CN112010968B - Method for rapidly extracting blood plasma of patient with COVID-19 in convalescence stage for preparing immunoglobulin G - Google Patents

Method for rapidly extracting blood plasma of patient with COVID-19 in convalescence stage for preparing immunoglobulin G Download PDF

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CN112010968B
CN112010968B CN202011117433.7A CN202011117433A CN112010968B CN 112010968 B CN112010968 B CN 112010968B CN 202011117433 A CN202011117433 A CN 202011117433A CN 112010968 B CN112010968 B CN 112010968B
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CN112010968A (en
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魏卿
肖海蓉
刘庆喜
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Shenzhen Boya Perception Pharmaceutical Co ltd
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    • C07ORGANIC CHEMISTRY
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    • C07K16/00Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/08Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from viruses
    • C07K16/10Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from viruses from RNA viruses
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    • C07ORGANIC CHEMISTRY
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    • C07K16/065Purification, fragmentation
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    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K2039/505Medicinal preparations containing antigens or antibodies comprising antibodies
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    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K2317/00Immunoglobulins specific features
    • C07K2317/70Immunoglobulins specific features characterized by effect upon binding to a cell or to an antigen
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Abstract

The invention relates to a method for rapidly extracting COVID-19 patient convalescent plasma for preparing immunoglobulin G, in particular to a method for rapidly separating component plasma from whole blood by using a closed multi-cell component automatic separation system (MACSS) to prepare covvid-19 immunoglobulin G for intravenous injection, for example, to prepare super immunoglobulin for intravenous injection. The immunoglobulin can be used for treating patients infected by novel coronavirus. The method is to separate peripheral blood taken from a human into three component layers using a closed multicellular component automated separation system: red blood cell layer, cell concentration layer and plasma layer, and then performing virus inactivation on the obtained plasma to obtain the plasma for preparing immunoglobulin G for intravenous injection. Also relates to a method for preparing an intravenous immunoglobulin G preparation by using the plasma component obtained by the method. The method of the invention has fast speed of obtaining the blood plasma, and the antibody titer of the prepared blood plasma and the immunoglobulin G for intravenous injection is high.

Description

Method for rapidly extracting blood plasma of patient with COVID-19 in convalescence stage for preparing immunoglobulin G
Technical Field
The invention belongs to the technical field of medical biology, and particularly relates to a method for preparing intravenous injection COVID-19 immunoglobulin by quickly separating component plasma from whole blood. In particular, it relates to a method for preparing covi-19 igg for intravenous injection by rapidly separating component plasma from whole blood using a closed multi-cellular component Automated Cell Separation System (MACSS, ThermoGenesis Corp.). The intravenous injection COVID-19 immunoglobulin can be used for treating patients infected by the novel coronavirus COVID-19.
Background
2019 Coronavirus (Coronavir Disease 2019, COVID-19) is also called novel Coronavirus, is a Disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has a latency period of 1-14 d, and is mostly 3-7 d. The clinical manifestations of flu-like symptoms mainly include fever, dry cough and hypodynamia. According to the severity of symptoms, the clinical classification is light, common, heavy and dangerous. Severe cases often cause dyspnea after 1 week, critically ill patients rapidly progress to acute respiratory distress syndrome, septic shock, uncorrectable metabolic acidosis, hemorrhagic coagulation dysfunction, multiple organ failure and the like, and severe cases can cause death of patients.
With the success of convalescent plasma in the treatment of a variety of acute viral infections, such as ebola, Severe Acute Respiratory Syndrome (SARS) virus and Middle East Respiratory Syndrome (MERS) virus, the treatment of convalescent plasma has been prepared for treatment or medical research, and its unique treatment technical advantages have become more and more certain and recognized, and although there is no specific drug therapy for the new coronavirus at present, it has been discovered that the convalescent coronavirus pneumonia convalescent person has high titer antibodies in vivo, which can resist the new coronavirus, can reduce the virus content in the patient, and some of them may neutralize the virus and prevent a new round of infection. The specific antibody in the blood plasma of a rehabilitee can neutralize SARS-CoV-2 virus in a patient, and is helpful for improving clinical symptoms and prognosis outcome of the patient. The purpose of the plasma treatment of the novel coronavirus pneumonia rehabilitation patient is to enable the novel coronavirus infector to achieve symptomatic and supportive treatment under the condition that no specific drug treatment is available at present, and especially heavy and critical patients can relieve symptoms and improve the activity endurance of the patients.
Human ImmunoGlobulin (Ig), also known as an antibody, is a major substance in the human body that immunoreacts with foreign antigens such as bacteria, viruses, and other toxins or foreign substances. The plasma-derived human immunoglobulin preparations are classified into the following types according to the injection route: the main component of Intravenous Immunoglobulin (IVIG) and Intramuscular injection human Immunoglobulin (IMIG) is Immunoglobulin G which is one of the most important plasma proteins, has the molecular weight of 150kDa, has the content of 6.6-14.5G/L in plasma, accounts for about 75% of the total amount of the plasma Immunoglobulin and contains 2-3% of sugar. The high-titer SARS-CoV-2 specific immunoglobulin G exists in the plasma of a patient with COVID-19 in the convalescence, can neutralize novel coronavirus, is the key point for curing the patient with COVID-19, achieves symptomatic and supportive therapy under the condition of no specific drug therapy at present, and can relieve symptoms and improve the activity endurance of the patient especially for heavy and critical patients.
Current methods for obtaining plasma from donors are inefficient and/or less safe, such as conventional centrifugation procedures.
The invention provides a closed multi-cellular component automatic Separation System (MACSS), which can directly separate component plasma from peripheral blood whole blood of a patient in the recovery period of COVID-19 in a short time without infusing anticoagulant to a donor or other reagent factors such as component Ficoll and the like which have influence on plasma components, ensures that the collected plasma has high originality and does not destroy the activity and function of immunoglobulin G contained in the plasma. Furthermore, the peripheral blood whole blood can be separated into three components directly after being separated by the separation system: red blood cells, plasma, mononuclear cell suspensions; the plasma can be further prepared by the process, the SARS-CoV-2 specific immunoglobulin G is purified and used for intravenous infusion, and the erythrocyte and monocyte suspension can be directly used for other preparation processes. However, it has been found that even if plasma is separated using a closed multicellular component automated separation system in a conventional manner, there is a problem such as a low antibody titer of the resulting plasma. Thus, increasing the antibody titer of plasma is a technical problem directly faced by the person skilled in the art.
Disclosure of Invention
The invention aims to provide a method for obtaining plasma with higher antibody titer, in particular to a method for quickly extracting recovered plasma of a patient with COVID-19 and the plasma with higher antibody titer, and a method for using the plasma for preparing immunoglobulin G. It has surprisingly been found that with the method of the present invention, technical effects as described in one or more aspects herein can be obtained. The present invention has been completed based on such findings.
To this end, the first aspect of the present invention provides a method for rapidly separating and obtaining plasma for preparing covi-19 immunoglobulin G for intravenous injection by separating peripheral blood taken from a human into three component layers using a closed multi-cellular component automated separation system: erythrocyte layer, cell concentration layer, plasma layer, subjecting the obtained plasma to virus inactivation, optionally freezing the plasma at-20 deg.C or below to obtain plasma for preparing COVID-19 immunoglobulin G for intravenous injection.
The method according to the first aspect of the present invention, wherein said viral inactivation is photochemical inactivation of methylene blue.
The method according to the first aspect of the present invention, wherein the peripheral blood is peripheral blood selected from the group consisting of: SARS-CoV-2 natural infector (also called COVID-19 patient), SARS-CoV-2 natural infector through serum antibody titer/serum neutralizing antibody titer confirmation convalescent person (i.e. COVID-19 patient convalescent period), SARS-CoV-2 vaccine injection person and serum antibody titer/serum neutralizing antibody titer confirmation immunized person.
According to the method of the first aspect of the present invention, a plasma alanine aminotransferase activity of less than 40U/L is obtained.
According to the method of the first aspect of the present invention, the plasma obtained therefrom is negative for HBsAg, syphilis, HIV-I, HIV-II antibody, and HCV antibody when detected using an approved detection kit.
According to the method of the first aspect of the invention, plasma is obtained having a protein content of more than 50 g/L.
The method according to the first aspect of the invention, wherein the peripheral blood is venipuncture collected peripheral blood and placed in a blood collection bag containing an anticoagulant.
The method according to the first aspect of the present invention, wherein a separation aid is further added to the peripheral blood before separation is performed with the closed multicellular component automatic separation system; in one embodiment, the separation aid is a sterile aqueous solution comprising sodium oleate and magnesium chloride; in one embodiment, the separation aid has a sodium oleate concentration of 5% and magnesium chloride is 0.5mol/L in terms of magnesium ions; in one embodiment, the separation aid is formulated as follows: dissolving a specified amount of sodium oleate and magnesium chloride in water for injection, filtering with a 0.45 mu m microporous filter membrane, packaging in a glass bottle, and sterilizing at 121 ℃ for 15 minutes under hot pressure to obtain the injection; in one embodiment, the volume ratio of the separation aid to peripheral blood is 1: 100.
the method according to the first aspect of the invention, comprising the steps of:
(1) 250mL of peripheral blood (such as peripheral blood donated in the convalescence of patients with COVID-19) collected by a venipuncture method, placing the blood collection bag (such as anticoagulant, such as sodium citrate, contained in the collection bag), and placing the blood collection bag on a horizontal shaking bed to be fully and uniformly mixed for 15 minutes;
(2) using a closed multi-component automatic Cell Separation System, namely, inserting a plastic needle of a disposable Separation cup into a sterile interface on a blood collection bag, hanging the blood collection bag, and naturally flowing 60ml of blood in the blood collection bag into a central cabin in the Separation cup; 0.6ml of separation aid was added to the central chamber before the addition of blood; separating the blood collecting bag from the disposable separating cup by using a welding pipeline of a sterile jointer, and then placing the disposable separating cup on a horizontal shaking table to be fully and uniformly mixed for 10 minutes;
(3) the disposable separating cup is placed in a programmable centrifuge for centrifugal operation after being balanced, and the parameters of the centrifuge are set according to the following programs:
program numbering Acceleration Speed reduction Relative centrifugal force/RCF Duration/min
1 9 7 2000 8.5
2 9 7 50 2
3 9 7 500 2
4 9 7 50 1
5 9 7 250 0.5
6 9 7 50 1
During the initial high-speed portion of centrifugation, 2000RCF, cells in the peripheral blood sample are separated by density stratification into three components in a single-use separator cup: red blood cell layer, cell concentrated layer, plasma layer;
the speed was reduced to 50RCF and during this first low speed centrifugation, most of the red blood cells were directed to the red blood cell recovery vessel;
briefly increase the speed to 500RCF to further stratify the cells in the process chamber;
again reduced to 50RCF, further removing red blood cells;
prior to plasma collection, the relative centrifugal force was briefly increased to 250RCF during which the cell concentrate layer and plasma further stratified;
again to 50RCF, the cell concentrate layer was transferred through a transfer tube to the recovery compartment, leaving most of the plasma in the central compartment;
(4) decelerating and stopping rotating the centrifugal machine, and respectively and independently collecting red blood cells, a cell concentration layer and blood plasma in the disposable separating cup;
(5) connecting the pipeline of the central chamber on the disposable separating cup and the pipeline of the transfer bag by using an aseptic tube connecting machine, and transferring the separated plasma in the central chamber into the transfer bag; after a pipeline is welded by a sterile jointer, the separated plasma is subjected to virus inactivation by a methylene blue photochemical method, and then is quickly frozen to be below 20 ℃ below zero within 6 hours and stored for preparing a preparation for intravenous injection of COVID-19 immunoglobulin G.
Further, the second aspect of the present invention provides a method for preparing an intravenous COVID-19 immunoglobulin G formulation, comprising the steps of:
(1) rapidly separating peripheral blood (e.g., peripheral blood from convalescent stages of a COVID-19 patient) using a closed multicellular component automated separation system to obtain a plasma component;
(2) precipitating plasma by low-temperature ethanol method to obtain components I + II + III;
(3) after the components I + II + III are subjected to pressure filtration, separating the component II from the components I + III;
(4) performing precipitation dissolution and column chromatography purification on the component II, and performing ultrafiltration to obtain an immunoglobulin G semi-finished product 1;
(5) performing precipitation dissolution and column chromatography purification on the components I and III, and performing ultrafiltration to obtain an immunoglobulin G semi-finished product 2;
(6) mixing the semi-finished products 1 and 2, sterilizing, filtering and inactivating viruses to obtain a COVID-19 immunoglobulin G stock solution;
(7) the immunoglobulin G stock solution is prepared and packaged to obtain the intravenous injection COVID-19 immunoglobulin G product.
The process according to the second aspect of the present invention, wherein step (1) is as described in any embodiment of the first aspect of the present invention.
The method according to the second aspect of the invention, comprising the steps of:
(1) according to the method according to any one of the embodiments of the first aspect of the present invention, peripheral blood (e.g., peripheral blood of a patient in convalescent period of COVID-19) is rapidly separated using a closed multicellular component automated separation system to obtain a plasma component;
(2) placing the cryopreserved plasma obtained in the step (1) into a plasma melting tank for melting, centrifuging to remove cryoprecipitate, diluting with normal saline until the protein content of the plasma is within the range of 4.5-5.5 g/L, adjusting the pH to 5.95 +/-0.05, slowly adding ethanol until the ethanol concentration reaches 19%, standing for 10-12 h, and performing filter pressing until filtrate is clear and bright, wherein the precipitate on a filter press is a component I + II + III; dissolving the component I, II and III precipitates with 10 times of low-temperature injection water at 0-4 ℃, adjusting the pH value to 4.70-4.80, fully stirring, adjusting the pH value to 5.20 +/-0.05 and continuously stirring; slowly adding ethanol to make the ethanol concentration reach 14%, adjusting the pH value to 5.20 +/-0.05, and standing for 12h at the temperature of minus 3.5 ℃ to minus 4.5 ℃; adding a filter aid into the material tank, performing filter pressing until a filtrate is clear and bright, separating a precipitate containing the components I + III and a supernatant containing the component II, adding ethanol into the component II until the ethanol concentration is 25%, and performing filter pressing to obtain a precipitate containing the component II;
(3) dissolving and diluting the component II precipitate obtained in the step (2) with water for injection, and adding a filter aid to carry out deep filtration until the solution is clear and bright; loading the sample to a DEAE Sepharose Fast Flow gel column, eluting with acetic acid eluent with pH4.0, and ultrafiltering and dialyzing the intercepted target component with an ultrafiltration membrane with the aperture of 30kD until the protein content is more than or equal to 50G/L to obtain an immunoglobulin G semi-finished product 1;
(4) stirring and dissolving the component I + III precipitate obtained in the step (2) by using 20mmol/L acetic acid-sodium acetate buffer solution, heating to 20 +/-1 ℃, adding n-octanoic acid in a spraying mode until the concentration is 20mmol/L, violently stirring to precipitate impurity protein, performing pressure filtration by using a pressure filter to obtain clear and transparent filtrate, and collecting a supernatant solution; adjusting the pH of the supernatant solution to 5.7 +/-0.3, filtering with a 0.22 mu m membrane, loading the supernatant solution onto a Macro cap Q ion exchange column, eluting with an acetic acid-sodium acetate buffer solution for column chromatography, filtering the collected eluent with a nano membrane, and removing potential viruses including parvoviruses to obtain a filtrate; adjusting pH of the filtrate to 4.2 + -0.2, ultrafiltering with water for injection containing 40mmol/L acetic acid solution for desalting (the ultrafiltration membrane retains relative molecular mass of 10 kDa), maintaining pH of the product at 4.5 + -0.05, and the conductivity at or below 1ms/cm, and concentrating to obtain product with protein content of more than 50G/L, which is immunoglobulin G semi-finished product 2;
(5) mixing the semi-finished products 1 and 2 obtained in the steps (3) and (4), performing nanofiltration sterilization and low-hatching inactivated virus to obtain immunoglobulin G stock solution (serving as a semi-finished product), which is also called as injection-intravenous COVID-19 immunoglobulin G stock solution; then the stock solution of the injection COVID-19 immunoglobulin G is diluted by 0.9 percent sodium chloride injection to prepare the injection COVID-19 immunoglobulin G preparation (injection) for intravenous injection, namely the finished product.
In the steps of the preparation method of the present invention, although the specific steps described therein are distinguished in some detail or in language description from the steps described in the preparation examples of the detailed embodiments below, the above-described method steps can be fully summarized by those skilled in the art in light of the detailed disclosure throughout the present disclosure.
Any embodiment of any aspect of the invention may be combined with any other embodiment of the invention, as long as they do not contradict. Furthermore, in any embodiment of any aspect of the invention, any feature may be applicable to that feature in any other embodiment of the invention, provided that they do not contradict.
The invention is further described below.
All documents cited herein are incorporated by reference in their entirety and to the extent such documents do not conform to the meaning of the present invention, the present invention shall control. Further, the various terms and phrases used herein have the ordinary meaning as is known to those skilled in the art, and even though such terms and phrases are intended to be described or explained in greater detail herein, reference is made to the term and phrase as being inconsistent with the known meaning and meaning as is accorded to such meaning throughout this disclosure.
At present, the method for obtaining the immunoglobulin G at home and abroad is mainly to purify blood plasma or related components II + III thereof or related components I + II thereof, and is prepared by directly extracting the components I + III, mainly because the components I + III are complex, have high separation and purification difficulty and are not suitable for separation. However, the preliminary study of the present inventors has found that the fraction I + III contains a certain amount of IgG, which is very valuable for recovery. Therefore, an object of the present invention is to provide a process for preparing immunoglobulin G from fraction II and fraction I + III, respectively, which is aimed at improving the recovery efficiency of immunoglobulin G from plasma and contributing to the treatment of COVID-19 diseases.
Another objective of the invention is to provide a preparation method for rapidly obtaining component plasma from peripheral blood for preparing COVID-19 immunoglobulin G for intravenous injection.
As described herein, the methods of the present invention achieve one or more of the advantages described herein, such as rapid plasma production, and high antibody titers of the produced plasma and COVID-19 igg.
Detailed Description
The present invention will be further described by the following examples, however, the scope of the present invention is not limited to the following examples. It will be understood by those skilled in the art that various changes and modifications may be made to the invention without departing from the spirit and scope of the invention. The present invention has been described generally and/or specifically with respect to materials used in testing and testing methods. Although many materials and methods of operation are known in the art for the purpose of carrying out the invention, the invention is nevertheless described herein in as detail as possible. The following examples further illustrate the invention without limiting it.
In processing a blood sample, the present invention, as not otherwise specified, uses a closed multicellular component Automated Separation System, i.e., a Multicomponent Automated Cell Separation System (MACSS) or PXP System, a device manufactured by ThermoGenesis Corp, www.thermogenesis.com, which is a semi-Automated, functionally closed System capable of collecting precise volumes of Cell concentrate components from a blood sample, comprising: plasma, erythrocyte sediment and single nucleated cell sediment components. The separation system is made up of four main components: the system comprises a disposable separating cup, a chargeable control module, an alternating current power supply module and a DataTrak software system. The disposable separation cup includes separate recovery compartments (red blood cell recovery compartment, cell concentrate recovery compartment), a central compartment (plasma recovery compartment) and an integrated clamping mechanism. The control module component of the separation system is a microprocessor controlled device that is used in conjunction with the single use separation cup during centrifugation to direct the transfer of red blood cells, concentrated mononuclear cells (cell concentrate) and plasma to separate compartments within the single use separation cup. After centrifugation, the control module was placed in a docking station to download the process data using ThermoGenesis ® DataTrak software.
Example 1 Rapid isolation of blood plasma from convalescent patients with COVID-19
1. Collecting peripheral blood (more than 250mL) donated to a patient with COVID-19 (the patient is labeled as patient U herein) in the convalescence stage by venipuncture, placing the peripheral blood in a blood collection bag (the collection bag is filled with anticoagulant sodium citrate), and placing the blood collection bag on a horizontal shaking bed to be fully and uniformly mixed for 15 minutes; [ the SARS-CoV-2 infected person can also be referred to as a COVID-19 patient who is a SARS-CoV-2 naturally infected person and who is recovered after confirmation of the serum antibody titer/serum neutralizing antibody titer ]
2. Using a closed multicellular component Automated Separation System (MACSS) from ThermoGenesis corp, the plastic needle of a disposable Separation cup is inserted into a sterile port on a blood collection bag, and the blood collection bag is hung so that 60ml of blood therein naturally flows into a central chamber in the Separation cup; 0.6ml of separation aid was added to the central chamber before the addition of blood; separating the blood collecting bag from the disposable separating cup by using a welding pipeline of a sterile jointer, and then placing the disposable separating cup on a horizontal shaking table to be fully and uniformly mixed for 10 minutes; [ the separation aid is a sterile aqueous solution containing sodium oleate in a concentration of 5% and magnesium chloride in an amount of 0.5mol/L in terms of magnesium ions. The preparation method of the sterilized aqueous solution is well known to those skilled in the art, and for example, a prescribed amount of sodium oleate and magnesium chloride is dissolved in water for injection, filtered with a 0.45 μm microporous membrane, sealed in a glass bottle, and autoclaved at 121 ℃ for 15 minutes to obtain the sterilized aqueous solution. The sodium oleate is of grade for injection
3. The disposable cups were trimmed and placed in a commercially available programmable centrifuge (Thermo Scientific centrifuge was used in this experiment) for centrifugation, and the centrifuge parameters were programmed as follows:
program numbering Acceleration Speed reduction Relative Centrifugal Force (RCF) Duration (min)
1 9 7 2000 8.5
2 9 7 50 2
3 9 7 500 2
4 9 7 50 1
5 9 7 250 0.5
6 9 7 50 1
4. During the initial high-speed portion of centrifugation (2000RCF), cells in the peripheral blood sample are separated into three components by density stratification in a single-use separator cup: (1) a Red Blood Cell (RBC) layer, (2) a cell concentrate layer, and (3) a plasma layer;
5. the speed was reduced to 50RCF and during this first low speed centrifugation, most of the red blood cells were directed to the red blood cell recovery vessel;
6. briefly increase the speed at 500RCF to further stratify the cells in the process chamber;
7. again reduced to 50RCF, further removing red blood cells;
8. the relative centrifugal force was briefly increased to 250RCF before plasma was collected, during which time the cell concentrate layer and plasma further layered.
9. Once again reduced to 50RCF, the concentrated layer of cells was transferred through a transfer tube to the recovery compartment, leaving most of the plasma in the central compartment. The centrifuge decelerates and stops rotating, and red blood cells, a cell concentrated layer (single nucleated cells) and plasma can be collected separately in the disposable separating cup, and the separating process only takes 15 min.
10. The line of the center chamber of the disposable separation cup and the line of the 100mL transfer bag were connected by a sterile tube adapter, and the separated plasma in the center chamber was transferred into the 100mL transfer bag. After welding a pipeline by using a sterile jointer, performing virus inactivation on the separated plasma by using a methylene blue photochemical method, then quickly freezing the plasma to the temperature below-20 ℃ within 6 hours, and storing the plasma for later use.
11. The activity of alanine Aminotransferase (ALT) measured by a speed method of the blood plasma after the rapid separation by the method is not higher than 40, the HBsAg, the syphilis, the HIV-I, HIV-II antibody and the HCV antibody are negative after being detected by an approved detection kit, the protein content of the blood plasma is not lower than 50g/L, and the blood plasma meeting the requirements is used as the blood plasma of a patient with COVID-19 in the convalescence stage and can be used for the subsequent steps.
Example 2 preparation of component I + II + III from raw plasma and separation of component II from component I + III,
1. preparing a buffer solution:
0.15mol/L phosphate buffer solution of pH4.75: every 1kg of Na required2HPO4•12H2Regulating the pH value to 4.75 by using 53g of O and 27mL of glacial acetic acid to obtain Buffer A;
0.5mol/L phosphate buffer solution with pH 5.25: every 1kg of Na required2HPO4•12H2O is 160.6g, and the pH value is adjusted to 5.25 by 24mL of glacial acetic acid to obtain Buffer B;
③ component I + III balance liquid for filter pressing: every 1kg institute95% ethanol 0.13kg, Na are needed2HPO4•12H2O is 1.9g, and glacial acetic acid is 0.39 mL;
1mol/L sodium chloride solution: 58.5g of NaCl is needed for every 1kg, and water is added to 1 kg;
1mol/L sodium bicarbonate solution: adding 84.0g of NaCl required by every 1kg of NaCl and adding water to 1 kg;
sixthly, 1mol/L HCL solution: preparing 10.0L of 1.0mol/L HCL, wherein the required HCL amount is 834ml, and supplementing water for injection to 10L;
2. taking out the plasma bag (obtained by the method of example 1) from a freezing environment, sterilizing the surface of the plasma bag by using 75% ethanol, washing the plasma bag by using injection water (the temperature of the injection water for washing is not more than 30 ℃), breaking the plasma bag, putting the broken plasma into a plasma melting tank for melting, and controlling the temperature of the plasma to be less than or equal to 4 ℃. Centrifuging the melted blood plasma by a tubular centrifuge, controlling the temperature of the centrifuged liquid to be less than or equal to 4 ℃, and controlling the liquid outlet speed of the centrifuge to be less than or equal to 2000 mL/min. Removing cryoprecipitate in the plasma after centrifugation;
3. the centrifuged plasma was diluted with physiological saline until the protein content of the plasma was 4.5-5.5 g/L (5.0 g/L in this example). Under the condition that the temperature of various materials is controlled at-5 ℃, adding 0.15mol/L phosphate buffer solution with pH4.75 into 100ml of diluted blood plasma to adjust the pH to 5.95 +/-0.05, then slowly adding ethanol to enable the ethanol concentration to reach 19%, and then standing the blood plasma product for 10-12 hours;
4. performing filter pressing on the plasma product after standing by using a filter press, controlling the liquid inlet pressure to be less than or equal to 0.24Mpa and the liquid outlet temperature to be-5 ℃, so that the filtrate is clear and bright, and the precipitate on the filter press is the components I + II + III;
5. dissolving the component I, II and III precipitates in a material tank by using 10 times of low-temperature injection water at 0-4 ℃, wherein the temperature in the dissolving process is controlled at 0-4 ℃, and the dissolving time is more than or equal to 2 hours;
6. adding Buffer A, adjusting the pH value to 4.70-4.80, and fully stirring the suspension at the temperature of 0-3 ℃;
7. adding Buffer B, adjusting pH to 5.20 + -0.05, and stirring for 30 min;
8. ethanol was added slowly to bring the ethanol concentration to 14%. Adding Buffer B, adjusting the pH value to 5.20 +/-0.05, controlling the temperature to be within the range of minus 3.5 ℃ to minus 4.5 ℃, and standing for 12 hours;
9. filter aid 0.3% diatomaceous earth and 0.3% perlite was added to the material tank, and filter-pressed with a filter press. The filter pressing conditions are controlled as follows: the liquid inlet pressure is less than or equal to 0.24Mpa, the liquid outlet temperature is minus 3.5 ℃ to minus 4.5 ℃, the components I + III in the components I + II + III are separated in the sediment when the filtrate is clear and transparent, and the component II is dissolved in the supernatant, so that the purpose of separating the components I + III from the component II is achieved.
10. Dropwise adding 1.5mol/L NaCl solution into the supernatant of the component II, adjusting the conductivity to be 4.4 +/-0.2 ms/cm, and then adding ethanol until the ethanol concentration is 25%;
11. performing filter pressing by using a filter press, adjusting the inlet pressure to be less than or equal to 0.24Mpa and the outlet temperature to be-6.5 to-7.5 ℃, and obtaining the component II as a precipitate after the filter pressing is finished.
EXAMPLE 3 precipitation solubilization and column chromatography purification of immunoglobulin G of fraction II
1. Preparing a buffer solution:
chromatographic equilibrium solution: adding Na to every 1kg2HPO4•12H2Dissolving O3 g and glacial acetic acid in 0.27mL by adding low-temperature injection water, adjusting the pH value to 6.6-7.0, the conductivity to 1.3-1.5 ms/cm and the temperature to 0-0.5 ℃;
pH4.0 phosphate buffer: adding Na to every 1kg2HPO4•12H217.9g of O, 29.2g of NaCl and about 1.5mL of glacial acetic acid, and is dissolved by low-temperature injection water;
③ pH4.0 acetic acid eluent: NaAc.3H is added to every 1kg220.7g of O, 58.5g of NaCl and 20.5mL of glacial acetic acid, and adding water for injection to adjust the pH = 4.0;
2. dissolving and diluting the component II precipitate obtained in the example 2 by 10 times of water for injection, wherein the dissolving temperature is 0-4 ℃, the dissolving time is more than or equal to 2 hours, after dissolving, adjusting the pH to 6.6-7.0, the conductivity to 1.4ms and the protein concentration to 1-2%, adding filter aid 0.3% of diatomite and 0.3% of perlite for deep filtration, and filtering until the solution is clear and bright;
3. the DEAE Sepharose Fast Flow gel is washed by phosphate buffer solution with pH4.0 to pH 6.6-7.4, and then the DEAE Sepharose Fast Flow chromatographic column is balanced by chromatographic equilibrium liquid with pH 6.6-7.0 and conductivity of 1.4 ms. Loading the solution obtained in the previous step into a chromatographic column, eluting with an acetic acid eluent with the pH value of 4.0, controlling the flow-through speed to be 5-10L/min, collecting the immunoglobulin G (with the purity of more than 97%), adjusting the pH value of the eluted target component to be 3.6-3.7, and then carrying out the following ultrafiltration.
4. And (3) ultrafiltration: and (3) selecting an ultrafiltration membrane with the pore diameter of 30kD, and carrying out ultrafiltration dialysis on the immunoglobulin G product flowing through by using injection water with the volume of 10 times, wherein the temperature of an ultrafiltrate is controlled to be 0-15 ℃, the protein content after ultrafiltration is not less than 50G/L, and the pH value is 4.0 +/-0.4. Adding maltose into the filtrate after ultrafiltration to reach a concentration of 10%, and measuring the pH value to be 4.0 +/-0.4 again, wherein the protein content is more than or equal to 50 g/L. This preparation was immunoglobulin G intermediate 1.
Example 4 precipitation solubilization and column chromatography purification of fractions I + III immunoglobulin G
1. Dissolving the component I + III precipitate obtained in example 2 with 20mmol/L acetic acid-sodium acetate buffer solution (pH 4.5 and 7 deg.C) under stirring for 3 hr, wherein the amount of the buffer solution is 3 times of the precipitate amount (the protein content of the component I + III precipitate is not less than 25g/L after dissolving);
2. after the sample is fully dissolved, the temperature of the product is raised to 20 +/-1 ℃ through a full-automatic temperature raising and lowering system, then 0.3mol/L NaOH solution is added to adjust the pH value to 4.5 +/-0.05, then the n-caprylic acid is added at a spraying speed of 20mL/min to ensure that the n-caprylic acid in the solution is uniformly distributed until the concentration of the n-caprylic acid in the solution is 20mmol/L, the addition of the n-caprylic acid is stopped, and the mixture is vigorously stirred for more than 2 hours to precipitate impurity protein (non-immunoglobulin G). Washing a filter plate of a filter press with injection water at 20 ℃ at a flow rate of 20g/min, drying the filter plate with normal-temperature compressed air, pressing and filtering a product after balancing, washing the filter plate with injection water at 20 ℃ after the product is pressed and filtered, recovering protein, obtaining clear and transparent filtrate, and collecting supernatant solution.
3. Macro cap Q ion exchange column equilibration: balancing 5 times of column volume with 20mmol/L acetic acid-sodium acetate buffer solution (pH5.5 + -0.05), and washing the chromatographic column at linear flow rate of 2cm/min or less;
4. ion exchange column chromatography: regulating the pH of a supernatant solution collected after the n-octanoic acid precipitation and virus inactivation to 5.7 +/-0.3 by using 0.3mol/L NaOH solution, filtering by using a 0.22 mu m filter, wherein the filtering pressure is less than or equal to 0.02Mpa, and eluting by using a pre-balanced Macro cap Q ion exchange column with 20mmol/L acetic acid-sodium acetate buffer solution for column chromatography; loading flow rate is less than or equal to 2cm/min, so that macromolecular impurities are combined on the chromatographic column, eluting the chromatographic column by using equilibrium liquid with 3 times of column volume after loading is finished, and collecting eluent; [ column regeneration: respectively treating the chromatographic column with 5 times of 1mol/L NaCl solution, 5 times of 0.1mol/L HCl solution and 3 times of 0.3mol/L NaOH solution for column regeneration, wherein the solution flow rate is less than or equal to 2cm/min ]
5. Nano-membrane filtration: pre-filtering the eluate with 0.1 μm filter membrane, and filtering with Millipore viresolve Pro nano membrane to remove potential viruses including parvovirus to obtain filtrate;
6. and (3) ultrafiltration: adjusting pH of the filtrate to 4.2 + -0.2 with 0.3mol/L HCl solution, ultrafiltering and desalting the product with 10 times volume of injection water containing 40mmol/L acetic acid solution, intercepting the relative molecular mass of 10kDa with ultrafiltration membrane to maintain pH of the product at 4.5 + -0.05 and conductivity of less than or equal to 1ms/cm, and concentrating to obtain product with protein content of more than 50G/L, which is immunoglobulin G semi-finished product 2.
EXAMPLE 5 preparation of injection solution for intravenous injection of COVID-19 immunoglobulin G
Mixing the semi-finished products 1 and 2 obtained in the examples 3 and 4, and performing nanofiltration sterilization and low-hatching inactivation of viruses to obtain immunoglobulin G stock solution (serving as a semi-finished product), which is also called as intravenous injection COVID-19 immunoglobulin G stock solution; then the stock solution of the injection COVID-19 immunoglobulin G is diluted by 0.9 percent sodium chloride injection to prepare the injection of the injection COVID-19 immunoglobulin G for intravenous injection, namely the finished product.
Example 6 detection of neutralizing antibody titer by human immunoglobulin G
After pathogenic microorganisms such as viruses and bacteria invade a human body, an immune system in the human body is activated, B cells are stimulated to generate a plurality of antibodies, but only part of the antibodies can rapidly recognize the pathogenic microorganisms and are combined with antigens on the surfaces of the pathogenic microorganisms to prevent the pathogenic microorganisms from being combined with receptors on the surfaces of target cells to invade the cells, so that the human body is protected from infection. Neutralization means that when the virus enters the body, the immune cells secrete neutralizing proteins into the blood, and the neutralizing proteins are combined with virus particles to prevent the virus from infecting the cells, and simultaneously destroy the structure of the virus particles to neutralize the virus. The stock solution of COVID-19 immunoglobulin G for intravenous injection contains a neutralizing antibody aiming at SARS-Cov-2 virus, can block the capability of virus invading cells, and the titer of the neutralizing antibody of SARS-Cov-2 reflects the capability of inhibiting virus invading cells, and is an important index for quality control of COVID-19 immunoglobulin G for intravenous injection. The neutralizing ability of SARS-CoV-2 virus of immunoglobulin G product obtained by the method of the present invention, plasma of patients in convalescence stage of COVID-19, and commercially available human immunoglobulin for intravenous injection (PH4) was examined by antibody neutralization test.
The results of the Elisa neutralization test are as follows:
antibody titer (IU/mL) = 24.756X 10E2 of COVID-19 immunoglobulin G stock solution (product of example 5) for intravenous injection,
antibody titer (IU/mL) = 11.172X 10E2 in convalescent plasma of patients with COVID-19 (product of example 1),
antibody titer (IU/mL) =0.306 × 10E2 for immunoglobulin for injection (PH4, commercially available).
The result shows that the intravenous injection COVID-19 immunoglobulin G product prepared by the method has higher SARS-CoV-2 neutralizing antibody titer, and shows that the product can play a significant effect in resisting virus invasion.
Example 7 preparation of injection for intravenous injection of COVID-19 immunoglobulin G
The preparation process of examples 1 to 5 above can be referred to as test A in the present invention.
In experiment 1 of this example (which may be referred to herein as test B), 60ml of peripheral blood from the patient described in example 1 was used, following the procedures of examples 1-5, except that no magnesium salt was added to the separation aid used in step 2 of example 1, to sequentially prepare various materials including patient convalescent plasma, product COVID-19 prepared in the procedure of example 1, and product CoVID-19 immunoglobulin G stock solution, product CoVID-19 prepared in the procedure of example 5; then, with reference to the method of example 6, the antibody titers of the following two materials obtained in this experiment were measured: the antibody titer of convalescent plasma of COVID-19 patient =3.814 × 10E2, and the antibody titer of intravenous COVID-19 immunoglobulin G stock solution =8.137 × 10E 2.
In experiment 2 of this example (which may be referred to herein as test C), 60ml of peripheral blood from the patient described in example 1 was used, following the procedures of examples 1-5, except that no sodium oleate was added to the separation aid used in step 2 of example 1, to sequentially prepare various materials, including the product COVID-19 patient convalescent plasma prepared in the procedure of example 1, the product COVID-19 immunoglobulin G stock prepared in the procedure of example 5; then, with reference to the method of example 6, the antibody titers of the following two materials obtained in this experiment were measured: antibody titer of convalescent plasma of COVID-19 patient =4.362 × 10E2, and antibody titer of intravenous COVID-19 immunoglobulin G stock solution =11.428 × 10E 2.
In experiment 3 of this example (which may be referred to herein as test D), using 60ml of peripheral blood from the patient described in example 1, with reference to the procedures of examples 1-5, except that no separation aid was added in step 2 of example 1, various materials were prepared in sequence, including the product COVID-19 patient convalescent plasma prepared in the procedure of reference example 1, and the product COVID-19 immunoglobulin G stock prepared in the procedure of reference example 5; then, with reference to the method of example 6, the antibody titers of the following two materials obtained in this experiment were measured: the antibody titer of convalescent plasma of COVID-19 patient =4.037 × 10E2, and the antibody titer of intravenous COVID-19 immunoglobulin G stock solution =12.627 × 10E 2.
As can be seen from the results of this experiment, it was unexpectedly found that when a blood sample is treated using a closed multicellular Automated Separation System, i.e., a multi component Automated Cell Separation System (MACSS), the antibody titer of the resulting plasma can be significantly mentioned by adding sodium oleate and magnesium salts to the blood sample at the same time. In addition, since sodium oleate and magnesium salts are added in relatively small amounts and are common pharmaceutical adjuvants that can be used for injection, even residues in the final intravenous formulation are tolerable.
Example 8 preparation of injection for intravenous injection of COVID-19 immunoglobulin G
Collecting 250mL of peripheral blood donated to another patient COVID-19 (the patient is labeled as patient V) in the convalescence stage by venipuncture, placing the peripheral blood in a blood collection bag (the collection bag is filled with anticoagulant sodium citrate), and placing the blood collection bag on a horizontal shaking bed to mix thoroughly for 15 minutes; the plasma of patients in convalescence stage COVID-19 and stock solutions of COVID-19 immunoglobulin G to be administered intravenously in convalescence stage COVID-19 in example 8, referred to as test 8A, test 8B, test 8C and test 8D, were prepared by the methods of test A, test B, test C and test D described in examples 1 to 5 and 7 of the present invention, respectively. The antibody titers of the two types of materials obtained in this example were determined by the method described in example 6, and the results were as follows: antibody titer =12.314 × 10E2 for convalescent plasma of covi-19 patients of trial 8A, and =25.831 × 10E2 for intravenous covi-19 immunoglobulin G stock of trial 8A; the antibody titer of convalescent plasma of COVID-19 patients of trial 8B =3.862 × 10E2, the antibody titer of intravenous COVID-19 immunoglobulin G stock of trial 8B =10.537 × 10E 2; the antibody titer of convalescent plasma of COVID-19 patients of trial 8C =4.358 × 10E2, the antibody titer of intravenous COVID-19 immunoglobulin G stock of trial 8C =9.836 × 10E 2; the antibody titer of convalescent plasma of COVID-19 patients of trial 8D =4.581 × 10E2, and the antibody titer of intravenous COVID-19 immunoglobulin G stock of trial 8D =11.167 × 10E 2.
EXAMPLE 9 preparation of injection solution for intravenous injection of COVID-19 immunoglobulin G
Collecting 250mL of peripheral blood donated to another patient COVID-19 (the patient is marked as patient W) in the convalescence stage by venipuncture, placing the peripheral blood into a blood collection bag (the collection bag is filled with anticoagulant sodium citrate), and placing the blood collection bag on a horizontal shaking bed to be fully and uniformly mixed for 15 minutes; the plasma of patients in convalescence stage COVID-19 and stock solution of COVID-19 immunoglobulin G to be administered intravenously in convalescence stage COVID-19 in example 9, referred to as test 9A, test 9B, test 9C and test 9D, were prepared by the methods of test A, test B, test C and test D described in examples 1 to 5 and 7 of the present invention, respectively. The antibody titers of the two types of materials obtained in this example were determined by the method described in example 6, and the results were as follows: antibody titer =11.273 × 10E2 for convalescent plasma of covi-19 patients of trial 9A, and =21.474 × 10E2 for intravenous covi-19 igg stock of trial 9A; the antibody titer of convalescent plasma of COVID-19 patients of trial 9B =3.745 × 10E2, the antibody titer of intravenous COVID-19 immunoglobulin G stock solution of trial 9B =9.835 × 10E 2; the antibody titer of convalescent plasma of COVID-19 patients of trial 9C =3.428 × 10E2, the antibody titer of intravenous COVID-19 immunoglobulin G stock of trial 9C =8.647 × 10E 2; the antibody titer of convalescent plasma of COVID-19 patients in trial 9D =3.264 × 10E2, and the antibody titer of intravenous COVID-19 immunoglobulin G stock in trial 9D =9.386 × 10E 2.
The alanine aminotransferase activity of each plasma obtained in the above examples 1-5 and 7-9 is lower than 40U/L, the HBsAg, syphilis, HIV-I, HIV-II antibody and HCV antibody are all negative after being detected by an approved detection kit, the protein content is higher than 50G/L, and 29.4-31.7 ml of plasma which can be used for preparing intravenous injection CODVID-19 immunoglobulin G can be obtained after 60ml of peripheral blood is processed by a closed multi-cell component automatic separation system; for example, the plasma of COVID-19 patient in convalescence obtained in example 1 has alanine aminotransferase activity of 11.7U/L, HBsAg, syphilis, HIV-I, HIV-II antibody and HCV antibody are all negative after being detected by approved detection kit, the protein content is higher than 52.2g/L, and 60ml of peripheral blood can be processed by closed multi-cell component automatic separation system to obtain 30.4 ml.
Although the present invention has been described above by taking peripheral blood of SARS-CoV-2 naturally infected persons in convalescence as an example for the preparation of COVID-19 immunoglobulin G for intravenous injection, it is known that these preparation methods are also applicable to peripheral blood of immunized persons who have been confirmed by serum antibody titer/serum neutralizing antibody titer from (i) SARS-CoV-2 naturally infected persons, (ii) SARS-CoV-2 naturally infected persons, and (iii) SARS-CoV-2 vaccine injectables and (iv) SARS-CoV-2 vaccine injectables.
The above-described embodiments are merely preferred embodiments for fully illustrating the present application, and the scope of the present application is not limited thereto. The equivalent substitution or change made by the person skilled in the art on the basis of the present application is within the protection scope of the present application. The protection scope of this application is subject to the claims.

Claims (7)

1. A method for rapidly separating and obtaining plasma for preparing COVID-19 immunoglobulin G for intravenous injection, comprising the following steps:
(1) 250mL of peripheral blood of a SARS-CoV-2 naturally infected person collected by a venipuncture method and a recovered person confirmed by serum antibody titer/serum neutralizing antibody titer is placed in a blood collection bag, and the blood collection bag is placed on a horizontal shaking bed and fully mixed for 15 minutes;
(2) using a closed multi-cell component automatic separation system, inserting a plastic needle of a disposable separation cup into a sterile interface on a blood collection bag, hanging the blood collection bag, and naturally flowing 60ml of blood in the blood collection bag into a central cabin in the separation cup; 0.6ml of separation aid was added to the central chamber before the addition of blood; separating the blood collecting bag from the disposable separating cup by using a welding pipeline of a sterile jointer, and then placing the disposable separating cup on a horizontal shaking table to be fully and uniformly mixed for 10 minutes; the separation auxiliary agent is a sterilized aqueous solution containing sodium oleate and magnesium chloride, wherein the concentration of the sodium oleate is 5%, and the concentration of the magnesium chloride is 0.5mol/L calculated by magnesium ions; the closed automatic separation System for multicellular components is PXP systems produced by ThermoGenesis Corp;
(3) the disposable separating cup is placed in a programmable centrifuge for centrifugal operation after being balanced, and the parameters of the centrifuge are set according to the following programs:
Figure DEST_PATH_IMAGE002
during the initial high-speed portion of centrifugation, 2000RCF, cells in the peripheral blood sample are separated by density stratification into three components in a single-use separator cup: red blood cell layer, cell concentrated layer, plasma layer;
the speed was reduced to 50RCF and during this first low speed centrifugation, most of the red blood cells were directed to the red blood cell recovery vessel;
briefly increase the speed to 500RCF to further stratify the cells in the process chamber;
again reduced to 50RCF, further removing red blood cells;
prior to plasma collection, the relative centrifugal force was briefly increased to 250RCF during which the cell concentrate layer and plasma further stratified;
again to 50RCF, the cell concentrate layer was transferred through a transfer tube to the recovery compartment, leaving most of the plasma in the central compartment;
(4) decelerating and stopping rotating the centrifugal machine, and respectively and independently collecting red blood cells, a cell concentration layer and blood plasma in the disposable separating cup;
(5) connecting the pipeline of the central chamber on the disposable separating cup and the pipeline of the transfer bag by using an aseptic tube connecting machine, and transferring the separated plasma in the central chamber into the transfer bag; after a pipeline is welded by a sterile jointer, the separated plasma is subjected to virus inactivation by a methylene blue photochemical method, and then is quickly frozen to be below 20 ℃ below zero within 6h, and is stored to obtain the plasma which is ready for preparing a preparation for intravenous injection of COVID-19 immunoglobulin G.
2. A method according to claim 1, wherein the alanine aminotransferase activity in the plasma obtained is less than 40U/L.
3. The method according to claim 1, wherein the plasma obtained is negative for HbsAg, syphilis, HIV-I, HIV-II antibodies, HCV antibodies when tested with an approved test kit.
4. A method according to claim 1, wherein the plasma obtained has a protein content higher than 50 g/L.
5. The method of claim 1, wherein step (1) said blood collection bag contains an anticoagulant.
6. The method according to claim 1, wherein the separation aid is formulated as follows: dissolving a specified amount of sodium oleate and magnesium chloride in water for injection, filtering with a 0.45 mu m microporous filter membrane, packaging in a glass bottle, and sterilizing at 121 ℃ for 15 minutes under hot pressure.
7. A method of preparing an intravenous COVID-19 immunoglobulin G formulation, the method comprising the steps of:
(1) obtaining a plasma fraction using the method of any one of claims 1 to 6;
(2) precipitating plasma by low-temperature ethanol method to obtain components I + II + III;
(3) after the components I + II + III are subjected to pressure filtration, separating the component II from the components I + III;
(4) performing precipitation dissolution and column chromatography purification on the component II, and performing ultrafiltration to obtain an immunoglobulin G semi-finished product 1;
(5) performing precipitation dissolution and column chromatography purification on the components I and III, and performing ultrafiltration to obtain an immunoglobulin G semi-finished product 2;
(6) mixing the semi-finished products 1 and 2, sterilizing, filtering and inactivating viruses to obtain a COVID-19 immunoglobulin G stock solution;
(7) the immunoglobulin G stock solution is prepared and packaged to obtain the intravenous injection COVID-19 immunoglobulin G preparation.
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