Plasma in Prehospital and Austere Environments,” Anesthesiology, 136: 327-335 (2022).
Pusateri, A. E., “Dried plasma: state of the science and recent developments,” Transfusion, 56: S128-S139 (2016).
Chaffin, J., “Liquid Plasma,” [online], [retrieved on Nov. 2, 2021], Retrieved from https://www.bbguy.org/education/glossary/gl104/, entire document, 2 Pages.
Chaffin, J., “Thawed Plasma,” [online], [retrieved on Nov. 2, 2021], Retrieved from https://www.bbguy.org/education/glossary/elt04/, entire document, 2 Pages.
Barrows, E., “Freeze-dried Plasma The Trail Back to the Battlefield,” Defense AT&L Technology Transition, pp. 16-19 (Sep.-Oct. 2006).
Martinaud, C., et al., “In Vitro Hemostatic Properties of French Lyophilized Plasma,” Anesthesiology, 117: 339-346 (2012).
Sicard, B., et al., “Lyophilized Plasma in Out-of-Hospital Resuscitation: Risk Benefit Balance,” Ann Emerg Med, S141:357 (2017).
Jost, D., et al., “Pre-hospital Administration of Lyophilized Plasma for Post-traumatic Coagulopathy Treatment (PREHO-PLYO),” [online], [retrieved on Apr. 25, 2022], Retrieved from https://clinicaltrials.gov/ct2/show/study/NCT02736812 , entire document, 9 Pages.
News 4 WOAI San Antonio, “Freeze-dried plasma saves special ops soldiers”, [Youtube], [retrieved on Apr. 25, 2022], Retrieved from https://www.youtube.com/watch?v=rstOwnwkw. , entire document, 6 Pages.
Lee, T., et al., “The use of lyophilized plasma in a severe multi-injury pig model,” Transfusion, 53: 72S-79S (2013).
Holcomb, J.B., et al., “Increased Plasma and Platelet to Red Blood Cell Ratios Improves Outcome in 466 Massively Transfused Civilian Trauma Patients,” Ann Surg, 3: 447-458 (2008).
Gatnau, R., “Spray dried porcine plasma as a source of protein and immunoglobins for weanling pigs.” Unpublished master's thesis, Iowa State University, Ames, Iowa. (1990), entire document, 95 Pages.
Murad, M.H., et al., “The effect of plasma transfusion on morbidity and mortality: a systematic review and meta-analysis,” Transfusion, 50(6): 1370-1383 (2010).
Buchi Mini Spray Dryer B-191; www.buchi.com; Dec. 19, 2000 , entire document, 28 Pages.
DSS “Powdered Blood? Synthetic Blood Trials Show Promising Result” https://www.discoveryscientificsolutions.com/item/73 (downloaded Dec. 22, 2022), entire document, 3 Pages.
Hamilton GJ “Lyophilized plasma with ascorbic acid decreases inflammation in hemorrhagic shock.” J Trauma, 71 (2):292-7 (2011).
Hawksworth, U.S et al., Evaluation of lyophilized platelets as an infusible hemostatic agent in experimental non-compressible hemorrhage in swine, Journal of Thrombosis and Haemostasis, Oct. 2009, vol. 7, No. 10, pp. 1663-1671.
Solheim B G et al., Improved Preservation of Coagulation Factors After Pre-Storage Leukocyte Depletion of Whole Blood; Transfus Apher Sci., Oct. 2003. 29(2): pp. 133-139.
Goto et al., Characterization of the Unique Mechanism Mediating the Shear-dependent Binding of Soluble von Willebrand Factor to Platelets, The Journal of Biological Chemistry, vol. 270, No. 40, Oct. 6, 1995, pp. 23352-23361, 1995.
Horn, R.G., Addition of a polarizing microscope to the Weissenberg Rheogoniometer, 1979 American Institute of Physics, Rev. Sci. Instrum. 50(50, May 1979, pp. 659-661.
Moake, et al., Involvement of Large Plasma von Willebrand Factor (vWF) Multimers and Unusually Large vWF Forms Derived from Endothelial Cells in Shear Stress-induced Platelet Aggregation, The American Society for Clinical Investigation, Inc., vol. 78, Dec. 1986, pp. 1456-1461.
Shuja et al., Development and Testing of Freeze-Dried Plasma for the Treatment of Trauma-Associated Coagulopathy, The Journal of Trauma Injury, Infection and Critical Care, Presented at the 38th Annual Meeting of the Western Trauma Association, Feb. 24-Mar. 1, 2008, vol. 65, pp. 975-985.
“LyoPlas N—w A freeze-dried single donor plasma,” Brochure, DRK-Blutspendedienst West, Hagen, Germany: Deutsches Rotes Kreuz (May 2012), entire document, 14 pages.
“Mirasol Pathogen Reduction Technology System”, TerumoBCT (2012), entire document, 13 pages.
Parsons, J. C., “Coagulation Hereditary bleeding disorders von Willebrand disease,” [online], [retrieved on May 12, 2015], Retrieved from https://www.pathologyoutlines.com/topic/coagulationvonwillebra sease html entire document, 5 pages.
Martinaud, C., et al., “French Dried Plasma Program: Updated on prehospital and emergency unit use for massive hemorrhage management,” French Military Blood Institute (Jun. 27, 2017), entire document, 34 pages.
Heger, Andrea “Frozen and Freeze-dried solvent/detergent treated plasma: Two different pharmaceutical formations with comparable quality” Transfusion (62): pp. 2621-2630 (Sep. 11, 2022).
Highlights of Prescribing Information , Feb. 2021, <URL: https://octaplasusa.com/wp-content-uploads/2021/03/20210202_pil_952_US_25.pdf>, Downloaded Apr. 11, 2023; Octapharma USA Inc, pp. 1-9.
Operation Manual; Mini Spray Dryer B-290; Version G; www.buchi.com; Feb. 8, 2007, pp. 1-57.
Related Publications (1)
Number Date Country
20210290545 A1 Sep 2021 US
Provisional Applications (1)
Number Date Country
62052689 Sep 2014 US
Continuations (2)
Number Date Country
Parent 15383201 Dec 2016 US
Child 17337306 US
Parent 14858539 Sep 2015 US
Child 15383201 US